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1.
Postgrad Med ; 131(7): 438-444, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31482756

RESUMO

Pain is a subjective experience that is influenced by genetics, gender, social, cultural and personal parameters. Opposed to chronic pain, which by definition has to last for at least 3 months, acute pain is mostly because of trauma, acute medical conditions or treatment. The link between mood disorders and acute pain has proven to be increasingly significant since the link is bi-directional, and both act as risk factors for each other. Depression and anxiety are associated with increased perception of pain severity, whereas prolonged duration of acute pain leads to increased mood dysregulation. Although both depression and anxiety have a proven association with acute pain, the link between depression and acute pain is more thoroughly studied. Pain can be the presenting or sole complaint in depressed patients who present to primary care practices and is often overlooked by clinicians. However, reports on the perception of experimentally-induced pain in depressed patients are mixed, showing both an increased and decreased pain threshold and pain tolerance across various studies. Although less data is published about anxiety and pain, the relationship is consistent across studies as increased anxiety leads to increased severity of pain perceived and decreased pain tolerance. Anxiety as well as fear, stress, and catastrophizing are also shown to be mediators in the causal pathway between pain and disability.


Assuntos
Dor Aguda/psicologia , Transtornos de Ansiedade/psicologia , Transtorno Depressivo/psicologia , Dor Aguda/epidemiologia , Dor Aguda/fisiopatologia , Dor Aguda/terapia , Analgésicos/uso terapêutico , Antidepressivos/uso terapêutico , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/fisiopatologia , Transtornos de Ansiedade/terapia , Catastrofização/epidemiologia , Catastrofização/fisiopatologia , Catastrofização/psicologia , Terapia Cognitivo-Comportamental , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/fisiopatologia , Transtorno Depressivo/terapia , Humanos , Manejo da Dor , Limiar da Dor , Índice de Gravidade de Doença
2.
Psychiatr Danub ; 31(Suppl 3): 632-637, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488805

RESUMO

Gender differences in the prevalence, experiences and presentations of mental illnesses are well-known and are reflected in research findings, clinical practice, society and popular culture. This paper will compare and contrast the role that gender and other factors play in the portrayals of depressive illness in two acclaimed texts, 'The Bell Jar' by Sylvia Plath and, 'Darkness Visible' by William Styron.


Assuntos
Transtorno Depressivo/psicologia , Literatura Moderna , Cultura Popular , Sexismo , Feminino , Humanos , Masculino , Fatores Sexuais
3.
Am J Psychother ; 72(3): 67-74, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31533456

RESUMO

Using data from 202 patients with depression, the authors conducted a psychometric evaluation of the Dutch translation of the Competencies of Cognitive Therapy Scale-Self-Report and an initial psychometric evaluation of the newly developed Interpersonal Psychotherapy Skills Scale-Self-Report.


Assuntos
Terapia Cognitivo-Comportamental/educação , Depressão/psicologia , Depressão/terapia , Transtorno Depressivo/psicologia , Transtorno Depressivo/terapia , Adulto , Feminino , Humanos , Masculino , Psicometria , Autorrelato
4.
Artigo em Russo | MEDLINE | ID: mdl-31464298

RESUMO

This literature review considers meta-analyzes, systematic reviews and original research over the last decade addressing a comprehensive analysis of the antidepressant effect of targeted physical exercise and physical activity in general. Exercise is a promising non-pharmacological treatment for depression, showing effects that are comparable or may even exceed other first-line treatments of depression. The article introduces modern ideas about the mechanisms of depression and mechanisms of exercise effects on depression manifestations. The structures of the central nervous system, changing with the effective exercise-based treatment of depression, are indicated. Physical activity stimulates the secretion of growth factors, maintenance of angio-, synapto-, and neurogenesis. The regulation of antioxidant protection of neuronal mitochondria, a decrease in pro-inflammatory reactions and stress reactivity are also observed in response to regular exercise. Physical activity has a multimodal effect that stimulates biochemical pathways and restores neuronal structures disturbed in depression.


