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1.
PLoS One ; 17(7): e0271713, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35901017

RESUMO

BACKGROUND: Inadequate adherence to treatment is among the main underlying causes of depression becoming a chronic problem. In developing countries due to limited access to health care, inaccurate diagnoses, and scarcity of medications, poor adherence may become an even larger obstacle in the treatment of depression. The current study aims to assess the magnitude and factors related to treatment non-adherence among patients with depressive disorders. OBJECTIVE: To assess the magnitude and factors associated with treatment non adherence among patients with depressive disorders at St. Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia, 2019. METHODS: A hospital-based cross-sectional study was conducted among 415 respondents using systematic random sampling technique. Medication adherence was assessed by using Medication Adherence Rating Scale. Data was entered to Epi-data version 3.1 and analyzed using SPSS version 20. Binary logistic analysis was done and P-values less than 0.05 were considered statistically significant. RESULTS: The prevalence of treatment non-adherence among patients with depressive disorders was 26% (95%CI; 21.2, 32.5). Previous suicide attempt (AOR = 3.05, 95%CI; 1.82, 5.12), medication side effects (AOR = 2.46, 95%CI; 1.47, 4.11), moderate to high self-stigma (AOR = 2.60, 95%CI; 1.45, 4.66), and poor quality of life (AOR = 2.47, 95%CI; 1.42, 4.28) were significantly associated with treatment non-adherence among patients with depressive disorders. CONCLUSION AND RECOMMENDATION: Treatment non-adherence is a common problem among patients being treated for depressive disorders. Previous suicide attempts, medication side effects, moderate to high self-stigma, and poor quality of life were significantly associated with treatment non-adherence. Appropriate interventions should be developed to promote measures to facilitate adherence in this group of patients, and address the associated factors when applicable.


Assuntos
Transtorno Depressivo , Qualidade de Vida , Estudos Transversais , Transtorno Depressivo/tratamento farmacológico , Transtorno Depressivo/epidemiologia , Etiópia/epidemiologia , Hospitais Psiquiátricos , Humanos
2.
BMC Health Serv Res ; 22(1): 899, 2022 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-35818042

RESUMO

BACKGROUND: Prevalence of depression in older persons was a leading cause of disability. This group has the lowest access to service and retention in care compared to other age groups. This study aimed to explore continuing mental health service use and examined the predictive power of the mental health service delivery system and individual factors on mental health service use among older persons diagnosed with depressive disorders. METHODS: We employed an analytic cross-sectional study design of individual and organizational variables in 12 general hospitals selected using multi-stratified sampling. There were 3 clusters comprising community hospitals, advanced and standard hospitals, and university hospitals. Participants in each group were 150 persons selected by purposive sampling. We included older persons with a first or recurring diagnosis of a depressive disorder in the last 6 to 12 months of the data collection date. Data at the individual level included socio-demographic characteristics, Charlson Comorbidity Index, Attitude toward Depression and its treatment, and perceived social support. Data at the organizational level had hospital level, nurse competency, nurse-patient ratio, and appointment reminders. Descriptive statistics, Pearson chi-square test, latent class analysis (LCA), and marginal logistic regression model using generalized estimating equation (GEE) were used to analyze the data. RESULTS: The continuing mental health service use among older persons diagnosed with depressive disorders was 54%. The latent class analysis of four variables in the mental health services delivery organization yielded distinct and interpretable findings in two groups: high and low resource organization. The marginal logistic multivariable regression model using GEE found that organizational group and attitude toward depression and its treatment were significantly associated with mental health service use (p-value = 0.046; p-value = 0.003). CONCLUSIONS: The findings suggest that improving continuing mental health services use in older persons diagnosed with depressive disorders should emphasize specialty resources of the mental health services delivery system and attitude toward depression and its treatment.


