101
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Babakhanyan I, Carlozzi NE, McKenna BS, Casaletto KB, Heinemann AW, Heaton RK. National Institutes of Health Toolbox Emotion Battery: Application of Summary Scores to Adults With Spinal Cord Injury, Traumatic Brain Injury, and Stroke. Arch Phys Med Rehabil 2019; 100:1863-1871. [PMID: 31153854 DOI: 10.1016/j.apmr.2019.05.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 03/23/2019] [Accepted: 05/04/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To examine the validity of factor analytically based summary scores that were developed using the National Institutes of Health Toolbox Emotion Battery (NIHTB-EB); (ie, psychological well-being, social satisfaction, negative affect) normative sample in individuals with neurologic conditions. DESIGN Cross-sectional, observational cohort. SETTING Community. PARTICIPANTS A total of 1036 English-speaking adults from the National Institutes of Health Toolbox (NIHTB) normative project and 604 community-dwelling adults with neurologic conditions including spinal cord injury (SCI n=209), traumatic brain injury (TBI n=184), and stroke (cerebrovascular accident [CVA] n=211) (N=1640). INTERVENTION Not applicable. MAIN OUTCOME MEASURES The NIHTB-EB. RESULTS A series of univariate analyses comparing summary scores across the 4 groups (SCI, TBI, CVA, normative group) were conducted to identify group differences. Base rates (defined as >1 SD toward the problematic direction) were also identified. The normative group demonstrated better emotional functioning characterized by greater social satisfaction and psychological well-being (normative group > SCI, TBI, CVA; P's <.0001), and less negative affect (normative group < SCI, P=.016; normative group < TBI, P<.001; normative group < CVA; P=.034) compared with each neurologic group. Using base rates to identify problematic emotions for the 3 summary scores, there were higher rates of problematic emotions on all 3 summary scores for the neurologic groups compared with the normative group. CONCLUSIONS The NIHTB-EB summary scores demonstrate an increased prevalence of problematic emotions among individuals with 3 neurologic conditions, and might be useful for identifying individuals with similar conditions and potentially in need of psychological support.
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Affiliation(s)
- Ida Babakhanyan
- Department of Psychiatry, University of California San Diego, San Diego, CA.
| | - Noelle E Carlozzi
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Benjamin S McKenna
- Department of Psychiatry, University of California San Diego, San Diego, CA
| | - Kaitlin B Casaletto
- Memory and Aging Center, University of California San Francisco, Department of Neurology, San Francisco, CA
| | - Allen W Heinemann
- Shirley Ryan AbilityLab and Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL
| | - Robert K Heaton
- Department of Psychiatry, University of California San Diego, San Diego, CA
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102
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Fernández‐de‐las‐Peñas C, de‐la‐Llave‐Rincón AI, Cescon C, Barbero M, Arias‐Buría JL, Falla D. Influence of Clinical, Psychological, and Psychophysical Variables on Long‐term Treatment Outcomes in Carpal Tunnel Syndrome: Evidence From a Randomized Clinical Trial. Pain Pract 2019; 19:644-655. [DOI: 10.1111/papr.12788] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 04/18/2019] [Accepted: 04/19/2019] [Indexed: 12/14/2022]
Affiliation(s)
- César Fernández‐de‐las‐Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Universidad Rey Juan Carlos AlcorcónSpain
- Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca Universidad Rey Juan Carlos Alcorcón Madrid Spain
| | - Ana I. de‐la‐Llave‐Rincón
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Universidad Rey Juan Carlos AlcorcónSpain
- Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca Universidad Rey Juan Carlos Alcorcón Madrid Spain
| | - Corrado Cescon
- Rehabilitation Research Laboratory 2rLab Department of Business Economics, Health and Social Care University of Applied Sciences and Arts of Southern Switzerland Manno Switzerland
| | - Marco Barbero
- Rehabilitation Research Laboratory 2rLab Department of Business Economics, Health and Social Care University of Applied Sciences and Arts of Southern Switzerland Manno Switzerland
| | - José L. Arias‐Buría
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Universidad Rey Juan Carlos AlcorcónSpain
- Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca Universidad Rey Juan Carlos Alcorcón Madrid Spain
| | - Deborah Falla
- School of Sport, Exercise and Rehabilitation Sciences College of Life and Environmental Sciences Centre of Precision Rehabilitation for Spinal Pain (CPR Spine) University of Birmingham Birmingham UK
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103
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Beck Depression Inventory-II: Self-report or interview-based administrations show different results in older persons. Int Psychogeriatr 2019; 31:735-742. [PMID: 30298795 DOI: 10.1017/s1041610218001187] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
UNLABELLED ABSTRACTBeck Depression Inventory-II (BDI-II) is one of the most-used rating scales. It was developed as a tool administered either as a self-rating or interview-based, observer-rating scale. OBJECTIVE The goal of this study is to compare BDI-II scores obtained with two standard methods of administration in community-based older persons. METHODS BDI-II was administered at first in the self-rated version to a sample of 60 mentally healthy older persons (age 60-87 years). Afterward, the interview-based administration was performed. ANALYSES We compared the scores with nonparametric tests - Spearman's correlation coefficient and Wilcoxon Signed Ranks test. We also computed internal consistency. RESULTS Self-rated BDI-II yielded significantly higher total score than interview (p < 0.001, P = 88%). The correlation between total scores was moderate (rs = 0.46, p < 0.001). Item analysis revealed a larger decrease (lower scores) in the somatic items in the interview-based version. CONCLUSIONS The two methods of administration result in different total score in healthy older persons. Therefore, interpretation of the scores should reflect the administration, which should be always specified in the studies.
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104
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Alsaleh M, Videloup L, Lobbedez T, Lebreuilly J, Morello R, Thuillier Lecouf A. Improved Detection and Evaluation of Depression in Patients with Chronic Kidney Disease: Validity and Reliability of Screening (PHQ-2) and Diagnostic (BDI-FS-Fr) Tests of Depression in Chronic Kidney Disease. KIDNEY DISEASES 2019; 5:228-238. [PMID: 31768380 DOI: 10.1159/000497352] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 01/30/2019] [Indexed: 01/07/2023]
Abstract
Objective Depression is underdiagnosed and thus undertreated. This study aimed to validate the French version of the PHQ-2 (Patient Health Questionnaire-2) and BDF-FS-Fr (Beck Depression Inventory-Fast Screen-France) on patients with chronic kidney disease (CKD) living in France. Method A cross-sectional study was conducted on 109 patients of the Centre universitaire de maladies rénales, Centre Hospi-talier Universitaire (CHU) de Caen (37 patients with CKD on pre-dialysis and grafting stage, 36 grafted patients, and 36 dialyzed patients). Statistical Approach Test parameters and statistical aspects of assessing diagnostic and screening tests were used, including knowledge of and ability to calculate, sensitivity, specificity, positive and negative predictive values, diagnostic odds ratios, and the use of ROC (receiver operating characteristic) curves. Results PHQ-2 and BDI-FS-Fr statistical parameters for depression tested very positively and had a satisfactory AUC (area under the curve). The PHQ-2 had a satisfactory AUC > 0.70, sensitivity > 0.60, and specificity > 0.80. The BDI-FS-Fr had a satisfactory area under the curve (0.859) with sensitivity (83%) and specificity (0.859); and internal consistency (α = 0.668). The PHQ-2 and BDI-FS-Fr showed good internal and external validity of structure, construct validity, criterion validity, discriminant validity, internal consistency, and factorial validity. Conclusion The French versions of the PHQ-2 and BDI-FS have highly favorable psychometric properties. These instruments are valid self-assessment tools for screening and evaluating depression, its intensity, and its evolution. The PHQ-2 and BDI-FS-Fr thus have very good psychometric properties and are useful tools for researchers and practitioners. Regarding clinical practice in the hospital, clinicians and nurses can use the PHQ-2 to screen quickly for depression during routine consultations, during hospitalization, and in dialysis centers. The 7 items of the BDI-FS-Fr enable us to assess the depressive state, thereby avoiding a false diagnosis of depression among CKD patients in a clinical setting.
