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1.
PLoS One ; 16(3): e0248684, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33750955

RESUMO

BACKGROUND: The COVID-19 pandemic has been creating a panic and distressing situations among the entire population globally including Nepal. No study has been conducted assessing the psychological impact of this pandemic on the general public in Nepal. The objective of this study is to assess the mental health status during COVID-19 outbreak and explore the potential influencing factors among the population attending the hospital fever clinics with COVID-19 symptoms. METHODS: A cross-sectional survey was conducted between May-June, 2020 with a sample of 645 participants aged 18 and above in 26 hospitals across Nepal. Telephone interviews were conducted using a semi-structured questionnaire along with a validated psychometric tool, the Depression, Anxiety and Stress (DASS-21) scale. The metrics and scores of symptoms and their severity were created and analyzed. Multivariate logistic regression was used to determine the association of potential covariates with outcome variables. RESULTS: The prevalence of anxiety, depression and stress were 14%, 7% and 5% respectively. In reference to Karnali, participants from Bagmati province reported higher level of anxiety (OR 3.44, 95% CI 1.31-9.06), while stress (OR 4.27, 95% CI 1.09-18.32) and depressive symptoms (OR 3.11, 95% CI 1.05-9.23) observed higher among the participants in Province 1. Women were more at risk of anxiety (OR 3.41, 95% CI 1.83-6.36) than men. Similarly, people currently living in rented houses reported more stress (OR 2.97, 95% CI 1.05-8.43) and those living far from family reported higher rates of depressive symptoms (OR 3.44, 95% CI 1.03-11.46). CONCLUSION: The study identified increased prevalence of stress, anxiety and depressive symptoms during the initial stage of COVID-19 pandemic in Nepal. Considering the findings, there is urgent need to develop and implement appropriate community-based mental health programs targeting individuals who have had COVID-19 symptoms and who are prone to develop adverse mental health outcomes.


Assuntos
/patologia , Saúde Mental , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/etiologia , /epidemiologia , Estudos Transversais , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nepal/epidemiologia , Razão de Chances , Índice de Gravidade de Doença , Estresse Psicológico , Inquéritos e Questionários , Adulto Jovem
2.
Asian J Psychiatr ; 57: 102563, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33556918

RESUMO

Patients hospitalized with COVID-19 are at risk of developing many neuropsychiatric disorders, due to the effects of the disease on the brain and the psychosocial pressures of having the disease. The aim of the present study was to evaluate the characteristics and outcomes of patients who were hospitalized with a diagnosis of COVID-19, who underwent psychiatric consultations. The medical records of 892 patients hospitalized due to COVID-19 and the 89 among them who requested psychiatric consultations were analyzed retrospectively. After the psychiatric consultations, patients were most frequently diagnosed with delirium (38.2 %), adjustment disorder (27.0 %), depressive disorder (19.1 %) and anxiety disorder (11.2 %). Patients with delirium had longer hospital stays (p < 0.001), were transferred more frequently to intensive care units (p < 0.001), and had higher mortality rates during their hospital stays (p < 0.001), than all other patients. The need for oxygen (p < 0.001) and mechanical ventilation (p < 0.001) was also significantly higher in delirium patients, as well as in patients who received other psychiatric diagnoses. Neuropsychiatric disorders develop in patients receiving inpatient treatments in COVID-19 wards, and these disorders negatively affect the prognosis of COVID-19. Our findings suggest that the presence of neuropsychiatric disorders in in-patients with COVID-19 might be associated with the negative outcomes of the disease.


Assuntos
Transtornos de Adaptação/etiologia , Transtornos de Ansiedade/etiologia , /terapia , Delírio/etiologia , Transtorno Depressivo/etiologia , Transtornos de Adaptação/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Transtornos de Ansiedade/diagnóstico , Delírio/diagnóstico , Transtorno Depressivo/diagnóstico , Feminino , Mortalidade Hospitalar , Hospitalização , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Encaminhamento e Consulta , Estudos Retrospectivos , Resultado do Tratamento
3.
PLoS One ; 16(1): e0245864, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33481879