Assuntos
Depressão , Transtorno Depressivo , Terapia por Exercício , Antidepressivos , Depressão/psicologia , Depressão/terapia , Transtorno Depressivo/psicologia , Transtorno Depressivo/terapia , Exercício , Humanos , Neurogênese
5.
Psychiatr Hung ; 34(2): 199-213, 2019.
Artigo em Húngaro | MEDLINE | ID: mdl-31417008

RESUMO

The study deals with the psychiatric treatment of the writer with a tragic fate, Sylvia Plath. Sylvia's treatment began with electroconvulsive therapy for suicidal thoughts at the age of 20 and soon afterended up in hospital for an attempted suicide with sleeping pills to McLean Hospital.Her treatment was trusted on Doctor Ruth Beuscher with whom she's been remaining in touch directlyor indirectly (phone, mail) all her life. At the age of 30 she passed away committing suicide at her flatin London after having been treated with antidepressant for her assumably psychotic depression.In the article we provide an insight to the main therapeutic events of Sylvia's treatment and invitethe colleagues for an imaginary experiment based on modern knowledge and family system approach with a trauma focus (on theory of structural dissociation)- hoping it provides us with a conclusionto use in the treatment of suicidal patients.


Assuntos
Criatividade , Transtorno Depressivo/psicologia , Transtorno Depressivo/terapia , Poesia como Assunto/história , Suicídio/história , Suicídio/psicologia , Eletroconvulsoterapia , Feminino , Pesar , História do Século XX , Humanos , Ideação Suicida , Suicídio/prevenção & controle
6.
Artigo em Russo | MEDLINE | ID: mdl-31317903

RESUMO

AIM: To study structural correlates of apathy in patients with late-life depression. MATERIAL AND METHODS: Thirty-five patients (≥60 y.o.) with late-onset depression and 22 age-matched healthy volunteers underwent high resolution brain MRI-scanning, and a comprehensive neuropsychiatric examination including HAM-D and the Apathy Scale. RESULTS AND CONCLUSION: A morphometric analysis showed that apathy was associated with atrophy of the lateral prefrontal cortex and reduced grey matter volume of the caudate nucleus on the right, and the nucleus accumbens on the left. Depression correlated with reduced thickness of the medial orbitofrontal cortex bilaterally, rostral anterior cingulate gyrus on the left, isthmus cingulate gyrus on the right, and larger surface area of the entorhinal cortex. Total grey matter volume, grey/white matter volumes of the cerebellum, and cortical thickness in temporal and occipital regions were negatively correlated with both apathy and depression severity. Thus, atrophy of basal ganglia and lateral prefrontal cortex, well known neuroanatomical correlates of apathy in different psychiatric and neurological conditions, characterized it in late-life depression too. This supports the idea of independent pathophysiology of apathetic syndrome.


Assuntos
Apatia , Depressão , Transtorno Depressivo , Substância Branca , Encéfalo/diagnóstico por imagem , Depressão/complicações , Depressão/psicologia , Transtorno Depressivo/complicações , Transtorno Depressivo/psicologia , Giro do Cíngulo , Humanos , Imagem por Ressonância Magnética
7.
East Asian Arch Psychiatry ; 29(1): 20-25, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31237253

RESUMO

OBJECTIVES: This study aimed (1) to determine the prevalence of anxiety, depression, and TMJ osseous changes in elderly Vietnamese according to sex and residence, and (2) to investigate the association of temporomandibular joint (TMJ) osseous changes with anxiety, depression, and limitation of mandibular function. METHODS: Elderly people living in Danang, Vietnam were recruited. Participants were screened for anxiety and depression using the self-reported 7-item Generalized Anxiety Disorder Scale (GAD-7) and 9-item Patient Health Questionnaire (PHQ-9), respectively. Participants then self-rated the limitation of their mandibular function using the 20-item Jaw Functional Limitation Scale (JFLS-20) questionnaire. TMJ osseous changes (erosion, flattening, osteophytes, and sclerosis) were evaluated using digital orthopantomography. RESULTS: Of 179 participants aged 65 to 74 years, 17.9% and 35.8% had anxiety and depression symptoms, respectively. Compared with urban residents, rural residents had higher prevalence of anxiety (23.3% vs 12.4%, p = 0.009) and depression (46.62% vs 24.7%, p = 0.019). The prevalence of TMJ osseous changes was 58.1%. The most common TMJ osseous change was flattening (41.3%), followed by erosion (34.6%), sclerosis (16.2%), and osteophytes (7.8%). Participants with or without TMJ osseous changes were comparable in terms of GAD-7 score, PHQ-9 score, and JFLS-20 score and sub-scores. CONCLUSIONS: Anxiety and depression and TMJ osseous changes were prevalent in elderly Vietnamese. Rural residents had higher prevalence of anxiety and depression than urban residents. TMJ osseous changes were not associated with anxiety, depression, or limitation of mandibular function.