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Affiliation(s)
- Muaweah Alsaleh
- Center for Research on Risks and Vulnerabilities (CERReV) EA 3919 University of Caen Normandy, Caen, France
| | - Ludivine Videloup
- University Center for Renal Diseases, Caen University Hospital, Caen, France
| | - Thierry Lobbedez
- University Center for Renal Diseases, Caen University Hospital, Caen, France
| | - Joelle Lebreuilly
- Center for Research on Risks and Vulnerabilities (CERReV) EA 3919 University of Caen Normandy, Caen, France
| | - Remy Morello
- Department of Biostatistics and Clinical Research, Caen University Hospital, Caen, France
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105
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Calvo Lobo C, Vilar-Fernández JM, Losa-Iglesias ME, López-López D, Rodríguez-Sanz D, Palomo-López P, Becerro-de Bengoa-Vallejo R. Depression Symptoms Among Older Adults With and Without Subacute Low Back Pain. Rehabil Nurs 2019; 44:47-51. [PMID: 30586021 DOI: 10.1097/rnj.0000000000000137] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Lumbago, or low back pain (LBP), is a common musculoskeletal complaint among older adults that may also be associated with depression. The study objective was to investigate differences in Beck Depression Inventory depression symptoms scores among older adult patients with and without LBP. DESIGN This was a case-control study. METHODS A total of 152 older adult patients, recruited at an outpatient healthcare clinic (47 men, 105 women; 74.81 ± 6.9 years), were classified as having subacute LBP (n = 76) or non-LBP (n = 76) according to clinic records. FINDINGS Beck Depression Inventory scores (mean ± SD) among LBP patients (10.93 ± 6.18) were significantly higher compared to the non-LBP group (7.62 ± 5.70; p = .000085), whose scores indicated no depression symptoms. CONCLUSION Subacute LBP may represent a potential risk for increased depression among older adults. CLINICAL RELEVANCE Early detection of depression will assist rehabilitation nurses in prescribing the beneficial physical rehabilitation and exercise programs or provide the information and treatment recommendations to older adults with subacute LBP and their families. Also, it should be part of a nursing staff prevention strategy for patients who suffer this common musculoskeletal disorder.
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Affiliation(s)
- César Calvo Lobo
- Nursing and Physical Therapy Department, Institute of Biomedicine (IBIOMED), Universidad de León, Ponferrada, León, Spain
| | | | | | - Daniel López-López
- Research, Health and Podiatry Unit, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, A Coruña, Spain
| | - David Rodríguez-Sanz
- Department of Physical Therapy and Podiatry, Physical Therapy and Health Sciences, Research Group, Universidad Europea de Madrid, Madrid
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106
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A Systematic Review of the Diagnostic Accuracy of Depression Questionnaires for Cardiac Populations: IMPLICATIONS FOR CARDIAC REHABILITATION. J Cardiopulm Rehabil Prev 2019; 39:354-364. [PMID: 30870244 DOI: 10.1097/hcr.0000000000000408] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Depression is overrepresented in patients with cardiovascular disease and increases risk for future cardiac events. Despite this, depression is not routinely assessed within cardiac rehabilitation. This systematic review sought to examine available depression questionnaires to use within the cardiac population. We assessed each instrument in terms of its capability to accurately identify depressed patients and its sensitivity to detect changes in depression after receiving cardiac rehabilitation. METHODS Citation searching of previous reviews, MEDLINE, PsycInfo, and PubMed was conducted. RESULTS The Beck Depression Inventory-II (BDI-II) and the Hospital Anxiety and Depression Scale (HADS-D) are among the most widely used questionnaires. Screening questionnaires appear to perform better at accurately identifying depression when using cut scores with high sensitivity and specificity for the cardiac population. The BDI-II and the HADS-D showed the best sensitivity and negative predictive values for detecting depression. The BDI-II, the HADS-D, the Center for Epidemiological Studies-Depression Scale, and the 15-item Geriatric Depression Scale best captured depression changes after cardiac rehabilitation delivery. CONCLUSIONS The BDI-II is one of the most validated depression questionnaires within cardiac populations. Health practitioners should consider the BDI-II for depression screening and tracking purposes. In the event of time/cost constraints, a briefer 2-step procedure (the 2-item Patient Health Questionnaire, followed by the BDI-II, if positive) should be adopted. Given the emphasis on cut scores for depression diagnosis and limited available research across cardiac diagnoses, careful interpretation of these results should be done. Thoughtful use of questionnaires can help identify patients in need of referral or further treatment.
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107
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Pu B, Li C, Li J, Ying T, Hua C, Liu K, Li F, Huang Z, Zhao C, Li X. Improvement of quality of life and mental health in patients with spasmodic torticollis after microvascular decompression. Clin Neurol Neurosurg 2019; 180:57-60. [PMID: 30933844 DOI: 10.1016/j.clineuro.2019.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 02/27/2019] [Accepted: 03/03/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Although not life threatening, spasmodic torticollis (ST) impairs patients' daily activity, socialization and work. The aim of this study was to evaluate the quality of life (QOL) and mental health in patients with ST after microvascular decompression (MVD). PATIENTS AND METHODS From June 2014 to June 2017, patients with ST who underwent MVD in our department were included in this study. Toronto Western Sparse Torticollis Rating Scale (TWSTRS) were used to evaluate the ST symptoms. Quality of life was assessed by the craniocervical dystonia questionnaire (CDQ-24). Beck Depression Inventory (BDI-II) and Beck Anxiety Inventory (BAI) were used to evaluate the mental health. Intraoperative findings and follow-up results were analyzed. RESULTS A total of 104 consecutive patients were enrolled in this study. At the 12 months follow-up, the total effective rate was 81.73%. After MVD surgery, 88(84.62%) ST patients experienced QOL improvement. The severity of ST symptoms was positively correlated with the CDQ-24 score(r = 0.31, P = 0.02). Forty-eight patients (46.16%) with ST have moderate to severe depression and nine (8.65%) have depression preoperatively. Pain and disability domains of TWSTRS were found have high relation with BDI-II score(r = 0.27, P = 0.02; r = 0.33, P = 0.03). There was a positive correlation of educational levels with the BDI-II scores(r = 0.45, P = 0.02). CONCLUSION ST affects patients' QOL both physically and mentally. MVD for ST not only provides high spasm-relief rate but also leads to significantly higher QOL after surgery. Not only ST symptoms, but also psychiatric status of patients should be routinely followed. Psychological care and psychopharmaceuticals should also be considered for these patients.
