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1.
Int J Mol Sci ; 22(3)2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33572767

RESUMO

Sleep problems are frequently associated with the principal diagnostic criteria for many mental disorders. Alterations in the sleep of depressive patients are of high clinical significance because continuous sleep problems raise the chance of relapse, recurrence, or suicide, as well as the need for augmenting medications. Most antidepressants have been proven to influence the sleep architecture. While some classes of antidepressants improve sleep, others may cause sleep impairment. The successful treatment of depressive disorder also requires an understanding of the effects of antidepressants on sleep. This article briefly reviews the physiology of sleep and the typical alterations in the sleep architecture in depressive patients and updates the different effects of the majority of antidepressants including novel drugs in clinical practice on sleep. The summary of the updated scientific findings of the relationship between depression and sleep disturbances could be clinically beneficial in choosing the best medication for depressive patients with concurrent sleep disorders.


Assuntos
Antidepressivos/uso terapêutico , Transtorno Depressivo/complicações , Transtorno Depressivo/tratamento farmacológico , Transtornos do Sono-Vigília/complicações , Transtornos do Sono-Vigília/tratamento farmacológico , Sono/efeitos dos fármacos , Animais , Antidepressivos/farmacologia , Transtorno Depressivo/fisiopatologia , Humanos , Transtornos do Sono-Vigília/fisiopatologia
2.
Sci Rep ; 10(1): 22082, 2020 12 16.
Artigo em Inglês | MEDLINE | ID: mdl-33328497

RESUMO

Brain inflammation is one of hypotheses explaining complex pathomechanisms of depression. Angiotensin II (ANGII), which is associated with hypertension, also induces brain inflammation. However, there is no animal study showing the direct relationship between ANGII and depression. To address this issue, ANGII-containing osmotic pumps were implanted into adult male C57BL/6 mice subcutaneously for subacute (7 days) and chronic (at least 21 days) periods and behavioral and molecular analyses were conducted. Chronic infusion of ANGII into mice induced depressive-like behaviors, including the tail suspension test and forced swimming test, which were reversed by imipramine. Chronic infusion of ANGII also induced microglial activation in the hippocampus with increase of Il-1ß mRNA and decrease of Arg1 mRNA. In addition, chronic ANGII infusion activated the hypothalamic-pituitary-adrenal axis (HPA axis) and resulted in decreased hippocampal glucocorticoid receptor level. However, subacute ANGII infusion did not induce significant molecular and behavioral changes in mice compared to that of control. The molecular and behavioral changes by chronic ANGII infusion were reversed by co-treatment of minocycline or telmisartan. In addition, ANGII treatment also induced the pro-inflammatory changes in BV-2 microglial cells. Our results indicate that ANGII can induce depressive-like behaviors via microglial activation in the hippocampus and HPA axis hyperactivation in mice. These might suggest possible mechanism on depressive symptom in chronic hypertensive state.


Assuntos
Angiotensina II/farmacologia , Comportamento Animal/efeitos dos fármacos , Transtorno Depressivo/genética , Interleucina-1beta/genética , Estresse Psicológico/genética , Angiotensina II/efeitos adversos , Animais , Transtorno Depressivo/induzido quimicamente , Transtorno Depressivo/fisiopatologia , Modelos Animais de Doenças , Elevação dos Membros Posteriores , Hipocampo/efeitos dos fármacos , Hipocampo/patologia , Humanos , Sistema Hipotálamo-Hipofisário/efeitos dos fármacos , Camundongos , Camundongos Endogâmicos C57BL , Microglia/efeitos dos fármacos , Sistema Hipófise-Suprarrenal/efeitos dos fármacos , Estresse Psicológico/induzido quimicamente , Estresse Psicológico/fisiopatologia
3.
Life Sci ; 257: 118047, 2020 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-32629001

