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Sleep Medicine Nov 2017Narcolepsy is a chronic sleep disorder that is likely to have neuropsychiatric comorbidities. Depression is a serious mood disorder that affects individuals' daily...
OBJECTIVE
Narcolepsy is a chronic sleep disorder that is likely to have neuropsychiatric comorbidities. Depression is a serious mood disorder that affects individuals' daily activities and functions. The current study aimed to investigate the relationship between narcolepsy and depressive disorders.
METHODS
The study consisted of patients diagnosed with narcolepsy between January 2002, and December 2011 (n = 258), and age-matched and gender-matched controls (n = 2580) from Taiwan's National Health Insurance database. Both the patients and the controls were monitored through December 31, 2011, to identify the occurrence of a depressive disorder. A multivariate logistic regression model was used to assess the narcolepsy's potential influence on the comorbidity of a depressive disorder.
RESULTS
During the study period, 32.7%, 24.8%, and 10.9% of the narcoleptic patients were comorbid with any depressive disorder, dysthymic disorder, and major depressive disorder, respectively. When compared to the control subjects, the patients with narcolepsy were at greater risks of having any depressive disorder (aOR 6.77; 95% CI 4.90-9.37), dysthymic disorder (aOR 6.62; 95% CI 4.61-9.57), and major depressive disorder (aOR 6.83; 95% CI 4.06-11.48). Of the narcoleptic patients that were comorbid with depression, >50% had been diagnosed with depression prior to being diagnosed with narcolepsy.
CONCLUSIONS
This nationwide data study revealed that narcolepsy and depression commonly co-occurred. Since some symptoms of narcolepsy overlapped with those of depressive disorders, the findings serve as a reminder that clinicians must pay attention to the comorbidity of narcolepsy and depression.
Topics: Adult; Comorbidity; Depressive Disorder; Female; Humans; Male; Narcolepsy; Propensity Score; Risk; Taiwan
PubMed: 29157595
DOI: 10.1016/j.sleep.2017.07.022 -
Open Access Rheumatology : Research and... 2019Patients with rheumatoid arthritis (RA) are prone to depression due to several factors related to their RA, including chronic and persistent pain, functional disability,... (Review)
Review
Patients with rheumatoid arthritis (RA) are prone to depression due to several factors related to their RA, including chronic and persistent pain, functional disability, economic constraints, and the side effects of RA medication. Previous Iranian studies showed conflicting and inconclusive findings regarding the prevalence of depression among RA patients. Therefore, this systematic review and meta-analysis was conducted to estimate the true prevalence of depression in Iranian patients with RA. Search for eligible articles was performed using the keywords of depression, depressive disorder, dysthymic disorder, major depressive disorder, RA, and Iran, and their possible combinations in the following databases: Scientific Information Database, MagIran, Web of Science/ISI, PubMed, and Scopus. The search was restricted to articles published in Persian and English languages. The meta-analysis was performed using the random effects model, and the data were analyzed using the STATA software version 12. Overall, six articles were selected; the overall prevalence of depression among the Iranian patients with RA was 65.58% (95% CI: 56.53%-74.62%). There were no significant relationships between the prevalence of depression and articles' methodological quality and year of publication, participants' age, sample size, and duration of disease. More than half of RA patients suffer from depression. The overlap between the physical symptoms of RA and depression in this group of patients makes it difficult to correctly diagnose depression; therefore, initiative and efforts are required to improve the identification of early depression symptoms in RA patients in order to effectively manage their depression.
PubMed: 30863193
DOI: 10.2147/OARRR.S191459 -
Frontiers in Psychiatry 2022People may endorse suicidal behavior during a major depressive episode. Affective temperaments may play a role in this risk. We explored the relationship between...
BACKGROUND
People may endorse suicidal behavior during a major depressive episode. Affective temperaments may play a role in this risk. We explored the relationship between affective temperaments and suicide and identified some traits that can predict suicide risk in depression.
MATERIALS AND METHODS
We analyzed the results of the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Auto-questionnaire (TEMPS-A) in 284 participants recruited from a psychiatric clinic and the community in Beijing and compared the subscale scores (temperaments of cyclothymic, dysthymic, anxious, irritable, and hyperthymic) among major depressive disorders (MDDs) vs. the general population as well as depressive patients with vs. without suicide risk, using Student's test, chi-square test, rank-sum test, and multivariable regression modeling.