RESUMO

The worsening of neuropsychiatric symptoms such as depression, anxiety, and insomnia in patients with Parkinson's disease (PD) has been a concern during the COVID-19 pandemic, because most people worked in self-isolation for fear of infection. We aimed to clarify the impact of social restrictions imposed due to the COVID-19 pandemic on neuropsychiatric symptoms in PD patients and to identify risk factors associated with these symptoms. A cross-sectional, hospital-based survey was conducted from April 22, 2020 to May 15, 2020. PD patients and their family members were asked to complete paper-based questionnaires about neuropsychiatric symptoms by mail. PD patients were evaluated for motor symptoms using MDS-UPDRS part 2 by telephone interview. A total of 71 responders (39 PD patients and 32 controls) completed the study. Although there was no difference in the age distribution, the rate of females was significantly lower in PD patients (35%) than controls (84%) (P < 0.001). Participants with clinical depression (PHQ-9 score ≥ 10) were more common in PD patients (39%) than controls (6%) (P = 0.002). Multivariate logistic regression analysis revealed that an MDS-UPDRS part 2 score was correlated with the presence of clinical depression (PHQ-9 score ≥ 10) and clinical anxiety (GAD-7 score ≥ 7) (clinical depression: OR, 1.31; 95% CI, 1.04-1.66; P = 0.025; clinical anxiety: OR, 1.36; 95% CI, 1.07-1.72; P = 0.013). In the presence of social restrictions, more attention needs to be paid to the neuropsychiatric complications of PD patients, especially those with more severe motor symptoms.


Assuntos
Transtornos de Ansiedade/etiologia , Transtorno Depressivo/etiologia , Doença de Parkinson/complicações , Distúrbios do Início e da Manutenção do Sono/etiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Japão/epidemiologia , Masculino , Fatores de Risco
4.
Artigo em Inglês | MEDLINE | ID: mdl-33480484

RESUMO

Objective: There are multiple studies indicating that the Indian expat population working in the Middle East is at a significantly high risk for developing anxiety, depression, and suicidal thoughts. The coronavirus disease 2019 (COVID-19) pandemic can precipitate or exacerbate psychological distress among the expat population. The objective of this study was to evaluate psychological distress and coping mechanisms among Indian expats working in the Middle East during the COVID-19 pandemic. Methods: An online survey was conducted with a semistructured questionnaire using a nonprobability snowball sampling technique. In addition to demographic data, a list of COVID-19 pandemic-related questions, the Brief COPE, the 9-item Patient Health Questionnaire (PHQ-9), and the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7) were also utilized. Results: A total of 94 responses were received. Of the respondents, 52% reported clinically significant anxiety levels, and 41% reported clinically significant depression levels. Both the PHQ-9 and GAD-7 scores were significantly associated with the level of concern with air traffic restriction (P < .05). Conclusions: Our findings show that governments of both Indian and Middle Eastern countries should pay more attention to the mental health of the expat population while combating COVID-19.


Assuntos
Adaptação Psicológica , Transtornos de Ansiedade/etnologia , Transtorno Depressivo/etnologia , Angústia Psicológica , Estresse Psicológico/etnologia , Adulto , Transtornos de Ansiedade/etiologia , Estudos Transversais , Transtorno Depressivo/etiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Índia/etnologia , Masculino , Pessoa de Meia-Idade , Oriente Médio/etnologia , Estresse Psicológico/etiologia , Adulto Jovem
6.
Intensive Crit Care Nurs ; 63: 102999, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33342649

RESUMO

BACKGROUND: Healthcare workers have historically experienced symptoms of post-traumatic stress disorder, depression and anxiety with previous infectious outbreaks. It is unknown if critical care nurses have similar experiences. OBJECTIVES: The study aimed to examine the mental health of Critical Care Registered Nurses providing direct patient care during the initial phase of the COVID-19 pandemic in Canada. DESIGN: This was a convergent parallel mixed method study utilizing validated questionnaires and semi-structured qualitative interviews. SETTING: Critical care units in a single large 650 bed academic teaching hospital in western Canada. The critical care units serve a general mixed medical - surgical adult patient population. PARTICIPANTS: Critical Care Registered Nurses providing direct patient care in the intensive care and high acuity units at the designated site. METHODS: 109 participants completed two self-reported validated surveys, the Impact of Events Scale - Revised and the Depression, Anxiety and Stress Scale. 15 participants completed one-on-one semi-structured interviews that were analyzed using inductive thematic analysis. RESULTS: In the surveys, the participants reported clinical concern for (23%), probable (13%) and significant (38%) symptoms of post-traumatic stress disorder, as well as mild to severe depression (57%), anxiety (67%) and stress (54%). In the interviews, psychological distress was described as anxiety, worry, distress and fear related to: 1) rapidly changing policy and information, 2) overwhelming and unclear communication, 3) meeting patient care needs in new ways while staying safe, and 4) managing home and personal commitments to self and family. CONCLUSIONS: Critical care nurses experienced psychological distress associated with providing care to COVID-19 patients during the early phases of the pandemic.