RESUMO

AIM: The purpose of the study was to investigate what effects the sigma-1 receptor (S1R) could exert on the cardiac myocyte ion channels in a rodent model of depression and to explore the underlying mechanisms since depression is an independent risk factor for cardiovascular diseases including ventricular arrhythmias (VAs). MATERIALS AND METHODS: To establish the depression model in rats, chronic mild unpredictable stress (CMUS) for 28 days was used. The S1R agonist fluvoxamine was injected intraperitoneally from the second week to the last week for 21 days in total, and the effects were evaluated by patch clamp, western blot analysis, and Masson staining. KEY FINDINGS: We demonstrated that depression was improved after treatment with fluvoxamine. In addition, the prolongation of the corrected QT (QTc) interval under CMUS that increased vulnerability to VAs was significantly attenuated by stimulation of S1R due to the decreased amplitude of L-type calcium current (ICa-L) and the restoration of reduced transient outward potassium current (Ito) resulting from CMUS induction. The S1R also decelerated Ito inactivation and accelerated Ito recovery by activating Ca2+/calmodulin-dependent kinase II. Moreover, the stimulation of S1R ameliorated the structural remodeling as the substrate for maintenance of VAs. All these effects were abolished by the administration of S1R antagonist BD1047, which verified the roles for S1R. SIGNIFICANCE: Activation of S1R could decrease the vulnerability to VAs by inhibiting ICa-L and restoring Ito, in addition to ameliorating the CMUS-induced depressive symptoms and structural remodeling.


Assuntos
Depressão/metabolismo , Miócitos Cardíacos/metabolismo , Receptores sigma/fisiologia , Potenciais de Ação/efeitos dos fármacos , Animais , Arritmias Cardíacas/metabolismo , Depressão/fisiopatologia , Transtorno Depressivo/metabolismo , Transtorno Depressivo/fisiopatologia , Modelos Animais de Doenças , Fluvoxamina/metabolismo , Fluvoxamina/farmacologia , Ventrículos do Coração/efeitos dos fármacos , Canais Iônicos/efeitos dos fármacos , Canais Iônicos/metabolismo , Masculino , Ratos , Ratos Sprague-Dawley , Receptores sigma/metabolismo , Remodelação Ventricular/efeitos dos fármacos , Remodelação Ventricular/fisiologia
4.
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
5.
Am J Psychiatry ; 177(5): 381-390, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32354265

RESUMO

The search for more effective treatments for depression is a long-standing primary objective in both psychiatry and translational neuroscience. From initial models centered on neurochemical deficits, such as the monoamine hypothesis, research toward this goal has shifted toward a focus on network and circuit models to explain how key nodes in the limbic system and beyond interact to produce persistent shifts in affective states. To build these models, researchers have turned to two complementary approaches: neuroimaging studies in human patients (and their healthy counterparts) and neurophysiology studies in animal models, facilitated in large part by optogenetic and chemogenetic techniques. As the authors discuss, functional neuroimaging studies in humans have included largely task-oriented experiments, which have identified brain regions differentially activated during processing of affective stimuli, and resting-state functional MRI experiments, which have identified brain-wide networks altered in depressive states. Future work in this area will build on a multisite approach, assembling large data sets across diverse populations, and will also leverage the statistical power afforded by longitudinal imaging studies in patient samples. Translational studies in rodents have used optogenetic and chemogenetic tools to identify not just nodes but also connections within the networks of the limbic system that are both critical and permissive for the expression of motivated behavior and affective phenotypes. Future studies in this area will exploit mesoscale imaging and multisite electrophysiology recordings to construct network models with cell-type specificity and high statistical power, identifying candidate circuit and molecular pathways for therapeutic intervention.


Assuntos
Transtorno Depressivo/fisiopatologia , Animais , Modelos Animais de Doenças , Previsões , Humanos , Sistema Límbico , Estudos Longitudinais , Imagem por Ressonância Magnética , Rede Nervosa , Vias Neurais
7.
J Neuroinflammation ; 17(1): 54, 2020 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-32050990

RESUMO

Transcutaneous auricular vagus nerve stimulation (taVNS) is a relatively non-invasive alternative treatment for patients suffering from major depressive disorder (MDD). It has been postulated that acupuncture may achieve its treatment effects on MDD through suppression of vagal nerve inflammatory responses. Our previous research established that taVNS significantly increases amygdala-dorsolateral prefrontal cortex connectivity, which is associated with a reduction in depression severity. However, the relationship between taVNS and the central/peripheral functional state of the immune system, as well as changes in brain neural circuits, have not as yet been elucidated. In the present paper, we outline the anatomic foundation of taVNS and emphasize that it significantly modulates the activity and connectivity of a wide range of neural networks, including the default mode network, executive network, and networks involved in emotional and reward circuits. In addition, we present the inflammatory mechanism of MDD and describe how taVNS inhibits central and peripheral inflammation, which is possibly related to the effectiveness of taVNS in reducing depression severity. Our review suggests a link between the suppression of inflammation and changes in brain regions/circuits post taVNS.