Assuntos
Transtorno Depressivo , Transtornos Mentais , Serviços de Saúde Mental , Enfermeiras e Enfermeiros , Idoso , Idoso de 80 Anos ou mais , Competência Clínica , Estudos Transversais , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/terapia , Hospitais Gerais , Humanos , Análise de Classes Latentes , Transtornos Mentais/terapia
3.
Artigo em Russo | MEDLINE | ID: mdl-35758947

RESUMO

Anxiety and depressive disorders are characterized with frequent co-occurance. Depression comorbid to anxiety disorder increases severity of main disorder, aggravates it`s clinical course, worsens social functioning of the patients and decreases life quality, results resistance to therapy and increases the probability of suicidal attempts. In patients with depressive disorders onset of anxiety disorder results increased severity of disorder and decrease in quality of remission. There are different opinions on nature and phenomenology of comorbidity of anxiety and depressive disorders. There are biological and psychological factors of risk of comorbidity. Some scientists consider comorbid disorders to be independent and not to effect each other; others pay attention at common anatomic basis of comorbid disorders, which explains manifestation of comorbid disorder. Hierarchical analysis of clinical features of comorbid disorders favors nosological approach to understanding of comorbidity, and implicates the need for inclusion of transdiagnostic elements. Some authors consider comorbid disorders to be separate type of disorder, characterized with special dynamics of syndromes which reveals transformation of one disorder into another. Phenomenon of comorbidity can be described as part of concept of disease spread which estimates important role of bridge psychic states. Considering clinical features of comorbid disorders, difficulties of their therapy based on concepts of phenomenology of comorbid depressive and anxiety disorders recommendations on prevention, early diagnosing and managing of comorbid disorders were elaborated. Psychotherapy (including CBT, which demonstrated high efficiency) is an essential element of treatment of comorbid depressive and anxiety disorders. Psychotherapy is supposed to be correcting personality traits, cognitive mistakes and maladaptive strategies of coping with disorder, which support the comorbidity.


Assuntos
Terapia Cognitivo-Comportamental , Transtorno Depressivo , Ansiedade , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/terapia , Terapia Cognitivo-Comportamental/métodos , Comorbidade , Formação de Conceito , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/psicologia , Transtorno Depressivo/terapia , Humanos
4.
Artigo em Inglês | MEDLINE | ID: mdl-35742609

RESUMO

The COVID-19 pandemic has significantly affected the lives and mental health of people around the world, and it has become clinically essential to define risk factors in order to provide adequate prevention and support. The aim of the study was to describe coping strategies in Polish women related to the COVID-19 pandemic using the balance model, one of the most important concepts of positive psychotherapy (PPT after Peseschkian since 1977). The analysis included 735 women at the mean age of 39.61 years. The survey was conducted using the questionnaire form on the website. Based on Beck's depression test, depressive disorders were disclosed in 32.65%, and both the presence and severity of depressive syndromes were inversely correlated with age. Using a cluster analysis, three adaptation strategies could be identified, related to the different prevalence of depressive disorders. Relationships proved the most crucial area of the balance model, responsible for the effectiveness of the coping strategy. Based on the obtained results, it has to be concluded that preventive measures should primarily concern women aged < 25 years old and focus on strengthening the relationships area.


Assuntos
COVID-19 , Transtorno Depressivo , Adulto , COVID-19/epidemiologia , Depressão/epidemiologia , Transtorno Depressivo/epidemiologia , Feminino , Humanos , Saúde Mental , Pandemias/prevenção & controle , SARS-CoV-2
5.
Artigo em Inglês | MEDLINE | ID: mdl-35725018

RESUMO

INTRODUCTION: Depressive disorders are more common among persons with diabetes, as compared with persons without diabetes. The burden of glucose management is known to associate with depressive symptoms. This study aims to assess the effects of commencement of FreeStyle Libre flash glucose monitoring (FSL-FGM) on the mental health status of persons with diabetes. RESEARCH DESIGN AND METHODS: Post-hoc analysis of data from a 1-year prospective nationwide FSL-FGM registry. Participants who used FSL-FGM for 12 months and completed the 12-Item Short Form Health Survey version 2 (SF-12v2) questionnaires at baseline, 6 and 12 months were included. An SF-12v2 Mental Component Score (MCS) of ≤45 was used as a cut-off to discriminate between persons with and without a depressive disorder. RESULTS: A total of 674 patients were included with a mean age of 48.2 (±15.8) years, 51.2% men, 78.2% type 1 diabetes and baseline HbA1c 62.8 (±13.4) mmol/mol (7.9±1.2%). At baseline, 235 (34.9%) persons had an SF-12 MCS ≤45 while after 6 and 12 months these numbers decreased: 202 (30.0%, p<0.01) and 173 (25.7%, p<0.01). Overall, MCS improved from 48.5 at baseline to 50.7 after 6 months and 51.3 after 12 months. In multivariable regression analysis, age and MCS at baseline were associated with improvement of MCS after 12 months of FSL-FGM use. CONCLUSIONS: This analysis suggests that use of FSL-FGM is associated with a decreased rate of depressive disorders among persons with diabetes. Future studies are needed to corroborate these findings.


