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1.
PLoS One ; 16(8): e0255594, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34352012

RESUMO

INTRODUCTION: Implementation of evidence-based care for heavy drinking and depression remains low in global health systems. We tested the impact of providing community support, training, and clinical packages of varied intensity on depression screening and management for heavy drinking patients in Latin American primary healthcare. MATERIALS AND METHODS: Quasi-experimental study involving 58 primary healthcare units in Colombia, Mexico and Peru randomized to receive: (1) usual care (control); (2) training using a brief clinical package; (3) community support plus training using a brief clinical package; (4) community support plus training using a standard clinical package. Outcomes were proportion of: (1) heavy drinking patients screened for depression; (2) screen-positive patients receiving appropriate support; (3) all consulting patients screened for depression, irrespective of drinking status. RESULTS: 550/615 identified heavy drinkers were screened for depression (89.4%). 147/230 patients screening positive for depression received appropriate support (64%). Amongst identified heavy drinkers, adjusting for country, sex, age and provider profession, provision of community support and training had no impact on depression activity rates. Intensity of clinical package also did not affect delivery rates, with comparable performance for brief and standard versions. However, amongst all consulting patients, training providers resulted in significantly higher rates of alcohol measurement and in turn higher depression screening rates; 2.7 times higher compared to those not trained. CONCLUSIONS: Training using a brief clinical package increased depression screening rates in Latin American primary healthcare. It is not possible to determine the effectiveness of community support on depression activity rates due to the impact of COVID-19.


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Alcoólicos/psicologia , Depressão/terapia , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/prevenção & controle , Intoxicação Alcoólica/psicologia , Alcoolismo/diagnóstico , Colômbia/epidemiologia , Comorbidade , Atenção à Saúde , Depressão/psicologia , Transtorno Depressivo/psicologia , Transtorno Depressivo/terapia , Feminino , Humanos , Masculino , Programas de Rastreamento/métodos , México/epidemiologia , Pessoa de Meia-Idade , Peru/epidemiologia , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/tendências , Encaminhamento e Consulta , Detecção do Abuso de Substâncias/métodos
2.
Medicine (Baltimore) ; 100(31): e26747, 2021 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-34397817

RESUMO

OBJECTIVE: The incidence of non-suicidal self-injury (NSSI) behavior in adolescents is increasing year by year. Patients with a history of both depression and NSSI behavior tend to be at greater risk for suicide. At present, the mechanism of adolescent depressive disorder with NSSI behavior is not clear and still in research and exploration. The expression of the Silent Information Regulator 2 Related Enzyme 1 (SIRT1) gene is closely related to the level of serotonin in molecular mechanisms, and may be closely related to the occurrence and development of depressive disorder. This study aimed to explore the relationship between the SIRT1 gene and NSSI behaviors in adolescents with depressive disorder. METHODS: A total of 15 adolescent depressed patients with NSSI behavior and 15 healthy controls were enrolled in the study. Bisulfite Sequencing PCR (BSP) was used to test the methylation level of SIRT1 gene promoter region of the participants. The real-time fluorescent quantitative PCR was conducted to measure the mRNA expression level of SIRT1 gene. RESULTS: Our study found that the methylation level of SIRT1 gene promoter region at cytosine-guanine dinucleotide 5 (CpG5) site in depression group was higher than that of control group. Compared with that of control group, the plasma concentration of Sirt1 protein significantly decreased in depression group. CONCLUSION: Our study investigated the methylation level and the mRNA expression of SIRT1 gene in adolescent depressive patients with NSSI behavior. The study points towards finding an in vivo molecular marker for those adolescent patients.


Assuntos
Transtorno Depressivo/genética , Adolescente , Comportamento do Adolescente/psicologia , Distribuição de Qui-Quadrado , China/epidemiologia , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/psicologia , Feminino , Voluntários Saudáveis , Humanos , Masculino , Metilação , RNA Mensageiro/genética , Fatores de Risco , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/genética , Comportamento Autodestrutivo/psicologia , Sirtuína 1
4.
J Clin Psychiatry ; 82(2)2021 02 23.
Artigo em Inglês | MEDLINE | ID: mdl-33988925

