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Acta Psychiatrica Scandinavica Jan 2021To evaluate morbidity during long-term follow-up with clinical treatment of affective and schizoaffective disorder subjects followed from hospitalization for first major...
OBJECTIVE
To evaluate morbidity during long-term follow-up with clinical treatment of affective and schizoaffective disorder subjects followed from hospitalization for first major psychotic episodes.
METHODS
We followed adult subjects systematically at regular intervals from hospitalization for first-lifetime episodes of major affective and schizoaffective disorders with initial psychotic features. We compiled % of days with morbidity types from detailed records and life charts, reviewed earliest antecedent morbidities, compared both with final diagnoses and initial presenting illness types, and evaluated morbidity risk factors with regression modeling.
FINDINGS
With final diagnoses of bipolar-I (BD-I, n = 216), schizoaffective (SzAffD, 71), and major depressive (MDD, 42) disorders, 329 subjects were followed for 4.47 [CI: 4.20-4.47] years. Initial episodes were mania (41.6%), mixed states (24.3%), depression (19.5%), or apparent nonaffective psychosis (14.6%). Antecedent morbidity presented 12.7 years before first episodes (ages: SzAffD ≤ BD-I < MDD). Long-term % of days ill ranked SzAffD (83.0%), MDD (57.8%), BD-I (45.0%). Morbidity differed by diagnosis and first-episode types, and was predicted by first episodes and suggested by antecedent illnesses. Long-term wellness was greater with BD-I diagnosis, first episode not mixed or psychotic nonaffective, rapid onset, and being older at first antecedents, but not follow-up duration.
CONCLUSIONS
Initially, psychotic BD-I, SzAffD, or MDD subjects followed for 4.47 years from first hospitalization experienced much illness, especially depressive or dysthymic, despite ongoing clinical treatment. Antecedent symptoms arose years before index first episodes; antecedents and first episode types predicted types and amounts of long-term morbidity, which ranked: SzAffD > MDD > BD-I.
Topics: Adult; Depressive Disorder, Major; Hospitalization; Humans; Longitudinal Studies; Morbidity; Psychotic Disorders
PubMed: 33043430
DOI: 10.1111/acps.13243 -
Brain Sciences Dec 2023(1) Background: Bipolar disorder (BD) is divided into type I (BD-I) and type II (BD-II). Polarity at onset (PO) is a proposal to specify the clinical course of BD, based...
(1) Background: Bipolar disorder (BD) is divided into type I (BD-I) and type II (BD-II). Polarity at onset (PO) is a proposal to specify the clinical course of BD, based on the type of the first episode at disorder onset-depressive (D-PO) or manic (M-PO). At the same time, affective temperaments represent preexisting variants of the spectrum of affective disorders. Our objectives were to investigate the hypothesis that temperament may exert an influence on PO, and that this factor can serve as an indicator of the forthcoming course of the disorder, carrying significant therapeutic implications. (2) Methods: We included 191 patients with BD and examined clinical variables and temperament; the latter was assessed using the short version of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Auto-questionnaire (TEMPS-A-39-SV). We tested the associations between these variables and PO using standard univariate/bivariate methods followed by multivariate logistic regression models. (3) Results: 52.9% of the sample had D-PO and 47.1% had M-PO. D-PO and M-PO patients scored higher for dysthymic and hyperthymic temperaments, respectively ( < 0.001). Also, they differed in BD subtypes, age at first affective episode, illness duration, number of depressive episodes, seasonality, suicide risk, substance use, lithium, and benzodiazepine use ( < 0.05). Only BD-II and age at first depressive episode were predictors of D-PO, whereas BD-I, age at first manic/hypomanic episode, and hyperthymic temperament were predictors of M-PO ( < 0.01). (4) Conclusions: Our findings point to the importance of carefully assessing temperament and PO in patients with BD, to better predict the clinical course and tailor therapeutic interventions to individual patients' needs.
PubMed: 38248232
DOI: 10.3390/brainsci14010017 -
Clinical Practice and Epidemiology in... 2022Cocaine/crack use affects immune system molecules and development of mental disorders has been identified.
BACKGROUND
Cocaine/crack use affects immune system molecules and development of mental disorders has been identified.
OBJECTIVE
To investigate the relationship of polymorphisms in the (-308G/A), IL-10 (-819C/T) and (-786T/C) genes with mental disorders in cocaine and crack users.
METHODS
A case-control study was carried out, which included 107 cocaine and crack users and 115 controls who never used healthy cocaine and crack. The SNPs in the (-308G/A), (-819C/T) and (-786T/C) genes were genotyped by real time PCR.