Assuntos
Transtorno Depressivo , Diabetes Mellitus Tipo 1 , Glicemia , Automonitorização da Glicemia , Transtorno Depressivo/epidemiologia , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/tratamento farmacológico , Diabetes Mellitus Tipo 1/epidemiologia , Feminino , Glucose , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
6.
Asian J Psychiatr ; 74: 103190, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35772291

RESUMO

Risk estimates of depression and anxiety disorders in primary care patients was studied in 7017 patients from 71 primary health centres in Kerala, India. When compared to those without, patients with a single chronic medical illness had approximately 3-4-fold higher rates of depression and anxiety disorders; this increases to 6-fold when the number of medical illnesses is two or more. Patients with hypertension, diabetes, epilepsy, tuberculosis, asthma, and arthritis had higher odds of depression after controlling for socio-demographic variables and co-occurring medical illnesses. The findings were replicated for anxiety disorders except for tuberculosis. Findings highlight the need for integrated interventions.


Assuntos
Transtornos de Ansiedade , Transtorno Depressivo , Ansiedade/epidemiologia , Transtornos de Ansiedade/epidemiologia , Doença Crônica , Comorbidade , Depressão/epidemiologia , Transtorno Depressivo/epidemiologia , Humanos , Atenção Primária à Saúde
7.
Epidemiol Psychiatr Sci ; 31: e36, 2022 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-35607805

RESUMO

AIM: The Covid-19 pandemic may be associated with an increase in mental disorders and mental distress. However, there are no representative studies testing the impact of stressors directly related to Covid-19. We aimed to determine whether Covid-19-related stressors were associated with mental disorders, depressive and anxiety symptoms in the second year of the pandemic. METHOD: This cross-sectional observational epidemiological survey was conducted from June to October 2021. We interviewed a representative sample of the adult population in Serbia (18-65 years) in the second year of the pandemic, at a time when large parts of the population had been affected by the pandemic in different ways. A multistage probabilistic household sampling of the adult population in 60 municipalities was used. Mental disorders were assessed by in-person interviews using the Mini International Neuropsychiatric Interview. Depressive and anxiety symptoms were measured by PHQ-9 and GAD-7 scales. Covid-19-related stressors (Sars-CoV-2 infection, the infection of a close relative, self-isolation and lack of protective equipment at work), as well as other stressors during the pandemic (not directly related to the risk of the infection), were measured. The associations with mental disorders, depressive and anxiety symptoms were explored through univariable and multivariable regression analyses. RESULTS: In total, 1203 individuals (mean age 43.7 ± 13.6 years, 48.7% male) were interviewed. Most respondents (67.8%) of the sample had already experienced Covid-19-related stressors (20.1% had Sars-CoV-2 infection; 43.2% had a close relative member who had Covid-19; 28.2% reported lack of appropriate protection; 27.5% had been quarantined) and about 50% had already been vaccinated. The prevalence of any mental disorder was 15.2% (95% CI 13.2-17.2): mood disorders 4.6%, anxiety disorders 4.3% and substance use disorders 8.0%. Mean PHQ-9 was 3.2 ± 3.8 and GAD-7 was 2.1 ± 3.1. In this study, one Covid-19 stressor, i.e. lack of protective equipment, was weakly associated with a greater frequency of anxiety disorders (p = 0.023), while the other stressors had significant associations with several groups of mental disorders and symptom levels. CONCLUSIONS: Our study did not provide any evidence that the prevalence of mental disorders exceeds the range of pre-pandemic data reported in the literature. Covid-related stressors, although frequently reported, did not dramatically influence the prevalence of mental disorders. The provision of the appropriate equipment at workplaces might lead to the reduction of anxiety disorders.


