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Revista Medica Del Instituto Mexicano... Sep 2023Traditionally, psychopathology has been related to suicide risk, furthermore if we bear in mind that the recent meta-analysis on the relationship between some mental...
BACKGROUND
Traditionally, psychopathology has been related to suicide risk, furthermore if we bear in mind that the recent meta-analysis on the relationship between some mental disorders and the risk of suicide attempt are inconclusive, and have been performed with non-clinical samples.
OBJECTIVE
To establish the psychopathological differences between female adolescent patients with and without suicide attempt.
MATERIAL AND METHODS
Comparative, prospective, correlational and cross-sectional study. A sample of 50 female participants was used, divided into 2 groups: one of cases, (n = 25), made up of female patients between 15 and 19 years of age with suicide attempt, and a control group of pairs (n = 25) with no history of suicide attempt. The following instruments were applied: the Plutchik Impulsivity Scale, the Beck Hopelessness Scale, the K-Sads-PL, the Beck Suicidal Ideation Scale, and the Hamilton Depression Scale.
RESULTS
A greater presence of the disorders evaluated was found: major depressive disorder, dysthymic disorder, generalized anxiety disorder and panic disorder in the group with suicide attempt. Furthermore, the case group obtained higher mean scores on the Beck Hopelessness Scale, the Beck Suicidal Ideation Scale, the Hamilton Depression Scale and the Plutchik Impulsivity Scale.
CONCLUSIONS
The results agree with most of previous studies. It is suggested to carry out preventive interventions in cases where a considerably increased risk is detected.
Topics: Humans; Female; Adolescent; Suicide, Attempted; Depressive Disorder, Major; Cross-Sectional Studies; Prospective Studies; Mental Disorders; Suicidal Ideation; Risk Factors
PubMed: 37768952
DOI: 10.5281/zenodo.8316441 -
European Psychiatry : the Journal of... Nov 2021Ratings of affective temperament types show promise in helping to differentiate diagnostic groups among major affective disorders as well as to predict associations with...
BACKGROUND
Ratings of affective temperament types show promise in helping to differentiate diagnostic groups among major affective disorders as well as to predict associations with important aspects of morbidity including suicidal risk.
METHODS
The Temperament Evaluation of Memphis, Pisa, Paris, and San Diego auto-rating (TEMPS-A) questionnaire was completed by 858 unselected, consecutive, consenting adults diagnosed with a DSM-5 major affective disorder (173 bipolar-1 [BD-1]), 250 BD-2, 435 major depressive disorder [MDD]) to score for anxious (anx), cyclothymic (cyc), dysthymic (dys), hyperthymic (hyp), and irritable (irr) affective temperaments. We tested their associations with diagnosis and selected clinical factors, including diagnosis, depression scores, suicidal ideation or acts, substance abuse, episodes/year, and %-time ill.
RESULTS
Scores for cyc ranked: BD-2 > BD-1 > MDD; anx ranked: MDD > BD-2 > BD-1; irr was greater in BD than MDD; dys was greater in MDD than BD; hyp did not differ by diagnosis. We confirmed associations of suicidal risk with higher scores of all temperament types except lower hyp scores. Higher cyc and irr scores and lower anx scores were associated with substance abuse. Several scores were higher with measures of greater affective morbidity: cyc with current depression, episodes/year, and %-time ill; irr with more episodes and depressions/year and greater %-time manic. Some of these associations were selective for BD or MDD.
CONCLUSIONS
The findings indicate that TEMPS-A ratings of affective temperament types can contribute to differential diagnoses and predict types and amounts of affective morbidity, as well as detecting suicidal risks.
Topics: Adult; Bipolar Disorder; Depressive Disorder, Major; Humans; Irritable Mood; Morbidity; Personality Inventory; Surveys and Questionnaires; Temperament
PubMed: 34812134
DOI: 10.1192/j.eurpsy.2021.2252 -
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 -
Frontiers in Psychology 2019The current study aimed to examine the association between long-term (36 months) multimodal (pharmacological and psychological) treatment and psychopathology and...
AIM
The current study aimed to examine the association between long-term (36 months) multimodal (pharmacological and psychological) treatment and psychopathology and health-related quality of life (HRQoL) in children with attention deficit/hyperactivity disorder (ADHD) from the perspectives of both the children and parents.
