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BMC Nephrology Aug 2017Objective of the study is to assess prevalence and survival among end stage renal disease patients with restless legs syndrome (RLS) within a national database (USRDS).
BACKGROUND
Objective of the study is to assess prevalence and survival among end stage renal disease patients with restless legs syndrome (RLS) within a national database (USRDS).
METHODS
A case-control, retrospective analysis was performed. Differences in characteristics between the groups, RLS and those with no sleep disorder (NSD), were determined using χ2 tests. Cox proportional hazard regression was used to assess survival between those with RLS and propensity score matched controls.
RESULTS
Cases of restless legs syndrome were defined as patients that had received an ICD-9 code of 333.94 at any point during their treatment (n = 372). RLS group demonstrated a significantly higher proportion of patients with major depressive disorder, dysthymic disorder, anxiety, depression, minor depressive disorder, and psychological disorder. The difference between the survival was not statistically significant in those without sleep disorder as compared to those with RLS (HR =1.16±0.14, p = 0.3).
CONCLUSIONS
True prevalence of RLS in dialysis patients can only be estimated if knowledge gap for care providers in diagnosis of RLS is addressed. RLS patients also have increased incidence of certain psychological disorders which needs to be addressed.
Topics: Aged; Case-Control Studies; Centers for Medicare and Medicaid Services, U.S.; Cohort Studies; Databases, Factual; Female; Humans; Kidney Failure, Chronic; Male; Middle Aged; Mortality; Restless Legs Syndrome; Retrospective Studies; United States
PubMed: 28764654
DOI: 10.1186/s12882-017-0660-0 -
Systematic Reviews Feb 2016Of the over 1 million reported cases of traumatic brain injuries reported annually in the USA, a sizeable proportion are characterized as mild. Although it is generally...
BACKGROUND
Of the over 1 million reported cases of traumatic brain injuries reported annually in the USA, a sizeable proportion are characterized as mild. Although it is generally well-accepted that most people who suffer a mild traumatic brain injury recover within 1 to 3 months, a proportion of individuals continue to experience physiological, psychological, and emotional symptoms beyond the expected window of recovery. Depression is commonly reported following mild traumatic brain injury; however, its course, consequences, and prognostic factors remain to be well understood.
METHODS
A systematic review will be conducted of available prospective longitudinal studies of adult mild traumatic brain injury-related depression. The aim of the systematic review is to describe the course of mild traumatic brain injury-related depression, along with its prognostic factors and health consequences. The review will comply with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. A thorough database search of peer-reviewed publications in English and French will be conducted in PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane, Embase, Scopus, Erudit, and Cairn. Independent investigators will perform study selection and data extraction. Risk of bias will be assessed using the Quality in Prognosis Studies tool, and methodological quality will be evaluated using a system inspired by the Scottish Intercollegiate Guidelines Network Methodology. Results will be presented through qualitative description and tabulation.
DISCUSSION
This will be the first systematic review conducted with the aim of describing the course, prognostic factors, and health-related outcomes of depression in adults who have suffered a mild traumatic brain injury. The findings of the planned systematic review have the potential to guide research and clinical practice to effectively develop and implement evidence-based interventions aimed at preventing and alleviating mild traumatic brain injury-related depression.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42015019214.
Topics: Brain Concussion; Brain Injuries; Depressive Disorder, Major; Disease Progression; Dysthymic Disorder; Humans; Prognosis; Systematic Reviews as Topic
PubMed: 26852224
DOI: 10.1186/s13643-016-0196-6 -
Behavioral Medicine (Washington, D.C.) 2017Human immunodeficiency virus (HIV)-positive rural individuals carry a 1.3-times greater risk of a depressive diagnosis than their urban counterparts. This randomized... (Randomized Controlled Trial)
Randomized Controlled Trial
Human immunodeficiency virus (HIV)-positive rural individuals carry a 1.3-times greater risk of a depressive diagnosis than their urban counterparts. This randomized clinical trial tested whether telephone-administered interpersonal psychotherapy (tele-IPT) acutely relieved depressive symptoms in 132 HIV-infected rural persons from 28 states diagnosed with Diagnostic and Statistical Manual of Mental Disorders-IV major depressive disorder (MDD), partially remitted MDD, or dysthymic disorder. Patients were randomized to either 9 sessions of one-on-one tele-IPT (n = 70) or standard care (SC; n = 62). A series of intent-to-treat (ITT), therapy completer, and sensitivity analyses assessed changes in depressive symptoms, interpersonal problems, and social support from pre- to postintervention. Across all analyses, tele-IPT patients reported significantly lower depressive symptoms and interpersonal problems than SC controls; 22% of tele-IPT patients were categorized as a priori "responders" who reported 50% or higher reductions in depressive symptoms compared to only 4% of SC controls in ITT analyses. Brief tele-IPT acutely decreased depressive symptoms and interpersonal problems in depressed rural people living with HIV.