RESUMO

OBJECTIVE: Suicide is a priority health problem. Suicide assessment depends on imperfect clinician assessment with minimal ability to predict the risk of suicide. Machine learning/deep learning provides an opportunity to detect an individual at risk of suicide to a greater extent than clinician assessment. The present study aimed to use deep learning of structural magnetic resonance imaging (MRI) to create an algorithm for detecting suicidal ideation and suicidal attempts. METHODS: We recruited 4 groups comprising a total of 186 participants: 33 depressive patients with suicide attempt (SA), 41 depressive patients with suicidal ideation (SI), 54 depressive patients without suicidal thoughts (DP), and 58 healthy controls (HCs). The confirmation of depressive disorder, SA and SI was based on psychiatrists' diagnosis and Mini-International Neuropsychiatric Interview (MINI) interviews. In the generalized q-sampling imaging (GQI) dataset, indices of generalized fractional anisotropy (GFA), the isotropic value of the orientation distribution function (ISO), and normalized quantitative anisotropy (NQA) were separately trained in convolutional neural network (CNN)-based deep learning and DenseNet models. RESULTS: From the results of 5-fold cross-validation, the best accuracies of the CNN classifier for predicting SA, SI, and DP against HCs were 0.916, 0.792, and 0.589, respectively. In SA-ISO, DenseNet outperformed the simple CNNs with a best accuracy from 5-fold cross-validation of 0.937. In SA-NQA, the best accuracy was 0.915. CONCLUSIONS: The results showed that a deep learning method based on structural MRI can effectively detect individuals at different levels of suicide risk, from depression to suicidal ideation and attempted suicide. Further studies from different populations, larger sample sizes, and prospective follow-up studies are warranted to confirm the utility of deep learning methods for suicide prevention and intervention.


Assuntos
Encéfalo/diagnóstico por imagem , Aprendizado Profundo , Transtorno Depressivo/psicologia , Redes Neurais de Computação , Ideação Suicida , Tentativa de Suicídio/prevenção & controle , Adulto , Algoritmos , Estudos de Casos e Controles , Transtorno Depressivo/diagnóstico por imagem , Feminino , Humanos , Entrevista Psicológica , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neuroimagem , Medição de Risco , Tentativa de Suicídio/psicologia , Tentativa de Suicídio/estatística & dados numéricos , Adulto Jovem
5.
J Psychiatr Pract ; 27(3): 184-193, 2021 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-33939372

RESUMO

BACKGROUND: Anxiety and depressive disorders frequently recur, but participation in effective psychological interventions to prevent relapse is limited. The reasons for nonparticipation are largely unknown, hampering successful implementation. The aims of this study were: (1) to investigate reasons why patients with remitted anxiety or depressive disorders refuse cognitive-behavioral therapy relapse prevention interventions (RPIs), (2) to compare these reasons with reasons to participate, and (3) to gain insight into patients' preferences regarding relapse prevention. METHODS: A qualitative study was conducted in which data were gathered from 52 semistructured interviews with patients who either refused or agreed to participate in psychological relapse prevention. The constant comparative method was used. RESULTS: The data showed that those who refused to participate (1) did have knowledge about relapse risks in general, (2) but did not relate this risk to themselves, and therefore, did not feel the need for relapse prevention, or (3) declined to participate for logistical reasons or reasons related to the content of the intervention. Preferences concerning the form and content of RPIs were very diverse. CONCLUSIONS: Psychoeducation on relapse should be provided to patients to help them relate recurrence risks to themselves. RPIs should also be individually tailored.


Assuntos
Transtornos de Ansiedade/prevenção & controle , Transtornos de Ansiedade/psicologia , Transtorno Depressivo/prevenção & controle , Transtorno Depressivo/psicologia , Cooperação do Paciente/psicologia , Pesquisa Qualitativa , Feminino , Humanos , Masculino , Educação de Pacientes como Assunto , Recidiva , Prevenção Secundária
6.
Lancet Psychiatry ; 8(6): 500-511, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33957075