Assuntos
Transtornos de Ansiedade/epidemiologia , Transtorno Depressivo/epidemiologia , Transtornos da Articulação Temporomandibular/epidemiologia , Transtornos da Articulação Temporomandibular/psicologia , Idoso , Transtornos de Ansiedade/psicologia , Comorbidade , Depressão , Transtorno Depressivo/psicologia , Feminino , Humanos , Masculino , Côndilo Mandibular/fisiopatologia , Prevalência , População Rural/estatística & dados numéricos , Fatores Sexuais , Articulação Temporomandibular/fisiopatologia , Transtornos da Articulação Temporomandibular/fisiopatologia , População Urbana/estatística & dados numéricos , Vietnã/epidemiologia
8.
Braz J Med Biol Res ; 52(7): e8434, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31241715

RESUMO

The natural flavonoid glycoside baicalin (BA) produces a variety of pharmaceutical effects, particularly for psychiatric/neurological disorders. This study evaluated the behavioral and neuroprotective effects of BA in mice subjected to chronic unpredictable mild stress, a model of depression. BA (25 and 50 mg/kg) significantly increased sucrose consumption and reduced immobility times in the tail suspension and forced swim tests, demonstrating that BA alleviated depression-like behaviors. Moreover, BA reduced the levels of inflammatory cytokines, such as interleukin 1ß, interleukin 6, and tumor necrosis factor α, in serum and in the hippocampus. BA also abrogated increases in NMDAR/NR2B and Ca2+/calmodulin-dependent protein kinase II, and the decrease in phosphorylated ERK and reactive oxygen species production in mice subjected to chronic unpredictable mild stress. These findings suggested that the antidepressive effects of BA are due to the regulation of an NMDAR/NR2B-ERK1/2-related pathway and inhibition of inflammatory cytokines and oxidative stress. Thus, BA represents a potential candidate drug for patients suffering from depression.


Assuntos
Transtorno Depressivo/tratamento farmacológico , Flavonoides/administração & dosagem , Elevação dos Membros Posteriores/psicologia , Estresse Oxidativo/efeitos dos fármacos , Animais , Transtorno Depressivo/metabolismo , Transtorno Depressivo/psicologia , Modelos Animais de Doenças , Interleucina-1beta/sangue , Interleucina-6/sangue , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Fator de Necrose Tumoral alfa/sangue
9.
Z Psychosom Med Psychother ; 65(2): 198, 2019 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-31154929

RESUMO

Long-term effectiveness of psychodynamic inpatient therapy on depressive disorders - Catamnestic- Results of the STOP-D-Study Objectives: Depression is one of the most common disorders with a rate of recurrence between 60-75 %. The effectiveness of psychodynamic therapy is well-proven, but there is still a lack of studies proving the long-term effectiveness of inpatient treatment on depressive symptom load. Methods: After psychodynamic inpatient treatment in a psychodynamically oriented psychosomatic hospital unit, the reduction in general and depressive symptom load (e. g. BDI, HAMD, SCL-90-R) was evaluated by a six-month follow up design. The study was set up as naturalistic multicenter intervention study including a female follow-up sample (N = 291; age 25-45 years). Results: The symptom improvement reached by the inpatient treatment remained stable at the follow-up survey. Patients treated with antidepressant medication showed stronger depressive symptom load at discharge and follow-up survey compared to patients without antidepressant medication. Sociodemographic variables and a comorbid personality disorder were not associated with increased drop-out rates, but depressive symptom load and a premature ending of the treatment. Conclusions: The obtained results demonstrate the long-term effectiveness of inpatient psychodynamic psychotherapy. Further studies about the influence of post-hospital psychotherapy and medical treatment as well as patient satisfaction seem necessary.


