-
The Australian and New Zealand Journal... Jul 2022Evidence indicates that mood disorders often co-occur with substance-related disorders. However, pooling comorbidity estimates can be challenging due to heterogeneity in... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND OBJECTIVES
Evidence indicates that mood disorders often co-occur with substance-related disorders. However, pooling comorbidity estimates can be challenging due to heterogeneity in diagnostic criteria and in the overall study design. The aim of this study was to systematically review and, where appropriate, meta-analyse estimates related to the pairwise comorbidity between mood disorders and substance-related disorders, after sorting these estimates by various study designs.
METHODS
We searched PubMed (MEDLINE), Embase, CINAHL and Web of Science for publications between 1980 and 2017 regardless of geographical location and language. We meta-analysed estimates from original articles in 4 broadly defined mood and 35 substance-related disorders.
RESULTS
After multiple eligibility steps, we included 120 studies for quantitative analysis. In general, regardless of variations in diagnosis type, temporal order or use of adjustments, there was substantial comorbidity between mood and substance-related disorders. We found a sixfold elevated risk between broadly defined mood disorder and drug dependence (odds ratio = 5.7) and fivefold risk between depression and cannabis dependence (odds ratio = 4.9) while the highest pooled estimate, based on period prevalence risk, was found between broadly defined dysthymic disorder and drug dependence (odds ratio = 11.3). Based on 56 separate meta-analyses, all pooled odds ratios were above 1, and 46 were significantly greater than 1 (i.e. the 95% confidence intervals did not include 1).
CONCLUSION
This review found robust and consistent evidence of an increased risk of comorbidity between many combinations of mood and substance-related disorders. We also identified a number of under-researched mood and substance-related disorders, suitable for future scrutiny. This review reinforces the need for clinicians to remain vigilant in order to promptly identify and treat these common types of comorbidity.
Topics: Comorbidity; Humans; Mood Disorders; Odds Ratio; Prevalence; Substance-Related Disorders
PubMed: 34708662
DOI: 10.1177/00048674211054740 -
Journal of Affective Disorders Dec 2021We report results of an internet-based field study evaluating the diagnostic guidelines for ICD-11 mood disorders. Accuracy of clinicians' diagnostic judgments applying... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
We report results of an internet-based field study evaluating the diagnostic guidelines for ICD-11 mood disorders. Accuracy of clinicians' diagnostic judgments applying draft ICD-11 as compared to the ICD-10 guidelines to standardized case vignettes was assessed as well as perceived clinical utility.
METHODS
1357 clinician members of the World Health Organization's Global Clinical Practice Network completed the study in English, Spanish, Japanese or Russian. Participants were randomly assigned to apply ICD-11 or ICD-10 guidelines to one of eleven pairs of case vignettes.
RESULTS
Clinicians using the ICD-11 and ICD-10 guidelines achieved similar levels of accuracy in diagnosing mood disorders depicted in vignettes. Those using the ICD-11 were more accurate in identifying depressive episode in recurrent depressive disorder. There were no statistically significant differences detected across classifications in the accuracy of identifying dysthymic or cyclothymic disorder. Circumscribed problems with the proposed ICD-11 guidelines were identified including difficulties differentiating bipolar type I from bipolar type II disorder and applying revised severity ratings to depressive episodes. Clinical utility of ICD-11 bipolar disorders was found to be significantly lower than for ICD-10 equivalent categories.
LIMITATIONS
Standardized case vignettes were manipulated to evaluate specific changes. The degree of accuracy of clinicians' diagnostic judgments may not reflect clinical decision-making with patients.
CONCLUSIONS
Alignment of the ICD-11 with current research appears to have been achieved without sacrificing diagnostic accuracy or clinical utility though specific training may be necessary as ICD-11 is implemented worldwide. Areas in which the ICD-11 guidelines did not perform as intended resulted in further revisions.
Topics: Bipolar Disorder; Humans; International Classification of Diseases; Judgment; Mood Disorders; Russia
PubMed: 34706426
DOI: 10.1016/j.jad.2021.08.050 -
Bulletin of Experimental Biology and... Oct 2021Comparative analysis of blood sera from women with alcohol dependence and depressive disorders or from conditionally healthy women revealed reduced level of antibodies...
Comparative analysis of blood sera from women with alcohol dependence and depressive disorders or from conditionally healthy women revealed reduced level of antibodies to dopamine, norepinephrine, serotonin, glutamate, and GABA in blood serum in women with dysthymic disorder and a depressive episode and their increased content in women with alcohol dependence in combination with depressive disorders.