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Affiliation(s)
- Benfang Pu
- Department of Neurological Surgery, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Changhua Li
- Department of Neurological Surgery, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jie Li
- Department of Neurological Surgery, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Tingting Ying
- Department of Neurological Surgery, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Chunhui Hua
- Department of Neurological Surgery, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - KaiZhang Liu
- Department of Neurological Surgery, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Fusheng Li
- Department of Neurological Surgery, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhenyu Huang
- Department of Neurological Surgery, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Changyi Zhao
- Department of Neurological Surgery, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xinyuan Li
- Department of Neurological Surgery, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
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108
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Wouk K, Gottfredson NC, Tucker C, Pence BW, Meltzer-Brody S, Zvara B, Grewen K, Stuebe AM. Positive Emotions During Infant Feeding and Postpartum Mental Health. J Womens Health (Larchmt) 2019; 28:194-202. [PMID: 30307779 PMCID: PMC6390657 DOI: 10.1089/jwh.2017.6889] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Research shows that individuals can improve mental health by increasing experiences of positive emotions. However, the role of positive emotions in perinatal mental health has not been investigated. This study explored the extent to which positive emotions during infant feeding are associated with maternal depression and anxiety during the first year postpartum. MATERIALS AND METHODS One hundred and sixty-four women drawn from a longitudinal cohort of mother-infant dyads were followed from the third trimester through 12 months postpartum. We measured positive emotions during infant feeding at 2 months using the mean subscale score of the modified Differential Emotions Scale. Depression and anxiety symptoms were assessed with the Beck Depression Inventory-II and State Trait Anxiety Inventory-State subscale at months 2, 6, and 12. Generalized linear mixed models were used to estimate crude and multivariable associations. RESULTS Among women with no clinical depression during pregnancy, higher positive emotions during infant feeding at 2 months were associated with significantly fewer depression symptoms at 2, 6, and 12 months and with lower odds of clinically significant depression symptoms at 2 and 6 months. In contrast to depression outcomes, women with clinical anxiety during pregnancy who experienced higher positive emotions had significantly fewer anxiety symptoms at 2, 6, and 12 months and lower odds of clinically significant anxiety at 2 and 6 months. CONCLUSIONS Positive emotions during infant feeding are associated with depression and anxiety outcomes during the first year postpartum and may be a modifiable protective factor for maternal mental health.
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Affiliation(s)
- Kathryn Wouk
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Nisha C. Gottfredson
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Christine Tucker
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Brian W. Pence
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Samantha Meltzer-Brody
- Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Bharathi Zvara
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Karen Grewen
- Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Alison M. Stuebe
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
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109
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de Sá Junior AR, Liebel G, de Andrade AG, Andrade LH, Gorenstein C, Wang YP. Can Gender and Age Impact on Response Pattern of Depressive Symptoms Among College Students? A Differential Item Functioning Analysis. Front Psychiatry 2019; 10:50. [PMID: 30809161 PMCID: PMC6379252 DOI: 10.3389/fpsyt.2019.00050] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 01/24/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Self-reported depressive complaints among college students might indicate different degrees of severity of depressive states. Through the framework of item response theory, we aim to describe the pattern of responses to items of the Beck Depression Inventory-II (BDI-II), in terms of endorsement probability and discrimination along the continuum of depression. Potential differential item functioning of the scale items of the BDI-II is investigated, by gender and age, to compare across sub-groups of students. Methods: The 21-item BDI-II was cross-sectionally administered to a representative sample of 12,677 Brazilian college students. Reliability was evaluated based on Cronbach's alpha coefficient. Severity (b i ) and discrimination (a) parameters of each BDI-II items were calculated through the graded response model. The influence of gender and age were tested for differential item functioning (DIF) within the item response theory-based approach. Results: The BDI-II presented good reliability (α = 0.91). Women and younger students significantly presented a higher likelihood of depression (cut-off > 13) than men and older counterparts. In general, participants endorsed more easily cognitive-somatic items than affective items of the scale. "Guilty feelings," "suicidal thoughts," and "loss of interest in sex" were the items that most likely indicated depression severity (b ≥ 3.60). However, all BDI-II items showed moderate-to-high discrimination (a ≥ 1.32) for depressive state. While two items were flagged for DIF, "crying" and "loss of interest in sex," respectively for gender and age, the global weight of these items on the total score was negligible. Conclusions: Although respondents' gender and age might present influence on response pattern of depressive symptoms, the measures of self-reported symptoms have not inflated severity scores. These findings provide further support to the validity of using BDI-II for assessing depression in academic contexts and highlight the value of considering gender- and age-related common symptoms of depression.
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Affiliation(s)
- Antonio Reis de Sá Junior
- Department of Health Sciences, Federal University of Santa Catarina, Araranguá, Brazil.,Institute and Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, Brazil
| | - Graziela Liebel
- Department of Collective Health, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Arthur Guerra de Andrade
- Institute and Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, Brazil.,Department of Neuroscience, Medical School, ABC Foundation, Santo André, Brazil
| | - Laura Helena Andrade
- Institute and Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, Brazil
| | - Clarice Gorenstein
- Institute and Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, Brazil.,Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Yuan-Pang Wang
- Institute and Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, Brazil
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110
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Zirk M, Storm V. Subjective Stroke Impact and Depressive Symptoms: Indications for a Moderating Role of Health-Related Locus of Control. Front Psychiatry 2019; 10:918. [PMID: 31920764 PMCID: PMC6930911 DOI: 10.3389/fpsyt.2019.00918] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 11/19/2019] [Indexed: 12/12/2022] Open
Abstract
Background: Stroke is one of the most common causes of death and disability worldwide. Subsequently, depression occurs in about one third of the stroke survivors. Health-related locus of control might serve as a modifiable cognitive factor to aid the recovery process. Aims: The present study aims to explore the role of health-related locus of control in the relation between subjective stroke impact and depressive symptoms after stroke. Methods: In the present cross-sectional study, N = 44 stroke patients (n = 18 female and n = 24 male) were recruited at two rehabilitation centers in Germany. Mean age was M = 65.8 (SD = 11.52, Range = 48-88). Self-report instruments included the stroke impact scale, health-related locus of control questionnaire, and Beck depression inventory. Data analysis was conducted in R using correlation and regression methods. Results: Subjective stroke impact and depressive symptoms were not directly associated (r s = -.20, p = .216). However, health-related locus of control moderated the relationship between subjective stroke impact and depressive symptoms (β = -0.42, p = .015), revealing a stronger negative relationship when control of one`s health was attributed externally. Conclusion: The results indicate that health-related locus of control plays a role in the relationship of subjective stroke impact and depressive symptoms. It is recommended to focus on control beliefs during the recovery process of stroke survivors. For developing targeted interventions, it is necessary to further investigate these associations while incorporating various health-related control belief concepts and replicate the present findings among larger samples.