Assuntos
COVID-19 , Transtorno Depressivo , Transtornos Mentais , Adulto , Ansiedade/epidemiologia , COVID-19/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Transtorno Depressivo/epidemiologia , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Pandemias , SARS-CoV-2 , Sérvia/epidemiologia , Inquéritos e Questionários
8.
Psychiatr Pol ; 56(1): 101-114, 2022 Feb 27.
Artigo em Inglês, Polonês | MEDLINE | ID: mdl-35569151

RESUMO

OBJECTIVES: The main aim of this study was to assess the effects of social and familial isolation due to COVID-19 on the mental well-being of patients staying in a residential medical care facility and evaluation of the effectiveness of therapeutic measures. METHODS: The study was conducted among the patients of a residential medical care facility (58 patients). A short form of the Geriatric Depression Scale (GDS) was used to assess the severity of depressive disorders. The number of medical and psychological interventions during the individual months of isolation was also compared. RESULTS: In February 2020, when there was no isolation, 87.9% of the study group did not suffer from depression compared to 72.4% during the period of full isolation. After introducing controlled methods for contacting loved ones, the number of individuals with no depressive symptoms increased again. A mean of 1.76 medical and 0.23 psychological interventions per one patient were conducted during the period of full isolation. CONCLUSIONS: The number of medical and psychological interventions was higher during the period of full isolation compared to months without compulsory isolation due to COVID-19. After the introduction of full isolation, the scores in the GDS were significantly higher, which means that the residents were at a higher risk of depressive disorders than in the months without isolation.


Assuntos
COVID-19 , Transtorno Depressivo , Idoso , COVID-19/epidemiologia , Depressão/epidemiologia , Transtorno Depressivo/epidemiologia , Humanos , Assistência de Longa Duração , Pandemias , Isolamento Social/psicologia
10.
Artigo em Russo | MEDLINE | ID: mdl-35394722

RESUMO

OBJECTIVE: The aim of this work was to analyze the frequency and, spectrum of mental disorders (MD), and stressful factors, as well as the characteristics of anxiety and depressive spectrum disorders (ADSD) in patients with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS). MATERIAL AND METHODS: The study included 155 patients (37 (23.9%) men and 118 (76.1%) women) aged 18 to 69 years ((M±SD) 37.7±12.3 years), including. 61 (39.3%) patients - with a reliable diagnosis of SLE according to the 2019 EULAR/ACR criteria, 48 (30.9%) patients with - SLE with secondary APS and 46 (29.7%) - with primary APS (PAPS), established according to the international criteria of 2006. RESULTS: The majority of the examined patients were found to hadve MD (current MD in 145 (93.5%) patients). ADSD prevailed in all groups: in 58 (95.1%) patients with SLE, in 42 (87.5%) - with SLE with APS and in, 39 (84.8%) - with APS. Patients with SLE were exposed to stressful events in childhood (predominantly parental deprivation) more often than patients with SLE with APS and PAPS were exposed to stressful events in childhood (93.4% versus 81.2% and 69.6%, respectively; predominantly parental deprivation). ADSD in these patients developed mainly in pre-adolescence, with a tendency towards chronic variants without remission, which leads to a greater vulnerability of the patients in this group to stressful events compared with patients with APS (p=0.05). CONCLUSION: When diagnosing and treating MD in patients with SLE and APS, special attention should be paid to the analysis of the history of stressful eventsstress history of patients, which affects the formation of common predisposing and provoking factors, both MD and RD, aggravating their course and prognosis.


Assuntos
Síndrome Antifosfolipídica , Transtorno Depressivo , Lúpus Eritematoso Sistêmico , Adolescente , Síndrome Antifosfolipídica/complicações , Síndrome Antifosfolipídica/diagnóstico , Síndrome Antifosfolipídica/epidemiologia , Ansiedade/epidemiologia , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/etiologia , Feminino , Humanos , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/epidemiologia , Masculino
12.
Aust N Z J Psychiatry ; 56(8): 910-948, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35362327