Topics: Adult; Depression; Depressive Disorder, Major; Female; HIV Infections; Humans; Male; Middle Aged; Psychotherapy; Remote Consultation; Rural Population; Treatment Outcome
PubMed: 27115565
DOI: 10.1080/08964289.2016.1160025 -
Turk Psikiyatri Dergisi = Turkish... 2019In this study, we aimed to adapt the Structured Clinical Interview for DSM-5-ClinicianVersion into Turkish and to demonstrate its reliability. METHOD: A total of 185...
In this study, we aimed to adapt the Structured Clinical Interview for DSM-5-ClinicianVersion into Turkish and to demonstrate its reliability. METHOD: A total of 185 patients, both inpatient and outpatient, from two different university hospitals were included. Training sessions on the features and use of SCID-5/CV were held before the data collection. During the study, in order to test the diagnostic agreement and accuracy, two psychiatrists remained present at the evaluation of each participant; alternatively being interviewer and the observer. Cohen's kappa coefficient for inter-rater reliability was calculated for every diagnostic category. RESULTS: The patient group had a mean age of 37.2 (±13.5) years and 55.7% were female. The education status was as follows: 2.7% were illiterate, 1.7% literate with no primary education, 33% had primary education, 23.8% had secondary education and 38.9% had higher education. The calculated kappa value showed excellent agreement for schizophrenia (κ=0.93), bipolar disorder (κ=0.96), major depressive disorder (κ=0.89), dysthymic disorder (κ=0.82), alcohol use disorder (κ=0.96), panic disorder (κ=0.84), agoraphobia (κ=0.85), social anxiety disorder (κ=0.95), generalized anxiety disorder (κ=0.89), obsessive compulsive disorder (κ=0.87), posttraumatic stress disorder (κ=0.89), adult attention deficit and hyperactivity disorder (κ=1.00), specific phobias (κ=0.82) and very good agreement with adjustment disorder (κ=0.78) and somatic symptom disorder (κ=0.65). CONCLUSION: Similar to the past SCID versions, kappa values were found to be quite high and all were statistically significant. The Turkish version of SCID-5/ CV can be reliably used in both clinical practice and clinical studies.
Topics: Adolescent; Adult; Aged; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Interview, Psychological; Male; Mental Disorders; Middle Aged; Psychiatric Status Rating Scales; Reproducibility of Results; Translations; Turkey; Young Adult
PubMed: 31170307
DOI: No ID Found -
Agreement Among Categorical, Dimensional, and Impairment Criteria for ADHD and Common Comorbidities.Journal of Attention Disorders Aug 2016To compare the results of categorically based versus dimensionally based scoring algorithms for a Diagnostic and Statistical Manual of Mental Disorders (4th ed.;...
OBJECTIVE
To compare the results of categorically based versus dimensionally based scoring algorithms for a Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV)-referenced teacher rating scale for assessing ADHD and commonly co-occurring conditions and to determine their relative agreement with ratings of symptom-induced impairment.
METHOD
Teachers completed Child and Adolescent Symptom Inventory-4R (CASI-4R) ratings for 1,092 youth (ages 6-18 years) referred to a child and adolescent psychiatry outpatient service. Caseness was determined according to DSM-IV symptom count (categorical model) and T-score (dimensional model) criteria.
RESULTS
Agreement between symptom count and T-score cutoffs was generally good (kappa ≥ 0.61) for ADHD-Inattentive, ADHD-Hyperactive-Impulsive, ADHD-Combined (except adolescent females), Oppositional Defiant Disorder, and Conduct Disorder, but this was not the case for anxiety and depressive disorders where only 15% of kappas were good. Agreement of impairment cutoff with T-score and symptom count cutoffs ranged from poor to good.
CONCLUSION
In general, although in many cases CASI-4R categorical and dimensional scoring algorithms generated similar results, there was considerable variability across disorders, age groups, scoring method, and in some cases, gender. Moreover, symptom counts and T-scores are not a proxy for assessing impairment suggesting that each scoring strategy likely provides unique information for clinical decision-making.