Assuntos
Encéfalo/fisiopatologia , Transtorno Depressivo/terapia , Rede Nervosa/fisiopatologia , Estimulação do Nervo Vago , Transtorno Depressivo/fisiopatologia , Humanos
8.
Psychiatr Clin North Am ; 43(1): 139-151, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32008680

RESUMO

Interest in the coexistence of manic and depressive symptoms fostered hypotheses on neurobiological underpinnings of mixed states. Neurobiological properties of mixed states, however, have not been comprehensively described. The authors searched databases for articles on neurobiological markers related to mixed states. Results showed that mixed states are characterized by elevated central and peripheral monoamine levels, greater alterations in hypothalamic-pituitary-adrenal axis, increased inflammation, and greater circadian rhythms dysfunction than nonmixed forms. Furthermore, the magnitude of pathophysiologic alterations in mixed states exceeds those associated with nonmixed mania or depression and suggest that hyperactivation and hyperarousal are core features of mixed states.


Assuntos
Transtorno Bipolar/fisiopatologia , Transtorno Depressivo/fisiopatologia , Animais , Biomarcadores , Ritmo Circadiano , Depressão/fisiopatologia , Humanos , Sistema Hipotálamo-Hipofisário/fisiopatologia , Camundongos , Sistema Hipófise-Suprarrenal/fisiopatologia
9.
Adv Exp Med Biol ; 1191: 35-59, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32002921

RESUMO

Electrocortical network dynamics are integral to brain function. Linear and nonlinear connectivity applications enrich neurophysiological investigations into anxiety disorders. Discrete EEG-based connectivity networks are unfolding with some homogeneity for anxiety disorder subtypes. Attenuated delta/theta/beta connectivity networks, pertaining to anterior-posterior nodes, characterize panic disorder. Nonlinear measures suggest reduced connectivity of ACC as an executive neuro-regulator in germane "fear circuitry networks" might be more central than considered. Enhanced network complexity and theta network efficiency at rest define generalized anxiety disorder, with similar tonic hyperexcitability apparent in social anxiety disorder further extending to task-related/state functioning. Dysregulated alpha connectivity and integration of mPFC-ACC/mPFC-PCC relays implicated with attentional flexibility and choice execution/congruence neurocircuitry are observed in trait anxiety. Conversely, state anxiety appears to recruit converging delta and beta connectivity networks as panic, suggesting trait and state anxiety are modulated by discrete neurobiological mechanisms. Furthermore, EEG connectivity dynamics distinguish anxiety from depression, despite prevalent clinical comorbidity. Rethinking mechanisms implicated in the etiology, maintenance, and treatment of anxiety from the perspective of EEG network science across micro- and macroscales serves to shed light and move the field forward.


Assuntos
Transtornos de Ansiedade/fisiopatologia , Encéfalo/fisiopatologia , Eletroencefalografia , Rede Nervosa , Transtornos de Ansiedade/diagnóstico , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/fisiopatologia , Medo , Humanos
10.
J Clin Psychiatry ; 81(2)2020 02 11.
Artigo em Inglês | MEDLINE | ID: mdl-32074414

RESUMO

OBJECTIVE: The cognitive theory of suicide postulates that hopelessness is an essential precondition for suicidal ideation in patients with depressive disorder . However, the explanatory power and predictive value of hopelessness for suicidal ideation remain uncertain. METHODS: From 1997 to 2007, patients with depressive disorder who were cohorts from the Vantaa Depression Studies (n = 406) completed the Scale for Suicide Ideation (SSI), Beck Hopelessness Scale (BHS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Perceived Social Support Scale-Revised (PSSS-R), and Eysenck Personality Inventory-Q (EPI-Q) at baseline, 6 and 18 months, and 5 years. We conducted a mixed-effects generalized linear regression and clustered receiver-operating characteristics analysis to test how well BDI and BHS predict severe suicidal ideation within and between patients. RESULTS: BHS predicted clinically significant suicidal ideation (odds ratio [OR] = 2.8), explaining 13.1% of between-patient and and 3.5% of within-patient variance of SSI. Adjusting for the fixed effect of BDI removed a substantial part of the effect of BHS on SSI (adjusted OR = 1.38, P = .018). BAI moderated the effect of BHS on SSI, whereas EPI-Q and PSSS-R did not. BDI detected suicidal ideation more accurately (area under the receiver-operating characteristics curve [AUC] = 0.846) than BHS (AUC = 0.754). CONCLUSIONS: In patients with depressive disorder, hopelessness explains suicidal ideation, but largely because it covaries with depressive symptoms. The role of hopelessness as a central determinant of suicidal ideation in depression may have been overestimated. Symptoms of anxiety moderate the association between hopelessness and suicidal ideation. Severity of depressive symptoms may predict suicidal ideation more accurately than hopelessness.