RESUMO

OBJECTIVE: Depression is one of the most prevalent and disabling mental health conditions among young people worldwide. The health and economic burdens associated with depressive illness are substantial. Suicide and depression are closely intertwined, yet a diagnosis of depression itself lacks predictive specificity for suicidal behaviour. To better inform suicide prevention and early intervention strategies for young people, improved identification of modifiable intervention targets is needed. The objective of this review was to identify clinical, psychosocial and biological correlates of suicidality in young people diagnosed with a broad range of unipolar and bipolar depressive disorders. METHOD: Systematic searches were conducted across MEDLINE, Embase and PsycINFO to identify studies of young people aged 15-25 years diagnosed with unipolar or bipolar depressive disorders. An assessment of suicidality was required for inclusion. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 and Synthesis Without Meta-analysis guidelines. RESULTS: We integrated findings from 71 studies including approximately 24,670 young people with clinically diagnosed depression. We identified 26 clinical, psychosocial and biological correlates of suicidality. Depression characteristics (type and severity), psychiatric comorbidity (particularly anxiety and substance use disorders) and neurological characteristics emerged as having the most evidence for being associated with suicidal outcomes. Our ability to pool data and conduct meaningful quantitative synthesis was hampered by substantial heterogeneity across studies and incomplete reporting; thus, meta-analysis was not possible. CONCLUSION: Findings of this review reinforce the notion that suicidality is a complex phenomenon arising from the interplay of multiple contributing factors. Our findings question the utility of considering a diagnosis of depression as a specific risk factor for suicidality in young people. Suicidality itself is transdiagnostic; adoption of a transdiagnostic approach to investigating its aetiology and treatment is perhaps warranted. Future research investigating specific symptoms, or symptom networks, might help to further our understanding of suicidality among young people experiencing mental illness.


Assuntos
Transtorno Bipolar , Transtorno Depressivo , Suicídio , Adolescente , Transtornos de Ansiedade/psicologia , Transtorno Depressivo/epidemiologia , Humanos , Ideação Suicida , Suicídio/prevenção & controle
13.
Front Public Health ; 10: 811168, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35359762

RESUMO

The aim of the study was to determine the influence of different exercise types on health-related quality of life (QOL) in men with depressive disorder (DD) in South (S) Korea. The data of 385 men aged 19 with DD were collected in S. Korea. The Euro Quality of Life 5 Dimensions (EQ-5D) index and Korea National Health and Nutrition Examination Survey (KNHANES) questionnaires were used to establish the purpose of this study. Furthermore, the complex sampling model was applied to investigate the influence of different exercise types on health-related QOL in participants. When reviewing the outcomes, the strength exercise and walking had significant influences on health-related QOL in men with DD in S. Korea. However, the flexibility exercise did not have a significant influence on them. Based on the results, strength exercise and walking were effective exercise types to increase levels of health-related QOL in men with DD in S. Korea.


Assuntos
Transtorno Depressivo , Exercício Físico , Qualidade de Vida , Adulto , Transtorno Depressivo/epidemiologia , Humanos , Masculino , Inquéritos Nutricionais , República da Coreia , Adulto Jovem
14.
PLoS One ; 17(3): e0264962, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35303003

RESUMO

BACKGROUND: The COVID-19 pandemic and lockdown pose a threat for adolescents' mental health, especially for those with an earlier vulnerability. Accordingly, these adolescents may need increased support from family and friends. This study investigated whether family functioning and peer connectedness protects adolescents with earlier internalizing or externalizing symptoms from increased depressive symptoms during the first Dutch COVID-19 lockdown in a low-risk community sample. METHODS: This sample comprised 115 adolescents (Mage = 13.06; 44% girls) and their parents (N = 111) and is part of an ongoing prospective study on child development. Internalizing and externalizing symptoms were self-reported a year before the COVID-19 lockdown. In an online survey during the first Dutch lockdown (April-May 2020), adolescents reported depressive symptoms and perceived peer connectedness, and parents reported family functioning. RESULTS: Twenty-four percent of adolescents reported clinically relevant symptoms of depression during the first COVID-19 lockdown. Depressive symptoms were significantly predicted by earlier internalizing, but not externalizing symptoms. Furthermore, higher quality of family functioning, but not peer connectedness, predicted fewer adolescent depressive symptoms. Family functioning and peer connectedness did not moderate the link between pre-existing internalizing symptoms and later depressive symptoms. CONCLUSIONS: In a low-risk community sample, one-in-four adolescents reported clinically relevant depressive symptoms at the first COVID-19 lockdown. Higher earlier internalizing symptoms and lower quality of family functioning increased risks. These results indicate that even in low-risk samples, a substantial group of adolescents and their families are vulnerable during times of crisis.