Topics: Adolescent; Algorithms; Attention Deficit Disorder with Hyperactivity; Attention Deficit and Disruptive Behavior Disorders; Child; Conduct Disorder; Diagnosis, Differential; Diagnostic and Statistical Manual of Mental Disorders; Dysthymic Disorder; Female; Humans; Hyperkinesis; Male; Retrospective Studies
PubMed: 23400215
DOI: 10.1177/1087054712475083 -
Journal of Medical Internet Research Jul 2020An increasing number of studies suggest that web-based interventions for patients with depression can reduce their symptoms and are expected to fill currently existing... (Randomized Controlled Trial)
Randomized Controlled Trial
Efficacy of a Guided Web-Based Self-Management Intervention for Depression or Dysthymia: Randomized Controlled Trial With a 12-Month Follow-Up Using an Active Control Condition.
BACKGROUND
An increasing number of studies suggest that web-based interventions for patients with depression can reduce their symptoms and are expected to fill currently existing treatment gaps. However, evidence for their efficacy has mainly been derived from comparisons with wait-list or treatment as usual controls. In particular, designs using wait-list controls are unlikely to induce hope and may even have nocebo effects, making it difficult to draw conclusions about the intervention's efficacy. Studies using active controls are rare and have not yielded conclusive results.
OBJECTIVE
The main objective of this study is to assess the acute and long-term antidepressant efficacy of a 6-week, guided, web-based self-management intervention building on the principles of cognitive behavioral therapy (iFightDepression tool) for patients with depression compared with web-based progressive muscle relaxation as an active control condition.
METHODS
A total of 348 patients with mild-to-moderate depressive symptoms or dysthymia (according to the Mini International Neuropsychiatric Interview) were recruited online and randomly assigned to 1 of the 2 intervention arms. Acute antidepressant effects after 6 weeks and long-term effects at 3-, 6-, and 12-month follow-up were studied using the Inventory of Depressive Symptomatology-self-rating as a primary outcome parameter and change in quality of life (Short Form 12) and user satisfaction (client satisfaction questionnaire) as secondary outcome parameters. Treatment effects were assessed using mixed model analyses.
RESULTS
Over the entire observation period, a greater reduction in symptoms of depression (P=.01) and a greater improvement of life quality (P<.001) was found in the intervention group compared with the active control group. Separate tests for each time point revealed significant effects on depressive symptoms at the 3-month follow-up (d=0.281; 95% CI 0.069 to 0.493), but not after 6 weeks (main outcome:d=0.192; 95% CI -0.020 to 0.404) and 6 and 12 months. The intervention was significantly superior to the control condition with respect to user satisfaction (25.31 vs 21.97; t=5.804; P<.01).
CONCLUSIONS
The fact that antidepressant effects have been found for a guided self-management tool in comparison with an active control strengthens the evidence base for the efficacy of web-based interventions. The antidepressant effect became most prominent at the 3-month follow-up. After 6 weeks of intervention, significant positive effects were observed on life quality but not on depressive symptoms. Although the effect size of such web-based interventions on symptoms of depression might be smaller than that suggested by earlier studies using wait-list control conditions, they can be a cost-effective addition to antidepressants and face-to-face psychotherapy.
TRIAL REGISTRATION
International Clinical Trials Registry Platform ICTRP080-15-09032015; https://apps.who.int/trialsearch/Trial2.aspx?TrialID=DRKS00009323.
Topics: Adult; Depression; Dysthymic Disorder; Female; Follow-Up Studies; Humans; Internet-Based Intervention; Male; Psychotherapy; Quality of Life; Self-Management; Time Factors
PubMed: 32673233
DOI: 10.2196/15361 -
JAMA Psychiatry Jan 2016Current information on the prevalence and sociodemographic and clinical profiles of individuals in the general population with DSM-5 drug use disorder (DUD) is limited....
IMPORTANCE
Current information on the prevalence and sociodemographic and clinical profiles of individuals in the general population with DSM-5 drug use disorder (DUD) is limited. Given the present societal and economic context in the United States and the new diagnostic system, up-to-date national information is needed from a single uniform data source.
OBJECTIVE
To present nationally representative findings on the prevalence, correlates, psychiatric comorbidity, disability, and treatment of DSM-5 DUD diagnoses overall and by severity level.
DESIGN, SETTING, AND PARTICIPANTS
In-person interviews were conducted with 36,309 adults in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III, a cross-sectional representative survey of the United States. The household response rate was 72%; person-level response rate, 84%; and overall response rate, 60.1%. Data were collected April 2012 through June 2013 and analyzed from February through March 2015.