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Affiliation(s)
- Miriam Zirk
- Department of Movement Science, Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
| | - Vera Storm
- Department of Exercise Psychology, Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
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111
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Win KL, Kawakami N, Htet Doe G. Factor structure and diagnostic efficiency of the Myanmar version BDI-II among substance users. Ann Gen Psychiatry 2019; 18:12. [PMID: 31367222 PMCID: PMC6647319 DOI: 10.1186/s12991-019-0236-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 07/09/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The Beck Depression Inventory II (BDI-II) has been accepted as one of the most commonly used self-report measures for depression. However, there is no study examining the psychometric properties of the BDI-II among substance users in low- and middle-income countries such as Myanmar. Therefore, this study aimed to evaluate the suitability of using this instrument in substance users and to examine the reliability and diagnostic efficiency to be compared with the International Classification of Diseases (ICD-10) among substance users in Northern Shan State of Myanmar. METHODS A respondent-driven sampling (RDS) method was applied for recruiting the participants in this study, and total 230 substance users were recruited. On the other hand, 50 participants who visited the drop-in center (DIC) were screened for depressive symptoms using ICD-10 during the days when one consultant psychiatrist doctor was presented. These participants were interviewed face-to-face by the consultant psychiatrist using a semi-structured questionnaire including the Myanmar version of the BDI-II (mBDI-II). RESULTS The mBDI-II showed moderate accuracy with an area under the curve of 0.68. The optimal cutoff score was 10 with the highest Youden index (0.48), and it had high sensitivity and specificity (0.78 and 0.70). The Cronbach's alpha coefficients for clinically depressed and non-clinically depressed substance users were 0.91 and 0.93, respectively. Confirmatory factor analysis of the mBDI-II indicated that a three-factor solution (cognitive, affective, and somatic) was the best fit for substance users. CONCLUSIONS The mBDI-II has sound psychometric properties among substance users with moderate accuracy and range of possible cutoff scores together with sensitivity and specificity.
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Affiliation(s)
- Khine Lae Win
- 1Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Norito Kawakami
- 1Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Gyaw Htet Doe
- Department of Psychiatry and Mental Health, Defense Services Medical Academy, Mingaladon Township, Yangon, 11021 Myanmar
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112
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Fernández-de-las-Peñas C, Falla D, Palacios-Ceña M, De-la-Llave-Rincón AI, Schneebeli A, Barbero M. Perceived Pain Extent Is Not Associated with Physical, Psychological, or Psychophysical Outcomes in Women with Carpal Tunnel Syndrome. PAIN MEDICINE 2018; 20:1185-1192. [DOI: 10.1093/pm/pny248] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain
- Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - María Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain
- Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Ana I De-la-Llave-Rincón
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain
- Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Alessandro Schneebeli
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Marco Barbero
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
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Ein N, Armstrong B, Vickers K. The effect of a very low calorie diet on subjective depressive symptoms and anxiety: meta-analysis and systematic review. Int J Obes (Lond) 2018; 43:1444-1455. [PMID: 30470803 DOI: 10.1038/s41366-018-0245-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 08/22/2018] [Accepted: 09/16/2018] [Indexed: 12/29/2022]
Abstract
There are conflicting findings regarding the effect very low calorie diets (VLCDs) have on self-reported depressive symptoms and anxiety levels. Some studies have reported decreased subjective depressive symptoms and anxiety post-diet, whereas other studies have not. Further complicating matters, the protocol for VLCDs vary substantially across studies, which could account for the mixed findings. The primary goal of this meta-analysis and systematic review was to determine the effect VLCDs have on subjective depressive symptoms and anxiety pre- to post-diet. In addition, potential moderators (the presence/absence of behavioral therapy, duration of diet, inclusion/exclusion of low intensity exercise, and amount of weight lost) were examined to assess the effect of procedural deviations across VLCD studies on depressive symptoms and anxiety. A random-effects model was used for the meta-analysis and included nine studies with 16 independent samples. To further explain the results, study rigor was examined in the systematic review, which included 11 studies with 20 independent samples. Depressive symptoms significantly decreased pre- to post-diet when behavioral therapy was implemented during the diet, the duration of the diet was relatively long (8-16 weeks), low intensity exercise was included, and the dieters lost 14.1 kg or more post-diet. However, no difference in depressive symptoms were observed pre- to post-diet when behavioral therapy was not included, the diet was shorter (1-7 weeks), no exercise was implemented and dieters lost <14 kg of weight post-diet. There was no change in anxiety pre- to post-diet. Health care providers involved in supervising VLCDs should consider using a VLCD of at least 8 weeks that includes behavioral therapy and low intensity exercise in order to enhance the potential benefits of VLCDs on depressive symptoms. More research is required to examine the effect of VLCDs on anxiety.
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Affiliation(s)
- Natalie Ein
- Department of Psychology, Ryerson University, Toronto, Ontario, Canada
| | - Bonnie Armstrong
- Department of Psychology, Ryerson University, Toronto, Ontario, Canada
| | - Kristin Vickers
- Department of Psychology, Ryerson University, Toronto, Ontario, Canada.
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Brenner LA, Hoisington AJ, Stearns-Yoder KA, Stamper CE, Heinze JD, Postolache TT, Hadidi DA, Hoffmire CA, Stanislawski MA, Lowry CA. Military-Related Exposures, Social Determinants of Health, and Dysbiosis: The United States-Veteran Microbiome Project (US-VMP). Front Cell Infect Microbiol 2018; 8:400. [PMID: 30510919 PMCID: PMC6252388 DOI: 10.3389/fcimb.2018.00400] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 10/23/2018] [Indexed: 12/23/2022] Open
Abstract
Significant effort has been put forth to increase understanding regarding the role of the human microbiome in health- and disease-related processes. In turn, the United States (US) Veteran Microbiome Project (US-VMP) was conceptualized as a means by which to serially collect microbiome and health-related data from those seeking care within the Veterans Health Administration (VHA). In this manuscript, exposures related to military experiences, as well as conditions and health-related factors among patients seen in VHA clinical settings are discussed in relation to common psychological and physical outcomes. Upon enrollment in the study, Veterans complete psychometrically sound (i.e., reliable and valid) measures regarding their past and current medical history. Participants also provide skin, oral, and gut microbiome samples, and permission to track their health status via the VHA electronic medical record. To date, data collection efforts have been cross-diagnostic. Within this manuscript, we describe current data collection practices and procedures, as well as highlight demographic, military, and psychiatric characteristics of the first 188 Veterans enrolled in the study. Based on these findings, we assert that this cohort is unique as compared to those enrolled in recent large-scale studies of the microbiome. To increase understanding regarding disease and health among diverse cohorts, efforts such as the US-VMP are vital. Ongoing barriers and facilitators to data collection are discussed, as well as future research directions, with an emphasis on the importance of shifting current thinking regarding the microbiome from a focus on normalcy and dysbiosis to health promotion and disease prevention.
