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A RH, Gong Q, Tuo YJ, Zhai ST, He BL, Zou EG, Wang ML, Huang TY, Zha CL, He MZ, Zhong GY, Feng YL, Li J. Syringa oblata Lindl extract alleviated corticosterone-induced depression via the cAMP/PKA-CREB-BDNF pathway. JOURNAL OF ETHNOPHARMACOLOGY 2025; 341:119274. [PMID: 39756715 DOI: 10.1016/j.jep.2024.119274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2024] [Revised: 12/07/2024] [Accepted: 12/19/2024] [Indexed: 01/07/2025]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Syringa oblata Lindl (ZDX) is a plant in the Oleaceae family that is the primary ingredient in the classic Tibetan medicine AKARU sinensis. The plant's stem is used as a medicine, and Tibetan doctors often use it as a sedative, a use with a history of nearly 100 years. Tibetan medicine mainly uses lilac to treat headache, forgetfulness, insomnia, irritability and other symptoms. Depression is a chronic mental disorder characterized by low mood, cognitive impairments, and physical discomfort, and it has become a significant public health issue. Given the limitations of existing treatments, interest in alternative therapies, including herbal medicines, is increasing. AIM To elucidate the mechanism of ZDX extract in the treatment of depression. MATERIALS AND METHODS A depression-like mouse model was established via the subcutaneous injection of corticosterone (CORT) into the groin, and a model of PC12 cell injury was established via CORT treatment. The antidepressant effect of the ZDX extract was subsequently evaluated via weight measurements, the sucrose preference test (SPT), the forced swimming test (FST), the open field test(OFT), the tail suspension test (TST), HE staining, Nissl staining and ELISA. Moreover, immunofluorescence staining, qRT‒PCR and Western blotting were used to determine whether ZDX extract can regulate the cAMP/PKA-CREB-BDNF pathway to prevent depression and neuronal apoptosis. RESULTS ZDX extract significantly improved depression-like behaviours; inhibited decreases in the protein levels of cAMP, PKA, CREB and BDNF; and increased proliferative activity in the hippocampus and cortex. In addition, in vitro, ZDX extract attenuated CORT-induced injury and apoptosis in hippocampal neurons and inhibited CORT-induced decreases in the mRNA expression levels of cAMP, PKA, CREB and BDNF. CONCLUSIONS These findings suggest that ZDX extract has potential as a novel antidepressant therapeutic agent, offering a complementary approach to current treatments by targeting multiple pathways involved in the pathogenesis of depression. Further research is warranted to explore the clinical applications of ZDX extract in the treatment of depression.
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Affiliation(s)
- Ru-Han A
- Jiangxi University of Chinese Medicine, Nanchang, 330006, PR China.
| | - Qin Gong
- Jiangxi University of Chinese Medicine, Nanchang, 330006, PR China.
| | - Yan-Jun Tuo
- Jiangxi University of Chinese Medicine, Nanchang, 330006, PR China.
| | - Shu-Ting Zhai
- Jiangxi University of Chinese Medicine, Nanchang, 330006, PR China.
| | - Bei-Lan He
- Jiangxi University of Chinese Medicine, Nanchang, 330006, PR China.
| | - En-Guo Zou
- Jiangxi University of Chinese Medicine, Nanchang, 330006, PR China.
| | - Mu-Lan Wang
- Jiangxi University of Chinese Medicine, Nanchang, 330006, PR China.
| | - Tian-Yu Huang
- Jiangxi University of Chinese Medicine, Nanchang, 330006, PR China.
| | - Chen-Liang Zha
- Jiangxi University of Chinese Medicine, Nanchang, 330006, PR China; National Pharmaceutical Engineering Center for Solid Preparation in Chinese Herbal Medicine, Nanchang, 330006, PR China.
| | - Ming-Zhen He
- Jiangxi University of Chinese Medicine, Nanchang, 330006, PR China.
| | - Guo-Yue Zhong
- Jiangxi University of Chinese Medicine, Nanchang, 330006, PR China.
| | - Yu-Lin Feng
- Jiangxi University of Chinese Medicine, Nanchang, 330006, PR China; National Pharmaceutical Engineering Center for Solid Preparation in Chinese Herbal Medicine, Nanchang, 330006, PR China.
| | - Jun Li
- Jiangxi University of Chinese Medicine, Nanchang, 330006, PR China; National Pharmaceutical Engineering Center for Solid Preparation in Chinese Herbal Medicine, Nanchang, 330006, PR China.
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Wang Y, Cui P, Cao M, Ai L, Zeng L, Li X, Chen D, Gong F, Fang L, Zhou C. Chronic restraint stress affects the diurnal rhythms of gut microbial composition and metabolism in a mouse model of depression. BMC Microbiol 2025; 25:38. [PMID: 39844033 PMCID: PMC11752688 DOI: 10.1186/s12866-025-03764-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 01/11/2025] [Indexed: 01/24/2025] Open
Abstract
BACKGROUND Depression is a common mental disorder accompanied by gut microbiota dysbiosis, which disturbs the metabolism of the host. While diurnal oscillation of the intestinal microbiota is involved in regulating host metabolism, the characteristics of the intestinal microbial circadian rhythm in depression remain unknown. Our aim was to investigate the microbial circadian oscillation signature and related metabolic pathways in a mouse model with depression-like behaviours. METHODS Chronic restraint stress (CRS) was used to induce depressive-like behaviours in C57BL/6J mice. The open field test (OFT) and forced swimming test (FST) were used to evaluate anxiety- and depressive-like behaviours in the control and CRS groups. Afterwards, faecal samples from the two groups were collected every four hours from ZT2 (9:00 am) to ZT22 (5:00 am). Faecal 16 S rRNA gene sequencing and metabolomics analysis were performed, and the microbial circadian rhythm was analysed via the MetaCycle package in R/RStudio. RESULTS CRS mice exhibited depressive-like behaviours after 4 weeks of restriction. Alpha- and beta-diversity analyses revealed that the microbial composition in control and CRS mice oscillated throughout the day. The circadian rhythm analyses revealed that at the phylum level, Bacteroidota, Firmicutes, Cyanobacteria and Patescibacteria showed circadian rhythmicity in the CRS group. At the genus level, Dubosiella and Romboutsia showed circadian rhythmicity in the control group, and Dubosiella abundance was correlated with tryptophan and galactose metabolism. In the CRS group, Bacteroides, Parabacteroides, and Rikenellaceae_RC9_gut_group showed circadian rhythmicity; among these genera, Parabacteroides was related to tryptophan metabolism, axon regeneration, phenylalanine metabolism and tyrosine metabolism. CONCLUSION Our data highlight the importance of observing the diurnal oscillation of the microbiome in host with depressive-like states. Rhythmicity in the microbiome may affect the host by regulating distinct metabolic pathways during the light and dark phases. A better combination of microbiota composition and oscillation would help to offer novel insight into key genera and their potential effects on depression.
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Affiliation(s)
- Yue Wang
- Department of Pediatric, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Peijin Cui
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Maolin Cao
- Department of General Practice, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Ling Ai
- Department of General Practice, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Li Zeng
- Department of Nephrology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Xue Li
- Central Laboratory, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Dan Chen
- Central Laboratory, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Fang Gong
- Department of Pediatric, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Liang Fang
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China.
- Yongchuan Hospital of Chongqing Medical University, No. 439 Xuanhua Road, Yongchuan, Chongqing, 402160, China.
| | - Chanjuan Zhou
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China.
- Central Laboratory, Yongchuan Hospital of Chongqing Medical University, Chongqing, China.
- Yongchuan Hospital of Chongqing Medical University, No. 439 Xuanhua Road, Yongchuan, Chongqing, 402160, China.
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Devkota G, Basnet P, Thapa B, Subedi M. Factors affecting mental health service delivery from primary healthcare facilities of western hilly district of Nepal: a qualitative study. BMJ Open 2025; 15:e080163. [PMID: 39753256 PMCID: PMC11749035 DOI: 10.1136/bmjopen-2023-080163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/03/2024] [Indexed: 01/23/2025] Open
Abstract
AIM To explore factors at different socioecological levels that affect mental health service delivery from primary healthcare (PHC) facilities of Arghakhanchi district, a western hilly district of Nepal. BACKGROUND Mental health service delivery has seen four transformational shifts from Alma Ata to Astana Declaration. Mental Health Gap Action Programme has facilitated the delivery of evidence-based interventions on mental, neurological and substance use disorders by non-specialised health workers in PHC settings as well as advocated scaling up of mental healthcare through integration of mental health in PHC. METHODS A cross-sectional qualitative study was conducted in Arghakhanchi district of Nepal from July to August 2019 that collected information through face-to-face key informant interviews of 16 purposively selected participants using validated interview guidelines. Thematic analysis was performed using RQDA package for EZR software. Validation of translated transcripts, member checking and inter-coder percent agreement were performed to maintain rigour in the study. RESULTS Lack of mental health training and no authority to prescribe psychotropic medications coupled with lack of mental health commodities acted as barriers for mental health service delivery. Awareness regarding mental health and modalities of treatment to the community and provision of training and authority to prescribe psychotropic medicines were recommended by the participants for proper mental health service delivery. CONCLUSIONS Awareness regarding mental illness treatment modalities to the community and mental health training for healthcare service providers would help increase mental health service delivery from PHC facilities. Moreover, strengthened referral system and availability of psychotropic medicines at the PHC level would assist in mental health service delivery from PHC facilities. However, regular monitoring and supervision of the services being delivered is essential.
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Affiliation(s)
| | - Puspa Basnet
- Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Bijay Thapa
- Patan Academy of Health Sciences, Lalitpur, Nepal
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Varghese SM, Patel S, Nandan A, Jose A, Ghosh S, Sah RK, Menon B, K V A, Chakravarty S. Unraveling the Role of the Blood-Brain Barrier in the Pathophysiology of Depression: Recent Advances and Future Perspectives. Mol Neurobiol 2024; 61:10398-10447. [PMID: 38730081 DOI: 10.1007/s12035-024-04205-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 04/19/2024] [Indexed: 05/12/2024]
Abstract
Depression is a highly prevalent psychological disorder characterized by persistent dysphoria, psychomotor retardation, insomnia, anhedonia, suicidal ideation, and a remarkable decrease in overall well-being. Despite the prevalence of accessible antidepressant therapies, many individuals do not achieve substantial improvement. Understanding the multifactorial pathophysiology and the heterogeneous nature of the disorder could lead the way toward better outcomes. Recent findings have elucidated the substantial impact of compromised blood-brain barrier (BBB) integrity on the manifestation of depression. BBB functions as an indispensable defense mechanism, tightly overseeing the transport of molecules from the periphery to preserve the integrity of the brain parenchyma. The dysfunction of the BBB has been implicated in a multitude of neurological disorders, and its disruption and consequent brain alterations could potentially serve as important factors in the pathogenesis and progression of depression. In this review, we extensively examine the pathophysiological relevance of the BBB and delve into the specific modifications of its components that underlie the complexities of depression. A particular focus has been placed on examining the effects of peripheral inflammation on the BBB in depression and elucidating the intricate interactions between the gut, BBB, and brain. Furthermore, this review encompasses significant updates on the assessment of BBB integrity and permeability, providing a comprehensive overview of the topic. Finally, we outline the therapeutic relevance and strategies based on BBB in depression, including COVID-19-associated BBB disruption and neuropsychiatric implications. Understanding the comprehensive pathogenic cascade of depression is crucial for shaping the trajectory of future research endeavors.
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Affiliation(s)
- Shamili Mariya Varghese
- Department of Pharmacology, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi, Kerala, 682 041, India
| | - Shashikant Patel
- Applied Biology Division, CSIR-Indian Institute of Chemical Technology, Tarnaka, Uppal Road, Hyderabad, Telangana, 500007, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Amritasree Nandan
- Department of Pharmacology, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi, Kerala, 682 041, India
| | - Anju Jose
- Department of Pharmacology, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi, Kerala, 682 041, India
| | - Soumya Ghosh
- Applied Biology Division, CSIR-Indian Institute of Chemical Technology, Tarnaka, Uppal Road, Hyderabad, Telangana, 500007, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Ranjay Kumar Sah
- Department of Pharmacology, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi, Kerala, 682 041, India
| | - Bindu Menon
- Department of Psychiatry, Amrita School of Medicine, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi, Kerala, 682 041, India
| | - Athira K V
- Department of Pharmacology, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi, Kerala, 682 041, India.
| | - Sumana Chakravarty
- Applied Biology Division, CSIR-Indian Institute of Chemical Technology, Tarnaka, Uppal Road, Hyderabad, Telangana, 500007, India.
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India.
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Pennisi F, Ricciardi GE, von Wagner C, Smith L, Kaushal A, Lyratzopoulos G, Merriel SWD, Hamilton W, Abel G, Valderas JM, Renzi C. Impact of Self-Reported Long-Term Mental Health Morbidity on Help-Seeking and Diagnostic Testing for Bowel-Related Cancer Symptoms: A Vignette Study. Cancer Med 2024; 13:e70426. [PMID: 39641393 PMCID: PMC11621967 DOI: 10.1002/cam4.70426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 10/23/2024] [Accepted: 11/04/2024] [Indexed: 12/07/2024] Open
Abstract
OBJECTIVE To investigate if pre-existing mental health morbidity (MHM) might influence help-seeking and willingness to undergo diagnostic investigations for potential colorectal cancer (CRC) symptoms. METHODS An online vignette survey was completed by 1307 adults aged > 50 years recruited through Prolific, a UK panel provider. Participants self-reported any chronic physical or MHM. After having been presented with vignettes describing new onset symptoms (rectal bleeding or change in bowel habit), participants answered questions on symptom attribution and attitudes to investigations. Using multivariable logistic regression we examined the association between MHM and symptom attribution, intended help-seeking, and willingness to undergo investigations, controlling for socio-demographic factors and physical morbidities. RESULTS Self-reported MHM (reported by 14% of participants) was not associated with cancer symptom attribution (29% of participants with or without MHM mentioned cancer as a possible reason for rectal bleeding and 14% for change in bowel habit). Individuals with self-reported MHM were less likely to contact a GP if experiencing a change in bowel habit (19% vs. 39%; adjusted (a)OR = 0.34, 95% CI 0.19-0.60) and to mention rectal bleeding to their GP (83% vs. 89%, aOR = 0.49, 95% CI 0.26-0.94). Although most participants would be willing to undergo a colonoscopy for these high-risk symptoms, those with depression/anxiety were less willing (90% vs. 96%; aOR: 0.37, 95% CI 0.16-0.87). CONCLUSIONS Individuals with self-reported MHM are less likely to seek help and less willing to undergo investigations for high-risk symptoms. Targeted support, for example, through additional mental health nurses, might facilitate prompt cancer diagnosis for the large group of people with MHM.