METHODS
The sample consisted of 23 children with ADHD (21 boys, 2 girls, mean age = 13.46 years, = 2.36) and 23 healthy control children (11 boys, 12 girls, mean age = 12.49 years, = 1.75). The Mini International Neuropsychiatric Interview for Children and Adolescents (MINI Kid) was applied to measure psychopathology and both parent and self-rated versions of the Inventory for the Measure of the Quality of Life in Children and Adolescents were used to assess HRQoL at baseline and at the 36-month follow-up visit. The ADHD group took part in multimodal (medical and behavioral) therapy. The healthy control group did not get any intervention.
RESULTS
At the baseline, the ADHD group was characterized with higher scores in nine MINI Kid scales and showed lower HRQoL than the control group according to both children and their parents. At the 36-month follow-up visit six scale scores (ADHD, social phobia, oppositional defiance and conduct disorder, major depressive episode, dysthymic disorder) showed statistically significant decreases in the ADHD group, while these scores were constant in the control group. Parent-rated HRQoL was significantly lower in the clinical group at baseline than at the end of the study, but there were no significant changes in the control group. Self-reported changes in HRQoL matched parent-reported changes.
INTERPRETATION
Multimodal therapy is associated with decreased psychopathology and improved HRQoL over the long term.
PubMed: 31607973
DOI: 10.3389/fpsyg.2019.02037 -
Population Health Metrics Sep 2020Depression is one of the major causes of disability worldwide. The objective of this study was to analyze the results of the Global Burden of Disease Study 2017...
BACKGROUND
Depression is one of the major causes of disability worldwide. The objective of this study was to analyze the results of the Global Burden of Disease Study 2017 (GBD-2017) for depressive disorders in Brazil and its Federated Units (FUs) in 1990 and 2017.
METHODS
We used GBD-2017 study methodology to evaluate the prevalence estimates, the disability-adjusted life-year (DALY), and the years lived with disability (YLDs) for depressive disorders, which include major depressive disorder and dysthymia. The YLD estimates and the position of these disorders in the DALY and YLD rankings were compared to those of seven other countries. The observed versus expected YLD, based on the sociodemographic index (SDI), were compared.
RESULTS
In GBD-2017, the prevalence of depressive disorders in Brazil was 3.30% (95% uncertainty interval [UI]: 3.08 to 3.57), ranging from 3.79% (3.53 to 4.09) in Santa Catarina to 2.78% in Pará (2.56 to 3.03), with significant differences between the Federated Units. From 1990 to 2017, there was an increase in number of YLD (55.19%, 49.57 to 60.73), but a decrease in the age-standardized rates (- 9.01%, - 11.66 to - 6.31). The highest proportion of YLD was observed in the age range of 15-64 years and among females. These disorders rank 4th and 13th as leading causes of YLD and DALY, respectively, in Brazil. In the other countries evaluated, the ranking of these disorders in the YLD classification was close to Brazil's, while in the DALY classification, there was higher variability. All countries had YLD rates similar to the overall rate. The observed/expected YLD ratio ranged from 0.81 in Pará to 1.16 in Santa Catarina. Morbidity of depressive disorders was not associated with SDI.
CONCLUSIONS
Depressive disorders have been responsible for a high disability burden since 1990, especially in adult women living in the Southern region of the country. The number of people affected by these disorders in the country tends to increase, requiring more investment in mental health aimed at advancements and quality of services. The epidemiological studies of these disorders throughout the national territory can contribute to this planning and to making the Brazilian health system more equitable.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bayes Theorem; Brazil; Child; Depressive Disorder; Dysthymic Disorder; Female; Global Burden of Disease; Global Health; Humans; Male; Middle Aged; Prevalence; Quality-Adjusted Life Years; Residence Characteristics; Socioeconomic Factors; Young Adult
PubMed: 32993670
DOI: 10.1186/s12963-020-00204-5 -
Oxidative Medicine and Cellular... 2021Oxidative stress (OS) increases during the human aging process, and the sedentary lifestyle could be a prooxidant factor. In this study, we determine the effect of...
