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Clinical Case Reports Sep 2021Comprehensive clinical assessment with integrated team approach is crucial in managing cases of non-organic visual loss. Apart from pharmacotherapy, psychosocial...
Comprehensive clinical assessment with integrated team approach is crucial in managing cases of non-organic visual loss. Apart from pharmacotherapy, psychosocial rehabilitation should also be adequately addressed.
PubMed: 34584704
DOI: 10.1002/ccr3.4809 -
Psychoneuroendocrinology Nov 2021Worldwide, oral contraceptive (OC) use is a very common form of birth control, although it has been associated with symptoms of depression and insomnia. Insomnia is a...
BACKGROUND
Worldwide, oral contraceptive (OC) use is a very common form of birth control, although it has been associated with symptoms of depression and insomnia. Insomnia is a risk factor for major depressive disorder (MDD) but may also be a symptom of the disorder. Despite the large number of women who use OC, it is yet unknown whether women with previous or current diagnosis of depression are more likely to experience more severe depressive and insomnia symptoms during concurrent OC use than women without diagnosis of depression.
AIM
This study examined associations between OC use and concurrent symptoms of depression (including atypical depression) and insomnia as well as between OC and prevalences of concurrent dysthymia and MDD. Participants were adult women with and without a history of MDD or dysthymia. We hypothesized that OC use is associated with concurrent increased severity of depressive symptoms and insomnia symptoms, as well as with an increased prevalence of concurrent diagnoses of dysthymia and MDD. We also hypothesized that a history of MDD or dysthymia moderates the relationship between OC use and depressive and insomnia symptoms.
METHODS
Measurements from premenopausal adult women from the Netherlands Study of Depression and Anxiety (NESDA) were grouped, based on whether participants were using OC or naturally cycling (NC). OC use, timing and regularity of the menstrual cycle were assessed with a structured interview, self-reported symptoms of depression (including atypical depression), insomnia with validated questionnaires, and MDD and dysthymia with structured diagnostic interviews.
RESULTS
We included a total of 1301 measurements in women who reported OC use and 1913 measurements in NC women (mean age 35.6, 49.8% and 28.9% of measurements in women with a previous depression or current depression, respectively). Linear mixed models showed that overall, OC use was neither associated with more severe depressive symptoms (including atypical depressive symptoms), nor with higher prevalence of diagnoses of MDD or dysthymia. However, by disentangling the amalgamated overall effect, within-person estimates indicated increased depressive symptoms and depressive disorder prevalence during OC use, whereas between-person estimated indicated lower depressive symptoms and prevalence of depressive disorders. OC use was consistently associated with more severe concurrent insomnia symptoms, in the overall estimates as well as in the within-person and between-person estimates. Presence of current or previous MDD or dysthymia did not moderate the associations between OC use and depressive or insomnia symptoms.
DISCUSSION
The study findings showed consistent associations between OC use and more severe insomnia symptoms, but no consistent associations between OC and depressive symptoms or diagnoses. Instead, post-hoc analyses showed that associations between OC and depression differed between within- and between person-estimates. This indicates that, although OC shows no associations on the overall level, some individuals might experience OC-associated mood symptoms. Our findings underscore the importance of accounting for individual differences in experiences during OC use. Furthermore, it raises new questions about mechanisms underlying associations between OC, depression and insomnia.
Topics: Adult; Contraceptives, Oral; Depression; Depressive Disorder, Major; Dysthymic Disorder; Female; Humans; Self Report; Sleep Initiation and Maintenance Disorders
PubMed: 34425359
DOI: 10.1016/j.psyneuen.2021.105390 -
Journal of Affective Disorders Oct 2021Major depressive disorder (MDD) has been associated with difficulties in social and interpersonal functioning. Deficits in emotion processing may contribute to the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Major depressive disorder (MDD) has been associated with difficulties in social and interpersonal functioning. Deficits in emotion processing may contribute to the development and maintenance of interpersonal difficulties in MDD. Although some studies have found that MDD is associated with deficits in recognition of emotion in faces, other studies have failed to find any impairment.
METHODS
The present meta-analysis of 23 studies, with 516 dysthymic/depressed participants and 614 euthymic control participants, examined facial emotion recognition accuracy in MDD. Several potential moderators were investigated, including type of emotion, symptom severity, patient status, method of diagnosis, type of stimulus, and stimulus duration.
RESULTS
Results showed that participants with MDD in inpatient settings (Hedges' g = -0.35) and with severe levels of symptom severity (g = -0.42) were less accurate in recognizing happy facial expressions of emotion (g = -0.25) compared to participants in outpatient settings (g = -0.24) and with mild symptoms of depression (g = -0.17). Studies that presented stimuli for longer durations (g = -0.26) tended to find lower accuracy levels in dysthymic/depressed, relative to euthymic, participants.
LIMITATIONS
Limitations include a lack of studies which examined gender identity, as well as other potential moderators.