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Affiliation(s)
- Flavia Pennisi
- PhD National Programme in One Health Approaches to Infectious Diseases and Life Science Research, Department of Public Health, Experimental and Forensic MedicineUniversity of PaviaPaviaItaly
- School of MedicineUniversità Vita‐Salute San RaffaeleMilanoItaly
| | - Giovanni Emanuele Ricciardi
- PhD National Programme in One Health Approaches to Infectious Diseases and Life Science Research, Department of Public Health, Experimental and Forensic MedicineUniversity of PaviaPaviaItaly
- School of MedicineUniversità Vita‐Salute San RaffaeleMilanoItaly
| | - Christian von Wagner
- Research Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Lauren Smith
- Research Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Aradhna Kaushal
- Research Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | | | | | - Willie Hamilton
- Department of Health and Community Sciences, Faculty of Health and Life SciencesUniversity of ExeterExeterUK
| | - Gary Abel
- Department of Health and Community Sciences, Faculty of Health and Life SciencesUniversity of ExeterExeterUK
| | - Jose Maria Valderas
- Department of Health and Community Sciences, Faculty of Health and Life SciencesUniversity of ExeterExeterUK
- Department of Family MedicineNational University Health SystemSingapore CitySingapore
- Centre for Research on Health Systems PerformanceNational University of SingaporeSingapore CitySingapore
| | - Cristina Renzi
- School of MedicineUniversità Vita‐Salute San RaffaeleMilanoItaly
- Research Department of Behavioural Science and HealthUniversity College LondonLondonUK
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Das KP, Gavade P. A review on the efficacy of artificial intelligence for managing anxiety disorders. Front Artif Intell 2024; 7:1435895. [PMID: 39479229 PMCID: PMC11523650 DOI: 10.3389/frai.2024.1435895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 09/16/2024] [Indexed: 11/02/2024] Open
Abstract
Anxiety disorders are psychiatric conditions characterized by prolonged and generalized anxiety experienced by individuals in response to various events or situations. At present, anxiety disorders are regarded as the most widespread psychiatric disorders globally. Medication and different types of psychotherapies are employed as the primary therapeutic modalities in clinical practice for the treatment of anxiety disorders. However, combining these two approaches is known to yield more significant benefits than medication alone. Nevertheless, there is a lack of resources and a limited availability of psychotherapy options in underdeveloped areas. Psychotherapy methods encompass relaxation techniques, controlled breathing exercises, visualization exercises, controlled exposure exercises, and cognitive interventions such as challenging negative thoughts. These methods are vital in the treatment of anxiety disorders, but executing them proficiently can be demanding. Moreover, individuals with distinct anxiety disorders are prescribed medications that may cause withdrawal symptoms in some instances. Additionally, there is inadequate availability of face-to-face psychotherapy and a restricted capacity to predict and monitor the health, behavioral, and environmental aspects of individuals with anxiety disorders during the initial phases. In recent years, there has been notable progress in developing and utilizing artificial intelligence (AI) based applications and environments to improve the precision and sensitivity of diagnosing and treating various categories of anxiety disorders. As a result, this study aims to establish the efficacy of AI-enabled environments in addressing the existing challenges in managing anxiety disorders, reducing reliance on medication, and investigating the potential advantages, issues, and opportunities of integrating AI-assisted healthcare for anxiety disorders and enabling personalized therapy.
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Affiliation(s)
- K. P. Das
- Department of Computer Science, Christ University, Bengaluru, India
| | - P. Gavade
- Independent Practitioner, San Francisco, CA, United States
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Yoo A, Li F, Youn J, Guan J, Guyer AE, Hostinar CE, Tagkopoulos I. Prediction of adolescent depression from prenatal and childhood data from ALSPAC using machine learning. Sci Rep 2024; 14:23282. [PMID: 39375420 PMCID: PMC11458604 DOI: 10.1038/s41598-024-72158-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 09/04/2024] [Indexed: 10/09/2024] Open
Abstract
Depression is a major cause of disability and mortality for young people worldwide and is typically first diagnosed during adolescence. In this work, we present a machine learning framework to predict adolescent depression occurring between ages 12 and 18 years using environmental, biological, and lifestyle features of the child, mother, and partner from the child's prenatal period to age 10 years using data from 8467 participants enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC). We trained and compared several cross-sectional and longitudinal machine learning techniques and found the resulting models predicted adolescent depression with recall (0.59 ± 0.20), specificity (0.61 ± 0.17), and accuracy (0.64 ± 0.13), using on average 39 out of the 885 total features (4.4%) included in the models. The leading informative features in our predictive models of adolescent depression were female sex, parental depression and anxiety, and exposure to stressful events or environments. This work demonstrates how using a broad array of evidence-driven predictors from early in life can inform the development of preventative decision support tools to assist in the early detection of risk for mental illness.
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Affiliation(s)
- Arielle Yoo
- Department of Computer Science, University of California - Davis, Davis, USA
- Genome Center, University of California - Davis, Davis, USA
- USDA/NSF AI Institute for Next Generation Food Systems (AIFS), Davis, USA
| | - Fangzhou Li
- Department of Computer Science, University of California - Davis, Davis, USA
- Genome Center, University of California - Davis, Davis, USA
- USDA/NSF AI Institute for Next Generation Food Systems (AIFS), Davis, USA
| | - Jason Youn
- Department of Computer Science, University of California - Davis, Davis, USA
- Genome Center, University of California - Davis, Davis, USA
- USDA/NSF AI Institute for Next Generation Food Systems (AIFS), Davis, USA
| | - Joanna Guan
- Department of Psychology, University of California - Davis, Davis, USA
- Center for Mind and Brain, University of California - Davis, Davis, USA
| | - Amanda E Guyer
- Center for Mind and Brain, University of California - Davis, Davis, USA
- Department of Human Ecology, University of California - Davis, Davis, USA
| | - Camelia E Hostinar
- Department of Psychology, University of California - Davis, Davis, USA
- Center for Mind and Brain, University of California - Davis, Davis, USA
| | - Ilias Tagkopoulos
- Department of Computer Science, University of California - Davis, Davis, USA.
- Genome Center, University of California - Davis, Davis, USA.
- USDA/NSF AI Institute for Next Generation Food Systems (AIFS), Davis, USA.
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Sharma A, Dhingra D, Bhutani R, Nayak A, Garg A. Depression-reminiscent Behavior Induced by Chronic Unpredictable
Mild Stress Paradigm in Mice Substantially Abrogated by Diosmin. CURRENT PSYCHIATRY RESEARCH AND REVIEWS 2024; 20:251-269. [DOI: 10.2174/0126660822261988231127072951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 01/03/2025]
Abstract
Background:
Diosmin has already been described and documented to be neuroprotective,
antioxidant and anti-inflammatory. It may possess or hold depressionalleviating
activity. Therefore, the purpose of the current research protocol is to investigate
the depression-relieving proficiency of diosmin in stressed and unstressed mice.
Methods:
Male mice (Swiss albino) were imperiled to an unpredictable chronic stress paradigm
every day for three sequential weeks, and depression-resembling behavioral despair
was induced. Imipramine 15 mg/kg and diosmin (25, 50 and 100 mg/kg) were dispensed
for 21 successive days to discrete groups of stressed and unstressed mice.
Results:
Both diosmin (100 mg/kg) and 15 mg/kg imipramine administration for 3 consecutive
weeks substantially or significantly diminished the immobility period of mice imperiled
to stress in comparison to stressed mice gauzed with the vehicle. Diosmin (25, 50 and
100 mg/kg) and imipramine considerably reinstated the diminished sucrose proclivity (sucrose
preference percentage; %) in stressed mice, demonstrating their considerable or substantial
depression-relieving effects. The locomotor activities of mice were not considerably
altered by these drugs. Antidepressant-like activity of diosmin for immobility periods
and preference for sucrose was observed to be analogous to imipramine. Diosmin (100
mg/kg) and imipramine substantially quashed CUMS- persuaded escalation of plasma corticosterone
and nitrite levels, malondialdehyde levels and MAO-A activity in the brain of
stressed mice. Both drugs also substantially reversed CUMS-prompted reduction in catalase
activity and brain glutathione levels.
Conclusion:
Accordingly, diosmin revealed significant anti-depressive activity in mice
imperiled to chronic mild unpredictable stress paradigm conceivably via mitigation of nitrosative
and oxidative stress, reticence of brain MAO-A action, and sink drop of plasma
corticosterone degrees.
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Affiliation(s)
- Abhishek Sharma
- Department of Pharmacy, School of Medical and Allied Sciences, G D Goenka University,
Gurugram, 122103, Haryana, India
| | - Dinesh Dhingra
- Department of Pharmaceutical Sciences, Guru Jambheshwar
University of Science and Technology, Hisar, 125001, Haryana, India
| | - Rubina Bhutani
- Department of Pharmacy, School of Medical and Allied Sciences, G D Goenka University,
Gurugram, 122103, Haryana, India
| | - Amit Nayak
- Department of Pharmacy, School of Medical and Allied Sciences, G D Goenka University,
Gurugram, 122103, Haryana, India
| | - Adish Garg
- Department of Pharmaceutical Sciences, Guru Jambheshwar
University of Science and Technology, Hisar, 125001, Haryana, India
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Ravi V, Wang J, Flint J, Alwan A. Enhancing accuracy and privacy in speech-based depression detection through speaker disentanglement. COMPUT SPEECH LANG 2024; 86:101605. [PMID: 38313320 PMCID: PMC10836190 DOI: 10.1016/j.csl.2023.101605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
Speech signals are valuable biomarkers for assessing an individual's mental health, including identifying Major Depressive Disorder (MDD) automatically. A frequently used approach in this regard is to employ features related to speaker identity, such as speaker-embeddings. However, over-reliance on speaker identity features in mental health screening systems can compromise patient privacy. Moreover, some aspects of speaker identity may not be relevant for depression detection and could serve as a bias factor that hampers system performance. To overcome these limitations, we propose disentangling speaker-identity information from depression-related information. Specifically, we present four distinct disentanglement methods to achieve this - adversarial speaker identification (SID)-loss maximization (ADV), SID-loss equalization with variance (LEV), SID-loss equalization using Cross-Entropy (LECE) and SID-loss equalization using KL divergence (LEKLD). Our experiments, which incorporated diverse input features and model architectures, have yielded improved F1 scores for MDD detection and voice-privacy attributes, as quantified by Gain in Voice Distinctiveness G V D and De-Identification Scores (DeID). On the DAIC-WOZ dataset (English), LECE using ComparE16 features results in the best F1-Scores of 80% which represents the audio-only SOTA depression detection F1-Score along with a G V D of -1.1 dB and a DeID of 85%. On the EATD dataset (Mandarin), ADV using raw-audio signal achieves an F1-Score of 72.38% surpassing multi-modal SOTA along with a G V D of -0.89 dB dB and a DeID of 51.21%. By reducing the dependence on speaker-identity-related features, our method offers a promising direction for speech-based depression detection that preserves patient privacy.
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Affiliation(s)
- Vijay Ravi
- Department of Electrical and Computer Engineering, University of California, Los Angeles, CA, 90095, USA
| | - Jinhan Wang
- Department of Electrical and Computer Engineering, University of California, Los Angeles, CA, 90095, USA
| | - Jonathan Flint
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, 90095, USA
| | - Abeer Alwan
- Department of Electrical and Computer Engineering, University of California, Los Angeles, CA, 90095, USA
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Shakya P, Sood M, Mathur R, Prajapati N, Patil V. Pathways to care and barriers in treatment among patients with Dissociative disorders. Asian J Psychiatr 2024; 95:104000. [PMID: 38507864 DOI: 10.1016/j.ajp.2024.104000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 03/02/2024] [Accepted: 03/06/2024] [Indexed: 03/22/2024]
Abstract
INTRODUCTION Dissociative disorder patients often present with sudden and embarrassing symptoms, and it is difficult for the patient and care giver to understand initially, recognize the need for help and reach for appropriate treatment timely. This can result in high risk of engaging in dangerous behaviors such as self-harm and suicidal acts, impaired global functioning, and poor quality of life. Knowledge about the types of barriers which are there in treatment seeking, can help in planning strategies for their removal and to facilitate the treatment process. METHODS Cross-sectional study among patients (n=133) with Dissociative disorders which were recruited from January 2023 to June 2023 in a tertiary care hospital. Pathways to care and barriers in treatment for Dissociative disorders were assessed by interviewing patients using semi-structured proforma. The Dissociative Experience Scale and World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0)) were used to assess disease severity and impact of illness on various domains of life respectively. Group comparison was made to assess differences in social- clinical profile of patients choosing different modalities of treatment. RESULTS 133 patients of Dissociative disorders with mean age 29.6±9.2, showed their first-choice of help seeking from general practitioner/ neurologist (40.6%), traditional faith healers (35.3%), psychiatrist (18.1%) and 5.2% preferred alternative treatments. This trend changed with 2nd and 3rd contact of help seeking with greater preference for psychiatrist in their 2nd (n=45, 33.8%) and 3rd (n=69, 51.8%) contact. The median duration of untreated illness was 56 weeks (IQR 24-182 weeks). Social-clinical profile of patients varied with their choice of treatment, having lower education level (P = 0.013), longer duration of untreated illness (p=0.003), more severity of symptoms (p=0.032) and greater disability scores(p=0.002) in patients whose first treatment choice was traditional faith healers. More than 70% patients faced availability barriers, stigma, unawareness about mental illness and influence of others in treatment of choice as barriers in initiating and continuing treatment. CONCLUSION Patients with Dissociative disorders seek treatment from a multitude of healthcare providers including traditional faith healers, general physicians, and alternative medicine practitioners before reaching psychiatrist and undergoes various barriers in treatment. There is need to implement necessary measures for sensitization and awareness about Dissociative disorders to prevent prolonged and undue delays in initiation of appropriate management.