Assuntos
COVID-19/psicologia , Transtorno Depressivo/epidemiologia , Quarentena/psicologia , Adolescente , Mecanismos de Defesa , Transtorno Depressivo/psicologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Estudos Prospectivos , Autorrelato , Inquéritos e Questionários
15.
PLoS One ; 17(3): e0266402, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35358271

RESUMO

PURPOSE: The passage of the Affordable Care Act in the US resulted in more Americans with health insurance coverage as well as expanded health benefits. However, barriers in accessing health care still exist in the US especially as it relates to some of the most vulnerable Americans including those with depressive disorders. The purpose of this cross-sectional secondary data analysis was to examine the differences in health-related quality of life for individuals with depressive disorders in early years of the implementation of the Affordable Care Act as compared to later years of implementation. METHODS: This study used a repeated cross-sectional design that pooled data from the 2011-2017 Behavioral Risk Factor Surveillance System which is a nationally representative survey of the non-institutionalized U.S. population. Logistic regression models were used to evaluate the before and after impact of the Affordable Care Act on health related quality of life for those with depressive disorders. RESULTS: Those with depressive disorders in early years of implementation of the Affordable Care Act were less likely to report 14 or more days of poor physical health (AOR = 0.96; 95% CI: 0.95, 0.98), were less likely to report 14 or more days of poor mental health (AOR = 0.93; 95% CI: 0.92, 0.94), and less likely to report 14 or more days of overall poor physical and mental health (AOR = 0.93; 95% CI: 0.90, 0.96) as opposed to later years of implementation. CONCLUSIONS: Our results indicate poorer health related quality of life for those with depressive disorders in later years of implementation of the Affordable Care Act. Despite expanded mental health benefits under the Affordable Care Act, those benefits do not always translate into improved access or improved patient-reported outcomes. The federal government needs to comprehensively address mental health services in order to improve patient-reported outcomes and mental health treatment for those with depression.


Assuntos
Transtorno Depressivo , Qualidade de Vida , Sistema de Vigilância de Fator de Risco Comportamental , Estudos Transversais , Análise de Dados , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/terapia , Acesso aos Serviços de Saúde , Humanos , Cobertura do Seguro , Seguro Saúde , Medicaid , Patient Protection and Affordable Care Act , Estados Unidos/epidemiologia
16.
PLoS One ; 17(2): e0263999, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35176080

RESUMO

The unprecedented experience of national lockdowns and uncertainty of academic career due to the COVID-19 pandemic has multifaceted impacts on mental health among university students worldwide. This study determined its impact on depression and anxiety level, and associated risk factors among engineering students studying at College of Science and Technology (CST), Phuentsholing, Bhutan during the first lockdown in the country. Self-reported depression and anxiety levels were assessed using Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) respectively. Data was collected using an e-questionnaire link generated in Google form and the link was shared with students via the student's official email group. A total of 278 students (response rate, 26.9%) completed the questionnaire. The majority of respondents were male (69.8%) and were aged from 18 to 30 (Mean: 21.7 ±SD 2.07) years. The prevalence of self-reported moderate to severe depression and anxiety were 44.2% (95% CI, 38.5-49.6) and 27.3% (95% CI, 22.3-32.4) respectively. Participants having their family members as frontline workers reported a significantly higher level of anxiety (χ2 = 4.85, p = 0.028). In multivariable logistic regression analysis, students who were academically lagging showed a higher risk of depression (AOR = 5.36, 95% CI = 2.86-10.04) and anxiety (AOR = 3.83, 95%CI = 1.86-7.88) as compared to students who were not academically behind. A high percentage of depression and anxiety was reported by students of CST during the COVID-19 pandemic. Findings from the study highlight the importance of adopting appropriate online-based teaching and learning methods to ensure timely academic and professional achievements. Moreover, the relevant stakeholders should put health system strategies in place to provide psychological support to university students during the COVID-19 pandemic.