Assuntos
Ansiedade/fisiopatologia , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/fisiopatologia , Esperança , Escalas de Graduação Psiquiátrica/normas , Ideação Suicida , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença
11.
Artigo em Russo | MEDLINE | ID: mdl-32105269

RESUMO

AIM: To study neurophysiological processes during multichannel electrostimulation in patients with depressive disorder. MATERIAL AND METHODS: The study involved 6 patients with depressive disorder (F33). The technology noninvasive multichannel stimulation of neck neural struct SYMPATHOKOR-01 device. Clinical and psychometric methods, functional neuroimaging (fMRTP) and multichannel electroencephalography (EEG) were used to assess treatment effect. RESULTS: In all patients, fMRTP and EEG results show the disturbances of brain connectivity, which are correlated with the clinical state of the disease, before treatment. After five stimulation procedures, there is an increase in functional connection of the medial prefrontal cortex (according to rs-fMRI results) and an increase in the synchronization of various parts of the cortex (EEG results). CONCLUSION: The results demonstrate the possibilities of multichannel electrical stimulation of the neck nervous structures to restore the intracerebral connections disturbed during depression due to the activation of neuroplasticity.


Assuntos
Encéfalo/patologia , Encéfalo/fisiopatologia , Transtorno Depressivo/fisiopatologia , Transtorno Depressivo/terapia , Terapia por Estimulação Elétrica , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico , Transtorno Depressivo/diagnóstico por imagem , Transtorno Depressivo/patologia , Eletroencefalografia , Humanos , Imagem por Ressonância Magnética , Plasticidade Neuronal
12.
J Clin Neurosci ; 74: 25-31, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31982276

RESUMO

OBJECTIVE: This study wants to test whether the heart rate variability (HRV) analysis using sphygmomanometers can effectively reflect the physical and emotional distress of somatic symptom disorder (SSD) cases and assist in further health management. METHODS: This study includes 66 female SSD cases and 32 male SSD cases. All cases received a 200-second blood pressure (BP) measurement, after which the numerical figure for the heart rate was obtained from the BP signal for HRV analysis. All cases also filled out Patient Health Questionnaire-15 (PHQ-15), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI) to understand the extent of their somatic distress, depression, and anxiety. The relationship between psychological conditions and HRV indicators are examined statistically. Receiver operating characteristic (ROC) curve analysis was used to understand whether HRV indicators can assist in the determination of psychosomatic problems. RESULTS: Considering all and female SSD cases, low-frequency power (LF) and PHQ-15 in the HRV index have the most significant correlations. In male SSD cases, root mean square of successive NN interval differences (RMSSD) and BDI-II have the highest correlations. The results of ROC curve analysis indicate that LF is useful to judge the severity of female SSD cases, while RMSSD has reference value in determining whether male patients of SSD cases have depression or not. In addition, physical stress index (PSI) can also help determine the degree of depression in male SSD cases. CONCLUSION: The use of BP in HRV analysis can help in the monitoring of somatic distress and depression issues in SSD cases. LF, RMSSD, PSI are potential physiological indicators.


Assuntos
Sistema Nervoso Autônomo/fisiopatologia , Determinação da Pressão Arterial , Frequência Cardíaca/fisiologia , Sintomas Inexplicáveis , Adulto , Transtornos de Ansiedade/fisiopatologia , Transtorno Depressivo/fisiopatologia , Emoções , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
14.
Artigo em Inglês | MEDLINE | ID: mdl-31947739