RESUMO

BACKGROUND: Internet cognitive behavioural therapy (iCBT) is a viable delivery format of CBT for depression. However, iCBT programmes include training in a wide array of cognitive and behavioural skills via different delivery methods, and it remains unclear which of these components are more efficacious and for whom. METHODS: We did a systematic review and individual participant data component network meta-analysis (cNMA) of iCBT trials for depression. We searched PubMed, PsycINFO, Embase, and the Cochrane Library for randomised controlled trials (RCTs) published from database inception to Jan 1, 2019, that compared any form of iCBT against another or a control condition in the acute treatment of adults (aged ≥18 years) with depression. Studies with inpatients or patients with bipolar depression were excluded. We sought individual participant data from the original authors. When these data were unavailable, we used aggregate data. Two independent researchers identified the included components. The primary outcome was depression severity, expressed as incremental mean difference (iMD) in the Patient Health Questionnaire-9 (PHQ-9) scores when a component is added to a treatment. We developed a web app that estimates relative efficacies between any two combinations of components, given baseline patient characteristics. This study is registered in PROSPERO, CRD42018104683. FINDINGS: We identified 76 RCTs, including 48 trials contributing individual participant data (11 704 participants) and 28 trials with aggregate data (6474 participants). The participants' weighted mean age was 42·0 years and 12 406 (71%) of 17 521 reported were women. There was suggestive evidence that behavioural activation might be beneficial (iMD -1·83 [95% credible interval (CrI) -2·90 to -0·80]) and that relaxation might be harmful (1·20 [95% CrI 0·17 to 2·27]). Baseline severity emerged as the strongest prognostic factor for endpoint depression. Combining human and automated encouragement reduced dropouts from treatment (incremental odds ratio, 0·32 [95% CrI 0·13 to 0·93]). The risk of bias was low for the randomisation process, missing outcome data, or selection of reported results in most of the included studies, uncertain for deviation from intended interventions, and high for measurement of outcomes. There was moderate to high heterogeneity among the studies and their components. INTERPRETATION: The individual patient data cNMA revealed potentially helpful, less helpful, or harmful components and delivery formats for iCBT packages. iCBT packages aiming to be effective and efficient might choose to include beneficial components and exclude ones that are potentially detrimental. Our web app can facilitate shared decision making by therapist and patient in choosing their preferred iCBT package. FUNDING: Japan Society for the Promotion of Science.


Assuntos
Terapia Cognitivo-Comportamental , Transtorno Depressivo/terapia , Internet , Transtorno Depressivo/psicologia , Humanos , Metanálise em Rede , Avaliação de Resultados em Cuidados de Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto , Análise de Sistemas
7.
Cogn Behav Ther ; 50(3): 179-184, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34018469

RESUMO

The novel 2019 SARS-2-CoV causing COVID-19 has had a devastating impact on the entire world. COVID-19 is a broad-based stressor, and research to date has documented increases in mental health problems, including anxiety, depression, and substance use, since the onset of COVID-19. By taking a transdiagnostic approach, scholars can help elucidate mechanisms and vulnerability as well as resiliency related to behavioral health problems in the context of COVID-19. The aim of the current special issue of Cognitive Behaviour Therapy was to showcase ongoing research focused on transdiagnostic factors in the context of COVID-19. The purpose of this issue is to highlight the significance of this work in the pandemic for research and practice; illustrate some of the many domains currently being explored via innovative approaches; and explicate fruitful areas for programmatic study. We hope that readers will recognize the important role of transdiagnostic models and their potential to offset the mental, addictive, and physical health disease burden of COVID-19.


Assuntos
Transtornos de Ansiedade/diagnóstico , Ansiedade/diagnóstico , Comportamento Aditivo/diagnóstico , COVID-19/psicologia , Depressão/diagnóstico , Transtorno Depressivo/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Ansiedade/psicologia , Transtornos de Ansiedade/psicologia , Comportamento Aditivo/psicologia , Depressão/psicologia , Transtorno Depressivo/psicologia , Humanos , Pandemias , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/psicologia
8.
Geriatr Nurs ; 42(3): 780-781, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34001377

RESUMO

The older population and medically frail persons are at higher risk of severe infections and death from coronavirus disease 2019 (COVID-19). Long-term care (LTC) facilities are encouraged to take various actions to safeguard residents and reduce the spread of COVID-19 including by restricting visitors, which leads to isolation. The imposed isolation undermines the autonomy of older adults living in LTC facilities, especially those with dementia, and the isolation from loved ones can worsen cognition and depression. The purpose of this case report is to highlight isolation practices implemented to reduce the spread of COVID-19 in an LTC facility, which increased the social isolation and worsened cognition and depression in a resident with dementia and depression. Because many residents of LTC facilities have dementia, this case is an example of the need for interventions to support the mental health of persons living in LTC facilities during the COVID-19 pandemic.


Assuntos
COVID-19/prevenção & controle , Demência/psicologia , Transtorno Depressivo/psicologia , Assistência de Longa Duração/psicologia , Distanciamento Físico , Isolamento Social/psicologia , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , COVID-19/transmissão , Feminino , Humanos
9.
Am J Gastroenterol ; 116(7): 1485-1494, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-33840729