Topics: Alcoholism; Autoantibodies; Case-Control Studies; Depressive Disorder; Dopamine; Dysthymic Disorder; Female; Glutamic Acid; Humans; Middle Aged; Norepinephrine; Serotonin; gamma-Aminobutyric Acid
PubMed: 34705169
DOI: 10.1007/s10517-021-05299-w -
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 -
The Lancet. Psychiatry Nov 2021In China, depressive disorders have been estimated to be the second leading cause of years lived with disability. However, nationally representative epidemiological data...
BACKGROUND
In China, depressive disorders have been estimated to be the second leading cause of years lived with disability. However, nationally representative epidemiological data for depressive disorders, in particular use of mental health services by adults with these disorders, are unavailable in China. The present study, part of the China Mental Health Survey, 2012-15, aims to describe the socioeconomic characteristics and the use of mental health services in people with depressive disorders in China.
METHODS
The China Mental Health Survey was a cross-sectional epidemiological survey of mental disorders in a multistage clustered-area probability sample of adults of Chinese nationality (≥18 years) from 157 nationwide representative population-based disease surveillance points in 31 provinces across China. Trained investigators interviewed the participants with the Composite International Diagnostic Interview 3.0 to ascertain the presence of lifetime and 12-month depressive disorders according to DSM-IV criteria, including major depressive disorder, dysthymic disorder, and depressive disorder not otherwise specified. Participants with 12-month depressive disorders were asked whether they received any treatment for their emotional problems during the past 12 months and, if so, the specific types of treatment providers. The Sheehan Disability Scale (SDS) was used to assess impairments associated with 12-month depressive symptoms. Data-quality control procedures included logic check by computers, sequential recording check, and phone-call check by the quality controllers, and reinterview check by the psychiatrists. Data were weighted according to the age-sex-residence distribution data from China's 2010 census population survey to adjust for differential probabilities of selection and differential response, as well as to post-stratify the sample to match the population distribution.
FINDINGS
28 140 respondents (12 537 [44·6%] men and 15 603 [55·4%] women) completed the survey between July 22, 2013, and March 5, 2015. Ethnicity data (Han or non-Han) were collected for only a subsample. Prevalence of any depressive disorders was higher in women than men (lifetime prevalence odds ratio [OR] 1·44 [95% CI 1·20-1·72] and 12-month prevalence OR 1·41 [1·12-1·78]), in unemployed people than employed people (lifetime OR 2·38 [95% CI 1·68-3·38] and 12-month OR 2·80 [95% CI 1·88-4·18]), and in people who were separated, widowed, or divorced compared with those who were married or cohabiting (lifetime OR 1·87 [95% CI 1·39-2·51] and 12-month OR 1·85 [95% CI 1·40-2·46]). Overall, 574 (weighted % 75·9%) of 744 people with 12-month depressive disorders had role impairment of any SDS domain: 439 (83·6%) of 534 respondents with major depressive disorder, 207 (79·8%) of 254 respondents with dysthymic disorder, and 122 (59·9%) of 189 respondents with depressive disorder not otherwise specified. Only an estimated 84 (weighted % 9·5%) of 1007 participants with 12-month depressive disorders were treated in any treatment sector: 38 (3·6%) in speciality mental health, 20 (1·5%) in general medical, two (0·3%) in human services, and 21 (2·7%) in complementary and alternative medicine. Only 12 (0·5%) of 1007 participants with depressive disorders were treated adequately.
INTERPRETATION
Depressive disorders in China were more prevalent in women than men, unemployed people than employed, and those who were separated, widowed, or divorced than people who were married or cohabiting. Most people with depressive disorders reported social impairment. Treatment rates were very low, and few people received adequate treatment. National programmes are needed to remove barriers to availability, accessibility, and acceptability of care for depression in China.
FUNDING
National Health Commission and Ministry of Science and Technology of People's Republic of China.
TRANSLATION
For the Chinese translation of the abstract see Supplementary Materials section.
Topics: Adult; Age Distribution; Aged; China; Cross-Sectional Studies; Depressive Disorder, Major; Diagnostic and Statistical Manual of Mental Disorders; Dysthymic Disorder; Global Burden of Disease; Humans; Mental Health Services; Middle Aged; Population Surveillance; Prevalence; Risk Factors; Sex Distribution; Socioeconomic Factors; Surveys and Questionnaires
PubMed: 34559991
DOI: 10.1016/S2215-0366(21)00251-0 -
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