Assuntos
Transtornos de Ansiedade/psicologia , COVID-19/complicações , Transtorno Depressivo/psicologia , Internet/estatística & dados numéricos , Saúde Mental , Estresse Psicológico/psicologia , Estudantes/psicologia , Adolescente , Adulto , Transtornos de Ansiedade/epidemiologia , Butão/epidemiologia , COVID-19/epidemiologia , COVID-19/virologia , Estudos Transversais , Transtorno Depressivo/epidemiologia , Feminino , Humanos , Masculino , Prevalência , SARS-CoV-2/isolamento & purificação , Estresse Psicológico/epidemiologia , Inquéritos e Questionários , Universidades , Adulto Jovem
17.
PLoS One ; 17(2): e0263334, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35180242

RESUMO

Globally, anxiety and depression are the most common psychiatric disorders that add large burdens to individuals and society; however, the mechanisms underlying these disorders are unclear. Several studies have found that eczema is a shared risk factor for both these conditions. We identified and evaluated eligible observational studies from EMBASE and PubMed. In total, 20 relevant cohort and case-control studies comprising 141,910 patients with eczema and 4,736,222 control participants fulfilled our established criteria. Information extracted included study design, location, sample size, sex distribution of cases and controls or reference cohorts, measurements of outcomes, odds ratio (OR) with 95% confidence interval (CI), and adjusted factors for exposure associated with outcome risk. The meta-analysis was performed by calculating the pooled OR with 95% CI, and heterogeneity was assessed using Cochrane Q and I2 statistics. The pooled effect showed a positive association (n = 4,896,099, OR = 1.63, 95% CI [1.42-1.88], p<0.001) between eczema and depression or anxiety, with positive associations also observed in the depression (n = 4,878,746, OR = 1.64, 95% CI [1.39-1.94], p<0.001) and anxiety (n = 4,607,597, OR = 1.68, 95% CI [1.27-2.21], p<0.001) groups. Subgroup and sensitivity analyses confirmed that these findings were stable and reliable. This study suggests that eczema is associated with an increased risk of developing depression and anxiety, which may assist clinicians in the prevention or treatment of these disorders.


Assuntos
Transtornos de Ansiedade/epidemiologia , Transtorno Depressivo/epidemiologia , Eczema/epidemiologia , Adolescente , Adulto , Transtornos de Ansiedade/prevenção & controle , Estudos de Casos e Controles , Criança , Pré-Escolar , Estudos de Coortes , Comorbidade , Transtorno Depressivo/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Fatores de Risco , Adulto Jovem
18.
PLoS One ; 17(2): e0263760, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35139136

RESUMO

BACKGROUND: Pregnancy is a time of major psychological changes making pregnant women more susceptible to depression and anxiety. Prevalence is higher among women living in Bangladesh, India and Pakistan, compared to high-income countries, due to poor understanding and lack of mental health integration within antenatal care. Antenatal depression/anxiety is associated with adverse outcomes including postnatal depression, low birth weight and impaired fetal development. Existing systematic reviews provided only limited information on the social determinants of antenatal depression/anxiety in these South Asian countries. OBJECTIVE: This review aimed to identify, synthesise and appraise the evidence on the social determinants associated with antenatal depression and anxiety in women living in Bangladesh, India and Pakistan. METHODS: We searched five databases (MEDLINE, Embase, PsycINFO, Scopus, Web of Science) and PROSPERO. Observational studies published between 1st January 2000 and 4th January 2021 were included if they were in the English language, used validated tools for measuring depression/anxiety in pregnant women and reported statistical associations or raw numbers. Summary estimates were obtained using random-effects model. Heterogeneity and publication bias was measured using the I2 statistic and Egger's test, respectively. This review was registered on PROSPERO (reference: CRD42020167903). RESULTS: We included 34 studies (with 27,379 women). Meta-analysis of Adjusted Odds Ratios (AOR) found that Intimate partner violence (AOR 2.48, 95% CI 1.41-4.33), unplanned pregnancy (AOR 1.53, 95% CI 1.28-1.83), male gender preference (AOR 3.06, 95% CI 1.40-6.72) and poor relationship with in-laws (AOR 2.69, 95% CI 1.25-5.80) were significantly associated with antenatal depression/anxiety. CONCLUSION: The review identified a complex range of social determinants of antenatal depression and anxiety in Bangladesh, India and Pakistan. Screening tools to identify pregnant women at high risk should be integrated within antenatal care to prevent adverse outcomes. Knowledge of these social determinants will inform the development of such screening tools and interventions.


Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Complicações na Gravidez/epidemiologia , Determinantes Sociais da Saúde/estatística & dados numéricos , Ansiedade/etiologia , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/etiologia , Ásia/epidemiologia , Depressão/etiologia , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/etiologia , Feminino , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/estatística & dados numéricos , Gravidez , Complicações na Gravidez/etiologia , Cuidado Pré-Natal/estatística & dados numéricos , Prevalência
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