RESUMO

INTRODUCTION: Psychological comorbidities are associated with irritable bowel syndrome (IBS), but little is known about their cumulative effect on its prognosis. We examined this issue in a longitudinal 12-month follow-up study. METHODS: We collected complete demographic, symptom, and psychological comorbidity data (anxiety, depression, somatic symptom disorder, perceived stress, and gastrointestinal symptom-specific anxiety) at baseline from 807 adults who met Rome IV criteria for IBS. At 12 months, we collected data regarding IBS symptom severity and impact, consultation behavior, and treatments commenced from 452 individuals successfully followed up. We examined the cumulative effects of psychological comorbidities at baseline on subsequent IBS disease behavior. RESULTS: At baseline, among the 807 participants, 177 (21.9%) had 1, 139 (17.2%) 2, 103 (12.8%) 3, 89 (11.0%) 4, and 54 (6.7%) 5 psychological comorbidities. IBS symptom severity at baseline increased significantly with the number of psychological comorbidities (72.2% of those with 5 psychological comorbidities reported severe symptoms, vs 29.1% of those with none, P < 0.001). Among 452 (56.0%) participants followed up at 12 months, those with a higher number of psychological comorbidities at baseline were significantly more likely to have seen a gastroenterologist (33.3% of those with 5 psychological comorbidities, vs 21.4% of those with none, P = 0.001), cycle through more treatments (P < 0.0001), to report more severe IBS symptoms (66.7% with 5, vs 24.4% with none, P < 0.001) and continuous abdominal pain (22.1% with none, vs 61.9% with 5, P < 0.001), and to report that symptoms impacted on daily activities ≥50% of the time (90.5% with 5, vs 41.2% with none, P < 0.001). DISCUSSION: The prognosis of individuals with Rome IV-defined IBS worsens according to incremental increases in psychological comorbidity. This has important clinical and research implications.


Assuntos
Transtornos de Ansiedade/epidemiologia , Transtorno Depressivo/epidemiologia , Síndrome do Intestino Irritável/epidemiologia , Transtornos Somatoformes/epidemiologia , Estresse Psicológico/epidemiologia , Adulto , Idoso , Transtornos de Ansiedade/psicologia , Comorbidade , Efeitos Psicossociais da Doença , Transtorno Depressivo/psicologia , Feminino , Humanos , Síndrome do Intestino Irritável/psicologia , Síndrome do Intestino Irritável/terapia , Masculino , Pessoa de Meia-Idade , Prognóstico , Índice de Gravidade de Doença , Transtornos Somatoformes/psicologia , Estresse Psicológico/psicologia
10.
Nutrients ; 13(5)2021 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-33925406

RESUMO

We explored the differences in dietary habits and dietary patterns between individuals characterized by irrational beliefs with no or low anxiety and depressive symptoms and individuals characterized by irrational beliefs with high anxiety and depressive symptomatology. Within the context of the ATTICA cohort study (2002-2012), 853 participants without evidence of cardiovascular disease (453 men (45 ± 13 years) and 400 women (44 ± 18 years)) underwent mental health assessment through the irrational beliefs inventory (IBI), the Zung self-rating depression scale (ZDRS) and the state-trait anxiety inventory (STAI). Demographic characteristics, a thorough medical history, dietary behaviour and other lifestyle behaviours were also evaluated and analysed using factor analysis. Five main factors related to dietary patterns were extracted for the high-IBI/low-STAI group of participants (explaining the 63% of the total variation in consumption), whereas four factors were extracted for the high-IBI/high-STAI participants, the high-IBI/low-ZDRS participants and the high-IBI/high-ZDRS participants, explaining 53%, 54% and 54% of the total variation, respectively. A Western-type dietary pattern was the most dominant factor for individuals reporting irrational beliefs and anxiety or depressive symptomatology. The high refined carbohydrates and fats dietary pattern was the most dominant factor for individuals with irrational beliefs but without psychopathology. Linear regression analysis showed that irrational beliefs, in combination with anxiety or depression, age, sex and BMI, were important predictors of adherence to the Mediterranean diet. Dietary habits interact with irrational beliefs and, in association with the consequent psychological disorders, are associated with overall diet, and presumably may affect the health status of individuals.


Assuntos
Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/psicologia , Dieta/métodos , Nutrientes , Adulto , Estudos de Coortes , Dieta/estatística & dados numéricos , Feminino , Grécia/epidemiologia , Inquéritos Epidemiológicos/métodos , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade
11.
Psychiatry Res ; 300: 113905, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33827013

RESUMO

Few studies have examined changes in mental health before and after the outbreak of COVID-19. We examined changes in the prevalence of major depression and generalized anxiety disorder (GAD) between February 2019 and March-April 2020; if there were changes in major depression and GAD during six weeks of nationwide lockdown; and we identified factors that predicted major depression and GAD across the six-week lockdown period. Nationally representative samples of Irish adults were gathered using identical methods in February 2019 (N = 1020) and March-April 2020 (N = 1041). The latter was reassessed six weeks later. Significantly more people screened positive for depression in February 2019 (29.8% 95% CI = 27.0, 32.6) than in March-April 2020 (22.8% 95% CI = 20.2, 25.3), and there was no change in GAD. There were no significant changes in depression and GAD during the lockdown. Major depression was predicted by younger age, non-city dwelling, lower resilience, higher loneliness, and higher somatic problems. GAD was predicted by a broader set of variables including several COVID-19 specific variables. These findings indicate that the prevalence of major depression and GAD did not increase as a result of, or during the early phase of the COVID-19 pandemic in Ireland.