Assuntos
Transtornos de Ansiedade/etiologia , /psicologia , Cuidados Críticos/psicologia , Cuidados Críticos/estatística & dados numéricos , Transtorno Depressivo/etiologia , Pessoal de Saúde/psicologia , Adulto , Canadá/epidemiologia , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/epidemiologia , Pandemias , Inquéritos e Questionários
8.
Cir Cir ; 88(5): 562-568, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33064695

RESUMO

Objective: The objective of the study was to determine the state of anxiety, depression, and stress present in the society during the development of the 2019 coronavirus pandemic. Methods: Mixed methods study; a three-section questionnaire was developed which included sociodemographic, perceptions, emotions, and behaviors related to the 2019 coronavirus pandemic, and two emotional assessment psychometric tests. The proportions and confidence intervals of the variables were calculated and compared using the Chi-square test. Results: More than 40% of the subjects presented some degree of anxiety and 41.3% depression; the proportion of stress was < 30%. Of the subjects who experienced anxiety, 18.6% also had moderate-to-very severe depression or stress. Conclusion: There are emotional indicators derived from the 2019 coronavirus pandemic in almost half of the study population. The identification and timely treatment of these states could lessen the psychological impact due to 2019 coronavirus.


Assuntos
Ansiedade/etiologia , Betacoronavirus , Infecções por Coronavirus/psicologia , Depressão/etiologia , Pandemias , Pneumonia Viral/psicologia , Estresse Psicológico/etiologia , Adulto , Ansiedade/epidemiologia , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/etiologia , Infecções por Coronavirus/epidemiologia , Depressão/epidemiologia , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/etiologia , Emoções , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , México , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Psicometria , Assunção de Riscos , Índice de Gravidade de Doença , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
9.
JAMA Netw Open ; 3(10): e2025591, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33095252

RESUMO

Importance: The coronavirus disease 2019 (COVID-19) pandemic and quarantine measures have raised concerns regarding their psychological effects on populations. Among the general population, university students appear to be particularly susceptible to experiencing mental health problems. Objectives: To measure the prevalence of self-reported mental health symptoms, to identify associated factors, and to assess care seeking among university students who experienced the COVID-19 quarantine in France. Design, Setting, and Participants: This survey study collected data from April 17 to May 4, 2020, from 69 054 students living in France during the COVID-19 quarantine. All French universities were asked to send an email to their students asking them to complete an online questionnaire. The targeted population was approximately 1 600 000 students. Exposure: Living in France during the COVID-19 quarantine. Main Outcomes and Measures: The rates of self-reported suicidal thoughts, severe distress, stress, anxiety, and depression were assessed using the 22-item Impact of Events Scale-Revised, the 10-item Perceived Stress Scale, the 20-item State-Trait Anxiety Inventory (State subscale), and the 13-item Beck Depression Inventory, respectively. Covariates were sociodemographic characteristics, precariousness indicators (ie, loss of income or poor quality housing), health-related data, information on the social environment, and media consumption. Data pertaining to care seeking were also collected. Multivariable logistic regression analyses were performed to identify risk factors. Results: A total of 69 054 students completed the survey (response rate, 4.3%). The median (interquartile range) age was 20 (18-22) years. The sample was mainly composed of women (50 251 [72.8%]) and first-year students (32 424 [47.0%]). The prevalence of suicidal thoughts, severe distress, high level of perceived stress, severe depression, and high level of anxiety were 11.4% (7891 students), 22.4% (15 463 students), 24.7% (17 093 students), 16.1% (11 133 students), and 27.5% (18 970 students), respectively, with 29 564 students (42.8%) reporting at least 1 outcome, among whom 3675 (12.4%) reported seeing a health professional. Among risk factors identified, reporting at least 1 mental health outcome was associated with female gender (odds ratio [OR], 2.10; 95% CI, 2.02-2.19; P < .001) or nonbinary gender (OR, 3.57; 95% CI, 2.99-4.27; P < .001), precariousness (loss of income: OR, 1.28; 95% CI, 1.22-1.33; P < .001; low-quality housing: OR, 2.30; 95% CI, 2.06-2.57; P < .001), history of psychiatric follow-up (OR, 3.28; 95% CI, 3.09-3.48; P < .001), symptoms compatible with COVID-19 (OR, 1.55; 95% CI, 1.49-1.61; P < .001), social isolation (weak sense of integration: OR, 3.63; 95% CI, 3.35-3.92; P < .001; low quality of social relations: OR, 2.62; 95% CI, 2.49-2.75; P < .001), and low quality of the information received (OR, 1.56; 95% CI, 1.49-1.64; P < .001). Conclusions and Relevance: The results of this survey study suggest a high prevalence of mental health issues among students who experienced quarantine, underlining the need to reinforce prevention, surveillance, and access to care.