RESUMO

Research shows that adolescents with mental illnesses have a bias for processing negative facial emotions, and this may play a role in impaired social functioning that often co-exists with a mental health diagnosis. This study examined associations between psychological and somatic problems and facial emotion recognition in early adolescence; as any processing biases in this age-group may be an early indicator of later mental illnesses. A community sample of 40 12-year-olds self-rated their symptoms of anxiety, depression, and somatization via two mental health screeners. They also completed a computerized emotion recognition task in which they identified photographs of 40 faces showing expressions of anger, fear, sadness, happiness, or neutral expression. Results showed that increased symptoms of anxiety, depression, and somatization were significantly associated with fewer correct responses to angry expressions. These symptoms were also associated with faster and more accurate recognition of fearful expressions. However, there was no association between mental health and recognition of sad affect. Finally, increased psychological and/or somatic symptomology was also associated with better identification of neutral expressions. In conclusion, youth with increased psychological and/or somatic problems exhibited a processing bias for negative anger and fear expressions, but not sadness. They showed better processing of neutral faces than youth with fewer psychological and/or somatic problems. Findings are discussed in relation to indicators of mental illnesses in early adolescence and the potential underpinning neural mechanisms associated with mental health and emotional facial recognition.


Assuntos
Comportamento do Adolescente/fisiologia , Comportamento do Adolescente/psicologia , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/fisiopatologia , Emoções/fisiologia , Reconhecimento Facial/fisiologia , Reconhecimento Psicológico/fisiologia , Adolescente , Criança , Expressão Facial , Feminino , Humanos , Masculino , Valor Preditivo dos Testes
15.
Cyberpsychol Behav Soc Netw ; 23(2): 119-125, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31923362

RESUMO

Video games are a leisure activity with mass appeal for individuals of all ages. However, for some individuals, playing video games may become problematic and addictive, resulting in negative consequences affecting their physical, social, and psychological well-being. Internet gaming disorder (IGD) has estimated prevalence rates of around 3 percent and has been strongly associated with several psychopathologies, including depression. Given that emotion regulation (ER) and mindfulness are fluid constructs that can be enhanced, the potential for intervention and prevention is considerable. Thus, this study sought to, as a first step in determining clinical relevance, explore the differences in ER, mindfulness, and impulsivity among emerging adult gamers who met criteria for IGD, depression, or both IGD and depression (Dep + IGD). A sample of 1,536 gamers (45 percent male, Mage = 20.45 years old) completed an online survey, including an assessment for IGD, depression, difficulties with ER, impulsivity, and mindfulness. Relative to individuals below IGD and depression cutoffs (control), the clinical groups (IGD, depression, and Dep + IGD) reported greater ER difficulties, higher impulsivity, and lower mindfulness. Finally, relative to the IGD + depression group, the other two clinical groups had fewer difficulties with cognitive impulsivity, whereas the depression group reported more difficulties with strategy use. These results suggest that gamers should be considered a heterogeneous group and that comorbid disorders are important considerations when developing targeted treatments for individuals with IGD.


Assuntos
Comportamento Aditivo/fisiopatologia , Depressão/fisiopatologia , Transtorno Depressivo/fisiopatologia , Regulação Emocional/fisiologia , Comportamento Impulsivo/fisiologia , Atenção Plena , Jogos de Vídeo , Adulto , Comportamento Aditivo/epidemiologia , Comorbidade , Depressão/epidemiologia , Transtorno Depressivo/epidemiologia , Feminino , Humanos , Masculino , Adulto Jovem
16.
Biol Res Nurs ; 22(2): 178-187, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31867989

RESUMO

PURPOSE: Patients with Type 2 diabetes (T2D) have increased risk of depression and anxiety. Evidence suggests that a heightened inflammatory state may contribute to this association. Females experience more depression and higher inflammation levels than males. This study compared associations of serum high-sensitivity C-reactive protein (hs-CRP) levels with symptoms of depression and anxiety between men and women with Type 2 diabetes mellitus (T2DM). METHOD: Cross-sectional data including demographic and disease characteristics, symptoms of depression and anxiety, clinical data, and laboratory values were collected from 392 patients with T2DM recruited from a general hospital in Shandong Province, China. We evaluated associations between serum hs-CRP level and symptoms of depression and anxiety in males and females separately using multiple linear regressions and χ2 tests for trend. RESULTS: Sex moderated the association between serum hs-CRP level and symptoms of depression (B = .112 [SE = 0.049]; p = .022) and anxiety (B = .137 [SE = 0.053]; p = .011). Among females, hs-CRP level was positively associated with depression (B = .034, 95% confidence interval [CI] = [.006, .061]; p = .016, false discovery rate [FDR]-adjusted p = .020) and anxiety (B = .041, 95% CI [.011, .071], p = .007, FDR-adjusted p = .007). Positive trends indicated a higher prevalence of clinically significant symptoms of depression and anxiety in higher serum hs-CRP categories in females. No associations were found in males. CONCLUSION: Findings demonstrate that associations between serum hs-CRP level and symptoms of depression and anxiety in patients with T2D are sex-specific, with only females demonstrating a significant positive association.