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Affiliation(s)
- Lisa A Brenner
- Rocky Mountain Mental Illness Research Education and Clinical Center, Rocky Mountain Regional VA Medical Center (MIRECC), Aurora, CO, United States.,Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Cam pus, Aurora, CO, United States.,Departments of Psychiatry and Neurology, University of Colorado Anschutz Medical Cam pus, Aurora, CO, United States.,Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United States
| | - Andrew J Hoisington
- Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United States.,Department of Systems Engineering, Air Force Institute of Technology, Wright-Patterson AFB, OH, United States
| | - Kelly A Stearns-Yoder
- Rocky Mountain Mental Illness Research Education and Clinical Center, Rocky Mountain Regional VA Medical Center (MIRECC), Aurora, CO, United States.,Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Cam pus, Aurora, CO, United States.,Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United States
| | - Christopher E Stamper
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Jared D Heinze
- Rocky Mountain Mental Illness Research Education and Clinical Center, Rocky Mountain Regional VA Medical Center (MIRECC), Aurora, CO, United States.,Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Teodor T Postolache
- Rocky Mountain Mental Illness Research Education and Clinical Center, Rocky Mountain Regional VA Medical Center (MIRECC), Aurora, CO, United States.,Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United States.,Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, United States.,VISN 5 MIRECC, Department of Veterans Affairs, Baltimore, MD, United States
| | - Daniel A Hadidi
- Rocky Mountain Mental Illness Research Education and Clinical Center, Rocky Mountain Regional VA Medical Center (MIRECC), Aurora, CO, United States.,Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Cam pus, Aurora, CO, United States
| | - Claire A Hoffmire
- Rocky Mountain Mental Illness Research Education and Clinical Center, Rocky Mountain Regional VA Medical Center (MIRECC), Aurora, CO, United States.,Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Cam pus, Aurora, CO, United States
| | - Maggie A Stanislawski
- Rocky Mountain Mental Illness Research Education and Clinical Center, Rocky Mountain Regional VA Medical Center (MIRECC), Aurora, CO, United States.,Department of Epidemiology, University of Colorado Anschutz Medical Cam pus, Aurora, CO, United States
| | - Christopher A Lowry
- Rocky Mountain Mental Illness Research Education and Clinical Center, Rocky Mountain Regional VA Medical Center (MIRECC), Aurora, CO, United States.,Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Cam pus, Aurora, CO, United States.,Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United States.,Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States.,Center for Neuroscience, University of Colorado Boulder, Boulder, CO, United States.,Center for Neuroscience, University of Colorado Anschutz Medical Cam pus, Aurora, CO, United States
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Ben Romdhan S, Farhat N, Nasri A, Lesage S, Hdiji O, Ben Djebara M, Landoulsi Z, Stevanin G, Brice A, Damak M, Gouider R, Mhiri C. LRRK2 G2019S Parkinson's disease with more benign phenotype than idiopathic. Acta Neurol Scand 2018; 138:425-431. [PMID: 29989150 DOI: 10.1111/ane.12996] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 06/21/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The LRRK2-G2019S mutation is the most common cause of Parkinson's disease (PD) in North Africa. G2019S-PD has been described as similar to idiopathic with minor clinical differences. The aim of this study was to determine the G2019S-related phenotype and to investigate gender and gene dosage effects on clinical features of G2019S carriers. PATIENTS AND METHODS The G2019S mutation was screened in 250 Tunisian patients with PD. Twenty-four patients carrying mutations in other PD genes were excluded. Logistic regression models were used to compare clinical features between the studied groups. RESULTS G2019S carriers (107 cases) and non-carriers (119 cases) were similar in disease duration, levodopa doses, and gender and phenotype distributions. However, carriers had a younger age at examination, higher level of education, and were more likely to report family history of PD and to develop PD at earlier age (P = 0.017). Adjusted for age, sex, disease duration, levodopa-equivalent dose and educational level, MMSE scores remained significantly higher (adjust P = 0.019) and UPDRS-III scores were lower (adjust P = 0.012) in the G2019S carriers than non-carriers. Demographic characteristics of men and women with G2019S mutation were similar, but men had higher level of education, better cognition (adjust P-value for educational level = 0.042) and less tendency towards depression than females (adjust P = 0.046). Furthermore, PD phenotype did not differ between the homozygous and heterozygous G2019S carriers. CONCLUSION In this study, G2019S carriers had a more benign phenotype than non-carriers. Cognitive impairment and depression were less common in G2019S male carriers compared with females. In addition, we found that LRRK2 gene dosage does not influence the severity of PD.