RESULTS
The incidence of suicidal risk in depressive subjects was 47.62% (80/168). Being unmarried ( < 0.001), unemployed ( = 0.007), and temperaments of dysthymic, cyclothymic, anxious, and irritable scores (all < 0.001) were significantly more prevalent in patients with depression than in the general population. Young age ( < 0.001), female sex ( = 0.037), unmarried ( = 0.001), more severe depression ( < 0.001), and dysthymic, anxious, and cyclothymic temperament (all < 0.05) were significantly more prevalent in patients with depressive disorder than those without suicide risk. The logistic regression analysis showed that younger age (odds ratio [] = 0.937, 95% 0.905∼0.970), female sex ( = 2.606, 95% 1.142∼5.948), more severe depression ( = 1.145, 95% 1.063∼1.234), cyclothymic temperament ( = 1.275, 95% 1.102∼1.475), and dysthymic temperament ( = 1.265, 95% 1.037∼1.542) were all independently associated with high suicidal risk in patients with first-onset major depression ( < 0.05).
CONCLUSION
Temperament traits differ between the general population and people suffering from MDD. Subjects with MDD who have much more severe depressive symptoms and a cyclothymic or dysthymic temperament were at a high risk of suicide.
PubMed: 35747102
DOI: 10.3389/fpsyt.2022.893195 -
Neuroscience and Biobehavioral Reviews May 2017Despite it has not been formally included in DSM-5 as a disorder, 'Internet addiction (IA)' has become a worldwide issue. It can be broadly defined as a non-chemical,... (Review)
Review
Despite it has not been formally included in DSM-5 as a disorder, 'Internet addiction (IA)' has become a worldwide issue. It can be broadly defined as a non-chemical, behavioral addiction, which involves human-machine interaction. We pinpoint it as an "instrumental" form of social interaction (i.e. mediated by machines), a notion that appears useful for the sake of possible preclinical modeling. The features of Internet use reveals as addictive when this comes at the expense of genuine real-life sociability, with an overlap towards the hikikomori phenomenon (i.e., extreme retreat to one's own room). Due to the specific neuro-developmental plasticity in adolescence, IA poses risks to youths' mental health, and may likely produce negative consequences in everyday life. The thwarted development of adolescents' identity, self-image and adaptive social relationships is discussed: the IA adolescents often suffer loss of control, feelings of anger, symptoms of distress, social withdrawal, and familial conflicts. Further, more severe clinical conditions are also associated to IA, such as dysthymic, bipolar, affective, social-anxiety disorders, as well as major depression. This paper overviews the literature on IA, from neuro-biological, psycho-social and clinical standpoints, taking into account recent debates on diagnostic criteria, nosographic label and assessment tools. Neuroimaging data and neurochemical regulations are illustrated with links to pathogenetic hypotheses, which are amenable to validation through innovative preclinical modeling.
Topics: Adolescent; Adolescent Behavior; Behavior, Addictive; Depressive Disorder, Major; Humans; Internet
PubMed: 28027952
DOI: 10.1016/j.neubiorev.2016.12.024 -
Global Journal of Health Science Aug 2016The purpose of this study was to assess cognitive vulnerability and response style in clinical and normal individuals.
AIM
The purpose of this study was to assess cognitive vulnerability and response style in clinical and normal individuals.
METHOD
A sample of 90 individuals was selected for each of the 3 groups of Generalized Anxiety disorder, Dysthymic disorder and normal individuals. They completed MCQ and RSQ.
RESULTS
Results analyzed by MANOVA and post hoc showed significant differences among groups. Dysthymic group and GAD reported higher scores on cognitive confidence compared to the normal group. Individuals with GAD showed highly negative beliefs about need to control thought, compared to the other groups, but in cognitive self-consciousness they have no differences with the normal group. In regard to uncontrollability, danger and positive beliefs, GAD group had higher levels than the other groups. Although normal and GAD group didn't show any significant differences in response style, there was a significant difference between Dysthymic group and other groups in all response styles.
DISCUSSION
Beliefs and meta-cognitive strategies can be distinguished between clinical and non clinical individuals. Also, findings support the Self-Regulatory Executive Function model. ary committee was effective in recognizing, designing and implementing tailored interventions for reduction of medication errors. A systematic approach is urgently needed to decrease organizational susceptibility to errors, through providing required resources to monitor, analyze and implement effective interventions.