Assuntos
Transtornos de Ansiedade/etiologia , Proteína C-Reativa/análise , Transtorno Depressivo/etiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/fisiopatologia , Inflamação/complicações , Inflamação/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Transtornos de Ansiedade/fisiopatologia , China , Estudos Transversais , Transtorno Depressivo/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Fatores Sexuais
17.
Psychiatry Res ; 284: 112687, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31740213

RESUMO

Psychomotor symptoms of depression are understudied despite having a severe impact on patient outcomes. This review aims to summarize the evidence on motor features of depression assessed with instrumental procedures, and examine age-related differences. We included studies investigating posture, balance and gait ascertained with instrumental measurements among individuals with depressive symptoms or disorders. Studies on subjects with specific physical illnesses were excluded. Methodological quality was assessed with the Newcastle - Ottawa Scale (NOS) and PRISMA guidelines were followed. 33 studies (13 case-control, five cross-sectional, nine longitudinal and six intervention) with overall low-medium quality were included. Different instruments were employed to assess posture (e.g. digital cameras), balance (balance, stepping platform) or gait (e.g. Six-Minute-Walking Test, instrumented walkways). Results suggest that depression in adults is associated with significant impairments of posture, balance and gait. Motor abnormalities among depressed older adults may depend on the interplay of physical diseases, cognitive impairment and mood. Very few intervention studies measured motor symptoms as outcome. Available evidence suggests, however, that antidepressant drugs and physical exercise may be beneficial for motor abnormalities. Despite the lack of high-quality studies, instrumental assessments confirm the presence and importance of motor abnormalities in depression, with potential age-related differences in their pathophysiology.


Assuntos
Transtorno Depressivo/fisiopatologia , Transtorno Depressivo/psicologia , Marcha/fisiologia , Equilíbrio Postural/fisiologia , Antidepressivos/farmacologia , Antidepressivos/uso terapêutico , Estudos de Casos e Controles , Estudos Transversais , Transtorno Depressivo/terapia , Exercício Físico/fisiologia , Exercício Físico/psicologia , Marcha/efeitos dos fármacos , Humanos , Estudos Longitudinais , Equilíbrio Postural/efeitos dos fármacos
18.
Psychiatry Res ; 285: 112713, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31810745

RESUMO

The purpose of this study was to investigate the changes in resting-state brain functional network connectivity (FNC) in young depressed patients with and without suicidal behavior, and the relationship between FNC and suicidal attempts in depressed youths using resting-state fMRI (RS-fMRI). We conducted independent component analysis (ICA) to identify intrinsically connected neural networks and analyze the alterations of intra- and inter-network connectivity using FNC analysis in 35 depressed youth with suicidal attempts (SU group), 18 patients without suicidal attempts (NSU group) and 47 healthy controls (HC), and investigate brain-behavior associations between the FNC coefficients and clinical behavior in the SU group. SU group showed significantly decreased internetwork connectivity between anterior default mode network (aDMN) and salience network (SN), as well as the right frontal-parietal network (rFPN). However, the internetwork connectivity between the SN and rFPN in SU group was higher than that in NSU group. Moreover, decreased aDMN-rFPN connectivity was negatively correlated with BHS scores, and the differences in SN-rFPN and aDMN-pDMN connectivity were negatively associated with the HAMD score in the SU group. Our findings may provide new insights into the patterns of functional organization in the brain of suicidal depressed patients.


Assuntos
Encéfalo/diagnóstico por imagem , Transtorno Depressivo/diagnóstico por imagem , Transtorno Depressivo/psicologia , Imagem por Ressonância Magnética/métodos , Rede Nervosa/diagnóstico por imagem , Tentativa de Suicídio/psicologia , Adolescente , Adulto , Encéfalo/fisiopatologia , Mapeamento Encefálico/métodos , Transtorno Depressivo/fisiopatologia , Feminino , Humanos , Masculino , Rede Nervosa/fisiopatologia , Ideação Suicida , Adulto Jovem
19.
Clin Rehabil ; 34(2): 170-181, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31608676