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Affiliation(s)
- Pooja Shakya
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
| | - Mamta Sood
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
| | - Rahul Mathur
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
| | - Nisha Prajapati
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
| | - Vaibhav Patil
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
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11
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Zhu D, Lyu K. Anti-stigmatizing: a collaborative autoethnography on recovery from depression. Front Psychiatry 2024; 15:1360967. [PMID: 38690206 PMCID: PMC11059567 DOI: 10.3389/fpsyt.2024.1360967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 03/11/2024] [Indexed: 05/02/2024] Open
Abstract
Introduction Despite extensive research on clinical treatments for depression, there remains a significant gap in understanding of the lived experiences and recovery journeys of those with depression. This study sought to explore the recovery process through an "anti-stigmatizing" lens, emphasizing the cultural-psychological mechanisms at play and the importance of personal narratives in shaping the recovery trajectory. Methods Using a collaborative autoethnographic approach, this report focuses on the first author's journey of depression recovery. This research methodology allows for an in-depth exploration of subjective experiences, with a specific emphasis on the interaction between societal stigma, personal identity, and mental-health challenges. Results It is found that the depression-recovery experience can be divided into four stages from an anti-stigma perspective: (1) encountering the public stigma of emotions; (2) internalizing the stigma to a self-stigma; (3) "decriminalizing" the expected stigma of a "depressed" identity through diagnosis; and (4) being able to cope with and understanding the public stigma relating to depression when facing it again. Key factors that were found to contribute to recovery were self-awareness, community empowerment, and recognition and acceptance by close friends and family. Discussion We propose a reconceptualization of depression that incorporates a societal perspective on internalized stigma. Recovery from depression is not merely a medical process; it also pertains to how the patient frees themselves from public stigma. The results strongly indicate the need for a paradigm shift toward a more inclusive and empathetic approach to mental-health care, and we emphasize the importance of personal narratives in depression recovery.
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Affiliation(s)
- Danlei Zhu
- Institute of Vocational & Adult Education, East China Normal University, Shanghai, China
| | - Keyi Lyu
- Jing Hengyi School of Education, Hangzhou Normal University, Hangzhou, China
- Chinese Education Modernization Research Institute of Hangzhou Normal University, Hangzhou, China
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12
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Claeys M, Van den Broeck A, Houkes I, de Rijk A. Line Managers' Perspectives and Responses when Employees Burn Out. JOURNAL OF OCCUPATIONAL REHABILITATION 2024; 34:169-179. [PMID: 37402928 PMCID: PMC10899266 DOI: 10.1007/s10926-023-10117-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/05/2023] [Indexed: 07/06/2023]
Abstract
PURPOSE Little is known about whether burnout can be stopped at an emerging stage. To develop this knowledge, we focus on line managers' perspectives and responses when an employee who seems to be heading for burnout is still at work. METHODS We interviewed 17 line managers working in the educational and health care sectors, who had been confronted with the sickness absence of at least one employee due to burnout in the past. Interviews were transcribed, coded, and analyzed thematically. RESULTS During the period that the employee seemed to be developing burnout while still at work, line managers experienced three different, successive phases: picking up signals, role-taking, and re-evaluation. Line managers' personal frame of reference (e.g., having experience with burnout) seemed to influence whether and how they picked up signals of burnout. Line managers not picking up signals, did not take any action. When picking up the signals, the managers however generally took an active role: they started a conversation, changed work tasks, and - at a later stage - adapted the employee's job description, sometimes without consulting the employee. The managers felt powerless yet learned from the experience when subsequently re-evaluating the period during which employees developed symptoms of burnout. These re-evaluations resulted in an adapted personal frame of reference. CONCLUSION This study shows that improving line managers' frame of reference, e.g., by organizing meetings and/or training, may help them to detect early signals of burnout and take action. This is a first step to prevent the further development of early burnout symptoms.
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Affiliation(s)
- M Claeys
- Faculty of Health, Medicine and Life Science, Maastricht University, Maastricht, 6229 ER, the Netherlands
| | - A Van den Broeck
- Department of Work and Organization Studies, KU Leuven - Campus Brussels, Leuven, Belgium
| | - I Houkes
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - A de Rijk
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
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Ravi V, Wang J, Flint J, Alwan A. A Privacy-Preserving Unsupervised Speaker Disentanglement Method for Depression Detection from Speech. CEUR WORKSHOP PROCEEDINGS 2024; 3649:57-63. [PMID: 38650610 PMCID: PMC11034881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
The proposed method focuses on speaker disentanglement in the context of depression detection from speech signals. Previous approaches require patient/speaker labels, encounter instability due to loss maximization, and introduce unnecessary parameters for adversarial domain prediction. In contrast, the proposed unsupervised approach reduces cosine similarity between latent spaces of depression and pre-trained speaker classification models. This method outperforms baseline models, matches or exceeds adversarial methods in performance, and does so without relying on speaker labels or introducing additional model parameters, leading to a reduction in model complexity. The higher the speaker de-identification score (DeID), the better the depression detection system is in masking a patient's identity thereby enhancing the privacy attributes of depression detection systems. On the DAIC-WOZ dataset with ComparE16 features and an LSTM-only model, our method achieves an F1-Score of 0.776 and a DeID score of 92.87%, outperforming its adversarial counterpart which has an F1Score of 0.762 and 68.37% DeID, respectively. Furthermore, we demonstrate that speaker-disentanglement methods are complementary to text-based approaches, and a score-level fusion with a Word2vec-based depression detection model further enhances the overall performance to an F1-Score of 0.830.
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Affiliation(s)
- Vijay Ravi
- Department of Electrical and Computer Engineering, University of California Los Angeles, California, USA 90095
| | - Jinhan Wang
- Department of Electrical and Computer Engineering, University of California Los Angeles, California, USA 90095
| | - Jonathan Flint
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, California, USA 90095
| | - Abeer Alwan
- Department of Electrical and Computer Engineering, University of California Los Angeles, California, USA 90095
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Khoo LS, Lim MK, Chong CY, McNaney R. Machine Learning for Multimodal Mental Health Detection: A Systematic Review of Passive Sensing Approaches. SENSORS (BASEL, SWITZERLAND) 2024; 24:348. [PMID: 38257440 PMCID: PMC10820860 DOI: 10.3390/s24020348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024]
Abstract
As mental health (MH) disorders become increasingly prevalent, their multifaceted symptoms and comorbidities with other conditions introduce complexity to diagnosis, posing a risk of underdiagnosis. While machine learning (ML) has been explored to mitigate these challenges, we hypothesized that multiple data modalities support more comprehensive detection and that non-intrusive collection approaches better capture natural behaviors. To understand the current trends, we systematically reviewed 184 studies to assess feature extraction, feature fusion, and ML methodologies applied to detect MH disorders from passively sensed multimodal data, including audio and video recordings, social media, smartphones, and wearable devices. Our findings revealed varying correlations of modality-specific features in individualized contexts, potentially influenced by demographics and personalities. We also observed the growing adoption of neural network architectures for model-level fusion and as ML algorithms, which have demonstrated promising efficacy in handling high-dimensional features while modeling within and cross-modality relationships. This work provides future researchers with a clear taxonomy of methodological approaches to multimodal detection of MH disorders to inspire future methodological advancements. The comprehensive analysis also guides and supports future researchers in making informed decisions to select an optimal data source that aligns with specific use cases based on the MH disorder of interest.
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Affiliation(s)
- Lin Sze Khoo
- Department of Human-Centered Computing, Faculty of Information Technology, Monash University, Clayton, VIC 3800, Australia;
| | - Mei Kuan Lim
- School of Information Technology, Monash University Malaysia, Subang Jaya 46150, Malaysia; (M.K.L.); (C.Y.C.)
| | - Chun Yong Chong
- School of Information Technology, Monash University Malaysia, Subang Jaya 46150, Malaysia; (M.K.L.); (C.Y.C.)
| | - Roisin McNaney
- Department of Human-Centered Computing, Faculty of Information Technology, Monash University, Clayton, VIC 3800, Australia;
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15
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Anza-Ramirez C, Najarro L, Bernabé-Ortiz A, Diez-Canseco F, Fottrell E, Abubakar I, Hernández-Vásquez A, Carrillo-Larco RM, Hurst JR, Miranda JJ. Multimorbidity and acute infectious diseases in urban and semi-urban settings in Peru: A mixed-methods study. JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2024; 14:26335565241256826. [PMID: 38798989 PMCID: PMC11119522 DOI: 10.1177/26335565241256826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 05/07/2024] [Indexed: 05/29/2024]
Abstract
Background The co-occurrence of chronic diseases and acute infectious events exacerbates disability and diminishes quality of life, yet research in Low- and Middle-Income countries is scarce. We aimed to investigate the relationship between infectious events and multimorbidity in resource-constrained settings. Methods We conducted a sequential mixed-method study in Lima and Tumbes, Peru, with participants having multimorbidity from the CRONICAS Cohort Study. They completed a questionnaire on the occurrence, treatment, and health-seeking behaviour related to acute infectious events. Qualitative interviews explored the perceptions and links between multimorbidity and acute infectious events for a subgroup of participants. Findings Among individuals with multimorbidity, low awareness of chronic conditions and poor medication adherence. The cumulative incidence for respiratory and gastrointestinal infections, the most reported acute conditions, was 2.0 [95%CI: 1.8-2.2] and 1.6 [1.2-1.9] events per person per year, respectively. Individuals with cancer (6.4 [1.6-11.2] events per person per year) or gastrointestinal reflux (7.2 [4.4-10.1] events per person per year) reported higher cumulative incidence of infectious events than others, such as those with cardiovascular and metabolic conditions (5.2 [4.6-5.8] events per person per year). Those with three or more chronic conditions had a slightly higher cumulative incidence compared with individuals with two conditions (5.7 [4.4-7.0] vs 5.0 [4.4-5.6] events per person per year). Around 40% of individuals with multimorbidity sought healthcare assistance, while others chose drugstores or didn't seek help. Our qualitative analysis showed diverse perceptions among participants regarding the connections between chronic and acute conditions. Those who recognized a connection emphasized the challenges in managing these interactions. Interpretation Our study advances understanding of multimorbidity challenges in resource-limited settings, highlighting the impact of acute infections on patients' existing multimorbidity burden.
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Affiliation(s)
- Cecilia Anza-Ramirez
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Lizzete Najarro
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Antonio Bernabé-Ortiz
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Francisco Diez-Canseco
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Edward Fottrell
- UCL Institute for Global Health, University College London, London, UK
| | - Ibrahim Abubakar
- UCL Institute for Global Health, University College London, London, UK
| | - Akram Hernández-Vásquez
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Rodrigo M. Carrillo-Larco
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - John R. Hurst
- UCL Respiratory, University College London, London, UK
| | - Juan Jaime Miranda
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
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Jaber M, Kahwaji H, Nasr S, Baz R, Kim YK, Fakhoury M. Precision Medicine in Depression: The Role of Proteomics and Metabolomics in Personalized Treatment Approaches. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1456:359-378. [PMID: 39261438 DOI: 10.1007/978-981-97-4402-2_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/13/2024]
Abstract
Depression, or major depressive disorder (MDD), is a widespread mental health condition marked by enduring feelings of sorrow and loss of interest. Treatment of depression frequently combines psychotherapy, medication, and lifestyle modifications. However, the occurrence of treatment resistance in certain individuals makes it difficult for physicians to effectively manage this disorder, calling for the implementation of alternative therapeutic strategies. Recently, precision medicine has gained increased attention in the field of mental health, paving the way for more personalized and effective therapeutic interventions in depression. Also known as personalized medicine, this approach relies on genetic composition, molecular profiles, and environmental variables to customize therapies to individual patients. In particular, precision medicine has offered novel viewpoints on depression through two specific domains: proteomics and metabolomics. On one hand, proteomics is the thorough study of proteins in a biological system, while metabolomics focuses on analyzing the complete set of metabolites in a living being. In the past few years, progress in research has led to the identification of numerous depression-related biomarkers using proteomics and metabolomics techniques, allowing for early identification, precise diagnosis, and improved clinical outcome. However, despite significant progress in these techniques, further efforts are required for advancing precision medicine in the diagnosis and treatment of depression. The overarching goal of this chapter is to provide the current state of knowledge regarding the use of proteomics and metabolomics in identifying biomarkers related to depression. It also highlights the potential of proteomics and metabolomics in elucidating the intricate processes underlying depression, opening the door for tailored therapies that could eventually enhance clinical outcome in depressed patients. This chapter finally discusses the main challenges in the use of proteomics and metabolomics and discusses potential future research directions.
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Affiliation(s)
- Mohamad Jaber
- School of Medicine, American University of Beirut, Beirut, Lebanon
| | - Hamza Kahwaji
- School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Sirine Nasr
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon
| | - Reine Baz
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon
| | - Yong-Ku Kim
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Marc Fakhoury
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon.