Assuntos
Transtornos de Ansiedade/epidemiologia , Ansiedade/epidemiologia , COVID-19/psicologia , Depressão/epidemiologia , Transtorno Depressivo/epidemiologia , Saúde Mental , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/psicologia , Transtornos de Ansiedade/psicologia , Controle de Doenças Transmissíveis , Depressão/psicologia , Transtorno Depressivo/psicologia , Feminino , Humanos , Irlanda/epidemiologia , Solidão , Masculino , Pessoa de Meia-Idade , Pandemias , Prevalência , Adulto Jovem
12.
Global Health ; 17(1): 40, 2021 04 06.
Artigo em Inglês | MEDLINE | ID: mdl-33823875

RESUMO

BACKGROUND: Little is known about the prevalence of and risk factors for adolescent mental health problems during the COVID-19 outbreak. We aimed to investigate the prevalence of depressive symptoms, their association with study-relevant problems, and the moderating effect of parent-child relationship among Chinese adolescents during the school closures. METHODS: We performed a cross-sectional analysis with data collected in middle and high schools in Taizhou, China. Students completed an online survey between April 16 and May 14, 2020. Depressive symptoms were assessed using the Children's Depression Inventory. Three types of study problems were recorded, including having difficulty in studying at home, dislike of remote learning, and excessive screen entertainment time. Parental relationships were categorized into good or normal relationship and poor relationship. Linear regression and logistic regression analyses were conducted to investigate the associations between study-relevant problems and depressive symptoms. RESULTS: Using data from 6435 adolescents, we found that the prevalence of depressive symptoms was 17.7%. All the study problem measures were associated with more severe depressive symptoms. There was a moderating effect of the parental relationship on the associations between study problems and depressive symptoms. The association between number of study problems and depressive symptoms was stronger in adolescents with a poor parent-child relationship (regression coefficient 4.34 [95% CI 2.97, 5.72]) than those with a good or normal relationship (2.55 [2.35, 2.75]), p for interaction 0.002, on multivariable adjustment. CONCLUSIONS: Study problems due to school closures were particularly problematic for adolescents who had poor parent-child relationships. Public health initiatives could help students to adjust study habits and improve parent-child relationships, thereby protecting against the development of depression.


Assuntos
Sucesso Acadêmico , COVID-19/psicologia , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/psicologia , Relações Pais-Filho , Adolescente , China/epidemiologia , Análise por Conglomerados , Estudos Transversais , Feminino , Humanos , Masculino , Fatores de Risco , SARS-CoV-2
13.
Rev. psicopatol. salud ment. niño adolesc ; (37): 71-83, abr. 2021. tab
Artigo em Espanhol | IBECS | ID: ibc-202162

RESUMO

Calidad de Vida Relacionada con la Salud (CVRS) hace referencia a las valoraciones de la percepción de la salud por parte de una persona, recogiendo aspectos objetivos y subjetivos. Participaron 40 adolescentes con diagnóstico de depresión, procedentes de diez centros de salud pública de Chile. Se evaluaron las características del funcionamiento familiar y la CVRS en torno a diez dimensiones. Los resultados sugieren la importancia de obtener un tratamiento integral, que no apunte únicamente a lo sindromático, sino también a la funcionalidad, otorgando una noción esencial en el quehacer clínico infanto-juvenil


Health-Related Quality of Life (HRQOL) refers to a person's perception of health, including both objective and subjective aspects. Forty adolescents with a diagnosis of depression from ten public health centres in Chile participated. Characteristics of family functioning and HRQOL were assessed along ten dimensions. The results suggest the importance of obtaining a comprehensive treatment that does not only focus on syndromes, but also on functio­nality, which is an essential notion in the clinical work of children and adolescents


Qualitat de Vida Relacionada amb la Salut (QVRS) fa referència a les valoracions de la percepció de la salut per part d'una persona I recull aspectes objectius I subjectius. Van participar-hi 40 adolescents amb diagnòstic de depressió, procedents de deu centres de salut pública de Xile. Es van avaluar les característiques del funcionament familiar I de la QVRS al voltant de deu dimensions. Els resultats suggereixen la importància d'obtenir un tractament inte­gral, que no apunti únicament al que és sindròmic, sinó també a la funcionalitat, que atorgui una noció essencial en l'afer clínic infantil I juvenil