MAIN OUTCOMES AND MEASURES
Twelve-month and lifetime DUD, based on amphetamine, cannabis, club drug, cocaine, hallucinogen, heroin, nonheroin opioid, sedative/tranquilizer, and/or solvent/inhalant use disorders.
RESULTS
Prevalences of 12-month and lifetime DUD were 3.9% and 9.9%, respectively. Drug use disorder was generally greater among men, white and Native American individuals, younger and previously or never married adults, those with lower education and income, and those residing in the West. Significant associations were found between 12-month and lifetime DUD and other substance use disorders. Significant associations were also found between any 12-month DUD and major depressive disorder (odds ratio [OR], 1.3; 95% CI, 1.09-1.64), dysthymia (OR, 1.5; 95% CI, 1.09-2.02), bipolar I (OR, 1.5; 95% CI, 1.06-2.05), posttraumatic stress disorder (OR, 1.6; 95% CI, 1.27-2.10), and antisocial (OR, 1.4; 95% CI, 1.11-1.75), borderline (OR, 1.8; 95% CI, 1.41-2.24), and schizotypal (OR, 1.5; 95% CI, 1.18-1.87) personality disorders. Similar associations were found for any lifetime DUD with the exception that lifetime DUD was also associated with generalized anxiety disorder (OR, 1.3; 95% CI, 1.06-1.49), panic disorder (OR, 1.3; 95% CI, 1.06-1.59), and social phobia (OR, 1.3; 95% CI, 1.09-1.64). Twelve-month DUD was associated with significant disability, increasing with DUD severity. Among respondents with 12-month and lifetime DUD, only 13.5% and 24.6% received treatment, respectively.
CONCLUSIONS AND RELEVANCE
DSM-5 DUD is a common, highly comorbid, and disabling disorder that largely goes untreated in the United States. These findings indicate the need for additional studies to understand the broad relationships in more detail; estimate present-day economic costs of DUDs; investigate hypotheses regarding etiology, chronicity, and treatment use; and provide information to policy makers about allocation of resources for service delivery and research. Findings also indicate an urgent need to destigmatize DUD and educate the public, clinicians, and policy makers about its treatment to encourage affected individuals to obtain help.
Topics: Adolescent; Adult; Aged; Amphetamine-Related Disorders; Antisocial Personality Disorder; Bipolar Disorder; Borderline Personality Disorder; Cocaine-Related Disorders; Comorbidity; Depressive Disorder, Major; Diagnostic and Statistical Manual of Mental Disorders; Dysthymic Disorder; Female; Heroin Dependence; Humans; Inhalant Abuse; Male; Marijuana Abuse; Middle Aged; Opioid-Related Disorders; Personality Disorders; Prevalence; Schizotypal Personality Disorder; Severity of Illness Index; Stress Disorders, Post-Traumatic; Substance-Related Disorders; United States; Young Adult
PubMed: 26580136
DOI: 10.1001/jamapsychiatry.2015.2132 -
BMJ Open Nov 2020Composite diagnostic criteria alone are likely to create and introduce biases into diagnoses that subsequently have poor relationships with input symptoms. This study...
OBJECTIVES
Composite diagnostic criteria alone are likely to create and introduce biases into diagnoses that subsequently have poor relationships with input symptoms. This study aims to understand the relationships between the diagnoses and the input symptoms, as well as the magnitudes of biases created by diagnostic criteria and introduced into the diagnoses of mental illnesses with large disease burdens (major depressive episodes, dysthymic disorder, and manic episodes).
SETTINGS
General psychiatric care.
PARTICIPANTS
Without real-world data available to the public, 100 000 subjects were simulated and the input symptoms were assigned based on the assumed prevalence rates (0.05, 0.1, 0.3, 0.5 and 0.7) and correlations between symptoms (0, 0.1, 0.4, 0.7 and 0.9). The input symptoms were extracted from the diagnostic criteria. The diagnostic criteria were transformed into mathematical equations to demonstrate the sources of biases and convert the input symptoms into diagnoses.
PRIMARY AND SECONDARY OUTCOMES
The relationships between the input symptoms and diagnoses were interpreted using forward stepwise linear regressions. Biases due to data censoring or categorisation introduced into the intermediate variables, and the three diagnoses were measured.
RESULTS
The prevalence rates of the diagnoses were lower than those of the input symptoms and proportional to the assumed prevalence rates and the correlations between the input symptoms. Certain input or bias variables consistently explained the diagnoses better than the others. Except for 0 correlations and 0.7 prevalence rates of the input symptoms for the diagnosis of dysthymic disorder, the input symptoms could not fully explain the diagnoses.