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Affiliation(s)
- Sawssan Ben Romdhan
- Laboratory of Neurogenetics; Parkinson's Disease and Cerebrovascular Disease; University Hospital Habib Bourguiba; Sfax Tunisia
- Institut du Cerveau et de la Moelle épinière; INSERM U1127; Sorbonne Université; UPMC Paris VI Univ. UMR_S1127; CNRS UMR 7225; Paris France
- École Pratique des Hautes Études EPHE; PSL Research University; Paris France
| | - Nouha Farhat
- Laboratory of Neurogenetics; Parkinson's Disease and Cerebrovascular Disease; University Hospital Habib Bourguiba; Sfax Tunisia
| | - Amina Nasri
- Department of Neurology; University Hospital Razi; Tunis; Mannouba Tunisia
| | - Suzanne Lesage
- Institut du Cerveau et de la Moelle épinière; INSERM U1127; Sorbonne Université; UPMC Paris VI Univ. UMR_S1127; CNRS UMR 7225; Paris France
| | - Olfa Hdiji
- Laboratory of Neurogenetics; Parkinson's Disease and Cerebrovascular Disease; University Hospital Habib Bourguiba; Sfax Tunisia
| | - Mouna Ben Djebara
- Department of Neurology; University Hospital Razi; Tunis; Mannouba Tunisia
| | - Zied Landoulsi
- Department of Neurology; University Hospital Razi; Tunis; Mannouba Tunisia
| | - Giovanni Stevanin
- Institut du Cerveau et de la Moelle épinière; INSERM U1127; Sorbonne Université; UPMC Paris VI Univ. UMR_S1127; CNRS UMR 7225; Paris France
- École Pratique des Hautes Études EPHE; PSL Research University; Paris France
| | - Alexis Brice
- Institut du Cerveau et de la Moelle épinière; INSERM U1127; Sorbonne Université; UPMC Paris VI Univ. UMR_S1127; CNRS UMR 7225; Paris France
| | - Mariem Damak
- Laboratory of Neurogenetics; Parkinson's Disease and Cerebrovascular Disease; University Hospital Habib Bourguiba; Sfax Tunisia
| | - Riadh Gouider
- Department of Neurology; University Hospital Razi; Tunis; Mannouba Tunisia
| | - Chokri Mhiri
- Laboratory of Neurogenetics; Parkinson's Disease and Cerebrovascular Disease; University Hospital Habib Bourguiba; Sfax Tunisia
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Botelho L, Angoleri L, Zortea M, Deitos A, Brietzke A, Torres ILS, Fregni F, Caumo W. Insights About the Neuroplasticity State on the Effect of Intramuscular Electrical Stimulation in Pain and Disability Associated With Chronic Myofascial Pain Syndrome (MPS): A Double-Blind, Randomized, Sham-Controlled Trial. Front Hum Neurosci 2018; 12:388. [PMID: 30459575 PMCID: PMC6232764 DOI: 10.3389/fnhum.2018.00388] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 09/06/2018] [Indexed: 12/04/2022] Open
Abstract
Background: There is limited evidence concerning the effect of intramuscular electrical stimulation (EIMS) on the neural mechanisms of pain and disability associated with chronic Myofascial Pain Syndrome (MPS). Objectives: To provide new insights into the EIMS long-term effect on pain and disability related to chronic MPS (primary outcomes). To assess if the neuroplasticity state at baseline could predict the long-term impact of EIMS on disability due to MPS we examined the relationship between the serum brain-derived-neurotrophic-factor (BDNF) and by motor evoked potential (MEP). Also, we evaluated if the EIMS could improve the descending pain modulatory system (DPMS) and the cortical excitability measured by transcranial magnetic stimulation (TMS) parameters. Methods: We included 24 right-handed female with chronic MPS, 19-65 years old. They were randomically allocated to receive ten sessions of EIMS, 2 Hz at the cervical paraspinal region or a sham intervention (n = 12). Results: A mixed model analysis of variance revealed that EIMS decreased daily pain scores by -73.02% [95% confidence interval (CI) = -95.28 to -52.30] and disability due to pain -43.19 (95%CI, -57.23 to -29.39) at 3 months of follow up. The relative risk for using analgesics was 2.95 (95% CI, 1.36 to 6.30) in the sham group. In the EIMS and sham, the change on the Numerical Pain Scale (NPS0-10) throughout CPM-task was -2.04 (0.79) vs. -0.94 (1.18), respectively, (P = 0.01). EIMS reduced the MEP -28.79 (-53.44 to -4.15), while improved DPMS and intracortical inhibition. The MEP amplitude before treatment [(Beta = -0.61, (-0.58 to -0.26)] and a more significant change from pre- to post-treatment on serum BDNF) (Beta = 0.67; CI95% = 0.07 to 1.26) were predictors to EIMS effect on pain and disability due to pain. Conclusion: These findings suggest that a bottom-up effect induced by the EIMS reduced the analgesic use, improved pain, and disability due to chronic MPS. This effect might be mediated by an enhancing of corticospinal inhibition as seen by an increase in IC and a decrease in MEP amplitude. Likewise, the MEP amplitude before treatment and the changes induced by the EIMS in the serum BDNF predicted it's long-term clinical impact on pain and disability due MPS. The trial is recorded in ClinicalTrials.gov: NCT02381171.
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Affiliation(s)
- Leonardo Botelho
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Laboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Anesthesia and Perioperative Pain Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Pain and Palliative Care Service at Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Letícia Angoleri
- Laboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Anesthesia and Perioperative Pain Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Maxciel Zortea
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Laboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Anesthesia and Perioperative Pain Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Alicia Deitos
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Aline Brietzke
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Iraci L. S. Torres
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Department of Pharmacology, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Felipe Fregni
- Spaulding Center of Neuromodulation, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States
| | - Wolnei Caumo
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Laboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Heinrich M, Zagorscak P, Eid M, Knaevelsrud C. Giving G a Meaning: An Application of the Bifactor-(S-1) Approach to Realize a More Symptom-Oriented Modeling of the Beck Depression Inventory–II. Assessment 2018; 27:1429-1447. [DOI: 10.1177/1073191118803738] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The Beck Depression Inventory–II is one of the most frequently used scales to assess depressive burden. Despite many psychometric evaluations, its factor structure is still a topic of debate. An increasing number of articles using fully symmetrical bifactor models have been published recently. However, they all produce anomalous results, which lead to psychometric and interpretational difficulties. To avoid anomalous results, the bifactor-(S-1) approach has recently been proposed as alternative for fitting bifactor structures. The current article compares the applicability of fully symmetrical bifactor models and symptom-oriented bifactor-(S-1) and first-order confirmatory factor analysis models in a large clinical sample ( N = 3,279) of adults. The results suggest that bifactor-(S-1) models are preferable when bifactor structures are of interest, since they reduce problematic results observed in fully symmetrical bifactor models and give the G factor an unambiguous meaning. Otherwise, symptom-oriented first-order confirmatory factor analysis models present a reasonable alternative.
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118
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Prevalence of Depressive Symptoms in Patients Requesting Cosmetic Breast Surgery in Midwestern Brazil. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2018; 6:e1899. [PMID: 30534484 PMCID: PMC6250461 DOI: 10.1097/gox.0000000000001899] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 06/19/2018] [Indexed: 11/26/2022]
Abstract
Background The prevalence of depressive symptoms (DS) before cosmetic breast surgery was analyzed in the public (PbI) and private (PrI) institutions, comparing types of surgery and patients' sociodemographic characteristics. Methods A cross-sectional, observational, analytical study to evaluate the prevalence of DS in 185 patients of 18-71 years of age requesting 4 different cosmetic breast surgeries (with and without implants) at public and private institutions. Patients were assessed using the Beck Depression Inventory and analyzed for statistical comparison. Results The most common surgical procedures were reduction mammoplasty in the PbI and augmentation mammoplasty in the PrI. The prevalence of the positive risk for depressive disorder (≥15 points in Beck Depression Inventory) in the PbI was 25.8%, whereas in the PrI: 11.4% (P = 0.012). Moderate and severe DS were, respectively, 120% and 242% higher in the PbI than in the PrI. No patients requesting mastopexy without implants had DS. The highest prevalence (51.4%) of DS occurred in patients with breast implants indications (augmentation mammoplasty and mastopexy with implants). The presence (P = 0.12) or absence (P = 0.33) of implant did not demonstrate a higher risk of DS. Among all patients, 7% answered positively to the statements on suicide ideation, with predominance within the group of implants (54.5%). There were significant differences between the PbI and PrI. Conclusions The prevalence of DS was high (18.9%), with the risk being 2.3 times greater in the PbI. Patients from PbI and PrI showed significant different profiles. Patients for breast implants showed a higher score for suicide ideation.