Assuntos
Humanos , Masculino , Feminino , Adolescente , Transtorno Depressivo/psicologia , Qualidade de Vida/psicologia , Relações Familiares/psicologia , Fatores Sexuais , Fatores Socioeconômicos , Inquéritos e Questionários , Comportamento do Adolescente/psicologia , Relações Pais-Filho , Chile , Serviços Públicos de Saúde/estatística & dados numéricos
14.
PLoS One ; 16(3): e0247143, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33647035

RESUMO

There is increasing evidence that subjective caregiver burden is an important determinant of clinically significant anxiety in family carers. This meta-analysis aims to synthesise this evidence and investigate the relationship between subjective caregiver burden and anxiety symptoms in informal caregivers. We searched PubMed, CINAHL and PsycINFO up to January 2020. Combined estimates were obtained using a random-effects model. After screening of 4,312 articles, 74 studies (with 75 independent samples) were included. There was a large, positive association between subjective caregiver burden and anxiety symptoms (r = 0.51; 95% CI = 0.47, 0.54; I2 = 0.0%). No differences were found in subgroup analyses by type of study design (cross-sectional vs. longitudinal), sampling, control of confounders or care-recipient characteristics. Subjective caregiver burden is an important risk factor for anxiety in informal caregivers. Targeting subjective caregiver burden could be beneficial in preventing clinically significant anxiety for the increasing number of family carers worldwide.


Assuntos
Ansiedade/prevenção & controle , Fardo do Cuidador/psicologia , Cuidadores/psicologia , Adaptação Psicológica , Ansiedade/psicologia , Transtornos de Ansiedade/psicologia , Depressão/psicologia , Transtorno Depressivo/psicologia , Humanos , Qualidade de Vida/psicologia , Fatores de Risco
15.
Turk J Med Sci ; 51(4): 1631-1639, 2021 08 30.
Artigo em Inglês | MEDLINE | ID: mdl-33773523

RESUMO

Background/aim: The COVID-19 outbreak is known to increase stress levels of most patients with chronic diseases. Patients with ankylosing spondylitis (AS) and rheumatoid arthritis (RA) are highly susceptible to environmental stress. In the current study, we aimed to determine how the COVID-19 pandemic psychologically affected patients with chronic progressive diseases such as AS and RA and the effects of these psychological factors on disease activity. Materials and methods: Age and sex-matched patients with AS (n = 80), RA (n = 80), and healthy controls (n = 80) were included in the study. All participants were evaluated with the "Perceived COVID-19 Threat Form (PCTF)", "Suicide-Ideation Scale (SIS)", "Hospital Anxiety and Depression Scale (HADS)", "The Ability to Cope with Trauma (PACT)", and "Psychological General Well-Being Index (PGWB)" scales. BASDAI was used in patients with AS, and DAS28 was used in patients with RA to assess disease severity. Results: Compared to healthy individuals, patients with RA and AS had lower PGWB scores and higher HADS depression and anxiety subscale scores. Almost all psychometric assessment test scores were worse in AS patients with high-disease activity compared to those in low-disease activity. PACT scores were higher in patients with moderate RA compared to patients with mild RA (p = 0.006). While a positive correlation was identified between BASDAI and most of the psychometric assessment test scores (r = 0 .36 for PCTF, r = 0.53 for depressive scores, r = 0.54 for anxiety scores, r = 0.57 for suicidal ideation), DAS28 scores were found to be associated only with PACT total and PACT perceived forward-focused subscale scores (r = ­.26 and r = .33, respectively). Conclusion: Psychologically, AS and RA patients were found to be worse off compared to healthy controls. The perceived COVID threat and psychological status were associated with disease activity in AS, but not RA patients. Patients with chronic illnesses may be more vulnerable to the psychological effects of the pandemic, which can worsen disease activity.