RESULTS
As for the individuals included in this study, the average age of 31.4 years (± 8.59). We identified that the G/A genotype to TNFA (-308) (OR = 0.24; p = 0.03) and the A allele (OR = 0.30; p = 0.03) were associated with reduced risk for dysthymic disorder. The T allele of the IL-10 (-819) polymorphism was associated with decreased risk of developing panic disorder (OR = 0.44; p = 0.01), while the C allele was correlated with an increased risk for alcohol dependence (OR = 1.97; p = 0.04), alcohol abuse (OR = 1.81; p = 0.04) and psychotic syndrome (OR = 2.23; p = 0.01). C/C genotype was correlated with increased chances of developing current psychotic syndrome (OR = 4.23; p = 0.01).
CONCLUSION
Our results suggest that genetic polymorphisms promote susceptibility or promote protection for clinical phenotypes of psychiatric comorbidities in cocaine and crack users and be considered as good prognostic markers.
PubMed: 37274848
DOI: 10.2174/17450179-v18-e2201140 -
BMC Public Health Jun 2024Depressive disorders have been identified as a significant contributor to non-fatal health loss in China. Among the various subtypes of depressive disorders, dysthymia...
BACKGROUND
Depressive disorders have been identified as a significant contributor to non-fatal health loss in China. Among the various subtypes of depressive disorders, dysthymia is gaining attention due to its similarity in clinical severity and disability to major depressive disorders (MDD). However, national epidemiological data on the burden of disease and risk factors of MDD and dysthymia in China are scarce.
METHODS
This study aimed to evaluate and compare the incidence, prevalence, and disability-adjusted life-years (DALYs) caused by MDD and dysthymia in China between 1990 and 2019. The temporal trends of the depressive disorder burden were evaluated using the average annual percentage change. The comparative risk assessment framework was used to estimate the proportion of DALYs attributed to risk factors, and a Bayesian age-period-cohort model was applied to project the burden of depressive disorders.
RESULTS
From 1990 to 2019, the overall age-standardized estimates of dysthymia in China remained stable, while MDD showed a decreasing trend. Since 2006, the raw prevalence of dysthymia exceeded that of MDD for the first time, and increased alternately with MDD in recent years. Moreover, while the prevalence and burden of MDD decreased in younger age groups, it increased in the aged population. In contrast, the prevalence and burden of dysthymia remained stable across different ages. In females, 11.34% of the DALYs attributable to depressive disorders in 2019 in China were caused by intimate partner violence, which has increasingly become prominent among older women. From 2020 to 2030, the age-standardized incidence, prevalence, and DALYs of dysthymia in China are projected to remain stable, while MDD is expected to continue declining.
CONCLUSIONS
To reduce the burden of depressive disorders in China, more attention and targeted strategies are needed for dysthymia. It's also urgent to control potential risk factors like intimate partner violence and develop intervention strategies for older women. These efforts are crucial for improving mental health outcomes in China.
Topics: Humans; China; Dysthymic Disorder; Female; Adult; Middle Aged; Male; Young Adult; Depressive Disorder, Major; Adolescent; Prevalence; Aged; Risk Factors; Incidence; Disability-Adjusted Life Years; Bayes Theorem; Forecasting
PubMed: 38872130
DOI: 10.1186/s12889-024-18943-7 -
International Journal of Mental Health... Jul 2022Suicide was the main source of death from external causes in Spain in 2020, with 3,941 cases. The importance of identifying those mental disorders that influenced...
Suicide was the main source of death from external causes in Spain in 2020, with 3,941 cases. The importance of identifying those mental disorders that influenced hospital readmissions will allow us to manage the health care of suicidal behavior. The feature selection of each hospital in this region was carried out by applying Machine learning (ML) and traditional statistical methods. The results of the characteristics that best explain the readmissions of each hospital after assessment by the psychiatry specialist are presented. Adjustment disorder, alcohol abuse, depressive syndrome, personality disorder, and dysthymic disorder were selected for this region. The most influential methods or characteristics associated with suicide were benzodiazepine poisoning, suicidal ideation, medication poisoning, antipsychotic poisoning, and suicide and/or self-harm by jumping. Suicidal behavior is a concern in our society, so the results are relevant for hospital management and decision-making for its prevention.
PubMed: 35873865
DOI: 10.1007/s11469-022-00868-0 -
Arthroscopy : the Journal of... Feb 2023To investigate the association between preoperative mental health disorders and postoperative complications, readmissions, and ipsilateral revision procedures among...
Pre-existing Mental Health Diagnoses Are Associated With Higher Rates of Postoperative Complications, Readmissions, and Reoperations Following Arthroscopic Rotator Cuff Repair.
PURPOSE
To investigate the association between preoperative mental health disorders and postoperative complications, readmissions, and ipsilateral revision procedures among patients undergoing arthroscopic rotator cuff repair (RCR).