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119
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Tolahunase MR, Sagar R, Dada R. 5-HTTLPR and MTHFR 677C>T polymorphisms and response to yoga-based lifestyle intervention in major depressive disorder: A randomized active-controlled trial. Indian J Psychiatry 2018; 60:410-426. [PMID: 30581206 PMCID: PMC6278208 DOI: 10.4103/psychiatry.indianjpsychiatry_398_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND There is growing evidence suggesting that both genetic and environmental factors modulate treatment outcome in, a highly heterogeneous, major depressive disorder (MDD). 5-HTTLPR variant of the serotonin transporter gene (SLC6A4) and MTHFR 677C>T polymorphisms have been linked to the pathogenesis of MDD, and antidepressant treatment response. The evidence is lacking on the clinical utility of yoga in patients with MDD who have 5-HTTLPR and MTHFR 677C>T polymorphisms and less likely to respond to medications (SSRIs). AIMS We aimed to examine the impact of YBLI in those who have susceptible 5-HTTLPR and MTHFR 677C>T polymorphisms and are less likely to drug therapy with SSRIs. SETTINGS AND DESIGN In a 12 week randomized active-controlled trial, MDD patients (n = 178) were randomized to receive YBLI or drug therapy. METHODS Genotyping was conducted using PCR-based methods. The clinical remission was defined as BDI-II score ≤ 9. STATISTICAL ANALYSIS USED An intent-to-treat analysis was performed, and the association of genotype with treatment remission consisted of the logistic regression model. A P value of <0.05 was considered statistically significant. RESULTS Multivariate logistic regression models for remission including either 5-HTTLPR or MTHFR 677C>T genotypes showed statistically significant odds of remission in YOGA arm vs. DRUG arm. Neither 5-HTTLPR nor MTHFR 677C>T genotype showed any influence on remission to YBLI (P = 0.73 and P = 0.64, respectively). Further analysis showed childhood adversity interact with 5-HTTLPR and MTHFR 677C>T polymorphisms to decrease treatment response in DRUG treatment arm, but not in YOGA arm. CONCLUSIONS YBLI provides MDD remission in those who have susceptible 5-HTTLPR and MTHFR 677C>T polymorphisms and are resistant to SSRIs treatment. YBLI may be therapeutic for MDD independent of heterogeneity in its etiopathogenesis.
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Affiliation(s)
- Madhuri R Tolahunase
- Department of Anatomy, Lab for Molecular Reproduction and Genetics, All India Institute of Medical Sciences, New Delhi, India
| | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Rima Dada
- Department of Anatomy, Lab for Molecular Reproduction and Genetics, All India Institute of Medical Sciences, New Delhi, India
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Davison AS, Harrold JA, Hughes G, Norman BP, Devine J, Usher J, Hughes AT, Khedr M, Gallagher JA, Milan AM, J C G H, Ranganath LR. Clinical and biochemical assessment of depressive symptoms in patients with Alkaptonuria before and after two years of treatment with nitisinone. Mol Genet Metab 2018; 125:135-143. [PMID: 30049652 DOI: 10.1016/j.ymgme.2018.07.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 07/18/2018] [Accepted: 07/18/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Concerns exist over hypertyrosinaemia that is observed following treatment with nitisinone. It has been suggested that tyrosine may compete with tryptophan for uptake into the central nervous system, and or inhibit tryptophan hydroxylase activity reducing serotonin production. At the National Alkaptonuria (AKU) Centre nitisinone is being used off-licence to treat AKU, and there is uncertainty over whether hypertyrosinaemia may alter mood. Herein results from clinical and biochemical assessments of depression in patients with AKU before and after treatment with nitisinone are presented. PATIENTS AND METHODS 63 patients were included pre-nitisinone treatment, of these 39 and 32 patients were followed up 12 and 24 months after treatment. All patients had Becks Depression Inventory-II (BDI-II) assessments (scores can range from 0 to 63, the higher the score the more severe the category of depression), and where possible urinary monoamine neurotransmitter metabolites and serum aromatic amino acids were measured as biochemical markers of depression. RESULTS Mean (±standard deviation) BDI-II scores pre-nitisinone, and after 12 and 24 months were 10.1(9.6); 9.8(10.0) and 10.5(9.9) (p ≥ 0.05, all visits). Paired scores (n = 32), showed a significant increase at 24 months compared to baseline 10.5(9.9) vs. 8.6 (7.8) (p = 0.03). Serum tyrosine increased at least 6-fold following nitisinone (p ≤ 0.0001, all visits), and urinary 3-methoxytyramine (3-MT) increased at 12 and 24 months (p ≤ 0.0001), and 5-hydroxyindole acetic acid (5-HIAA) decreased at 12 months (p = 0.03). CONCLUSIONS BDI-II scores were significantly higher following 24 months of nitisinone therapy in patients that were followed up, however the majority of these patients remained in the minimal category of depression. Serum tyrosine and urinary 3-MT increased significantly following treatment with nitisinone. In contrast urinary 5-HIAA did not decrease consistently over the same period studied. Together these findings suggest nitisinone does not cause depression despite some observed effects on monoamine neurotransmitter metabolism.
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Affiliation(s)
- A S Davison
- Department of Clinical Biochemistry and Metabolic Medicine, Liverpool Clinical Laboratories, Royal Liverpool University Hospitals Trust, Liverpool L7 8XP, UK; Institute of Ageing and Chronic Disease, Musculoskeletal Biology, University of Liverpool, Liverpool L69 3GA, UK.