Assuntos
Transtorno Depressivo/psicologia , Transtorno Depressivo/terapia , Pacientes Internados/psicologia , Psicoterapia Psicodinâmica , Adulto , Depressão/complicações , Depressão/psicologia , Depressão/terapia , Transtorno Depressivo/complicações , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos da Personalidade/complicações , Fatores de Tempo , Resultado do Tratamento
10.
J Consult Clin Psychol ; 87(7): 577-589, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31219292

RESUMO

OBJECTIVE: This study investigates whether sexual minority patients have poorer treatment outcomes than heterosexual patients in England's Improving Access to Psychological Therapies (IAPT) services. These services provide evidence-based psychological interventions for people with depression or anxiety. METHOD: National routinely collected data were analyzed for a cohort who had attended at least 2 treatment sessions and were discharged between April 2013-March, 2015. Depression, anxiety and functional impairment were compared for 85,831 women (83,482 [97.2%] heterosexual; 1,285 [1.5%] lesbian; 1,064 [1.2%] bisexual) and 47,092 men (44,969 [95.5%] heterosexual; 1,734 [3.7%] gay; 389 [0.8%] bisexual). Linear and logistic models were fitted adjusting for baseline scores, and sociodemographic and treatment characteristics. RESULTS: Compared to heterosexual women, lesbian and bisexual women had higher final-session severity for depression, anxiety, and functional impairment and increased risk of not attaining reliable recovery in depression/anxiety or functioning (aORs 1.3-1.4) and reliable improvement in depression/anxiety or functioning (aORs 1.2-1.3). Compared to heterosexual and gay men, bisexual men had higher final-session severity for depression, anxiety, and functioning and increased risk of not attaining reliable recovery for depression/anxiety or functioning (aORs 1.5-1.7) and reliable improvement in depression/anxiety or functioning (aORs 1.3-1.4). Gay and heterosexual men did not differ on treatment outcomes. Racial minority lesbian/gay or bisexual patients did not have significantly different outcomes to their White lesbian/gay or bisexual counterparts. CONCLUSIONS: The reasons for treatment outcome inequities for bisexual patients and lesbian women (e.g., 30-70% increased risk of not recovering) need investigation. Health services should address these inequalities. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Transtornos de Ansiedade/terapia , Transtorno Depressivo/terapia , Minorias Sexuais e de Gênero/psicologia , Sexualidade/psicologia , Adulto , Transtornos de Ansiedade/psicologia , Transtorno Depressivo/psicologia , Inglaterra , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Grupos Minoritários , Resultado do Tratamento
11.
Psychiatr Prax ; 46(7): 394-398, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31137041

RESUMO

The aim of this clinical study was to detect differences between a civil and a military inpatient population with depressive disorders with respect to traits of male depression, personality disorders and value orientations. Fifty civil and fifty military participants answered various psychometric testings at the beginning of treatment. No differences were found concerning male depression. Personality traits and value orientations were found to be predictive for severity and frequency of depressive disorders in different depression inventories.


Assuntos
Transtorno Depressivo , Militares , Transtornos da Personalidade , Depressão , Transtorno Depressivo/psicologia , Alemanha , Humanos , Masculino , Militares/psicologia , Valores Sociais
12.
Tijdschr Psychiatr ; 61(4): 257-266, 2019.
Artigo em Holandês | MEDLINE | ID: mdl-31017284

RESUMO

BACKGROUND: Mental health problems are common in prison populations. Imprisonment may provide important opportunities to improve prisoners' mental health. To do so, it is important to systematically identify prisoners with mental health problems as soon as possible.
AIM: To examine the psychometric properties of the Brief Symptom Inventory (BSI) among male prisoners.
METHOD: A total of 1,624 male prisoners filled out the BSI. The following psychometric properties of the BSI scales were examined: distribution, internal consistency, inter-item correlations, and the factor structure. To examine the (criterion) validity, the BSI scores of different groups were compared.
RESULTS: Cronbach's α's of the BSI scales ranged from 0.97 to 0.76. In general, the observed factor structure resembled the intended nine BSI scales. Prisoners reported significantly higher scores on the BSI than men from the general population, but had lower scores than male psychiatric patients. Prisoners who had been treated for mental disorders prior to their detention, scored significantly higher than prisoners who had not.
CONCLUSION: The BSI showed reliable scales among prisoners and is well able to distinguish between different groups. KEY WORDS Brief Symptom Inventory, prisoners, psychiatry, psychometric properties.