Assuntos
Infecções por Coronavirus/psicologia , Transtornos Mentais/etiologia , Pandemias , Pneumonia Viral/psicologia , Isolamento Social/psicologia , Estudantes/psicologia , Ideação Suicida , Universidades , Adolescente , Adulto , Ansiedade/epidemiologia , Ansiedade/etiologia , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/etiologia , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Depressão/epidemiologia , Depressão/etiologia , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/etiologia , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Razão de Chances , Aceitação pelo Paciente de Cuidados de Saúde , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Prevalência , Quarentena , Estresse Psicológico/epidemiologia , Estresse Psicológico/etiologia , Inquéritos e Questionários , Adulto Jovem
10.
JAMA Netw Open ; 3(10): e2026064, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33104209

RESUMO

Importance: An immediate research priority is to investigate and monitor the psychological well-being among high-risk groups during the coronavirus disease 2019 (COVID-19) pandemic. Objective: To examine levels of severity of depressive symptoms over time among individuals with high risk in the UK during the COVID-19 pandemic. Design, Setting, and Participants: This cohort study is part of an ongoing large panel study of adults aged 18 years and older residing in the UK, the COVID-19 Social Study, established on March 21, 2020. Data analysis was conducted in May 2020. Exposures: Sociodemographic risk factors included belonging to the Black, Asian, and minority racial/ethnic communities, low socioeconomic position (SEP), and essential worker roles (eg, workers in health and social care, education, childcare, or key public services). Health-related and psychosocial risk factors included preexisting physical and mental health conditions, experience of psychological or physical abuse, and low social support. Main Outcomes and Measures: Depressive symptoms were measured on 7 occasions from March 21 to April 2, 2020, using the 9-item Patient Health Questionnaire (PHQ-9). Group-based depressive symptom trajectories were derived using latent growth mixture modeling. Results: The analytical sample comprised 51 417 adults aged 18 years and older (mean [SD] age, 48.8 [16.8] years; 26 276 [51.1%] women; 6145 members [12.0%] of Black, Asian, and minority racial/ethnic communities). Among these, 17 143 participants (33.3%) were in the lowest SEP quartile, and 11 342 participants (22.1%) were classified as essential workers. Three levels of severity of depressive symptoms were identified: low (30 850 participants [60.0%]), moderate (14 911 participants [29.0%]), and severe (5656 participants [11.0%]). After adjusting for covariates, experiences of physical or psychological abuse (odds ratio [OR], 13.16; 95% CI, 12.95-13.37; P < .001), preexisting mental health conditions (OR, 12.99; 95% CI, 12.87-13.11; P < .001), preexisting physical health conditions (OR, 3.41; 95% CI, 3.29-3.54; P < .001), low social support (OR, 12.72; 95% CI, 12.57-12.86; P < .001), and low SEP (OR, 5.22; 95% CI, 5.08-5.36; P < .001) were significantly associated with severe depressive symptoms. No significant association was found for race/ethnicity (OR, 1.07; 95% CI, 0.85-1.28; P = .56). Participants with essential worker roles were less likely to experience severe depressive symptoms (OR, 0.66; 95% CI, 0.53-0.80; P < .001). Similar patterns of associations were found for the group of participants with moderate depressive symptoms (abuse: OR, 5.34; 95% CI, 5.15-5.54; P < .001; mental health condition: OR, 4.24; 95% CI, 4.24-4.24; P < .001; physical health condition: OR, 1.89; 95% CI, 1.80-1.98; P < .001; low social support: OR, 4.71; 95% CI, 4.60-4.82; P < .001; low SEP: OR, 1.97; 95% CI, 1.87-2.08; P < .001). Conclusions and Relevance: In this cohort study of UK adults participating in the COVID-19 Social Study, people with psychosocial and health-related risk factors, as well as those with low SEP, were at the most risk of experiencing moderate or severe depressive symptoms during the COVID-19 pandemic.