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17
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Yang C, Zhang X, Chen Y, Li Y, Yu S, Zhao B, Wang T, Luo L, Gao S. Emotion-dependent language featuring depression. J Behav Ther Exp Psychiatry 2023; 81:101883. [PMID: 37290350 DOI: 10.1016/j.jbtep.2023.101883] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 04/06/2023] [Accepted: 05/27/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND OBJECTIVES Understanding language features of depression contributes to the detection of the disorder. Considering that depression is characterized by dysfunctions in emotion and individuals with depression often show emotion-dependent cognition, the present study investigated the speech features and word use of emotion-dependent narrations in patients with depression. METHODS Forty depression patients and forty controls were required to narrate self-relevant memories under five basic human emotions (i.e., sad, angry, fearful, neutral, and happy). Recorded speech and transcribed texts were analyzed. RESULTS Patients with depression, as compared to non-depressed individuals, talked slower and less. They also performed differently in using negative emotion, work, family, sex, biology, health, and assent words regardless of emotion manipulation. Moreover, the use of words such as first person singular pronoun, past tense, causation, achievement, family, death, psychology, impersonal pronoun, quantifier and preposition words displayed emotion-dependent differences between groups. With the involvement of emotion, linguistic indicators associated with depressive symptoms were identified and explained 71.6% variances of depression severity. LIMITATIONS Word use was analyzed based on the dictionary which does not cover all the words spoken in the memory task, resulting in text data loss. Besides, a relatively small number of depression patients were included in the present study and therefore the results need confirmation in future research using big emotion-dependent data of speech and texts. CONCLUSIONS Our findings suggest that consideration of different emotional contexts is an effective means to improve the accuracy of depression detection via the analysis of word use and speech features.
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Affiliation(s)
- Chaoqing Yang
- School of Foreign Languages, University of Electronic Science and Technology of China, Chengdu, China
| | - Xinying Zhang
- School of Foreign Languages, University of Electronic Science and Technology of China, Chengdu, China
| | - Yuxuan Chen
- School of Foreign Languages, University of Electronic Science and Technology of China, Chengdu, China
| | - Yunge Li
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Shu Yu
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Bingmei Zhao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Tao Wang
- School of Psychology, Qufu Normal University, Qufu, China
| | - Lizhu Luo
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China; Singapore Institute for Clinical Sciences, A*STAR Research Entities, Singapore.
| | - Shan Gao
- School of Foreign Languages, University of Electronic Science and Technology of China, Chengdu, China; The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China.
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18
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Marchetti I, Alloy LB, Koster EH. Breaking the vise of hopelessness: Targeting its components, antecedents, and context. Int J Cogn Ther 2023; 16:285-319. [PMID: 39131585 PMCID: PMC11314313 DOI: 10.1007/s41811-023-00165-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/05/2023] [Indexed: 08/13/2024]
Abstract
Hopelessness is a painful cognitive state that is related to depression and suicide. Despite its importance, only unsystematic efforts have been made to specifically target hopelessness in interventions, and no comprehensive review is currently available to guide future clinical studies. In this narrative review, we first analyze the phenomenon of hopelessness, by highlighting its components (e.g., dismal expectations, blocked goal-directed processing, and helplessness), antecedents (e.g., inferential styles), and contextual factors (e.g., loneliness and reduced social support). Then, we review the currently available interventions and manipulations that target these mechanisms, either directly or indirectly, and we highlight both their strengths and lacunae. Finally, we propose possible avenues to improve our clinical toolbox for breaking the vise of hopelessness.
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Affiliation(s)
- Igor Marchetti
- University of Trieste, Department of Life Sciences, Via Edoardo Weiss 21, 34128, Trieste, Italy
| | - Lauren B. Alloy
- Temple University, Department of Psychology and Neuroscience, Weiss Hall, 1701 N. 13th Street, Philadelphia, PA 19122, USA
| | - Ernst H.W. Koster
- Ghent University, Department of Experimental-Clinical and Health Psychology, Henri Dunantlaan 2, Ghent, B-9000, Belgium
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Mortezaei S, Rabiei R, Asadi F, Emami H. Development and usability evaluation of a mHealth application for albinism self-management. BMC Med Inform Decis Mak 2023; 23:106. [PMID: 37312174 DOI: 10.1186/s12911-023-02202-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 05/26/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Reduced or absence of melanin poses physical, social, and psychological challenges to individuals with albinism. Mobile health (mHealth) applications have the potential to improve the accessibility of information and services while reducing time and costs. This study aimed to develop and evaluate a mHealth application for self-management of albinism. METHODS This applied study was conducted in two stages (development and evaluation) in 2022. Initially, the functional requirements were determined, and the conceptual model of the application was then developed using Microsoft Visio 2021. In the second phase, the application was evaluated using the Mobile Application Usability Questionnaire (MAUQ) involving patients with albinism to reflect their views on the usability of the application. RESULTS The key capabilities of the application included: reminders, alerts, educational content, useful links, storage and exchange of images of skin lesions, specialist finder, and notifications for albinism-relevant events. Twenty-one users with albinism participated in the usability testing of the application. The users were predominantly satisfied with the application (5.53 ± 1.10; Max: 7.00). CONCLUSIONS The findings of this study suggest that the developed mobile application could assist individuals with albinism to effectively manage their condition by considering the users' requirements and services that the application should deliver.
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Affiliation(s)
- Saman Mortezaei
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Rabiei
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Farkhondeh Asadi
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Emami
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Sakib N, Islam MK, Faruk T. Machine Learning Model for Computer-Aided Depression Screening among Young Adults Using Wireless EEG Headset. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2023; 2023:1701429. [PMID: 37293375 PMCID: PMC10247322 DOI: 10.1155/2023/1701429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 04/09/2023] [Accepted: 04/17/2023] [Indexed: 06/10/2023]
Abstract
Depression is a disorder that if not treated can hamper the quality of life. EEG has shown great promise in detecting depressed individuals from depression control individuals. It overcomes the limitations of traditional questionnaire-based methods. In this study, a machine learning-based method for detecting depression among young adults using EEG data recorded by the wireless headset is proposed. For this reason, EEG data has been recorded using an Emotiv Epoc+ headset. A total of 32 young adults participated and the PHQ9 screening tool was used to identify depressed participants. Features such as skewness, kurtosis, variance, Hjorth parameters, Shannon entropy, and Log energy entropy from 1 to 5 sec data filtered at different band frequencies were applied to KNN and SVM classifiers with different kernels. At AB band (8-30 Hz) frequency, 98.43 ± 0.15% accuracy was achieved by extracting Hjorth parameters, Shannon entropy, and Log energy entropy from 5 sec samples with a 5-fold CV using a KNN classifier. And with the same features and classifier overall accuracy = 98.10 ± 0.11, NPV = 0.977, precision = 0.984, sensitivity = 0.984, specificity = 0.976, and F1 score = 0.984 was achieved after splitting the data to 70/30 ratio for training and testing with 5-fold CV. From the findings, it can be concluded that EEG data from an Emotiv headset can be used to detect depression with the proposed method.
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Affiliation(s)
- Nazmus Sakib
- Department of Electrical and Electronic Engineering, Independent University Bangladesh (IUB), Dhaka, Bangladesh
- Biomedical Instrumentation and Signal Processing Lab (BISPL), Independent University Bangladesh (IUB), Dhaka, Bangladesh
| | - Md Kafiul Islam
- Department of Electrical and Electronic Engineering, Independent University Bangladesh (IUB), Dhaka, Bangladesh
- Biomedical Instrumentation and Signal Processing Lab (BISPL), Independent University Bangladesh (IUB), Dhaka, Bangladesh
| | - Tasnuva Faruk
- Biomedical Instrumentation and Signal Processing Lab (BISPL), Independent University Bangladesh (IUB), Dhaka, Bangladesh
- Department of Public Health, Independent University Bangladesh (IUB), Dhaka, Bangladesh
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Asefa KZ, Bedada TD, Fufa JA, Gari FS, Gelcho GN, Akessa GM. Predictors of time to first symptomatic recovery of major depressive disordered patients: a case study at Jimma University Medical Center. BMC Psychiatry 2023; 23:37. [PMID: 36639751 PMCID: PMC9840281 DOI: 10.1186/s12888-022-04443-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 11/30/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Major Depressive Disorder is one of the most common mental disorders, and it is the main cause of disability worldwide with a prevalence ranging from 7 to 21%. OBJECTIVE The goal of this study was to predict the time it took for patients with severe depressive disorders at Jimma University Medical Center to experience their initial symptomatic recovery. STUDY DESIGN The researchers utilized a prospective study design. METHODS Patients with major depressive disorder were followed up on at Jimma University Medical Center from September 2018 to August 2020 for this study. The Gamma and Inverse Gaussian frailty distributions were employed with Weibull, Log-logistic, and Log-normal as baseline hazard functions. Akaike Information Criteria were used to choose the best model for describing the data. RESULTS This study comprised 366 patients, with 54.1% of them experiencing their first symptomatic recovery from a severe depressive disorder. The median time from the onset of symptoms to symptomatic recovery was 7 months. In the study area, there was a clustering effect in terms of time to first symptomatic recovery from major depressive disorder. According to the Log-normal Inverse-Gaussian frailty model, marital status, chewing khat, educational status, work status, substance addiction, and other co-variables were significant predictors of major depressive disorder (p-value < 0.05). CONCLUSION The best model for describing the time to the first symptomatic recovery of major depressive disorder is the log-normal Inverse-Gaussian frailty model. Being educated and working considerably were the variables that reduces the time to first symptomatic recovery from major depressive disorder; whereas being divorced, chewing khat, substance abused and other co-factors were the variables that significantly extends the time to first symptomatic recovery.
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Affiliation(s)
- Ketema Zerihun Asefa
- Department of Statistics, College of Natural and Computational Science, Madda Walabu University, Bale-Robe, Oromia Ethiopia
| | - Tadele Degefa Bedada
- Department of Statistics, College of Natural and Computational Science, Madda Walabu University, Bale-Robe, Oromia Ethiopia
| | - Jaleta Abdisa Fufa
- grid.411903.e0000 0001 2034 9160Department of Statistics, College of Natural Science, Jimma University, Jimma, Oromia Ethiopia
| | - Firomsa Shewa Gari
- grid.472250.60000 0004 6023 9726Department of Statistics, College of Natural and Computational Science, Assosa University, Assosa, Benishangul Gumuz Ethiopia
| | - Gurmessa Nugussu Gelcho
- Department of Statistics, College of Natural Science, Jimma University, Jimma, Oromia, Ethiopia.
| | - Geremew Muleta Akessa
- grid.411903.e0000 0001 2034 9160Department of Statistics, College of Natural Science, Jimma University, Jimma, Oromia Ethiopia
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22
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Milić J. How to design a reliable and practical biomarker: the electrophysiologic coefficient of depressiveness - δEPCD. Biomarkers 2022; 27:711-714. [PMID: 36196689 DOI: 10.1080/1354750x.2022.2122565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Jelena Milić
- Institute of Public Health of Serbia, Dr Milan Jovanovic Batut", Centar for Informatics and Biostatistics in Health Care
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23
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Alsanie WF, Alamri AS, Abdulaziz O, Salih MM, Alamri A, Asdaq SMB, Alhomrani MH, Alhomrani M. Antidepressant Effect of Crocin in Mice with Chronic Mild Stress. Molecules 2022; 27:molecules27175462. [PMID: 36080230 PMCID: PMC9457951 DOI: 10.3390/molecules27175462] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/19/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to investigate the antidepressant property of crocin (Crocetin digentiobiose ester) using a chronic mild stress (CMS)-induced depression model in experimental mice. The tail suspension test (TST) and the sucrose preference test were used to evaluate the antidepressant effect on albino mice of either sex after three weeks of CMS. The period of immobility in the TST and percentage preference for sucrose solution were recorded. By monitoring brain malondialdehyde (MDA) level, catalase (CAT) activity, and reduced glutathione (GSH) level, the antioxidant potential was assessed. Three dosages of crocin (4.84, 9.69, and 19.38 mg/kg) were evaluated. When compared to controls, animals that received crocin administration during three periods of CMS had considerably shorter immobility times during the TST. Crocin treatment also raised the percentage preference for sucrose solution in a dose-dependent manner, bringing it to parity with the conventional antidepressant, imipramine. Animals that received a high dose of crocin had a much greater spontaneous locomotor activity. Furthermore, a high dose of crocin remarkably lowered plasma corticosterone and nitrite levels brought on by CMS. Additionally, high doses of crocin given during CMS greatly enhanced reduced glutathione levels while considerably reducing the brain’s MDA and catalase activities. In conclusion, high doses of crocin may have an antidepressant effect in an animal model through several mechanisms. However, further studies should be carried out to explore the role of neurotransmitters for their antidepressant property.
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Affiliation(s)
- Walaa F. Alsanie
- Department of Clinical Laboratory Sciences, The Faculty of Applied Medical Sciences, Taif University, Taif 21944, Saudi Arabia
- Centre of Biomedical Sciences Research (CBSR), Deanship of Scientific Research, Taif University, Taif 21944, Saudi Arabia
| | - Abdulhakeem S. Alamri
- Department of Clinical Laboratory Sciences, The Faculty of Applied Medical Sciences, Taif University, Taif 21944, Saudi Arabia
- Centre of Biomedical Sciences Research (CBSR), Deanship of Scientific Research, Taif University, Taif 21944, Saudi Arabia
| | - Osama Abdulaziz
- Department of Clinical Laboratory Sciences, The Faculty of Applied Medical Sciences, Taif University, Taif 21944, Saudi Arabia
| | - Magdi M. Salih
- Department of Clinical Laboratory Sciences, The Faculty of Applied Medical Sciences, Taif University, Taif 21944, Saudi Arabia
| | - Abdulwahab Alamri
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Hail, Hail 81451, Saudi Arabia
| | - Syed Mohammed Basheeruddin Asdaq
- Department of Pharmacy Practice, College of Pharmacy, AlMaarefa University, Dariyah 13713, Saudi Arabia
- Correspondence: (S.M.B.A.); (M.A.)
| | | | - Majid Alhomrani
- Department of Clinical Laboratory Sciences, The Faculty of Applied Medical Sciences, Taif University, Taif 21944, Saudi Arabia
- Centre of Biomedical Sciences Research (CBSR), Deanship of Scientific Research, Taif University, Taif 21944, Saudi Arabia
- Correspondence: (S.M.B.A.); (M.A.)