Assuntos
Psiquiatria Legal , Transtornos Mentais/diagnóstico , Prisioneiros/psicologia , Psicometria , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/psicologia , Humanos , Masculino , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Saúde Mental , Países Baixos , Escalas de Graduação Psiquiátrica , Inquéritos e Questionários
13.
Mol Med Rep ; 19(5): 4185-4194, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30942466

RESUMO

Prenatal nicotine exposure (PNE) is closely related to depression in offspring. However, the underlying mechanism is still unclear. We hypothesized that neurosteroid in the hippocampus may mediate PNE­induced depression­like behaviors. Nicotine was subcutaneously administered (1.0 mg/kg) to pregnant rats twice daily from gestational day (GD) 9 to 20. In adolescent offspring, PNE significantly increased immobility time and decreased the sucrose preference in female rats. The numbers of hippocampal neurons declined in the CA3 and DG regions. Steroidogenic acute regulatory protein (StAR) expression was suppressed in female rats. In fetal offspring, the neuronal numbers of CA3 regions in PNE female fetal hippocampal were significantly decreased, accompanied by the enhanced content of corticosterone and StAR expression. These data indicated that PNE induced depression­like behavior in adolescent female rats via the regulation of neurosteroid levels in the hippocampus.


Assuntos
Transtorno Depressivo/etiologia , Hipocampo/metabolismo , Hipocampo/fisiopatologia , Exposição Materna/efeitos adversos , Neurotransmissores/metabolismo , Nicotina/efeitos adversos , Efeitos Tardios da Exposição Pré-Natal , Animais , Comportamento Animal , Biomarcadores , Transtorno Depressivo/psicologia , Modelos Animais de Doenças , Feminino , Expressão Gênica , Hipocampo/patologia , Gravidez , Ratos
14.
Artigo em Inglês | MEDLINE | ID: mdl-30986906

RESUMO

Floods are a significant public health problem linked with increased psychological morbidity. We aimed to investigate the effect of insurance-related factors on the association between flooding and probable mental health outcomes. We performed a secondary analysis of cross-sectional survey data from the English National Study of Flooding and Health (NSFH) collected two years after an initial flooding event in 2013-14. Our analysis focused on 851 respondents who experienced flooding or disruption. Multivariable logistic regression models were run for each exposure group. Among those whose homes had been flooded, not having household insurance was associated with increased odds of all outcomes compared to those with household insurance, significantly so for post-traumatic stress disorder (PTSD) (aOR 4.31, 95% CI 1.31-14.20). Those who reported severe stress due to insurance issues had increased odds of probable depression (aOR 11.08, 95% CI 1.11-110.30), anxiety (aOR 4.48, 95% CI 1.02-19.70) and PTSD (aOR 7.95, 95% CI 2.10-30.1) compared to those reporting no/mild stress. The study suggests there is increased psychological morbidity amongst the uninsured and those who report feeling severe stress as a result of insurance issues associated with flooding. Services should be prepared to support communities through insurance processes, to reduce probable mental health morbidity following a flood event.


Assuntos
Transtornos de Ansiedade/psicologia , Transtornos de Ansiedade/terapia , Transtorno Depressivo/psicologia , Transtorno Depressivo/terapia , Inundações , Cobertura do Seguro , Saúde Mental , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Adulto , Ansiedade , Estudos Transversais , Depressão , Características da Família , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoas sem Cobertura de Seguro de Saúde , Pessoa de Meia-Idade , Probabilidade , Saúde Pública
15.
BMC Public Health ; 19(1): 435, 2019 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-31023286