Oxidative stress (OS) increases during the human aging process, and the sedentary lifestyle could be a prooxidant factor. In this study, we determine the effect of sedentary lifestyle on OS during the aging process in Mexican women. A longitudinal study of two-year follow-up was carried out with 177 community-dwelling women (40-69 y) from Mexico City. We measured as OS markers plasma malondialdehyde, erythrocyte glutathione peroxidase (GPx) and superoxide dismutase (SOD), total plasma antioxidant status, uric acid level, antioxidant gap, and SOD/GPx ratio. To define OS using all the markers, we defined cut-off values of each parameter based on the 90 percentile of young healthy subjects and, we calculated a stress score (SS) ranging from 0 to 7, which represented the intensity of the marker modifications. All the women answered a structured questionnaire about prooxidant factors, including physical activity specially the type of activity, frequency, and duration, and they answered Spanish versions of self-assessment tests for establishing dysthymia and insomnia as potential confounders. Principal component and Poisson regression analysis were used as statistical tools, being two-year OS the primary outcome. The OS was considerate as SS ≥ 4 and sedentary lifestyle as <30 min/day of physical activity, beside several prooxidant factors and age that were covariables. SS is higher in sedentary lifestyle women after the two-year follow-up; although, the difference was statistically significant only in older women. Four principal components were associated with the OS, and 7 out of 8 prooxidant factors were important for the analysis, which were included in the Poisson model. The predictive factors for OS were the sedentary lifestyle (adjusted PR = 2.37, CI: 1.30-4.30, < 0.01), and age, in which the risk increases 1.06 (CI:1.02-2.11, < 0.01) by each year of age. Our findings suggest that a sedentary lifestyle increases the OS during the aging in Mexican women.
Topics: Adult; Aged; Aging; Antioxidants; Biomarkers; Dysthymic Disorder; Exercise; Female; Humans; Longitudinal Studies; Mexico; Middle Aged; Oxidative Stress; Sedentary Behavior; Sleep Initiation and Maintenance Disorders
PubMed: 34733404
DOI: 10.1155/2021/9971765 -
Behaviour Research and Therapy Aug 2020Studies suggest that depression severity and duration interact to predict outcomes in depression treatment. To our knowledge, no study has explored this question in a... (Randomized Controlled Trial)
Randomized Controlled Trial
Studies suggest that depression severity and duration interact to predict outcomes in depression treatment. To our knowledge, no study has explored this question in a sample with a placebo control, two therapies, and their combination nor with adolescents. We used data from the Treatment of Adolescent Depression Study (N = 439), in which adolescent were randomized to placebo (PBO), cognitive-behavioral therapy (CBT), antidepressants medications (MEDs), or their combination (COMB). We explore the interaction between depression severity, chronicity, and treatments (vs. placebo) in predicting outcomes. There was interaction between severity and chronicity when comparing COMB and CBT with PBO, but not MEDs. In non-chronic depression, the effects of CBT were inversely related to severity to the point that CBT appeared iatrogenic with more severe depression. In chronic depression, the effects of CBT did not vary by severity, but the relative effects of COMB grew, being smallest in milder, more dysthymic-like depression, and largest in chronic-severe depression. These findings support calls to classify depression by severity and chronicity as well efforts to risk stratify patients to different intensity of care according to these variables.
Topics: Adolescent; Antidepressive Agents; Chronic Disease; Cognitive Behavioral Therapy; Depressive Disorder; Female; Humans; Male; Prognosis; Severity of Illness Index; Time Factors; Treatment Outcome
PubMed: 32413595
DOI: 10.1016/j.brat.2020.103637 -
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 -
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 -
Scientific Reports Sep 2020We examined if manualized cognitive behavioral therapy (CBT) was more effective than Treatment As Usual (TAU) for clinically depressed adolescents within routine care.... (Randomized Controlled Trial)
Randomized Controlled Trial
We examined if manualized cognitive behavioral therapy (CBT) was more effective than Treatment As Usual (TAU) for clinically depressed adolescents within routine care. This multisite Randomized controlled trail included 88 clinically depressed adolescents (aged 12-21 years) randomly assigned to CBT or TAU. Multiple assessments (pre-, post treatment and six-month follow-up) were done using semi-structured interviews, questionnaires and ratings and multiple informants. The primary outcome was depressive or dysthymic disorder based on the KSADS. Completers, CBT (n = 19) and TAU (n = 26), showed a significant reduction of affective diagnoses at post treatment (76% versus 76%) and after six months (90% versus 79%). Intention-to-treat analyses on depressive symptoms showed that 41.6% within CBT and 31.8% within the TAU condition was below clinical cut-off at post treatment and after six-months, respectively 61.4% and 47.7%. No significant differences in self-reported depressive symptoms between CBT and TAU were found. No prediction or moderation effects were found for age, gender, child/parent educational level, suicidal criteria, comorbidity, and severity of depression. We conclude that CBT did not outperform TAU in clinical practice in the Netherlands. Both treatments were found to be suitable to treat clinically referred depressed adolescents. CBT needs further improvement to decrease symptom levels below the clinical cut-off at post treatment.
Topics: Adolescent; Adult; Child; Cognitive Behavioral Therapy; Humans; Netherlands; Surveys and Questionnaires; Treatment Outcome; Young Adult
PubMed: 32908173
DOI: 10.1038/s41598-020-71160-1