Assuntos
Artrite Reumatoide/complicações , Artrite Reumatoide/psicologia , COVID-19/psicologia , Transtornos Mentais/complicações , Transtornos Mentais/psicologia , Espondilite Anquilosante/complicações , Espondilite Anquilosante/psicologia , Adulto , Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/psicologia , Transtorno Depressivo/complicações , Transtorno Depressivo/psicologia , Feminino , Humanos , Masculino , Pandemias , Qualidade de Vida/psicologia , SARS-CoV-2 , Índice de Gravidade de Doença , Estresse Psicológico/complicações , Estresse Psicológico/psicologia
16.
Nutrients ; 13(3)2021 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-33653007

RESUMO

Diet has been associated with the risk of depression, whereas different subtypes of depression have been linked with different cardiovascular risk factors (CVRFs). In this study, our aims were to 1) identify dietary patterns with exploratory factor analysis, 2) assess cross-sectional associations between dietary patterns and depression subtypes, and 3) examine the potentially mediating effect of dietary patterns in the associations between CVRFs and depression subtypes. In the first follow-up of the population-based CoLaus|PsyCoLaus study (2009-2013, 3554 participants, 45.6% men, mean age 57.5 years), a food frequency questionnaire assessed dietary intake and a semi-structured interview allowed to characterize major depressive disorder into current or remitted atypical, melancholic, and unspecified subtypes. Three dietary patterns were identified: Western, Mediterranean, and Sweet-Dairy. Western diet was positively associated with current atypical depression, but negatively associated with current and remitted melancholic depression. Sweet-Dairy was positively associated with current melancholic depression. However, these dietary patterns did not mediate the associations between CVRFs and depression subtypes. Hence, although we could show that people with different subtypes of depression make different choices regarding their diet, it is unlikely that these differential dietary choices account for the well-established associations between depression subtypes and CVRFs.


Assuntos
Transtorno Depressivo Maior/psicologia , Transtorno Depressivo/psicologia , Dieta/estatística & dados numéricos , Ingestão de Alimentos/psicologia , Comportamento Alimentar/psicologia , Estudos Transversais , Transtorno Depressivo/etiologia , Transtorno Depressivo Maior/etiologia , Dieta/efeitos adversos , Inquéritos sobre Dietas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
17.
Cogn Behav Ther ; 50(4): 276-294, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33706676

RESUMO

The COVID-19 pandemic presents unique stressors (e.g. social isolation) that may increase substance use risk among young adults with a history of emotional disturbance. This study examined whether emotional disorder symptoms and transdiagnostic vulnerabilities during adolescence predicted young adult substance use during COVID-19, and whether using substances to cope with the pandemic's social conditions mediated these associations. Adolescents (N = 2,120) completed baseline surveys assessing transdiagnostic emotional vulnerabilities (anhedonia, distress intolerance, anxiety sensitivity, negative urgency) and symptoms (major depression[MD], generalized anxiety[GAD], panic disorder[PD], social phobia[SP], obsessive-compulsive disorder[OCD]) in adolescence (September-December 2016; M[SD] age = 17.45[0.38]). At follow-up (May-August 2020; M[SD] age = 21.16[0.39]), past 30-day substance use and using substances to cope with social isolation during the pandemic were reported. Adjusted models showed that baseline distress intolerance, anxiety sensitivity, negative urgency, and MD symptoms each significantly predicted higher number of past-month single-substance using days and number of substances used at follow-up (ßs = 0.04-0.06). In each case, associations were mediated by tendency to use substances to cope with the pandemic (ßindirect range: 0.028-0.061). To mitigate disproportionate escalation of substance use in young adults with a history of certain types of emotional disturbance, interventions promoting healthy coping strategies to deal with the pandemic's social conditions warrant consideration.


Assuntos
Adaptação Psicológica , Transtornos de Ansiedade/psicologia , COVID-19/psicologia , Transtorno Depressivo/psicologia , Uso Recreativo de Drogas/psicologia , Sintomas Afetivos/psicologia , Ansiedade/psicologia , Feminino , Humanos , Masculino , Pandemias , Adulto Jovem
18.
Ann R Coll Surg Engl ; 103(3): e77-e80, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33645270

RESUMO

Trichobezoar is a rare condition that occurs mostly in young women with psychiatric disorders such as trichotillomania and trichophagia. We report the case of a giant gastric trichobezoar in a 21-year-old woman who presented with chronic abdominal pain, vomiting and weight loss. Abdominal examination revealed a large epigastric mass. Endoscopic and imaging findings were highly suggestive of a gastric trichobezoar. Surgical extraction of the huge hair mass was successfully performed through an open gastrotomy. Postoperatively, history of a neglected chronic depression with suicidal ideation was diagnosed. Consequently, the patient was referred to the psychiatric department for mental healthcare, to prevent trichobezoar recurrences.