METHODS
A retrospective cohort study from 2010 to 2020 was performed using the PearlDiver database. Current Procedural Terminology and International Classification of Diseases codes were used to compare patients with and without mental health disorders who underwent arthroscopic RCR. Mental health disorders evaluated in this study include depressive disorder, major depressive disorder, major depressive affective disorder, bipolar disorder, dysthymic disorder, adjustment disorder, separation anxiety disorder, and posttraumatic stress disorder. Patients were matched at a 1:1 ratio based on age, sex, Charlson Comorbidity Index, body mass index, and tobacco use. Rates of complications and subsequent surgeries were compared between patients with and without a preoperative diagnosis of a mental health disorder.
RESULTS
The 1-year preoperative prevalence of a mental health disorder from 2010 to 2020 was 14.6%. After 1:1 matching, patients with a mental health disorder who underwent arthroscopic RCR were nearly twice as likely to undergo a revision procedure (odds ratio 1.94, 95% confidence interval 1.76-2.14, P < .001) and more than twice as likely to experience conversion to shoulder arthroplasty (odds ratio 2.29, 95% confidence interval 1.88-2.80, P < .001) within 2 years of initial arthroscopy when compared with patients without a mental disorder. Patients with a mental disorder also experienced increased risk for 90-day readmission (1.9% vs 0%, P < .001) as well as multiple postoperative medical complications.
CONCLUSIONS
Patients with pre-existing mental health diagnoses experience increased rates of 90-day postoperative complications and readmissions following arthroscopic RCR. In addition, patients with mental health diagnoses are more likely to undergo revision repair and conversion to shoulder arthroplasty within 2 years of the index procedure.
LEVEL OF EVIDENCE
Level III.
Topics: Humans; Rotator Cuff; Rotator Cuff Injuries; Arthroscopy; Retrospective Studies; Patient Readmission; Reoperation; Depressive Disorder, Major; Mental Health; Postoperative Complications; Treatment Outcome
PubMed: 35970453
DOI: 10.1016/j.arthro.2022.06.040 -
Psychotherapy Research : Journal of the... Nov 2021This study explored whether treatment outcomes in a trial on the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) vs. Supportive Psychotherapy (SP) for... (Randomized Controlled Trial)
Randomized Controlled Trial
This study explored whether treatment outcomes in a trial on the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) vs. Supportive Psychotherapy (SP) for patients with early-onset chronic depression differ between alliance patterns. Session-to-session ratings of the therapeutic alliance (Helping Alliance Questionnaire (HAQ)) from 254 outpatients with chronic depression (CBASP: 134; SP: 120) who took part in a multicenter randomized controlled trial of CBASP vs. SP were used to categorize patients into three alliance pattern categories for the patients' and therapists' rating separately. Based on the reliable change in the HAQ from one session to the next categories were: no rupture, unrepaired rupture, rupture-repair. Depression severity (24-item Hamilton Rating Scale for Depression) at post-treatment, at 12- and 24- months follow-up was the outcome. The alliance pattern categories for therapists and patients did not differ between CBASP and SP. Only the alliance patterns calculated for patients were associated with outcome: in the unrepaired rupture category, patients had higher HRSD-ratings across time points ( = 0.047). CBASP was not associated with more or fewer ruptures or repairs as compared to SP in the treatment of chronic depression. The study highlights the need to resolve ruptures to avoid poor outcomes. ClinicalTrials.gov identifier: NCT00970437.
Topics: Cognitive Behavioral Therapy; Depression; Dysthymic Disorder; Humans; Psychotherapy; Therapeutic Alliance; Treatment Outcome
PubMed: 33455531
DOI: 10.1080/10503307.2021.1874070 -
Prevelence of depression in Iranian women with breast cancer: a systematic review and meta-analysis.Przeglad Epidemiologiczny 2022Depression is a debilitating disease that is highly prevalent among cancer patients. Various studies in Iran have reported different prevalence. This systematic review... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Depression is a debilitating disease that is highly prevalent among cancer patients. Various studies in Iran have reported different prevalence. This systematic review and meta-analysis was conducted to estimate the overall prevalence of depression in Iranian women with breast cancer.
MATERIAL AND METHODS
In this study, published articles in Persian and English were collected without time limit. Keyword searches for depression, depressive disorder, dysthymic disorder, major depressive disorder, breast cancer, breast neoplasm, and Iran and all of their potential combinations were performed in Scientific Information Database (SID), MagIran, PubMed, Scopus, Web of Science databases. The heterogeneity between studies was assessed using the Q-Cochrane test and, given the significant heterogeneity, a random-effects model was used to estimate the overall prevalence of depression. Data were analyzed using STATA version 11 software.