CONCLUSIONS
Results of the current study support the existence of a broad facial emotion recognition deficit in individuals suffering from unipolar depression. Clinicians should be mindful of this and other research which suggests broad-based deficits in various forms of information processing, including attention, perception, and memory in depression.
Topics: Depressive Disorder, Major; Emotions; Facial Expression; Facial Recognition; Female; Gender Identity; Humans; Male
PubMed: 34229285
DOI: 10.1016/j.jad.2021.06.053 -
Journal of Psychosomatic Research Sep 2021The literature on childhood-onset depression and future compromised vascular function is suggestive but limited. The objective of this study was to determine if arterial...
OBJECTIVES
The literature on childhood-onset depression and future compromised vascular function is suggestive but limited. The objective of this study was to determine if arterial stiffness, a predictor of future cardiovascular disease (CVD), measured in young adulthood, is associated with childhood-onset depression.
METHODS
Cardiometabolic risk factors and pulse wave velocity (PWV), a measure of arterial stiffness, were cross-sectionally assessed in young adults with a history of childhood-onset depression (clinical diagnosis of major depressive episode or dysthymic disorder; N = 294 probands; initially recruited via child mental health facilities across Hungary; mean age of first depressive episode = 10.4 years), their never-depressed full biological siblings (N = 269), and never-depressed controls (N = 169). The mean ages of probands, siblings, and controls at the PWV visit were 25.6, 25.0, and 21.7 years, respectively, and 8.8% of the probands were in a current depressive episode.
RESULTS
Controlling for age, sex, age*sex, education, and family clusters, PWV (m/s) did not statistically differ across the groups (probands = 7.01; siblings = 6.98; controls = 6.81). However, after adjusting for key covariates, there were several across-group differences in CVD risk factors: compared to controls, probands and siblings had higher diastolic blood pressure and lower high-density lipoprotein cholesterol, probands had higher triglycerides, and siblings had higher body mass index (all p < 0.05).
CONCLUSION
We found limited evidence of an association between a history of childhood-onset depression and young adulthood arterial stiffness. However, our findings of elevated cardiovascular risk factors in those with childhood-onset depression suggest that pediatric depression may predispose to increased CVD risk later in life and warrants further investigation.
Topics: Adult; Cardiovascular Diseases; Child; Depression; Depressive Disorder, Major; Humans; Pulse Wave Analysis; Vascular Stiffness; Young Adult
PubMed: 34174712
DOI: 10.1016/j.jpsychores.2021.110551 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2021The aim: To explore the features of non-psychotic mental disorders in people with cosmetic defects and deformities of the external nose in order to optimize their...
OBJECTIVE
The aim: To explore the features of non-psychotic mental disorders in people with cosmetic defects and deformities of the external nose in order to optimize their treatment and rehabilitation measures.
PATIENTS AND METHODS
Material and methods: The authors examined 99 persons who reffered to a plastic surgeon for cosmetic rhinoplasty. The first group (Group I) included 30 individuals; they did not have cosmetic defects of the nose; however, these individuals fixed unreasonably great attention on the nose and persistently demanded to change its shape. The second group (Group II) included 69 individuals with visible defects and deformities of the external nose, which deviated from the established aesthetic norm, but did not distort the appearance and did not violate the physiological functions. A comprehensive clinical-anamnestic, clinical-psychopathological, psychodiagnostic and socio-demographic examination of patients was carried out.
RESULTS
Results: Patients of Group I with dysmorphophobic disorder and without defects and deformities of the nose, who insisted on surgical correction, compared with persons of Group II with minimal defects and deformities, had a deeper severity of depressive symptoms and personal anxiety with a predominance of dysthymic character accentuation, low adaptability, complete intolerance of themselves and their appearance, a high level of emotional discomfort and internal control.
CONCLUSION
Conclusions: It is necessary to improve a comprehensive system of psychotherapeutic measures in combination with pharmacotherapy, in order to reduce psychopathological symptoms, improve the level of psychosocial functioning of the patients and create the preconditions for decision to abandon surgery.
Topics: Esthetics; Humans; Mental Disorders; Nose; Rhinoplasty
PubMed: 34159930
DOI: No ID Found -
JMIR Medical Informatics Jun 2021In the era of big data, networks are becoming a popular factor in the field of data analysis. Networks are part of the main structure of BeGraph software, which is a 3D...
BACKGROUND
In the era of big data, networks are becoming a popular factor in the field of data analysis. Networks are part of the main structure of BeGraph software, which is a 3D visualization application dedicated to the analysis of complex networks.
OBJECTIVE
The main objective of this research was to visually analyze tendencies of mental health diseases in a region of Spain, using the BeGraph software, in order to make the most appropriate health-related decisions in each case.
METHODS
For the study, a database was used with 13,531 records of patients with mental health disorders in three acute medical units from different health care complexes in a region of Spain. For the analysis, BeGraph software was applied. It is a web-based 3D visualization tool that allows the exploration and analysis of data through complex networks.