CONCLUSIONS
There are biases created due to composite diagnostic criteria and introduced into the diagnoses. The design of the diagnostic criteria determines the prevalence of the diagnoses and the relationships between the input symptoms, the diagnoses, and the biases. The importance of the input symptoms has been distorted largely by the diagnostic criteria.
Topics: Bias; Depressive Disorder, Major; Dysthymic Disorder; Humans; Mania; Prevalence
PubMed: 33172939
DOI: 10.1136/bmjopen-2020-037022 -
The Journal of Clinical Psychiatry 2018Chronic pain is a disabling illness, often comorbid with depression. We performed a randomized controlled pilot study on mindfulness-based cognitive therapy (MBCT)... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
Chronic pain is a disabling illness, often comorbid with depression. We performed a randomized controlled pilot study on mindfulness-based cognitive therapy (MBCT) targeting depression in a chronic pain population.
METHOD
Participants with chronic pain lasting ≥ 3 months; DSM-IV major depressive disorder (MDD), dysthymic disorder, or depressive disorder not otherwise specified; and a 16-item Quick Inventory of Depressive Symptomatology-Clinician Rated (QIDS-C₁₆) score ≥ 6 were randomly assigned to MBCT (n = 26) or waitlist (n = 14). We adapted the original MBCT intervention for depression relapse prevention by modifying the psychoeducation and cognitive-behavioral therapy elements to an actively depressed chronic pain population. We analyzed an intent-to-treat (ITT) and a per-protocol sample; the per-protocol sample included participants in the MBCT group who completed at least 4 of 8 sessions. Changes in scores on the QIDS-C₁₆ and 17-item Hamilton Depression Rating Sale (HDRS₁₇) were the primary outcome measures. Pain, quality of life, and anxiety were secondary outcome measures. Data collection took place between January 2012 and July 2013.
RESULTS
Nineteen participants (73%) completed the MBCT program. No significant adverse events were reported in either treatment group. ITT analysis (n = 40) revealed no significant differences. Repeated-measures analyses of variance for the per-protocol sample (n = 33) revealed a significant treatment × time interaction (F₁,₃₁ = 4.67, P = .039, η²p = 0.13) for QIDS-C₁₆ score, driven by a significant decrease in the MBCT group (t₁₈ = 5.15, P < .001, d = >1.6), but not in the control group (t₁₃ = 2.01, P = .066). The HDRS₁₇ scores did not differ significantly between groups. The study ended before the projected sample size was obtained, which might have prevented effect detection in some outcome measures.
CONCLUSIONS
MBCT shows potential as a treatment for depression in individuals with chronic pain, but larger controlled trials are needed.
TRIAL REGISTRATION
ClinicalTrials.gov identifier: NCT01473615.
Topics: Chronic Pain; Cognitive Behavioral Therapy; Depressive Disorder, Major; Female; Humans; Male; Middle Aged; Mindfulness; Pilot Projects; Treatment Outcome
PubMed: 28252881
DOI: 10.4088/JCP.15m10160 -
Neuropsychopharmacologia Hungarica : a... Sep 2018When facing comorbidity, effects of medicating one disorder on the other disease is a key question for the clinician. As depression influences both development and...
When facing comorbidity, effects of medicating one disorder on the other disease is a key question for the clinician. As depression influences both development and outcome of oncological diseases, early diagnosis and therapy, primarily with antidepressants, is of paramount importance. This paper gives a survey on the effects of antidepressants on comorbid mood disorders, on the course of cancerous diseases and on the tumor itself. Response to therapy is similar for patients with comorbid and primary depression, just as there is no significant difference in tolerability. Early studies have shown that antidepressants increase the risk of tumor development, have negative effects on the outcome of oncological diseases and even increase mortality. However, recent epidemiological and clinical studies show opposing results and demonstrate beneficial action of antidepressants on various oncological diseases such as glióma and hepatocellular cancer. Like any drug, antidepressants have effects not only on targets in the brain but also on other organs, hence on tumor tissues as well. Latest preclinical studies demonstrate that certain antidepressants facilitate apoptosis, autophagy of tumor cells and potentiate the efficacy of anticancer agents acting as chemosensitizers. Direct and indirect antitumor effects of antidepressants are proven, however, their clinical use requires further studies focusing on the specificity of agents on different tumor types.
Topics: Antidepressive Agents; Comorbidity; Depression; Depressive Disorder; Dysthymic Disorder; Humans
PubMed: 30459285
DOI: No ID Found