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24
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Wagner J, Henderson S, Hoeft TJ, Gosdin M, Hinton L. Moving beyond referrals to strengthen late-life depression care: a qualitative examination of primary care clinic and community-based organization partnerships. BMC Health Serv Res 2022; 22:605. [PMID: 35524300 PMCID: PMC9074362 DOI: 10.1186/s12913-022-07997-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 04/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND National guidelines have called for greater integration of primary care and behavioral health services, with more recent attention to social care and community-based services. Under growing resource constraints healthcare organizations have tended to rely on referrals to external entities to address social care needs. Traditional referral models, however, may not be equipped to provide for the complex needs of older adults with depression. The Care Partners Project was designed to strengthen late-life depression care through integrated partnerships between primary care clinics and community-based organizations. We sought to understand how these integrated partnerships, with shared tasks and accountability across organizations, changed the nature of depression care for older adults. METHODS We conducted 65 in-depth, semi-structured interviews and six focus groups with service providers involved in the project, including care managers, primary care providers, and psychiatric consultants, and applied inductive and deductive qualitative thematic analysis to develop themes around participants' experiences with the partnered initiative. RESULTS We found the partnerships established by the Care Partners Project reshaped late-life depression care in two ways: (1) bidirectional communication across organizations facilitated greater recognition among providers of intersecting medical and social needs associated with late-life depression; and (2) depression care became more coordinated and effective as care teams established or strengthened relationships across organizations. CONCLUSIONS These findings highlight the ways cross-organizational health and social care partnerships that move beyond traditional referrals can strengthen late-life depression care and enhance organizational capacities.
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Affiliation(s)
- Jenny Wagner
- Evaluation Specialist, School of Medicine Office of Research, University of California, Davis, 2921 Stockton Blvd. Suite 1400, Sacramento, CA, 95817, USA.
| | - Stuart Henderson
- Director, Evaluation, School of Medicine Office of Research, University of California, Davis, 2921 Stockton Blvd. Suite 1400, Sacramento, CA, 95817, USA
| | - Theresa J Hoeft
- Research Assistant Professor, Department of Psychiatry and Behavioral Sciences, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195-6560, USA
| | - Melissa Gosdin
- Qualitative Research Analyst, Center for Healthcare Policy and Research, University of California, Davis, 2103 Stockton Blvd., Suite 2224, Sacramento, CA, 95817, USA
| | - Ladson Hinton
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, 2230 Stockton Blvd, Sacramento, CA, 95817, USA
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Köbler P, Krauss-Köstler EK, Stein B, Ficker JH, Wilhelm M, Dechêne A, Waller C. Specialized Biopsychosocial Care in Inpatient Somatic Medicine Units-A Pilot Study. Front Public Health 2022; 10:844874. [PMID: 35493384 PMCID: PMC9039260 DOI: 10.3389/fpubh.2022.844874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Specialized biopsychosocial care concepts are necessary to overcome the dualism between physical and psychosocial treatment in acute care hospitals. For patients with complex and chronic comorbid physical and mental health problems, neither standardized psychiatric/psychosomatic nor somatic care units alone are appropriate to their needs. The “Nuremberg Integrated Psychosomatic Acute Unit” (NIPA) has been developed to integrate treatment of both, psychosocial and physical impairments, in an acute somatic care setting. Method NIPA has been established in inpatient internal medical wards for respiratory medicine, oncology and gastroenterology. One to two patients per ward are regularly enrolled in the NIPA treatment while remaining in the same inpatient bed after completion of the somatic care. In a naturalistic study design, we evaluated treatment effects by assessment of symptom load at admission and at discharge using the Patient Health Questionnaire (PHQ) and the Generalized Anxiety Disorder Scale-7 (GAD-7). Furthermore, we assessed the severity of morbidity using diagnosis data during treatment. At discharge, we measured satisfaction with treatment through the Patient Satisfaction Questionnaire (ZUF-8). Results Data from 41 NIPA patients were analyzed (18–87 years, 76% female). Seventy-eight percent suffered from at least moderate depression and 49% from anxiety disorders. Other diagnoses were somatoform pain disorder, somatoform autonomic dysfunction, eating disorder and posttraumatic stress disorder. Hypertension, chronic lung diseases and musculoskeletal disorders as well as chronic oncological and cardiac diseases were the most common somatic comorbidities. Treatment resulted in a significant reduction of depressive mood (admission: M = 10.9, SD = 6.1, discharge: M = 7.6, SD = 5.3, d = 0.58, p = 0.001), anxiety (admission: M = 10.6, SD = 4.9, discharge: M = 7.3, SD = 4.1, d = 0.65, p< 0.001) and stress (admission: M = 6.0, SD = 3.6, discharge: M = 4.1, SD = 2.5, d = 0.70, p< 0.001). Somatic symptom burden was reduced by NIPA treatment (admission: M = 10.9, SD = 5.8, discharge: M = 9.6, SD = 5.5, d = 0.30), albeit not statistically significant (p = 0.073) ZUF-8 revealed that 89% reported large or full satisfaction and 11% partial dissatisfaction with treatment. Discussion NIPA acute care is bridging the gap for patients in need of psychosocial treatment with complex somatic comorbidity. Further long-term evaluation will show whether psychosocial NIPA care is able to reduce the course of physical illness and hospital costs by preventing hospitalization and short-term inpatient re-admissions.
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Affiliation(s)
- Paul Köbler
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical Private University, Nuremberg General Hospital, Nuremberg, Germany
| | - Eva K Krauss-Köstler
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical Private University, Nuremberg General Hospital, Nuremberg, Germany
| | - Barbara Stein
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical Private University, Nuremberg General Hospital, Nuremberg, Germany
| | - Joachim H Ficker
- Department of Internal Medicine 3, Respiratory Medicine, Paracelsus Medical Private University, Nuremberg General Hospital, Nuremberg, Germany
| | - Martin Wilhelm
- Department of Internal Medicine 5, Oncology/Hematology, Paracelsus Medical Private University, Nuremberg General Hospital, Nuremberg, Germany
| | - Alexander Dechêne
- Department of Internal Medicine 6, Gastroenterology, Paracelsus Medical Private University, Nuremberg General Hospital, Nuremberg, Germany
| | - Christiane Waller
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical Private University, Nuremberg General Hospital, Nuremberg, Germany
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Rygvold TW, Hatlestad-Hall C, Elvsåshagen T, Moberget T, Andersson S. Long-Term Potentiation-Like Visual Synaptic Plasticity Is Negatively Associated With Self-Reported Symptoms of Depression and Stress in Healthy Adults. Front Hum Neurosci 2022; 16:867675. [PMID: 35601905 PMCID: PMC9119023 DOI: 10.3389/fnhum.2022.867675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/29/2022] [Indexed: 11/13/2022] Open
Abstract
Long-term potentiation (LTP) is one of the most extensively studied forms of neuroplasticity and is considered the strongest candidate mechanism for memory and learning. The use of event-related potentials and sensory stimulation paradigms has allowed for the translation from animal studies to non-invasive studies of LTP-like synaptic plasticity in humans. Accumulating evidence suggests that synaptic plasticity as measured by stimulus-specific response modulation is reduced in neuropsychiatric disorders such as major depressive disorder (MDD), bipolar disorders and schizophrenia, suggesting that impaired synaptic plasticity plays a part in the underlying pathophysiology of these disorders. This is in line with the neuroplasticity hypothesis of depression, which postulate that deficits in neuroplasticity might be a common pathway underlying depressive disorders. The current study aims to replicate and confirm earlier reports that visual stimulus-specific response modulation is a viable probe into LTP-like synaptic plasticity in a large sample of healthy adults (n = 111). Further, this study explores whether impairments in LTP-like synaptic plasticity is associated with self-reported subclinical depressive symptoms and stress in a healthy population. Consistent with prior research, the current study replicated and confirmed reports demonstrating significant modulation of visual evoked potentials (VEP) following visual high-frequency stimulation. Current results further indicate that reduced LTP-like synaptic plasticity is associated with higher levels of self-reported symptoms of depression and perceived stress. This indicate that LTP-like plasticity is sensitive to sub-clinical levels of psychological distress, and might represent a vulnerability marker for the development of depressive symptoms.
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Affiliation(s)
- Trine Waage Rygvold
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | | | | | - Torgeir Moberget
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Stein Andersson
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
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27
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Schöler D, Kostev K, Demir M, Luedde M, Konrad M, Luedde T, Roderburg C, Loosen SH. An Elevated FIB-4 Score Is Associated with an Increased Incidence of Depression among Outpatients in Germany. J Clin Med 2022; 11:jcm11082214. [PMID: 35456304 PMCID: PMC9032098 DOI: 10.3390/jcm11082214] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/12/2022] [Accepted: 04/12/2022] [Indexed: 12/26/2022] Open
Abstract
Background: Liver disease and depression are known to be closely associated. Non-invasive tests (NIT), such as the FIB-4 score, have been recommended by different guidelines to rule out advanced fibrosis and to stratify the risk of liver-related outcomes in patients with chronic liver diseases. However, the predictive value of an elevated FIB-4 score regarding the development of depression and/or anxiety disorders among the general population is unknown. Methods: By using the Disease Analyzer database (IQVIA), which compiles diagnoses and laboratory values as well as basic medical and demographic data of patients followed in general practices in Germany, we identified 370,756 patients with available lab values for FIB-4 score calculation between 2005 and 2019. Patients with an FIB-4 score < 2 were matched 1:1 to patients with an FIB-4 index ≥ 2 by age, sex and yearly consultation frequency. Results: In regression analysis, the incidence rate ratio (IRR) of depression was significantly higher among patients with an FIB-4 score ≥ 2.0 compared to patients with a lower FIB-4 score <2.0 (IRR: 1.12, p < 0.001). This association was significant for both female (IRR: 1.10, p = 0.004) and male (IRR: 1.15, p < 0.001) patients and strongest in the age groups ≤50 years (IRR: 1.42, p < 0.001) and 51-60 years (IRR: 1.34, p < 0.001). There was no significant association between an elevated FIB-4 score ≥ 2.0 and the incidence of depression among patients aged 60 years and older. There was no significant increase in the IRR of anxiety disorders for patients with high or low FIB-4 scores. Conclusion: Our study suggests a previously unknown association between an elevated FIB-4 score and an increased incidence of depression. This finding suggests that the FIB-4 score is not only a valuable tool for the prediction of liver-specific endpoints but also may be of relevance for the prediction of extrahepatic comorbidities, which in turn may argue for clinical screening programs in patients with an elevated FIB-4.
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Affiliation(s)
- David Schöler
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany; (D.S.); (T.L.)
| | | | - Münevver Demir
- Clinic for Hepatology and Gastroenterology, Charité University Medical Center, Augustenburger Platz 1, 13353 Berlin, Germany;
| | - Mark Luedde
- KGP Bremerhaven, 27574 Bremerhaven, Germany;
| | - Marcel Konrad
- FOM University of Applied Sciences for Economics and Management, 60549 Frankfurt am Main, Germany;
| | - Tom Luedde
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany; (D.S.); (T.L.)
| | - Christoph Roderburg
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany; (D.S.); (T.L.)
- Correspondence: (C.R.); (S.H.L.); Tel.: +49-211-81-16330 (C.R. & S.H.L.)
| | - Sven H. Loosen
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany; (D.S.); (T.L.)
- Correspondence: (C.R.); (S.H.L.); Tel.: +49-211-81-16330 (C.R. & S.H.L.)
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Keatch C, Lambert E, Woods W, Kameneva T. Measuring Brain Response to Transcutaneous Vagus Nerve Stimulation (tVNS) using Simultaneous Magnetoencephalography (MEG). J Neural Eng 2022; 19. [DOI: 10.1088/1741-2552/ac620c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 03/28/2022] [Indexed: 11/12/2022]
Abstract
Abstract
Objective: Transcutaneous vagus nerve stimulation (tVNS) is form of non-invasive brain stimulation that delivers a sequence of electrical pulses to the auricular branch of the vagus nerve, and is used increasingly in the treatment of a number of health conditions such as epilepsy and depression. Recent research has focused on the efficacy of tVNS to treat different medical conditions, but there is little conclusive evidence concerning the optimal stimulation parameters.There are relatively few studies that have combined tVNS with a neuroimaging modality, and none that have attempted simultaneous magnetoencephalography (MEG) and tVNS due to the presence of large stimulation artifacts produced by the electrical stimulation which are many orders of magnitude larger than underlying brain activity. Approach: The aim of this study is to investigate the utility of MEG to gain insight into the regions of the brain most strongly influenced by tVNS and how variation of the stimulation parameters can affect this response in healthy participants. Main Results: We have successfully demonstrated that MEG can be used to measure brain response to tVNS. We have also shown that varying the stimulation frequency can lead to a difference in brain response, with the brain also responding in different anatomical regions depending on the frequency. Significance: The main contribution of this paper is to demonstrate the feasibility of simultaneous pulsed tVNS and MEG recording, allowing direct investigation of the changes in brain activity that result from different stimulation parameters. This may lead to the development of customised therapeutic approaches for the targeted treatment of different conditions.