RESUMO

OBJECTIVE: To evaluate feasibility and potential effectiveness of work-directed rehabilitation in people with common mental disorders. DESIGN: Pilot randomized controlled trial. SETTING: Primary healthcare, Sweden. SUBJECTS: Working adults (n = 42) of mean age 46.2 ± 11.1 years with depression or anxiety disorder. INTERVENTIONS: Eight weeks of work-directed rehabilitation (n = 21) or physical activity (n = 21). Work-directed rehabilitation included sessions with a physiotherapist and/or an occupational therapist, to develop strategies to cope better at work. Physical activity included a planning session and access to a local gym. MAIN MEASURES: Feasibility: attendance, discontinuation and adverse events. Measurements were the Work Ability Index, the Global Assessment of Functioning, the Montgomery-Asberg Depression Rating Scale, the Beck Anxiety Inventory and the World Health Organization-Five Well-Being Index. RESULTS: Attendance to rehabilitation sessions was 88% (n = 147/167) and discontinuation rate was 14% (n = 3/21). No serious adverse events were reported. Within both groups, there was a significant improvement in Work Ability Index score (mean change: 3.6 (95% confidence interval (CI): 0.45, 6.7) in work-directed rehabilitation and 3.9 (95% CI: 0.9, 7.0) in physical activity) with no significant difference between groups. For the other outcomes, significant improvements were found within but not between groups. Per-protocol analysis showed a trend toward the antidepressant effect of work-directed rehabilitation compared to physical activity (mean difference in depression score -3.1 (95% CI: -6.8, 0.4), P = 0.075). CONCLUSION: Work-directed rehabilitation was feasible to persons with common mental disorders and improved their work ability and mental health. Comparable improvements were seen in the physical activity group. Suggested modifications for a larger trial include adding a treatment-as-usual control.


Assuntos
Transtornos de Ansiedade/reabilitação , Transtorno Depressivo/reabilitação , Terapia por Exercício/métodos , Exercício Físico , Saúde Mental , Adulto , Transtornos de Ansiedade/fisiopatologia , Transtornos de Ansiedade/psicologia , Transtorno Depressivo/fisiopatologia , Transtorno Depressivo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Qualidade de Vida , Suécia , Avaliação da Capacidade de Trabalho
20.
J Adv Nurs ; 76(2): 566-576, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31713885

RESUMO

AIM: To identify the associations among posttraumatic stress, depressive and obsessive-compulsive symptoms (OCS) in outpatients with psychological trauma and to examine the mediating effect of social provision. BACKGROUND: Psychologically traumatized patients simultaneously experience depressive and OCS. Social provision may mediate multiple symptoms differently compared with social support. DESIGN: Cross-sectional and correlational study. METHODS: Data were collected between August 2016-May 2017. Psychiatric outpatients (N = 151) completed a structured questionnaire consisting of the Korean versions of the Social Provision Scale, Beck Depression Inventory-II, Maudsley Obsessional-Compulsive Inventory and Impact of Event Scale-Revised. Structural equation modelling was used to examine the recursive association among the three symptoms and the mediation of social provision. RESULTS: There was a recursive association between posttraumatic stress symptoms (PTSS) and depressive symptoms, which were simultaneously associated with OCS with a one-way direction. OCS and social provision partially mediated these identified associations among three symptoms. CONCLUSIONS: Our findings provide insight into the complex associations of multiple symptoms experienced by traumatized outpatients and the partial mediation of social provision. Psychiatric and mental health professionals may enhance social functioning and interpersonal interactions based on social provision components used for helping traumatized patients with obsessive-compulsive and depressive symptoms. IMPACT: There was a recursive association between PTSS and depressive symptoms that were simultaneously associated with OCS with a one-way direction. Social provision functions as a partial mediator when working with OCS. Mental health nurses can develop social provision interventions for depressive symptoms for traumatized outpatients with OCS.


Assuntos
Transtorno Depressivo/fisiopatologia , Transtorno Depressivo/psicologia , Transtorno Obsessivo-Compulsivo/fisiopatologia , Transtorno Obsessivo-Compulsivo/psicologia , Transtornos de Estresse Pós-Traumáticos/fisiopatologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Ferimentos e Lesões/psicologia , Adolescente , Adulto , Idoso , Estudos Transversais , Transtorno Depressivo/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/epidemiologia , Escalas de Graduação Psiquiátrica , República da Coreia/epidemiologia , Classe Social , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Inquéritos e Questionários , Adulto Jovem
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