Assuntos
Infecções por Coronavirus/psicologia , Depressão , Transtorno Depressivo , Nível de Saúde , Pandemias , Pneumonia Viral/psicologia , Índice de Gravidade de Doença , Classe Social , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Estudos de Coortes , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/etnologia , Infecções por Coronavirus/virologia , Depressão/epidemiologia , Depressão/etiologia , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/etiologia , Emprego , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Pneumonia Viral/etnologia , Pneumonia Viral/virologia , Grupos Populacionais/psicologia , Fatores de Risco , Reino Unido , Adulto Jovem
11.
PLoS One ; 15(10): e0240646, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33104711

RESUMO

The COVID-19 pandemic puts health workers at increased risk of adverse mental health outcomes. However, no studies have assessed health workers' experiences using qualitative methods during the COVID-19 outbreak in the United States to identify novel factors that could relate to their mental health. In May 2020, we distributed an online survey to health workers across 25 medical centers throughout the United States. The Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Primary Care-Post-Traumatic Stress Disorder, and Alcohol Use Disorders Identification Test-Concise and associated cutoff values were used to assess rates of probable major depression, generalized anxiety disorder, post-traumatic stress disorder, and alcohol use disorder, respectively. To provide insight into the factors shaping these and other mental health conditions, we included two open-ended questions asking respondents to recount their most upsetting and hopeful experiences during the COVID-19 pandemic and how it made them feel. Using a hybrid inductive-abductive approach and thematic content analysis, we created a Social Ecological Model to represent themes among health workers' experiences within five ecological levels: individual, interpersonal, organization, community, and public policy. Of the 1,132 participants who completed the survey, 14.0% had probable major depression, 15.8% probable generalized anxiety disorder, 23.1% probable post-traumatic stress disorder, and 42.6% probable alcohol use disorder. Individual level themes included participants' personal health and self-care behaviors. Interpersonal level themes included the health of their social circle, family functioning, and social support. Organization level themes included their hospital's management, resources, patient care, routine, and teams. Themes in the community level included the media, scientific knowledge about COVID-19, morale, behavior, and support of health workers. Lastly, government and health system leadership and shelter-in-place policy were themes within the public policy level. Our findings provide insights into novel factors that have impacted health workers' wellbeing during the COVID-19 pandemic. These factors should be further explored to inform interventions and public policy that mitigate mental health morbidities among health workers during this and future outbreaks.


Assuntos
Alcoolismo/etiologia , Transtornos de Ansiedade/etiologia , Betacoronavirus , Infecções por Coronavirus/psicologia , Transtorno Depressivo/etiologia , Pessoal de Saúde/psicologia , Pandemias , Pneumonia Viral/psicologia , Transtornos de Estresse Pós-Traumáticos/etiologia , Adulto , Alcoolismo/epidemiologia , Transtornos de Ansiedade/epidemiologia , Relações Comunidade-Instituição , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Transtorno Depressivo/epidemiologia , Feminino , Comportamentos Relacionados com a Saúde , Política de Saúde , Humanos , Relações Interpessoais , Masculino , Modelos Teóricos , Estresse Ocupacional/epidemiologia , Estresse Ocupacional/etiologia , Questionário de Saúde do Paciente , Pneumonia Viral/epidemiologia , Determinantes Sociais da Saúde , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Estados Unidos
15.
Medicine (Baltimore) ; 99(39): e22375, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32991457