PubMed: 27045393
DOI: 10.5539/gjhs.v8n8p8 -
Psychophysiology Jul 2019The etiology of major depressive disorder is heterogeneous, and differing pathways leading to the development of depression are proposed to account for alternative...
The etiology of major depressive disorder is heterogeneous, and differing pathways leading to the development of depression are proposed to account for alternative variants of depressive illness and their distinct comorbidity patterns. The present study was undertaken as a step toward developing a model for conceptualizing and quantifying dispositional proneness to depression, marked by reduced neural sensitivity to rewarding events and more persistent occurrence of depressive symptomatology. Using data for college and community adult participants (N = 201), we sought to quantify variations in depression proneness by combining symptom indicators of persistent depressive conditions (dysthymic disorder, depressive personality) with a brain potential response that has been shown to index sensitivity to pleasurable events-the reward positivity (RewP; Proudfit, 2015). We first extended prior work on the RewP and depression by showing that the magnitude of RewP covaried negatively with symptoms of persistent depressive conditions (dysthymia, depressive personality) but not with current levels of depression. Persistent depressive symptoms and the RewP were then combined to form a composite neuroclinical index of depression proneness. Compared to persistent depressive symptoms alone, this composite dimensional index showed improved specificity of relations with diagnostic criterion measures, that is, similar-level associations with other indicators of depression proneness but significantly lower associations with fear disorder symptomatology. These findings provide evidence that a dimension of depression proneness can be quantified effectively by combining psychological indicators of persistent depression with a neurophysiological index of a core depression-related process (i.e., reward sensitivity).
Topics: Adolescent; Adult; Brain; Depression; Depressive Disorder, Major; Disease Susceptibility; Electroencephalography; Evoked Potentials; Female; Humans; Reward; Severity of Illness Index; Young Adult
PubMed: 30950526
DOI: 10.1111/psyp.13367 -
Industrial Psychiatry Journal Oct 2021Child sexual abuse (CSA) occurs when a person involves the child in sexual activities for his/her sexual gratification, commercial gain, or both. We report a series of...
Child sexual abuse (CSA) occurs when a person involves the child in sexual activities for his/her sexual gratification, commercial gain, or both. We report a series of 12 cases of CSA, who presented to the psychiatry department with diverse psychiatric presentations associated with CSA. In most of these cases, the perpetrator was unmarried and known to the child. The presentation was varied with patients being diagnosed with obsessive-compulsive disorder, schizophrenia, acute and transient psychotic disorder, dysthymic disorder, recurrent depressive disorder, acute stress reaction, conversion disorder, borderline personality disorder, and moderate depressive episode with somatic symptoms. Individual and family counseling was an important part of management of these cases along with pharmacotherapy. More vigilance about CSA and mental health in all categories of health-care personnel would help in early detection and timely management of these cases.
PubMed: 34908694
DOI: 10.4103/0972-6748.328866 -
The American Journal of Psychiatry Feb 2022Previous work has demonstrated significant declines in the provision of outpatient psychotherapy by U.S. psychiatrists. The objective of this study was to characterize...
OBJECTIVE
Previous work has demonstrated significant declines in the provision of outpatient psychotherapy by U.S. psychiatrists. The objective of this study was to characterize patterns and trends of psychotherapy by U.S. psychiatrists from 1996 to 2016.
METHODS
A retrospective, nationally representative analysis of psychiatrist visits from 21 waves of the U.S. National Ambulatory Medical Care Survey between 1996 and 2016 (N=29,673) was conducted to assess rates of outpatient psychotherapy provision by U.S. psychiatrists. Provision was modeled as risk differences and adjusted by clinical, sociodemographic, geographic, and financial characteristics.
RESULTS
Between 1996 and 2016, the weighted percentage of visits involving psychotherapy declined significantly from 44.4% in 1996-1997 to 21.6% in 2015-2016. Declines were most marked among patients diagnosed with social phobia (29% to 8%), dysthymic disorder (65% to 30%), and personality disorders (68% to 17%). For patients diagnosed with schizophrenia, psychotherapy provision remained stable (10%-12%). In the 2010-2016 period, about half of psychiatrists (53%) no longer provided psychotherapy at all. Antidepressant, antipsychotic, and sedative-hypnotic prescriptions were negatively associated with psychotherapy provision. During the study period, sociodemographic disparities grew, with older, White patients residing in metropolitan areas in the Northeast or West increasingly becoming the most likely to receive psychotherapy. Self-pay predicted access to solo-practice psychiatrists, who saw fewer patients but more frequently, and were more likely to provide psychotherapy.