Assuntos
Bezoares/diagnóstico por imagem , Transtorno Depressivo/diagnóstico , Estômago/diagnóstico por imagem , Bezoares/psicologia , Bezoares/cirurgia , Transtorno Depressivo/psicologia , Feminino , Gastroscopia , Humanos , Laparotomia , Pica/psicologia , Estômago/cirurgia , Tomografia Computadorizada por Raios X , Tricotilomania/psicologia , Adulto Jovem
19.
Health Qual Life Outcomes ; 19(1): 103, 2021 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-33752686

RESUMO

BACKGROUND: More than 210,000 medical workers have fought against the outbreak of Coronavirus Disease 2019 (COVID-19) in Hubei in China since December 2019. However, the prevalence of mental health problems in frontline medical staff after fighting COVID-19 is still unknown. METHODS: Medical workers in Wuhan and other cities in Hubei Province were invited to participate a cross-sectional and convenience sampling online survey, which assessed the prevalence of anxiety, insomnia, depression, and post-traumatic stress disorder (PTSD). RESULTS: A total of 1,091 responses (33% male and 67% female) were valid for statistical analysis. The prevalence was anxiety 53%, insomnia 79%, depression 56%, and PTSD 11%. Healthcare workers in Wuhan were more likely to face risks of anxiety (56% vs. 52%, P = 0.03) and PTSD (15% vs. 9%, P = 0.03) than those in other cities of Hubei. In terms of educational attainment, those with doctoral and masters' (D/M) degrees may experience more anxiety (median of 7.0, [interquartile range (IQR) 2.0-8.5] vs. median 5.0 [IQR 5.0-8.0], P = 0.02) and PTSD (median 26.0 [IQR 19.5-33.0] vs. median 23.0 [IQR 19.0-31.0], P = 0.04) than those with lower educational degrees. CONCLUSIONS: The mental problems were an important issue for the healthcare workers after COVID-19. Thus, an early intervention on such mental problems is necessary for healthcare workers.


Assuntos
COVID-19 , Transtorno Depressivo/epidemiologia , Surtos de Doenças , Pessoal de Saúde/psicologia , Doenças Profissionais/epidemiologia , SARS-CoV-2 , Adulto , China/epidemiologia , Estudos Transversais , Transtorno Depressivo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/psicologia , Prevalência , Psicometria , Qualidade de Vida , Inquéritos e Questionários , Adulto Jovem
20.
Clín. salud ; 32(1): 1-6, mar. 2021. tab
Artigo em Inglês | IBECS | ID: ibc-201422

RESUMO

The purpose of this study was to assess the relationship of affective temperaments and personality traits with suicide attempts in patients suffering from depression. A total of 251 patients diagnosed with recurrent depressive disorder or major depression episode were divided in groups with previous suicide attempts (n = 168) and without such attempts (n = 83) and given a sociodemographic questionnaire, TEMPS-A, and a personality questionnaire, VP+2-70. In all temperaments other than hyperthymic, higher scores were predominant in the group of patients with previous suicide attempts. The model including affective temperaments and personality traits successfully classified 72.5% of cases. Only depressive temperament was found to be a significant positive predictor with negative valence close to statistical significance. The cross-sectional design limits our ability to draw conclusions about causality and current affective status of the patients was not controlled for. However, our findings further prove the importance of affective temperament as a screening tool for suicide risk in depressed patients


El objetivo de este estudio fue evaluar la relación de los temperamentos afectivos y los rasgos de personalidad con los intentos de suicidio en pacientes que sufren depresión. Un total de 251 pacientes diagnosticados de trastorno depresivo recurrente o episodio de depresión mayor se dividió en dos grupos, uno con intentos de suicidio previos (n = 168) y otro sin estas tentativas (n = 83), a los que se aplicó un cuestionario sociodemográfico, TEMPS-A, y un cuestionario de personalidad, VP+2-70. En todos los temperamentos que no eran los hipertímicos las puntuaciones más altas se dieron predominantemente en el grupo de pacientes con tentativas de suicidio previas. El modelo que incluye temperamentos afectivos y rasgos de personalidad clasificó adecuadamente al 72.5% de los casos. Solo el temperamento depresivo apareció como predictor positivo significativo con valencia negativa cercana a la significación estadística. El diseño transversal limita nuestra capacidad para sacar conclusiones sobre la causalidad además de que no se controló el estado afectivo actual de los pacientes. Sin embargo, los resultados destacan aún más la importancia del temperamento afectivo como herramienta de detección del riesgo de suicidio en pacientes deprimidos


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Sintomas Afetivos/psicologia , Caráter , Ideação Suicida , Temperamento , Transtornos da Personalidade/psicologia , Transtorno Depressivo/psicologia , Estudos Transversais , Fatores de Risco , Inventário de Personalidade , Inquéritos e Questionários , Fatores Socioeconômicos , Medição de Risco , Neuroticismo
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