RESUMO

BACKGROUND: Depressive disorder has gradually become one of the most commonly reported disabling psychiatric complication that occurs after traumatic brain injury (TBI). Currently classical antidepressant medications may not have the same effectiveness in patients with TBI as in patients without TBI. Non-pharmacological interventions have been considered to be effective for managing depressive symptoms or treating depressive disorder. But to date the comparative effectiveness of various types of non-pharmacological interventions has been synthesized in few studies, the evidence remains inconclusive. Thus, the purpose of this systematic review and network meta-analyses is to summarize high-quality evidence and identify the most effective non-pharmacological intervention when applied to treat the depressive disorder in patients after TBI. METHODS: The comprehensive literature search in electronic database including PubMed, Ovid Medline, Cochrane Library, Web of Science database, Embase Database, China National Knowledge Infrastructure (CNKI), and Wanfang Data Chinese database from inception to the search date. Only high-quality randomized controlled trials (RCTs) that have used non-pharmacological interventions to treat depressive disorder after TBI will be considered. Two independent reviewers will identify eligible studies, extract and manage data information, and then determine methodical quality of included studies. Overall efficacy will be assessed as primary outcome. Secondary outcomes involved treatment response, remission rate, overall acceptability, tolerability of treatment, social functioning, occurrence of adverse events, and suicide-related outcome. Cochrane risk of bias assessment tool will be adopted to assess the risk of bias. Study heterogeneity will be measured by the I statistic. Traditional pairwise meta-analyses will be performed using STATA, while WinBUGS with GeMTC package of R software will be used to carry out network meta-analysis. RESULTS: This systematic review will examine the relative efficacy, effectiveness, safety, tolerability and acceptability of non-pharmacological interventions, and then to identify the most effective non-pharmacological intervention for depressive disorder after TBI. EXPECTED CONCLUSION: Our work could be used to give clinical recommendations for practice guideline developers, psychiatrist, neurologist, policymakers, researchers as well as individual with depressive disorder after TBI, and will also identify gaps in knowledge that could be the subject of future research. ETHICS AND DISSEMINATION: Neither ethics approval nor patient informed consent is necessary since this protocol was designed based on the existing literature. The results will be disseminated electronically or in print through publications in peer-reviewed scientific journal. INPLASY REGISTRATION: INPLASY202080022.


Assuntos
Lesões Encefálicas Traumáticas/complicações , Transtorno Depressivo/terapia , Transtorno Depressivo/etiologia , Humanos , Metanálise como Assunto , Revisões Sistemáticas como Assunto
16.
PLoS One ; 15(7): e0235570, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32614895

RESUMO

BACKGROUND: The association among psychological, neuropsychological dysfunctions and functional/clinical variables in Chronic Heart Failure (CHF) has been extensively addressed in literature. However, only a few studies investigated those associations in the older population. PURPOSE: To evaluate the psychological/neuropsychological profile of older CHF patients, to explore the interrelation with clinical/functional variables and to identify potential independent predictors of patients' functional status. METHODS: This study was conducted with a multi-center observational design. The following assessments were performed: anxiety (Hospital Anxiety and Depression Scale, HADS), depression (Geriatric Depression Scale, GDS), cognitive impairment (Addenbrooke's Cognitive Examination Revised, ACE-R), executive functions (Frontal Assessment Battery, FAB), constructive abilities (Clock Drawing Test, CDT), psychomotor speed and alternated attention (Trail Making Test, TMT-A/B), functional status (6-minute walking test, 6MWT) and clinical variables (New York Heart Association, NYHA; Brain Natriuretic Peptide, BNP; left ventricular ejection fraction, LVEF; left ventricular end diastolic diameter, LVEDD; left ventricular end diastolic volume, LVEDV; tricuspid annular plane systolic excursion, TAPSE). RESULTS: 100 CHF patients (mean age: 74.9±7.1 years; mean LVEF: 36.1±13.4) were included in the study. Anxious and depressive symptoms were observed in 16% and 24,5% of patients, respectively. Age was related to TMT-A and CDT (r = 0.49, p<0.001 and r = -0.32, p = 0.001, respectively), Log-BNP was related to ACE-R-Fluency subtest, (r = -0.22, p = 0.034), and 6MWT was related to ACE-R-Memory subtest and TMT-A (r = 0.24, p = 0.031 and r = -0.32, p = 0.005, respectively). Both anxiety and depression symptoms were related to ACE-R-Total score (r = -0.25, p = 0.013 and r = -0.32, p = 0.002, respectively) and depressive symptoms were related to CDT (r = -0.23, p = 0.024). At multiple regression analysis, Log-BNP and TMT-A were significant and independent predictors of functional status: worse findings on Log-BNP and TMT-A were associated with shorter distance walked at the 6MWT. CONCLUSIONS: Psychological and neuropsychological screening, along with the assessment of psychomotor speed (TMT-A), may provide useful information for older CHF patients undergoing cardiac rehabilitation.