CONCLUSIONS
Previously reported declines in psychiatrist provision of psychotherapy continued through 2016, affecting nearly all clinical categories. In the 2010s, about half of psychiatrists practiced no psychotherapy at all, creating new challenges to the integration of neurobiological and psychosocial elements of clinical care.
Topics: Humans; Mental Disorders; Outpatients; Practice Patterns, Physicians'; Psychiatry; Psychotherapy; Retrospective Studies
PubMed: 34875872
DOI: 10.1176/appi.ajp.2021.21040338 -
Neuropsychiatric Disease and Treatment 2015To investigate the personality disorders (PDs) diagnosed in patients with depressive disorders.
PURPOSE
To investigate the personality disorders (PDs) diagnosed in patients with depressive disorders.
MATERIAL AND METHODS
This study included a cross-sectional analysis, and was an extension of the Thai Study of Affective Disorder (THAISAD) project. Eighty-five outpatients with depressive disorders were interviewed using the Mini International Neuropsychiatric Inventory to assess for depression, in accordance with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision and using the Thai version of the Structured Clinical Interview for PDs to assess for PD.
RESULTS
Seventy-seven percent of the patients had at least one PD, 40% had one PD and 60% had two or more PDs (mixed cluster). The most common PDs found were borderline PD (20%) and obsessive-compulsive PD (10.6%), while the occurrence of avoidant PD was low when compared to the findings of previous, related studies. Among the mixed cluster, cluster A combined with cluster C was the common mix. Both dysthymic disorder and double depression were found to have a higher proportion of PDs than major depressive disorder (85.7% versus 76.1%). Dependent PD was found to be less common in this study than in previous studies, including those carried out in Asia.
CONCLUSION
The prevalence of PDs among those with depressive disorder varied, and only borderline PD seems to be consistently high within and across cultures. Mixed cluster plays a prominent role in depression, so more attention should be paid to patients in this category.
PubMed: 25945052
DOI: 10.2147/NDT.S82884 -
Clinical Epidemiology 2020Psychiatric disorders such as attention-deficit/hyperactivity disorder may negatively impact drug compliance and the prognosis of enuresis. However, existing studies...
BACKGROUND
Psychiatric disorders such as attention-deficit/hyperactivity disorder may negatively impact drug compliance and the prognosis of enuresis. However, existing studies regarding associations between lifetime psychiatric disorders and childhood enuresis are primarily from Western countries, and studies from Taiwan are lacking.
METHODS
We conducted a population-based retrospective cohort analysis using the Taiwan Longitudinal Health Insurance Database 2010. A total of 1,146 children with enuresis (ICD-9-CM code: 307.6) and 4,584 randomly selected sex- and age-matched controls were identified between January 1, 1997 and December 31, 2011. Logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the development of psychiatric disorders in the children with enuresis.
RESULTS
Enuresis was more common in the younger children, and the rate was significantly higher in boys (58.7%) than in girls (41.3%). A total of 171 patients (14.9%) in the enuresis group had at least one psychiatric diagnosis vs 259 (5.7%) in the control group (p<0.001). Multivariate analysis showed that the presence of enuresis increased the odds of developing major depressive/dysthymic disorder (OR=2.841, 95% CI: 1.619, 4.987), attention-deficit/hyperactivity disorder (OR=3.156, 95% CI: 2.446, 4.073), autism spectrum disorder (OR=2.468, 95% CI: 1.264, 4.822), anxiety disorders (OR=3.113, 95% CI: 2.063, 4.699), intelligence disability (OR=3.989, 95% CI: 2.476, 6.426), disruptive behavior disorders (OR=3.749, 95% CI: 1.756, 8.004), and tic disorder (OR=2.660, 95% CI: 1.642, 4.308).
CONCLUSION
Children with enuresis are likely to have psychiatric disorders, and physicians should consider this during their evaluation.
PubMed: 32110107
DOI: 10.2147/CLEP.S230537