RESUMO

BACKGROUND: The study of the health effects of perceived discrimination based on ethnic and social traits has a long-standing and widespread tradition in epidemiological research, but less attention has been paid to the study of multiple discrimination, particularly its effects on mental health. The present work aims to analyse the association between multiple discrimination and depressive symptoms in Europe, and the impact of contextual socioeconomic circumstances on this relationship. METHODS: In this study, data from the 7th Round of the European Social Survey was used. Given that the outcome variable, CES-D8, is a depression scale from 0 to 24 possible values and the hierarchical organisation of individuals (level-1 units) clustered within countries (level-2 units), a linear multilevel model was carried out. RESULTS: Our findings suggest that multiple discrimination increases our risk of suffering depressive disorder, but in addition this work provides an important step forward to explain and understand how the relationship between multiple discrimination and depression might vary depending the socioeconomic context. In particular, we can observe that differences in the prevalence of depressive symptoms along multiple discrimination levels decrease as GDP per capita increases among European countries. CONCLUSION: This study is relevant since provides new evidence on how the association between multiple discrimination and depression operates at the micro and macro-level context, which is fundamental to understand how macro-economic fluctuations of countries may determine depressive disorders through the effect of single and combined forms of discrimination.


Assuntos
Depressão/epidemiologia , Transtorno Depressivo/epidemiologia , Produto Interno Bruto/estatística & dados numéricos , Discriminação Social/psicologia , Fatores Socioeconômicos , Adulto , Depressão/psicologia , Transtorno Depressivo/psicologia , Grupos Étnicos/psicologia , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multinível , Prevalência
16.
BMC Psychol ; 7(1): 23, 2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-30975192

RESUMO

BACKGROUND: The quality of an expectant mother's bonding to the fetus has been shown to be associated with important developmental outcomes. Previous studies suggest that bonding quality is predicted by, for example, social support, psychological well-being, and depression. However, little is known regarding the role of maternal cognition in maternal-fetal bonding. Early maladaptive schemas (EMSs) are negative and stable assumptions about oneself and one's relationships with others that are developed during childhood and adolescence. In the present study, we examined the associations between EMSs and the quality of the bonding to the fetus in expectant mothers. METHODS: The present investigation is part of a larger study in which 220 pregnant women (approximately 12% of the pregnant women in the region) and 130 of their partners were recruited from October 2015 until December 2017. The sample for the current study comprised 165 pregnant women (mean age 30.8 years, SD 4.1 years). The participants completed the Young Schema Questionnaire Short Form 3 (YSQ-S3) between gestational weeks 24 and 37 and the Maternal Antenatal Attachment Scale (MAAS) and the Edinburgh Postnatal Depression Scale (EPDS) between gestational weeks 31 and 41. RESULTS: All EMS domains correlated significantly and negatively with scores for quality of maternal-fetal bonding on the MAAS. Only the Disconnection and Rejection domain correlated significantly and negatively with MAAS scores for intensity of preoccupation with the fetus. The Disconnection and Rejection domain was a significant independent predictor of the quality of maternal-fetal bonding. Symptoms of depression mediated the effect of the EMS domains on the quality of maternal-fetal bonding. The EMS domains Disconnection and Rejection, Impaired Autonomy and Performance, and Impaired Limits showed significant direct effects on bonding quality. CONCLUSIONS: EMSs are related to expectant mothers' self-reported bonding to their fetuses. This association was mediated by the mothers' symptoms of depression. The results may have implications for the early identification of pregnant women at risk of bonding difficulties and encourage more studies on cognitive schemas and mechanisms for maternal-fetal bonding.


Assuntos
Cognição , Transtorno Depressivo/psicologia , Relações Materno-Fetais , Complicações na Gravidez/psicologia , Autoimagem , Adulto , Feminino , Humanos , Apego ao Objeto , Gravidez , Autorrelato , Inquéritos e Questionários
17.
Nord J Psychiatry ; 73(3): 195-199, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30929594