Assuntos
Reabilitação Cardíaca , Insuficiência Cardíaca/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Ansiedade/etiologia , Doença Crônica , Estudos Transversais , Transtorno Depressivo/etiologia , Emoções , Feminino , Insuficiência Cardíaca/complicações , Humanos , Masculino , Peptídeo Natriurético Encefálico/metabolismo , Análise de Regressão , Volume Sistólico/fisiologia , Teste de Sequência Alfanumérica , Função Ventricular Esquerda/fisiologia , Teste de Caminhada
17.
PLoS One ; 15(6): e0235046, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32579566

RESUMO

Post-ictal emergence of slow wave EEG (electroencephalogram) activity and burst-suppression has been associated with the therapeutic effects of the electroconvulsive therapy (ECT), indicating that mere "cerebral silence" may elicit antidepressant actions. Indeed, brief exposures to burst-suppressing anesthesia has been reported to elicit antidepressant effects in a subset of patients, and produce behavioral and molecular alterations, such as increased expression of brain-derived neurotrophic factor (BDNF), connected with antidepressant responses in rodents. Here, we have further tested the cerebral silence hypothesis by determining whether repeated exposures to isoflurane anesthesia reduce depressive-like symptoms or influence BDNF expression in male Wistar outbred rats (Crl:WI(Han)) subjected to chronic mild stress (CMS), a model which is responsive to repeated electroconvulsive shocks (ECS, a model of ECT). Stress-susceptible, stress-resilient, and unstressed rats were exposed to 5 doses of isoflurane over a 15-day time period, with administrations occurring every third day. Isoflurane dosing is known to reliably produce rapid EEG burst-suppression (4% induction, 2% maintenance; 15 min). Antidepressant and anxiolytic effects of isoflurane were assessed after the first, third, and fifth drug exposure by measuring sucrose consumption, as well as performance on the open field and the elevated plus maze tasks. Tissue samples from the medial prefrontal cortex and hippocampus were collected, and levels of BDNF (brain-derived neurotrophic factor) protein were assessed. We find that isoflurane anesthesia had no impact on the behavior of stress-resilient or anhedonic rats in selected tests; findings which were consistent-perhaps inherently related-with unchanged levels of BDNF.


Assuntos
Antidepressivos/farmacologia , Transtorno Depressivo/prevenção & controle , Isoflurano/farmacologia , Estresse Psicológico/prevenção & controle , Anestésicos Inalatórios , Animais , Fator Neurotrófico Derivado do Encéfalo/metabolismo , Transtorno Depressivo/etiologia , Transtorno Depressivo/fisiopatologia , Modelos Animais de Doenças , Eletroconvulsoterapia/métodos , Eletroencefalografia , Eletrochoque/efeitos adversos , Hipocampo/efeitos dos fármacos , Hipocampo/metabolismo , Hipocampo/fisiopatologia , Humanos , Isoflurano/administração & dosagem , Masculino , Córtex Pré-Frontal/efeitos dos fármacos , Córtex Pré-Frontal/metabolismo , Córtex Pré-Frontal/fisiopatologia , Ratos Wistar , Estresse Psicológico/etiologia , Estresse Psicológico/fisiopatologia
18.
Psychol Trauma ; 12(5): 499-501, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32525391

RESUMO

A survey of 503 Israelis, performed in April 2020, found high levels of anxiety and risk for depression; these mental health issues were associated with several stressors connected with the coronavirus and related policies. However, only a small percentage of the sample received mental health care from a professional, with native-born Israelis less likely than recent immigrants to receive such care. Some possible initiatives based on these findings are suggested. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Transtornos de Ansiedade/psicologia , Betacoronavirus , Infecções por Coronavirus/psicologia , Transtorno Depressivo/psicologia , Pneumonia Viral/psicologia , Estresse Psicológico/psicologia , Transtornos de Ansiedade/etiologia , Infecções por Coronavirus/complicações , Transtorno Depressivo/etiologia , Humanos , Israel , Pandemias , Pneumonia Viral/complicações , Estresse Psicológico/etiologia
19.
Gene ; 754: 144817, 2020 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-32473965