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It's giving me the blues: A fixed-effects and g-formula approach to understanding job insecurity, sleep disturbances, and major depression. Soc Sci Med 2022; 297:114805. [DOI: 10.1016/j.socscimed.2022.114805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 02/07/2022] [Accepted: 02/10/2022] [Indexed: 11/18/2022]
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Ch S, Sudha S, Reddy CG, T P, KSBS KS, Dasari P, Battula P, T N, A S. A Comparative Study on Safety and Efficacy of Desvenlafaxine Versus Sertraline in Depression. Cureus 2022; 14:e22717. [PMID: 35371643 PMCID: PMC8971119 DOI: 10.7759/cureus.22717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2022] [Indexed: 11/10/2022] Open
Abstract
Background Depression is one of the most predominant mental health issues that are prevalent now. Therefore, many clinical trials were being conducted to find the safest, most effective, and tolerable anti-depressant. This study aims to compare desvenlafaxine and sertraline regarding their safety and efficacy in treating depression. Methodology The patients who were diagnosed with depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria were included in the study and were divided into two groups. The severity of depression in these patients was evaluated using Beck Depression Inventory and Hamilton depression scale (HAM-D) before and after the treatment (four weeks). Results About 64% of the study sample were males, and 36% were females, with 77% of the patients in the desvenlafaxine group taking 100 mg dosage and about 74% patients taking 50 mg dosage in the sertraline group. The patients in both groups showed statistically significant (p < 0.00001) improvement after using these drugs. Conclusion Both desvenlafaxine and sertraline showed their efficacy in treating depression by improving the clinical outcome in patients. Sertraline was marginally better in clinical results. Finally, it is advisable to carry out more randomized trials to improve the patient’s quality of life.
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31
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Lai TL, Au CK, Chung HY, Lau CS. Depression in psoriatic arthritis: Related to socio-demographics, comorbid loads or disease activity? Int J Rheum Dis 2022; 25:474-480. [PMID: 35147299 DOI: 10.1111/1756-185x.14298] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 11/29/2022]
Abstract
AIM Psychological distress commonly occurs in patients with psoriatic arthritis (PsA). The primary objective of this study was to determine the prevalence of depression in PsA. The secondary objective was to explore its associated factors, including socio-demographics, disease activity data and comorbidities. METHODS Patients with PsA fulfilling the Classification Criteria for Psoriatic Arthritis were consecutively recruited from local rheumatology clinics. Depression was assessed by a self-administered Chinese-Cantonese version of the Hospital Anxiety and Depression Scale (HADS). RESULTS Two hundred and eight eligible patients with PsA were recruited, with 82 females and 126 males. Depression was found in 62 (29.8%) of them. The univariate model identified these associated factors: (1) Psoriasis Area and Severity Index score; (2) disease activity measurement, that is tender and swollen joint count, erythrocyte sedimentation rate, C-reactive protein, Disease Activity in Psoriatic Arthritis (DAPSA) score, Leeds Enthesitis Index and tender dactylitis count; (3) quality of life measurement, that is Health Assessment Questionnaire - Disability Index (HAQ-DI), pain and general health perception; (4) PsA duration; and (5) body mass index. The final regression model identified DAPSA and HAQ-DI were closely associated with depression, P = .007 and P = .02 respectively. Moderate and strong correlations with HADS score were found with DAPSA (Kendall's tau-b coefficient [τb] = 0.25) and HAQ-DI (τb = 0.4) respectively. No associations with depression were found between age, living and employment status, gender, demographics, inflammatory markers, disease duration, skin involvement and comorbidities, in term of Charlson's Comorbidity Index. CONCLUSION Depression was prevalent among PsA patients and it was closely correlated with disease activity and physical function impairment. Achieving low disease activity and maintaining physical function in patients with PsA may mitigate the psychological burden. The present study also highlighted the unmet needs of strategies to identify this common phenomenon.
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Affiliation(s)
- Tin Lok Lai
- Rheumatology Team, Department of Medicine, Tseung Kwan O Hospital, Hong Kong, Hong Kong
| | - Chi Kit Au
- Rheumatology Team, Department of Medicine, Tseung Kwan O Hospital, Hong Kong, Hong Kong
| | - Ho Yin Chung
- Rheumatology & Clinical Immunology Team, Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong
| | - Chak Sing Lau
- Rheumatology & Clinical Immunology Team, Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong
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Lin J, Chen T, He J, Chung RCK, Ma H, Tsang HWH. Impacts of acupressure treatment on depression: A systematic review and meta-analysis. World J Psychiatry 2022; 12:169-186. [PMID: 35111587 PMCID: PMC8783164 DOI: 10.5498/wjp.v12.i1.169] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/02/2021] [Accepted: 11/28/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Depression is recognized as a major public health problem with a substantial impact on individuals and society. Complementary therapies such as acupressure may be considered a safe and cost-effective treatment for people with depression. An increasing body of research has been undertaken to assess the effectiveness of acupressure in various populations with depression, but the evidence thus far is inconclusive.
AIM To examine the efficacy of acupressure on depression.
METHODS A systematic literature search was performed on PubMed, PsycINFO, Scopus, Embase, MEDLINE, and China National Knowledge (CNKI). Randomized clinical trials (RCTs) or single-group trials in which acupressure was compared with control methods or baseline in people with depression were included. Data were synthesized using a random-effects or a fixed-effects model to analyze the impacts of acupressure treatment on depression and anxiety in people with depression. The primary outcome measures were set for depression symptoms. Subgroups were created, and meta-regression analyses were performed to explore which factors are relevant to the greater or lesser effects of treating symptoms.
RESULTS A total of 14 RCTs (1439 participants) were identified. Analysis of the between-group showed that acupressure was effective in reducing depression [Standardized mean differences (SMDs) = -0.58, 95%CI: -0.85 to -0.32, P < 0.0001] and anxiety (SMD = -0.67, 95%CI: -0.99 to -0.36, P < 0.0001) in participants with mild-to-moderate primary and secondary depression. Subgroup analyses suggested that acupressure significantly reduced depressive symptoms compared with different controlled conditions and in participants with different ages, clinical conditions, and duration of intervention. Adverse events, including hypotension, dizziness, palpitation, and headache, were reported in one study.
CONCLUSION The evidence of acupressure for mild-to-moderate depressive symptoms was significant. Importantly, the findings should be interpreted with caution due to study limitations. Future research with a well-designed mixed method is required to consolidate the conclusion and provide an in-depth understanding of potential mechanisms underlying the effects.
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Affiliation(s)
- Jingxia Lin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 00852, China
- Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong 00852, China
| | - Tianhao Chen
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 00852, China
| | - Jiali He
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 00852, China
| | - Raymond CK Chung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 00852, China
| | - Haixia Ma
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 00852, China
| | - HWH Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 00852, China
- Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong 00852, China
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Eimontas J, Pakalniškienė V, Biliunaite I, Andersson G. A tailored Internet-delivered modular intervention based on cognitive behavioral therapy for depressed older adults: a study protocol for a randomized controlled trial. Trials 2021; 22:925. [PMID: 34915909 PMCID: PMC8674830 DOI: 10.1186/s13063-021-05903-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 12/01/2021] [Indexed: 11/12/2022] Open
Abstract
Background Depression is most common among the elderly and is associated with major impairment. With limited accessible treatments available, remotely provided interventions are needed. Internet-based interventions have been proven effective for a number of mental and somatic health problems. However, the elderly population has received relatively limited attention in previous studies. This study aims to address this gap by investigating the effectiveness of a tailored Internet-delivered modular intervention based on cognitive behavioral therapy (CBT). Methods A minimum of 60 participants will be recruited and randomly assigned to groups in a two-armed parallel controlled trial with a waiting list. The intervention group will have access to an 8-week therapist-supported modular intervention. The waiting list group will be instructed to wait for 8 weeks and then granted access to the intervention for 8 weeks. Pre, post, and 3-, 12-, and 24-month follow-up assessments are planned for measuring changes in depression symptoms, anxiety symptoms, and psychological well-being using PHQ-9, GDS, GAD-7, and WHO-5. Primary outcomes of all the participants will be analyzed using the intention-to-treat principle, and within- and between-group effect sizes will be calculated. Discussion Internet-based interventions could help address the existing treatment gap for depressed older adults. However, to date, the effectiveness of Internet-based CBT (ICBT) for depressed older adults has only been tested in a few studies. This trial will demonstrate if Internet-based CBT is effective for this population when compared to a waiting list control. Further analysis of secondary outcomes and participant behavior in the intervention will potentially reveal effectiveness moderating factors. Trial registration ClinicalTrials.gov NCT04728204. Registered on 15 January 2021. https://www.clinicaltrials.gov/ct2/show/NCT04728204?term=NCT04728204&draw=2&rank=1
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Affiliation(s)
- Jonas Eimontas
- Institute of Psychology, Vilnius University, Vilnius, Lithuania.
| | | | - Ieva Biliunaite
- Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
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Tüzün H, Demirköse H, Özkan S, İlhan MN. Socioeconomic Factors Related to Prevalence, Severity, and Contact Coverage of Depression in Primary Health Care. PSYCHIAT CLIN PSYCH 2021; 31:457-467. [PMID: 38765649 PMCID: PMC11079699 DOI: 10.5152/pcp.2021.21051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 10/28/2021] [Indexed: 05/22/2024] Open
Abstract
Background We determine factors related to the prevalence, severity, and contact coverage of depression using the Patient Health Questionnaire-9. Methods This cross-sectional study included 1059 individuals who applied to primary health care in Ankara before the onset of pandemic restrictions. Contact coverage was evaluated to include mental health care users. Results The prevalence of depression was 22.9%. Individuals who were unemployed (OR: 3.832; 95% CI: 2.053-7.151), women (OR: 1.646; 95% CI: 1.158-2.340), those without social support (OR: 1.933; 95% CI: 1.219-3.065), those who did not receive formal education (OR: 2.631; 95 % CI: 1.312-5.275), lower-income group (OR: 1.528; 95% CI: 1.071-2.180), and unmarried or divorced (OR: 2.644; 95% CI: 1.324-5.281) were found to be at risk of developing depression. Based on the linear regression model including patients diagnosed with depression, individuals who were unemployed (standardized β: 0.190), women (standardized β: 0.075), those without social support (standardized β: 0.096), and those who were unmarried or single (standardized β: 0.147) had the highest scale scores. Contact coverage for depression was 31.0%. Contact coverage was more likely in the upper-income group (OR: 2.239, 95% CI: 1.173-4.273). Conclusion Although depression is common among primary health care applicants, contact coverage is low. Developing screening programs for depression in primary health care may help improve community mental health. Socioeconomic factors that contribute to the emergence, severity, and contact coverage of depression indicate health inequalities. The development and severity of depression are mostly due to unemployment, which suggests the importance of employment-enhancing policies.
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Affiliation(s)
- Hakan Tüzün
- Department of Public Health, Gazi University Medical Faculty, Ankara, Turkey
| | - Hacer Demirköse
- Department of Public Health, Gazi University Medical Faculty, Ankara, Turkey
| | - Seçil Özkan
- Department of Public Health, Gazi University Medical Faculty, Ankara, Turkey
| | - Mustafa Necmi İlhan
- Department of Public Health, Gazi University Medical Faculty, Ankara, Turkey
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Optimizing prediction of response to antidepressant medications using machine learning and integrated genetic, clinical, and demographic data. Transl Psychiatry 2021; 11:381. [PMID: 34238923 PMCID: PMC8266902 DOI: 10.1038/s41398-021-01488-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 05/13/2021] [Accepted: 06/16/2021] [Indexed: 02/07/2023] Open
Abstract
Major depressive disorder (MDD) is complex and multifactorial, posing a major challenge of tailoring the optimal medication for each patient. Current practice for MDD treatment mainly relies on trial and error, with an estimated 42-53% response rates for antidepressant use. Here, we sought to generate an accurate predictor of response to a panel of antidepressants and optimize treatment selection using a data-driven approach analyzing combinations of genetic, clinical, and demographic factors. We analyzed the response patterns of patients to three antidepressant medications in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, and employed state-of-the-art machine learning (ML) tools to generate a predictive algorithm. To validate our results, we assessed the algorithm's capacity to predict individualized antidepressant responses on a separate set of 530 patients in STAR*D, consisting of 271 patients in a validation set and 259 patients in the final test set. This assessment yielded an average balanced accuracy rate of 72.3% (SD 8.1) and 70.1% (SD 6.8) across the different medications in the validation and test set, respectively (p < 0.01 for all models). To further validate our design scheme, we obtained data from the Pharmacogenomic Research Network Antidepressant Medication Pharmacogenomic Study (PGRN-AMPS) of patients treated with citalopram, and applied the algorithm's citalopram model. This external validation yielded highly similar results for STAR*D and PGRN-AMPS test sets, with a balanced accuracy of 60.5% and 61.3%, respectively (both p's < 0.01). These findings support the feasibility of using ML algorithms applied to large datasets with genetic, clinical, and demographic features to improve accuracy in antidepressant prescription.