RESUMO

BACKGROUND: Screening of depression has been recommended in primary care and Beck's 21-item Depression Inventory (BDI-21) is a commonly used tool for screening. Depression has been shown to be frequently accompanied by comorbidities. AIMS: This study aimed to analyze the characteristics, psychiatric diagnoses, and psychiatric comorbidity of primary care patients who have been screened for depression and referred to a depression nurse. METHODS: The study subjects were primary care patients aged ≥ 35 years with depressive symptoms (BDI-21 > 9). Their psychiatric diagnosis were based on a diagnostic interview (Mini-International Neuropsychiatric Interview; M.I.N.I.) conducted by a trained study nurse. RESULTS: Of the 705 study subjects, 617 (87.5%) had at least one and 66.1% had at least two psychiatric diagnoses. The most common diagnosis was depression (63.4%). The next most common diagnoses were generalized anxiety disorder (GAD) (48.1%) and panic disorder (22.8%). Only 8.8% of the study subjects had depression without other psychiatric disorders. Ten percent of the subjects had both depression and a generalized anxiety disorder (GAD). Also other psychiatric comorbidities were common. Age was inversely associated with the psychiatric diagnosis in the M.I.N.I. CONCLUSIONS: This study suggests that most of the primary care patients with increased depressive symptoms have a psychiatric disorder. Although depression is the most common diagnosis, there are several other concurrent psychiatric comorbidities. Therefore, diagnostic assessment of primary care patients with a screening score over 9 in the BDI-21 should be reconsidered.


Assuntos
Transtorno Depressivo/diagnóstico , Transtorno Depressivo/psicologia , Transtornos Mentais/psicologia , Atenção Primária à Saúde/estatística & dados numéricos , Adulto , Idoso , Comorbidade , Feminino , Finlândia , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica
18.
BMC Public Health ; 19(1): 430, 2019 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-31014301

RESUMO

BACKGROUND: Socioeconomic status (SES) has a strong association with depression or physical and mental health in general. However, as SES is a multifaceted construct these associations are not easy to explain. Further, there are several indicators and many studies only investigating two or less indicators at the same time. Therefore, this study aims to analyze the cross-sectional and longitudinal association of three defined SES dimensions (education, occupational position and household net-income) with the occurrence of elevated symptoms of depression relative to the impact of important covariates. METHODS: The study included observational data from 12,484 participants of the Gutenberg Health Study. The outcome was "elevated depressive symptoms" as defined by Patient Health Questionnaire (PHQ-2) ≥ 2 at the 2.5-year follow-up. Regression coefficients were adjusted for baseline covariates (age, sex, partnership, depression, anxiety, medical history of depressive or anxiety disorder and major medical diseases (MMD)) in addition to SES sum score and the three single indicators. We further examined interaction terms of the SES with sex, partnership and major medical diseases. We analyzed the sample stratified by elevated depressive symptoms at baseline, as we expected different trajectories in both subgroups. RESULTS: SES, education and household net-income were lower in the group of persons with PHQ-2 ≥ 2 at baseline, and they predicted the occurrence of PHQ-2 ≥ 2 at 2.5 year follow-up in the group of persons without elevated depressive symptoms at baseline after multivariable adjustment (SES: Odds Ratio (OR) 0.96, 0.95-0.98, p <  0.0001; education: OR 0.96, 0.93-0.99, p = 0.036; household net-income: OR 0.96, 0.92-0.99, p = 0.046) but not in the group of persons with elevated depressive symptoms at baseline. Further, we found that the impact of major medical diseases on the development of elevated depressive symptoms was buffered by high income. In addition, living in a partnership buffered the impact of a low occupational position. CONCLUSIONS: Regarding the SES, the dimensions education and household net-income seem to play the most important role for socioeconomic inequalities in persons in Mid-West Germany with depressive symptoms. TRIAL REGISTRATION: Reference no. 837.020.07; original vote: 22.3.2007, latest update: 20.10.2015.


Assuntos
Transtorno Depressivo/epidemiologia , Transtorno Depressivo/psicologia , Escolaridade , Renda/estatística & dados numéricos , Classe Social , Adulto , Idoso , Estudos Transversais , Feminino , Alemanha/epidemiologia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
19.
Drug Alcohol Depend ; 197: 228-235, 2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-30852375