RESULTS
The analysis of 22 selected articles with a total sample size of 3,082 showed that the overall prevalence of depression in women with breast cancer was 49.98% (95% confidence interval: 48.43-52.52). The prevalence of depression in Region 1 in the country was (28%; 95% confidence interval: 25.53-52.55) and in other regions, it was (63.79% with 95% confidence interval of 61.82-76.76). The highest and the lowest prevalence of depression were related to BDI (69.33%; 95% confidence interval: 67.19-71.48) and HADS (26.43%; 95% confidence interval: 23.14-29.72), respectively.
CONCLUSIONS
Half of the Iranian women with breast cancer had depression. Given the overlap of physical symptoms of cancer with depression, identifying at-risk patients for controlling and providing therapeutic interventions seems necessary.
Topics: Breast Neoplasms; Depression; Depressive Disorder, Major; Female; Humans; Iran; Poland; Prevalence
PubMed: 35860943
DOI: 10.32394/pe.76.04 -
Psychology, Health & Medicine Mar 2023Patients with cardiovascular disease have depression more often than the general population does. The aim of the study was to detect the associations between the...
Patients with cardiovascular disease have depression more often than the general population does. The aim of the study was to detect the associations between the psychological state and weather variables in patients who underwent coronary artery bypass grafting or valve surgery. The prospective study was performed during 2008-2012 in Kaunas, Lithuania. The psychological state of 233 patients was assessed by using the Symptom Checklist-90-Revised instrument. The assessment was carried out at 1.5 months, 1 year, and 2 years after the surgery. A sample of 531 measurements of psychological states was used. To investigate the relationships between psychological scores and daily weather variables, a mixed linear model was used adjusting for sex, the type of surgery, age, the marital status, the presence of arterial hypertension, diabetes, major depressive disorders, dysthymic disorders, agoraphobia, smoking before surgery, and myocardial infarction in the anamnesis. The mean somatisation score and air temperature on the second day prior to the survey were found to have a negative correlation in the multivariate model. Lower mean scores of anxiety and depression were linked to hotter days (air temperature >16.25°C on the second day) that did not occur in July or August. During colder days (air temperature <0.35°C), a higher mean score of anxiety and phobic anxiety was observed. A higher mean score of somatizations, depression, and anxiety was seen on the second day after the day with wind speed ≤2.85 kt and on the day after the day with relative humidity <66%. Both a decrease and an increase in daily atmospheric pressure were associated with a higher depression score. Our results confirm that among patients after open heart surgery, psychosomatic complaints are related to some weather changes. The obtained results can help to determine the complexity of weather patterns linked to poorer psychological health.
Topics: Humans; Depression; Depressive Disorder, Major; Prospective Studies; Weather; Myocardial Infarction; Cardiac Surgical Procedures
PubMed: 36203385
DOI: 10.1080/13548506.2022.2132411 -
PeerJ 2019Cognitive impairments in patients with depressive disorders have a negative impact on their daily skill functioning and quality of life. In this study, we evaluated the...
BACKGROUND
Cognitive impairments in patients with depressive disorders have a negative impact on their daily skill functioning and quality of life. In this study, we evaluated the cognitive profiles and associated factors of patients with depressive disorders with the Brief Assessment of Cognition in Affective Disorders (BAC-A).
METHODS
This cross-sectional study consisted of 75 patients with depressive disorders (56 patients with major depressive disorder (MDD) and 19 patients with depressive disorder NOS or dysthymic disorder (non-MDD)). We evaluated the participants' cognitive functions at euthymic status using the BAC-A. The BAC-A includes six subtests derived from the Brief Assessment of Cognition in Schizophrenia (BAC-S) and Affective Processing Tests. The current severity of depressive symptoms was assessed with the 17-item Hamilton Depression Rating Scale (HAMD-17), and we recorded any psychotropic drugs being used by the patients.
RESULTS
We observed no differences in cognitive profiles in the MDD group and non-MDD group after adjusting for educational levels, severity of depression, and psychotropic drugs. Instead, the HAMD-17 scores were negatively correlated to cognitive performance in working memory, motor speed, verbal fluency, attention and processing speed, executive function, composite score, and the six indexes of the Affective Processing Test measured by the BAC-A. A longer illness duration was associated with worse performance of four indexes of the Affective Processing Test. Furthermore, benzodiazepine use was associated with a worse performance of verbal memory, and antidepressant use was associated with better motor speed performance.
CONCLUSION
The current severity of depressive symptoms and psychotropic drugs being taken, not the diagnosis category, are associated with cognitive impairments in patients with depressive disorders. Clinicians should pay particular attention to managing residual depressive symptoms and prescribing adequate psychotropic drugs in order to eliminate depressive patients' cognitive deficits.
PubMed: 31396459
DOI: 10.7717/peerj.7432