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de la Rosa IA, Huang J, Gard CC, McDonald JA. Examining the Prevalence of Peripartum Depressive Symptoms in a Border Community. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2021; 2:210-218. [PMID: 34235508 PMCID: PMC8243707 DOI: 10.1089/whr.2020.0105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 05/24/2021] [Indexed: 11/12/2022]
Abstract
Introduction: Depression is one of the most common complications in pregnancy, affecting 10% to 20% of women. Untreated peripartum depression increases the risk of adverse life events, more considerable distress, homelessness, and illness later in life. This study explored the prevalence of peripartum depression and associated demographic characteristics in a population of low-income, Healthy Start program participants in one New Mexico county along the U.S.-Mexico border where knowledge of depression prevalence is lacking. Materials and Methods: Healthy Start caseworkers routinely administered the 10-item Edinburgh Postnatal Depression Scale (EPDS) to all pregnant and recently pregnant program participants between 2009 and 2017. Scores for the first prenatal screen, first postpartum screen, and all screens for 1453 women were studied. A score of >10 points out of a possible 30 indicated a positive screen. Screening outcome was examined in relation to age, race, ethnicity, primary language, and trimester of the prenatal screen. Crude and adjusted odds ratios were generated from logistic regression models. Results: Overall, 16.4% of women screened positive for depression. English-speaking women, non-Hispanic white women, and those ages >35 years were more likely to screen positive. Women >35 years also had higher odds of reporting thoughts of self-harm than younger women. Conclusion: In this low-income border population, non-Hispanic white, English-speaking women over the age of 35 were at the greatest risk of peripartum depression. These findings underscore the need for peripartum depression screening in this population.
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Affiliation(s)
- Iván A. de la Rosa
- School of Social Work, Southwest Institute for Health Disparities Research, New Mexico State University, Las Cruces, New Mexico, USA
| | - Junxin Huang
- Department of Economics, Applied Statistics, and International Business and Southwest Institute for Health Disparities Research, New Mexico State University, Las Cruces, New Mexico, USA
| | - Charlotte C. Gard
- Department of Economics, Applied Statistics, and International Business and Southwest Institute for Health Disparities Research, New Mexico State University, Las Cruces, New Mexico, USA
| | - Jill A. McDonald
- Department of Public Health Sciences, Southwest Institute for Health Disparities Research, New Mexico State University, Las Cruces, New Mexico, USA
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Devkota G, Basnet P, Thapa B, Subedi M. Factors affecting utilization of mental health services from Primary Health Care (PHC) facilities of western hilly district of Nepal. PLoS One 2021; 16:e0250694. [PMID: 33930894 PMCID: PMC8087454 DOI: 10.1371/journal.pone.0250694] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 04/13/2021] [Indexed: 11/03/2022] Open
Abstract
AIM To explore the factors affecting mental health service utilization from Primary Health Care facilities of Arghakhanchi district, a western hilly district of Nepal. BACKGROUND Mental health service utilization has many facilitating and hindering factors present at different socio-ecological levels. Stigma and lack of awareness in the community have been identified as the major barriers for mental health service demand and access worldwide. METHODS A cross-sectional qualitative study was conducted in Arghakhanchi district of Nepal in July-August 2019 that collected information through face-to-face In-depth and Key Informant Interviews of three categories of participants selected judgmentally. Thirty-two purposively selected participants from the three categories were interviewed using validated interview guidelines. Thematic analysis was performed using RQDA package for EZR software. Validation of translated transcripts, member checking and inter-coder percent agreement were performed to maintain rigor in the study. RESULTS Mental health stigma and inadequate awareness were identified as major factors that caused barriers for mental health service utilization at community level. They also influenced different factors at other socio-ecological levels to act as barriers. Awareness in community along with accessibility and availability of comprehensive mental health services were recommended by the participants for increasing service utilization from Primary Health Care facilities. CONCLUSION Individual, family and community awareness could help reduce and/or eliminate mental health stigma. Accessibility of health facilities and availability of comprehensive mental health services in Primary Health Care facilities could help increase service utilization from those facilities.
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Affiliation(s)
- Gaurav Devkota
- School of Public Health, Patan Academy of Health Sciences, Lalitpur, Nepal
- * E-mail:
| | - Puspa Basnet
- School of Public Health, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Bijay Thapa
- School of Public Health, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Madhusudan Subedi
- School of Public Health, Patan Academy of Health Sciences, Lalitpur, Nepal
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Ryu JS, Lee YM, Kim YS, Kang S, Park JS, Ahn CW, Nam JS, Seok JH. Association between BDNF Polymorphism and Depressive Symptoms in Patients Newly Diagnosed with Type 2 Diabetes Mellitus. Yonsei Med J 2021; 62:359-365. [PMID: 33779090 PMCID: PMC8007434 DOI: 10.3349/ymj.2021.62.4.359] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 01/05/2021] [Accepted: 01/26/2021] [Indexed: 01/01/2023] Open
Abstract
PURPOSE Little is known about the relationship between brain-derived neurotrophic factor (BDNF) gene polymorphisms and psychiatric symptoms in diabetes patients. We investigated the effects of BDNF Val/66/Met polymorphism, glucose status, psychological susceptibility, and resilience on anxiety and depression symptoms in patients newly diagnosed with type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS We examined biochemical factors and BDNF polymorphism in 89 patients who were newly diagnosed with T2DM. Psychiatric symptoms were investigated with the Hospital Anxiety and Depression Scale (HADS), and the Connor-Davidson Resilience Scale (CD-RISC) and Impact of Event Scale (IES) were used to assess psychological resilience and susceptibility to psychological distress, respectively. Logistic regression analyses were conducted to investigate factors associated with psychiatric symptoms. RESULTS We determined that 62 patients (70%) were Met-carriers. No significant differences were found between the Val/Val homozygous and Met-carrier groups regarding age, sex, body mass index, and clinical factors related to glycemic control and lipid profiles. HADS-anxiety and HADS-depression scores and IES factor scores were higher in the Met-carrier than the Val/Val homozygous group. Hemoglobin A1c (HbA1c) level was significantly inversely correlated with the severity of depressive symptoms. Resilience factors showed significant inverse correlations, and IES factors showed positive correlations with depressive symptom severity. In the logistic regression analysis model, depressive symptoms were significantly associated with HbA1c and BDNF polymorphism, whereas only the hyperarousal factor of the IES scale was associated with anxiety. CONCLUSION Depressive symptoms are associated with the presence of the Met-carriers and lower HbA1c in patients newly diagnosed with T2DM.
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Affiliation(s)
- Jin Sun Ryu
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea
| | - Young Mi Lee
- Department of Internal Medicine, Dongtan Jeil Women's Hospital & Sangwoon Medical Institute, Hwasung, Korea
| | - Yu Sik Kim
- Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea
| | - Shinae Kang
- Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Suk Park
- Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Chul Woo Ahn
- Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Sun Nam
- Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
| | - Jeong Ho Seok
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea.
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The ASHA (Hope) Project: Testing an Integrated Depression Treatment and Economic Strengthening Intervention in Rural Bangladesh: A Pilot Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18010279. [PMID: 33401489 PMCID: PMC7796166 DOI: 10.3390/ijerph18010279] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/28/2020] [Accepted: 12/28/2020] [Indexed: 11/17/2022]
Abstract
Depression, a debilitating disorder, is highly prevalent among low-income women in low- and middle-income countries. Standard psychotherapeutic approaches may be helpful, but low treatment uptake, low retention, and transient treatment effects reduce the benefit of therapy. This pilot randomized controlled trial examined the effectiveness and feasibility of an integrated depression treatment/economic strengthening intervention. The study took place in two villages in the Sirajganj district in rural Bangladesh. Forty-eight low-income women with depressive symptoms (Patient Health Questionnaire (PHQ-9) score ≥ 10) were recruited and randomized to intervention or control arms. The intervention included a six-month group-based, fortnightly depression management and financial literacy intervention, which was followed by a cash-transfer of $186 (equivalent to the cost of two goats) at 12 months' follow-up. The cash transfer could be used to purchase a productive asset (e.g., agricultural animals). The control arm received no intervention. Findings showed significant reduction in depression scores in the intervention group. The mean PHQ-9 score decreased from 14.5 to 5.5 (B ± SE, -9.2 ± 0.8 95% CI -10.9, -7.5, p < 0.01) compared to no change in the control group. Most other psycho-social outcomes, including tension, self-esteem, hope, social-support, and participation in household economic decision-making, also improved with intervention. An integrated depression treatment and financial empowerment intervention was found to be highly effective among rural low-income women with depression. Next steps involve formal testing of the model in a larger trial.
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MacMillan KK, Lewis AJ, Watson SJ, Power J, Galbally M. Maternal psychosocial predictors of pacifier use in a mother-infant interaction task: An observational study from the MPEWS pregnancy cohort. Infant Behav Dev 2020; 61:101505. [PMID: 33197785 DOI: 10.1016/j.infbeh.2020.101505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 10/19/2020] [Accepted: 11/01/2020] [Indexed: 10/23/2022]
Abstract
The prevalence of pacifier use is high but when it occurs outside of the recommended sleep context, it becomes more controversial. Using 211 mother-infant dyads recorded as part of the Mercy Pregnancy and Emotional Wellbeing Study, we examined the maternal psychosocial predictors of pacifier use within an interaction task (i.e., ten minutes face-to-face followed by 30-minutes unstructured play). Predictors included maternal emotional availability measured with the Emotional Availability Scales; depression measured by the Structured Clinical Interview for the DSM-IV-TR Clinician Version; and maternal history of childhood trauma measured by the Childhood Trauma Questionnaire. An unadjusted odds ratio demonstrated that women classified as non-emotionally available to their infants were three-and-a-half-times more likely to use a pacifier. Multivariate logistic regression including all maternal psychosocial predictors demonstrated that even when adjusting for cessation of breastfeeding, maternal emotional availability remained the only significant predictor of pacifier use. This is the first time that predictors of pacifier use have been examined with a sample of clinically depressed women, as well as women with childhood trauma history. The results provide preliminary evidence that women who are not emotionally available might be more likely to rely on a pacifier during mother-infant interaction.
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Affiliation(s)
| | | | - Stuart J Watson
- Psychology, Murdoch University, Perth, Australia; School of Medicine, University of Notre Dame, Fremantle, Australia
| | - Josephine Power
- School of Medicine, University of Notre Dame, Fremantle, Australia
| | - Megan Galbally
- Psychology, Murdoch University, Perth, Australia; School of Medicine, University of Notre Dame, Fremantle, Australia; Women's Health, Genetics and Mental Health Directorate, King Edward Memorial Hospital for Women, Subiaco, Australia; Faculty of Health and Medicine Sciences, University of Western Australia, Perth, Australia
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Poulsen K, Pachana NA. Depression and Anxiety in Older and Middle‐aged Adults With Diabetes. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/j.1742-9544.2010.00020.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Asgari Y, Ricciardelli LA. Depression in the community setting: Development and initial validation of the Daily Goals Scale. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Yasmin Asgari
- School of Psychology, Deakin University, Geelong, Victoria, Australia,
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Cai W, Ma W, Chen AW, Shen WD. Effects of electroacupuncture therapy for depression: Study protocol for a multicentered, randomized controlled trial. Medicine (Baltimore) 2020; 99:e22380. [PMID: 32957418 PMCID: PMC7505286 DOI: 10.1097/md.0000000000022380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION As a major public health problem, depression has a negative impact on individuals and society. The aim of this well-designed trial is to evaluate the efficacy and safety of electroacupuncture (EA) treatment for depression. METHODS/DESIGN A 3-arm parallel, nonblinded, randomized controlled trial will be performed in 4 hospitals (centers). A total of 144 participants will be divided into 3 groups: EA group, manual acupuncture (MA) group, and western medicine group. Participants in EA group and MA group will receive 12 sessions of acupuncture treatment for 4 weeks. Participants allocated to western medicine group will only take 20 mg fluoxetine orally per day for 4 weeks. The primary outcome is Hamilton Depression Scale. Secondary outcomes are Self-Rating Depression Scale, Depression Scale of traditional Chinese medicine (Depression Scale of Traditional Chinese Medicine), brain fMRI and blood biomarkers including neurotransmitters serotonin, dopamine, noradrenaline, inflammatory cytokines inerleukin (IL)-1β, tumor necrosis factor-α, IL-6, and neurotrophin BDNF. All the outcomes will be assessed at baseline, 4 weeks after EA treatment onset and 6-month follow-up. DISCUSSION The results of this trial will verify the efficacy and safety of EA treatment for depressive patients and provide acupuncturists and clinicians with robust clinical evidence. TRIAL REGISTRATION Chinese Clinical Trial Registry identifier: ChiCTR1900023420. Version 1. Registered on 26 May 2019. http://www.chictr.org.cn/edit.aspx?pid=37621&htm=4.
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Affiliation(s)
- Wa Cai
- Institute of Acupuncture and Anesthesia
- Department of Acupuncture, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wen Ma
- Institute of Acupuncture and Anesthesia
| | | | - Wei-Dong Shen
- Institute of Acupuncture and Anesthesia
- Department of Acupuncture, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Li M, Niu J, Yan P, Yao L, He W, Wang M, Li H, Cao L, Li X, Shi X, Liu X, Yang K. The effectiveness and safety of acupuncture for depression: An overview of meta-analyses. Complement Ther Med 2019; 50:102202. [PMID: 32444032 DOI: 10.1016/j.ctim.2019.102202] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 09/19/2019] [Accepted: 09/28/2019] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To provide an overview of existing meta-analysis (MAs) on the efficacy and safety of acupuncture for depression, and assess the methodological quality and the strength of evidence of the included MAs. METHODS We searched MAs of randomized trials that have evaluated the effects of acupuncture on depression in three international and three Chinese databases from their inception until August 2019. The methodological quality of included MAs was evaluated with the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), and the strength of evidence with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). We used the intra-class correlation coefficient (ICC) to assess reviewer agreement in the pre-experiment. RESULTS We included 31 MAs and 59 RCTs. The results of included MAs were conflicting, our meta-analyses found that acupuncture may confer small benefit in reducing the severity of depression by end of treatment than no treatment/wait list/treatment as usual(SMD -0.74, 95% CI -1.06 to -0.41, eight trials, 624 participants), control acupuncture (invasive, non-invasive sham controls) (SMD 0.27, 95% CI -0.51 to -0.04, 20 trials, 1055 participants), antidepressants(Selective serotonin reuptake inhibitors (SSRI)/ Tetracyclic antidepressants(TCAs)) (SMD -0.28, 95% CI -0.46 to -0.10, 30 trials, 3068 participants), acupuncture plus antidepressants versus antidepressants(SSRI/TCAs) (SMD -0.99, 95% CI -1.37 to -0.61, 17 trials, 1110 participants). Subgroup analyses showed that there was no difference between electro-acupuncture and invasive control (P = 0.37), electro-acupuncture and non-invasive control (P = 0.90), manual acupuncture and Tetracyclic antidepressants (P = 0.57), electro-acupuncture and Tetracyclic antidepressants (P = 0.07). Six MAs concluded that acupuncture reduced the incidence of adverse events compared with antidepressants. The evaluation with AMSTAR-2 showed that the quality of included MAs was low or critically low. The results of the GRADE evaluation showed that the strength of evidence was low to very low for most outcomes. CONCLUSIONS Although acupuncture appears to be more effective and safer than no treatment, control acupuncture and antidepressants, the quality of the available evidence was very low. Further methodologically rigorous and adequately powered primary studies are needed to confirm the effectiveness of acupuncture for depression.