RESUMO

BACKGROUND: Non-abstinent drinking reductions that predict improvement in how individuals feel or function, such as the World Health Organization (WHO) drinking risk levels, may be useful outcomes in clinical trials for alcohol use disorders (AUD). METHODS: Current drinkers in a U.S. national survey (n = 22,005) were interviewed in 2001-02 (Wave 1) and re-interviewed 3 years later (Wave 2). WHO drinking risk levels, a 4- level categorization system (very-high-risk, high-risk, moderate-risk, and low-risk drinkers) defined using estimated mean ethanol consumption (grams) per day in the prior 12 months, and DSM-IV depressive and anxiety disorders were assessed at both waves. Logistic regression was used to produce adjusted odds ratios (aOR) testing the associations of changes between Wave 1 and Wave 2 WHO risk levels to the presence or persistence of depression and/or anxiety disorder by each initial Wave 1 risk level. RESULTS: Among Wave 1 very-high-risk drinkers, lower odds of depression and/or anxiety disorders at Wave 2 were predicted by reductions in WHO risk levels of one-, two- or three-levels (aOR = 0.42, 0.37, 0.67, p-values 0.04-<.0001), as was the persistence of depression and/or anxiety disorders among those with such disorders at Wave 1 (aOR = 0.37, 0.29, 0.51, p-values .03-<.0001). Results were less consistent for participants initially drinking at lower risk levels. CONCLUSIONS: Among very-high-risk drinkers, reductions in the WHO drinking risk categories were associated with lower risk of depression and/or anxiety disorders. These results add to findings indicating reductions in WHO risk levels are a meaningful indicator of how individuals feel and function.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Alcoolismo/epidemiologia , Transtornos de Ansiedade/epidemiologia , Transtorno Depressivo/epidemiologia , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/psicologia , Transtornos de Ansiedade/psicologia , Transtorno Depressivo/psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Medição de Risco/normas , Estados Unidos/epidemiologia , Organização Mundial da Saúde , Adulto Jovem
20.
Sex Transm Infect ; 95(4): 254-261, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30814165

RESUMO

OBJECTIVE: To assess the association of symptoms of depression and anxiety with sexual risk behaviour and history, among women and heterosexual men attending genitourinary medicine (GUM) clinics. METHODS: Attitudes to and Understanding of Risk of Acquisition of HIV (AURAH) was a cross-sectional, self-administered questionnaire study recruited from 20 GUM clinics in England, 2013-2014. This analysis included women and heterosexual men. The prevalence of depression and anxiety symptoms was assessed. Modified Poisson regression was used to produce adjusted prevalence ratios (aPR) for the association of t demographic, socioeconomic and lifestyle factors with depression and anxiety, adjusted for gender, age, ethnicity, education level and study region. Among individuals reporting sex in the past 3 months, associations of depression and anxiety with sexual risk behaviour and history were assessed separately by gender, adjusted for age, ethnicity, study region, education and relationship status. RESULTS: Questionnaires were completed by 676 women and 470 heterosexual men. Depression symptoms were reported by 100 (14.8%) women and 33 men (7.0%). Anxiety symptoms were reported by 79 women (11.7%) and 21 men (4.5%). Among women reporting recent sex, those with depression symptoms were more likely to report condomless sex with a non-regular partner, aPR 1.38 (1.07-1.77) and recent condomless sex with two or more partners, 1.80 (1.25-2.59). Women with anxiety symptoms more likely to report recent condomless sex with two or more partners, 1.68 (1.13-2.50), low self-efficacy for condom use, 1.54 (1.02-2.31) and STI diagnosis in the last year 1.51 (1.04-2.20). Among heterosexual men reporting recent sex, depression and anxiety symptoms were associated with low self-efficacy with condom use, 2.32 (1.29-4.19) for depression and 2.23 (1.26-3.94) for anxiety, but not with measures of condomless sex. DISCUSSION: The associations between psychological symptoms and sexual risk behaviours highlight the importance of holistic assessment of need by both general and sexual health clinicians. We highlight the challenge in delivering holistic care associated with fragmentation of sexual health services.


Assuntos
Transtornos de Ansiedade/psicologia , Transtorno Depressivo/psicologia , Aceitação pelo Paciente de Cuidados de Saúde , Doenças Sexualmente Transmissíveis/psicologia , Instituições de Assistência Ambulatorial , Estudos Transversais , Feminino , Humanos , Londres , Masculino , Assunção de Riscos , Fatores Sexuais , Comportamento Sexual , Doenças Sexualmente Transmissíveis/prevenção & controle , Medicina Estatal , Inquéritos e Questionários , Adulto Jovem
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