RESUMO

Tanshinone IIA (Tan IIA) is reported to have neuroprotective effects to suppress cell apoptosis of cortical neurons induced by Aß25-35 through inhibiting oxidative stress. Nevertheless, few studies have investigated the effects of Tan IIA on depressive disorder. Here, we aimed to measure the effects of Tan IIA on chronic unpredictable mild stress (CUMS) induced mouse model and its underlying mechanism. For 28 days, mice were subjected to CUMS while Tan IIA was administered once daily at doses of 0, 1, 2.5, 5, or 10 mg/kg. CUMS exposure increased depressive-like behaviors, as indicated by increased immobility time in the forced swim and tail suspension tests, decreased sucrose preference in the sucrose preference test, and reduced exploratory behavior in the open field test. All of these behaviors were reversed dose-dependently by Tan IIA treatment. Oxidative stress was determined by measuring malondialdehyde, glutathione peroxidase, and superoxide dismutase activity and total antioxidant capacity. Levels of pro-inflammatory factors IL-1ß and IL-18, cAMP response element binding protein and brain derived neurotrophic factor were detected by ELISA and western blot assay, respectively. The results showed that CUMS increased oxidative stress and pro-inflammatory factors and decreased levels of cAMP response element binding protein and brain-derived neurotrophic factor. Tan IIA treatment again reversed these effects. Importantly, RasGRF1 expression increased in CUMS-exposed mice but decreased after Tan IIA administration. Using RasGRF1-/- mice to determine the role of RasGRF1 in mice exposed to CUMS, we found that knockdown of RasGRF1 reversed the effects of CUMS on mice, just like Tan IIA. These results indicate that Tan IIA may reverse depressive-like behaviors in CUMS-exposed mice by regulating RasGRF1.


Assuntos
Abietanos/farmacologia , Comportamento Animal/efeitos dos fármacos , Transtorno Depressivo/tratamento farmacológico , Inflamação/tratamento farmacológico , Estresse Psicológico/complicações , ras-GRF1/metabolismo , Animais , Anti-Inflamatórios não Esteroides/farmacologia , Transtorno Depressivo/etiologia , Transtorno Depressivo/patologia , Transtorno Depressivo/psicologia , Modelos Animais de Doenças , Feminino , Inflamação/etiologia , Inflamação/patologia , Inflamação/psicologia , Camundongos , Camundongos Endogâmicos C57BL , Estresse Oxidativo/efeitos dos fármacos , Natação , ras-GRF1/genética
20.
BMC Public Health ; 20(1): 617, 2020 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-32366283

RESUMO

BACKGROUND: Depression shows different patterns depending on socioeconomic status (SES) and metabolic syndrome (MS). However, the nature of this association remains poorly understood. The aim of this study was to examine whether the combination of MS and lower SES was associated with the prevalence of depression, based on data from the Korea National Health and Nutrition Examination Survey (KNHANES). METHODS: Data were obtained from a cross-sectional study of 24,102 adults (> 19 years of age) who participated in the KNHANES during 2008-2013 and for whom MS and depression data were available. MS was defined using the diagnostic criteria of the modified National Cholesterol Education Program Adult Treatment Panel III. Measure of depression was ascertained from self-reports of physician diagnosis. Multiple logistic regression analysis was used to evaluate the association between depression and MS as well as SES (alone and in combination). RESULTS: Overall, 622 of the 24,102 subjects (2.6%) met the criteria for depression. The prevalence of depression was associated with MS, a lower high-density lipoprotein cholesterol level, an elevated triglyceride level, a lower education level, and a lower household income. Participants with MS and a low SES had a higher likelihood of depression than those without MS and a high SES (odds ratio [OR] = 4.180 for low education level and OR = 3.994 for low household income level). CONCLUSIONS: This study suggests that the combination of SES and MS may play an important role in depression, which has implications for healthcare policy and depression management.


Assuntos
Transtorno Depressivo/etiologia , Disparidades nos Níveis de Saúde , Inquéritos Epidemiológicos/estatística & dados numéricos , Síndrome Metabólica/complicações , Síndrome Metabólica/epidemiologia , Classe Social , Adulto , Estudos Transversais , Transtorno Depressivo/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , República da Coreia/epidemiologia , Adulto Jovem
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