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Affiliation(s)
- Meixuan Li
- School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Evidence Based Social Science Research Center, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Junqiang Niu
- The First Hospital of Lanzhou University, Lanzhou, 730000, China
| | - Peijing Yan
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Institute of Clinical Research and Evidence Based Medicine, The Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Liang Yao
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, L8S4L8, Canada
| | - Wenbo He
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Meng Wang
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Huijuan Li
- School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Evidence Based Social Science Research Center, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Liujiao Cao
- School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Evidence Based Social Science Research Center, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Xiuxia Li
- School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Evidence Based Social Science Research Center, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Xiue Shi
- Institute of Evidence Based Rehabilitation Medicine of Gansu Province, Lanzhou, 730000, China
| | - Xingrong Liu
- School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence Based Social Science Research Center, Lanzhou University, Lanzhou, 730000, China.
| | - Kehu Yang
- School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Evidence Based Social Science Research Center, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China; Institute of Clinical Research and Evidence Based Medicine, The Gansu Provincial Hospital, Lanzhou, 730000, China.
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Shastri A, Aimola L, Tooke B, Quirk A, Corrado O, Hood C, Crawford MJ. Recognition and treatment of depression in older adults admitted to acute hospitals in England. Clin Med (Lond) 2019; 19:114-118. [PMID: 30872291 PMCID: PMC6454375 DOI: 10.7861/clinmedicine.19-2-114] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Levels of awareness and treatment of depression in older adults admitted to acute hospitals are unclear. This study aims to examine the proportion of older adults diagnosed with depression in acute hospitals, treatment, referral, and communication between secondary and primary healthcare services following discharge. Retrospective examination of records of 766 older adults admitted to 27 acute hospitals in England was carried out. Ninety-eight (12.7%, 95% confidence interval (CI) = 10.6-15.3) records included a diagnosis of depression of which eight (1.0%, 95% CI = 0.5-2.0) had a new diagnosis made during their hospital admission. All newly diagnosed and 76 (84.4%, 95% CI = 75.5-90.5) of those with an existing diagnosis of depression were prescribed antidepressant medication. Six (75.0%, 95% CI = 40.9-92.8) of those with a new diagnosis, and 21 (23.3%, 95% CI = 15.8-33.0) with an existing diagnosis of depression were referred to liaison psychiatry. References to mental health were made in 50 (51.0%, 95% CI = 41.2-60.6) discharge letters sent to primary care. Very few older adults admitted to acute hospitals in this study were diagnosed with depression during their inpatient stay. Opportunities for improving the mental and physical health of such patients appear to be being missed.
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Affiliation(s)
| | | | | | - Alan Quirk
- Royal College of Psychiatrists, London, UK
| | | | - Chloe Hood
- Royal College of Psychiatrists, London, UK
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46
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Dhiman P, Malik N, Sobarzo-Sánchez E, Uriarte E, Khatkar A. Quercetin and Related Chromenone Derivatives as Monoamine Oxidase Inhibitors: Targeting Neurological and Mental Disorders. Molecules 2019; 24:molecules24030418. [PMID: 30678358 PMCID: PMC6385169 DOI: 10.3390/molecules24030418] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 01/21/2019] [Accepted: 01/22/2019] [Indexed: 01/17/2023] Open
Abstract
Monoamine oxidase inhibitions are considered as important targets for the treatment of depression, anxiety, and neurodegenerative disorders, including Alzheimer’s and Parkinson’s diseases. This has encouraged many medicinal chemistry research groups for the development of most promising selective monoamine oxidase (MAO) inhibitors. A large number of plant isolates also reported for significant MAO inhibition potential in recent years. Differently substituted flavonoids have been prepared and investigated as MAO-A and MAO-B inhibitors. Flavonoid scaffold showed notable antidepressant and neuroprotective properties as revealed by various and established preclinical trials. The current review made an attempt to summarizing and critically evaluating the new findings on the quercetin and related flavonoid derivatives functions as potent MAO isoform inhibitors.
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Affiliation(s)
- Priyanka Dhiman
- Faculty of Pharmaceutical Sciences, M. D. University, Rohtak 124001, India.
| | - Neelam Malik
- Faculty of Pharmaceutical Sciences, M. D. University, Rohtak 124001, India.
| | - Eduardo Sobarzo-Sánchez
- Laboratory of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Santiago de Compostela, Campus Vida, 15782 Santiago de Compostela, Spain.
- Instituto de Investigación e Innovación en Salud, Facultad de Ciencias de la Salud, Universidad Central de Chile, 8370178 Santiago, Chile.
| | - Eugenio Uriarte
- Instituto de Ciencias Químicas Aplicadas, Universidad Autónoma de Chile, 7500912 Santiago, Chile.
- Departamento de Química Orgánica, Facultad de Farmacia, Universidad de Santiago de Compostela, 15782 Santiago de Compostela, Spain.
| | - Anurag Khatkar
- Faculty of Pharmaceutical Sciences, M. D. University, Rohtak 124001, India.
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Fry CE, Sommers BD. Effect of Medicaid Expansion on Health Insurance Coverage and Access to Care Among Adults With Depression. Psychiatr Serv 2018; 69:1146-1152. [PMID: 30152271 PMCID: PMC6395562 DOI: 10.1176/appi.ps.201800181] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Multiple studies have detailed the relationship between Medicaid expansion under the Affordable Care Act and various health and financial outcomes. However, fewer studies have examined Medicaid expansion's effects on individuals with psychiatric diagnoses. This study sought to determine the relationship between Medicaid expansion and various health and financial outcomes among low-income adults with depression. METHODS This quasi-experimental study used a random-digit-dial survey of U.S. citizens ages 19-64 with incomes below 138% of the federal poverty level. Surveys were conducted in three southern states (two expansion states, Arkansas and Kentucky, and one nonexpansion state, Texas) between 2013 and 2016. The study sample consisted of those with a positive screen for depression-score of ≥2 on the two-item Patient Health Questionnaire (N=4,853). Survey-weighted difference-in-differences regressions were conducted with insurance status, health care access and utilization, and affordability of care as outcomes of interest. Subgroup analyses stratified the sample on the basis of the respondent's residence in a health professional shortage area (HPSA) in mental health and severity of depression. RESULTS Medicaid expansion was associated with a significant reduction in the proportion of adults with depression who lacked health insurance (-23 percentage points, 95% confidence interval=-32 to -14, p<.001). Medicaid expansion was also associated with significant reductions in delaying care and medications because of cost. These changes were similar regardless of residence in a mental health HPSA and severity of depression. CONCLUSIONS Medicaid expansion was associated with improved access to care and medication among persons with depression, even in areas with relative shortages of mental health professionals.
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Affiliation(s)
- Carrie E Fry
- Ms. Fry is a doctoral candidate in health policy and statistics, Harvard Graduate School of Arts and Sciences, Cambridge, Massachusetts. Dr. Sommers is with the Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, and with the Department of Medicine, Brigham and Women's Hospital, Boston
| | - Benjamin D Sommers
- Ms. Fry is a doctoral candidate in health policy and statistics, Harvard Graduate School of Arts and Sciences, Cambridge, Massachusetts. Dr. Sommers is with the Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, and with the Department of Medicine, Brigham and Women's Hospital, Boston
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48
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Grigoroglou C, Munford L, Webb RT, Kapur N, Doran T, Ashcroft DM, Kontopantelis E. Association between a national primary care pay-for-performance scheme and suicide rates in England: spatial cohort study. Br J Psychiatry 2018; 213:600-608. [PMID: 30058517 DOI: 10.1192/bjp.2018.143] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Pay-for-performance policies aim to improve population health by incentivising improvements in quality of care.AimsTo assess the relationship between general practice performance on severe mental illness (SMI) and depression indicators under a national incentivisation scheme and suicide risk in England for the period 2006-2014. METHOD Longitudinal spatial analysis for 32 844 small-area geographical units (lower super output areas, LSOAs), using population-structure adjusted numbers of suicide as the outcome variable. Negative binomial models were fitted to investigate the relationship between spatially estimated recorded quality of care and suicide risk at the LSOA level. Incidence rate ratios (IRRs) were adjusted for deprivation, social fragmentation, prevalence of depression and SMI as well as other 2011 Census variables. RESULTS No association was found between practice performance on the mental health indicators and suicide incidence in practice localities (IRR=1.000, 95% CI 0.998-1.002). IRRs indicated elevated suicide risks linked with area-level social fragmentation (1.030; 95% CI 1.027-1.034), deprivation (1.013, 95% CI 1.012-1.014) and rurality (1.059, 95% CI 1.027-1.092). CONCLUSIONS Primary care has an important role to play in suicide prevention, but we did not observe a link between practices' higher reported quality of care on incentivised mental health activities and lower suicide rates in the local population. It is likely that effective suicide prevention needs a more concerted, multiagency approach. Better training in suicide prevention for general practitioners is also essential. These findings pertain to the UK but have relevance to other countries considering similar programmes.Declaration of interestNone.
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Affiliation(s)
- Christos Grigoroglou
- NIHR School for Primary Care Research,Centre for Primary Care,Division of Population Health, Health Services Research and Primary Care,University of Manchester, Manchester Academic Health Sciences Centre (MAHSC),UK
| | - Luke Munford
- Research Fellow in Health Economics,Centre for Health Economics,Division of Population Health, Health Services Research and Primary Care,University of Manchester, Manchester Academic Health Sciences Centre (MAHSC),UK
| | - Roger T Webb
- Professor in Mental Health Epidemiology,Centre for Mental Health and Safety,University of Manchester, NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester Academic Health Sciences Centre (MAHSC),UK
| | - Nav Kapur
- Professor of Psychiatry and Population Health,Centre for Suicide Prevention,University of Manchester, Greater Manchester Mental Health Trust and NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester Academic Health Sciences Centre (MAHSC),UK
| | - Tim Doran
- Professor of Health Policy,Department of Health Sciences,University of York,UK
| | - Darren M Ashcroft
- Professor of Pharmacoepidemiology,Centre for Pharmacoepidemiology and Drug Safety,School of Health Sciences,Faculty of Biology, Medicine and Health,University of Manchester, NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester Academic Health Sciences Centre (MAHSC),UK
| | - Evangelos Kontopantelis
- Professor of Data Science and Health Services Research,Faculty of Biology, Medicine and Health,University of Manchester, Manchester Academic Health Sciences Centre (MAHSC),UK
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Alrasheedi AA. Deficits in history taking skills among final year medical students in a family medicine course: A study from KSA. J Taibah Univ Med Sci 2018; 13:415-421. [PMID: 31435357 PMCID: PMC6695087 DOI: 10.1016/j.jtumed.2018.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 06/26/2018] [Accepted: 07/02/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES History taking is considered an important diagnostic tool in medicine. Medical students should be competent in focused history-taking skills to reach initial diagnosis. The aim of this study was to identify deficits in history-taking skills among final year medical students in family medicine courses in Qassim University, KSA. METHODS All objective structured clinical examination (OSCE) sheets were collected and analysed to evaluate the history-taking component of the final examination from 2016 until January 2018. RESULTS A total of 94 OSCE sheets were evaluated. Achievement in some history taking skills of the students was low (differential diagnosis 31.9%, alarming symptoms of disease 39.4%, clarification of major complaint-associated symptoms 47.9%, and stress, anxiety, and depression screening 59.6%). However, the students' performances were better with respect to communication skills in general and exploration of the patients' ideas, concerns, and expectations. Significantly more male than female students had a better performance in some skills such as facilitating technique, appropriately exploring major complaint-associated symptoms, enquiring about differential diagnoses, and to rule out alarm symptoms. CONCLUSIONS In this study, the students' performance was generally better with respect to communication skills and psychosocial history. However, the students showed poor knowledge in other aspects of history-taking skills as they failed to formulate more than one hypothesis and to ask about alarm symptoms. Teaching communication and clinical reasoning skills and connecting physical and psychosocial aspects of patient care promotes understanding of the patient as a whole and should be taught in all courses of the clinical phase, with emphasis on bedside training.
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Affiliation(s)
- Ahmad A. Alrasheedi
- Corresponding address: Department of Family and Community Medicine, College of Medicine, Qassim University, P.O. Box 6655, Buraidah 51452, KSA.
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Wang Q, Tian W. Prevalence, awareness, and treatment of depressive symptoms among the middle‐aged and elderly in China from 2008 to 2015. Int J Health Plann Manage 2018; 33:1060-1070. [DOI: 10.1002/hpm.2581] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 06/29/2018] [Indexed: 11/09/2022] Open
Affiliation(s)
- Qun Wang
- Faculty of Humanities and Social SciencesDalian University of Technology Dalian China
| | - Wenyao Tian
- School of Political StudiesUniversity of Ottawa Ottawa Canada
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