RESULTS
The results obtained with the BeGraph software allowed us to determine the main disease in each of the health care complexes evaluated. We noted 6.50% (463/7118) of admissions involving unspecified paranoid schizophrenia at the University Clinic of Valladolid, 9.62% (397/4128) of admissions involving chronic paranoid schizophrenia with acute exacerbation at the Zamora Hospital, and 8.84% (202/2285) of admissions involving dysthymic disorder at the Rio Hortega Hospital in Valladolid.
CONCLUSIONS
The data analysis allowed us to focus on the main diseases detected in the health care complexes evaluated in order to analyze the behavior of disorders and help in diagnosis and treatment.
PubMed: 34132650
DOI: 10.2196/15527 -
Frontiers in Psychology 2021Emotional disorder symptoms are highly prevalent and a common cause of disability among children and adolescents. Screening and early detection are needed to identify...
Emotional disorder symptoms are highly prevalent and a common cause of disability among children and adolescents. Screening and early detection are needed to identify those who need help and to improve treatment outcomes. Nowadays, especially with the arrival of the COVID-19 outbreak, assessment is increasingly conducted online, resulting in the need for brief online screening measures. The aim of the current study was to examine the reliability and different sources of validity evidence of a new web-based screening questionnaire for emotional disorder symptoms, the DetectaWeb-Distress Scale, which assesses mood (major depression and dysthymic disorder), anxiety (separation anxiety, generalized anxiety, social phobia, panic disorder/agoraphobia, and specific phobia), obsessive-compulsive disorder, post-traumatic stress disorder, suicidality (suicidal ideation, plans, and attempts), and global distress. A total of 1,499 participants (aged 8-18) completed the DetectaWeb-Distress Scale and specific questionnaires for emotional disorder symptoms, suicidal behaviors, and well-being through a web-based survey. Results indicated that a structural model of 10 correlated factors fits reasonably better in comparison to the remaining models; measurement invariance for age and gender; good internal consistency (McDonald's ω ranging from 0.65 to 0.94); and significant positive correlation with other measures of anxiety, depression, PTSD, or distress, and negative correlation with well-being measures, displaying support for convergent-discriminant validity. We also found that girls scored higher than boys on most of the subscales, and children had higher scores for social anxiety, specific phobia, panic disorder, and obsessive-compulsive symptoms, whereas adolescents scored higher on depressive symptoms, suicidality, and generalized anxiety, but the effect sizes were small to medium for all comparisons. The DetectaWeb-Distress Scale is a valid, innovative, and useful online tool for the screening and evaluation of preventive programs for mental health in children and adolescents.
PubMed: 33658965
DOI: 10.3389/fpsyg.2021.627604 -
BMJ Open Feb 2021To assess the global prevalence estimates of depressive symptoms, dysthymia and major depressive disorders (MDDs) among homeless people. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To assess the global prevalence estimates of depressive symptoms, dysthymia and major depressive disorders (MDDs) among homeless people.
DESIGN
Systematic review and meta-analysis.
DATA SOURCES
Databases including PubMed, Scopus and Web of Science were systematically searched up to February 2020 to identify relevant studies that have reported data on the prevalence of depressive symptoms, dysthymia and MDDs among homeless people.
ELIGIBILITY CRITERIA
Original epidemiological studies written in English that addressed the prevalence of depressive problems among homeless people.
DATA EXTRACTION AND SYNTHESIS
A random-effect meta-analysis was performed to pool the prevalence estimated from individual studies. Subgroup and sensitivity analyses were employed to compare the prevalence across the groups as well as to identify the source of heterogeneities. The Joanna Briggs Institute's quality assessment checklist was used to measure the study quality. Cochran's Q and the I test were used to assess heterogeneity between the studies.
RESULTS
Forty publications, including 17 215 participants, were included in the final analysis. This meta-analysis demonstrated considerably higher prevalence rates of depressive symptoms 46.72% (95% CI 37.77% to 55.90%), dysthymia 8.25% (95% CI 4.79% to 11.86%), as well as MDDs 26.24% (95% CI 21.02% to 32.22%) among homeless people. Our subgroup analysis showed that the prevalence of depressive symptoms was high among younger homeless people (<25 years of age), whereas the prevalence of MDD was high among older homeless people (>50 years of age) when compared with adults (25-50 years).
CONCLUSION
This review showed that nearly half, one-fourth and one-tenth of homeless people are suffering from depressive symptoms, dysthymia and MDDs, respectively, which are notably higher than the reported prevalence rates in the general population. The findings suggest the need for appropriate mental health prevention and treatment strategies for this population group.
Topics: Adult; Depression; Depressive Disorder, Major; Dysthymic Disorder; Ill-Housed Persons; Humans; Middle Aged; Prevalence
PubMed: 33622940
DOI: 10.1136/bmjopen-2020-040061 -
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 -
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