| | - J A Harrold
- Department of Psychological Sciences, University of Liverpool, Liverpool L69 7ZA, UK
| | - G Hughes
- Department of Psychological Sciences, University of Liverpool, Liverpool L69 7ZA, UK
| | - B P Norman
- Institute of Ageing and Chronic Disease, Musculoskeletal Biology, University of Liverpool, Liverpool L69 3GA, UK
| | - J Devine
- Department of Clinical Biochemistry and Metabolic Medicine, Liverpool Clinical Laboratories, Royal Liverpool University Hospitals Trust, Liverpool L7 8XP, UK
| | - J Usher
- Department of Clinical Biochemistry and Metabolic Medicine, Liverpool Clinical Laboratories, Royal Liverpool University Hospitals Trust, Liverpool L7 8XP, UK
| | - A T Hughes
- Department of Clinical Biochemistry and Metabolic Medicine, Liverpool Clinical Laboratories, Royal Liverpool University Hospitals Trust, Liverpool L7 8XP, UK; Institute of Ageing and Chronic Disease, Musculoskeletal Biology, University of Liverpool, Liverpool L69 3GA, UK
| | - M Khedr
- Department of Clinical Biochemistry and Metabolic Medicine, Liverpool Clinical Laboratories, Royal Liverpool University Hospitals Trust, Liverpool L7 8XP, UK; Institute of Ageing and Chronic Disease, Musculoskeletal Biology, University of Liverpool, Liverpool L69 3GA, UK
| | - J A Gallagher
- Institute of Ageing and Chronic Disease, Musculoskeletal Biology, University of Liverpool, Liverpool L69 3GA, UK
| | - A M Milan
- Department of Clinical Biochemistry and Metabolic Medicine, Liverpool Clinical Laboratories, Royal Liverpool University Hospitals Trust, Liverpool L7 8XP, UK; Institute of Ageing and Chronic Disease, Musculoskeletal Biology, University of Liverpool, Liverpool L69 3GA, UK
| | - Halford J C G
- Department of Psychological Sciences, University of Liverpool, Liverpool L69 7ZA, UK
| | - L R Ranganath
- Department of Clinical Biochemistry and Metabolic Medicine, Liverpool Clinical Laboratories, Royal Liverpool University Hospitals Trust, Liverpool L7 8XP, UK; Institute of Ageing and Chronic Disease, Musculoskeletal Biology, University of Liverpool, Liverpool L69 3GA, UK
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de Sá Junior AR, de Andrade AG, Andrade LH, Gorenstein C, Wang YP. Response pattern of depressive symptoms among college students: What lies behind items of the Beck Depression Inventory-II? J Affect Disord 2018. [PMID: 29525353 DOI: 10.1016/j.jad.2018.02.064] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND This study examines the response pattern of depressive symptoms in a nationwide student sample, through item analyses of a rating scale by both classical test theory (CTT) and item response theory (IRT). METHODS The 21-item Beck Depression Inventory-II (BDI-II) was administered to 12,711 college students. First, the psychometric properties of the scale were described. Thereafter, the endorsement probability of depressive symptom in each scale item was analyzed through CTT and IRT. Graphical plots depicted the endorsement probability of scale items and intensity of depression. Three items of different difficulty level were compared through CTT and IRT approach. RESULTS Four in five students reported the presence of depressive symptoms. The BDI-II items presented good reliability and were distributed along the symptomatic continuum of depression. Similarly, in both CTT and IRT approaches, the item 'changes in sleep' was easily endorsed, 'loss of interest' moderately and 'suicidal thoughts' hardly. Graphical representation of BDI-II of both methods showed much equivalence in terms of item discrimination and item difficulty. The item characteristic curve of the IRT method provided informative evaluation of item performance. LIMITATION The inventory was applied only in college students. CONCLUSION Depressive symptoms were frequent psychopathological manifestations among college students. The performance of the BDI-II items indicated convergent results from both methods of analysis. While the CTT was easy to understand and to apply, the IRT was more complex to understand and to implement. Comprehensive assessment of the functioning of each BDI-II item might be helpful in efficient detection of depressive conditions in college students.
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Affiliation(s)
- Antonio Reis de Sá Junior
- Department of Health Sciences, Federal University of Santa Catarina, Araranguá, SC, Brazil; Institute & Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Arthur Guerra de Andrade
- Institute & Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, SP, Brazil; Department of Neuroscience, Medical School, ABC Foundation, Santo André, SP, Brazil
| | - Laura Helena Andrade
- Institute & Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Clarice Gorenstein
- Institute & Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, SP, Brazil; Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Yuan-Pang Wang
- Institute & Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, SP, Brazil.
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Wang T, Fu H, Kaminga AC, Li Z, Guo G, Chen L, Li Q. Prevalence of depression or depressive symptoms among people living with HIV/AIDS in China: a systematic review and meta-analysis. BMC Psychiatry 2018; 18:160. [PMID: 29855289 PMCID: PMC5984474 DOI: 10.1186/s12888-018-1741-8] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 05/11/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The number of people living with HIV/AIDS (PLHA) in China continues to increase. Depression, a common mental disorder in this population, may confer a higher likelihood of worse health outcomes. An estimate of the prevalence of this disorder among PLHA is required to guide public health policy, but the published results vary widely and lack accuracy in China. The goal of this study was to estimate the pooled prevalence of depression or depressive symptoms among PLHA in China. METHODS A systematic literature search of several databases was conducted from inception to June 2017, focusing on studies reporting on depression or depressive symptoms among PLHA in China. The risk of bias of individual studies was assessed using a modified version of the Newcastle-Ottawa scale. The overall prevalence estimates were pooled using random-effects meta-analysis. Differences according to study-level characteristics were examined using stratified meta-analysis and meta-regression. RESULTS Seventy-four observational studies including a total of 20,635 PLHA were included. The pooled prevalence of depression or depressive symptoms was 50.8% (95% CI: 46.0-55.5%) among general PLHA, 43.9% (95% CI: 36.2-51.9%) among HIV-positive men who have sex with men, 85.6% (95% CI: 64.1-95.2%) among HIV-positive former blood/plasma donors, and 51.6% (95% CI: 31.9-70.8%) among other HIV-positive populations. Significant heterogeneity was detected across studies regarding these prevalence estimates. Heterogeneity in the prevalence of depression among the general population of PLHA was partially explained by the geographic location and baseline survey year. CONCLUSIONS Because of the significant heterogeneity detected across studies regarding these prevalence estimates of depression or depressive symptoms, the results must be interpreted with caution. Our findings suggest that the estimates of depression or depressive symptoms among PLHA in China are considerable, which highlights the need to integrate screening and providing treatment for mental disorders in the treatment package offered to PLHA, which would ultimately lead to better health outcomes in PLHA.
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Affiliation(s)
- Tingting Wang
- 0000 0001 0379 7164grid.216417.7Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province China
| | - Hanlin Fu
- 0000 0001 0379 7164grid.216417.7Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province China
| | - Atipatsa Chiwanda Kaminga
- 0000 0001 0379 7164grid.216417.7Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province China ,grid.442592.cDepartment of Mathematics, Mzuzu University, Mzuzu 2, Malawi
| | - Zhanzhan Li
- 0000 0001 0379 7164grid.216417.7Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan Province China
| | - Guiping Guo
- 0000 0004 1803 0208grid.452708.cDepartment of Medical Psychology, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province China
| | - Lizhang Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China.
| | - Qiongxuan Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China.
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Wrzosek M, Wojnar M, Sawicka A, Tałałaj M, Nowicka G. Insomnia and depressive symptoms in relation to unhealthy eating behaviors in bariatric surgery candidates. BMC Psychiatry 2018; 18:153. [PMID: 29843671 PMCID: PMC5972435 DOI: 10.1186/s12888-018-1734-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 05/11/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Alongside obesity, insomnia and depression are common public health problems. Sleep problems are currently believed to be associated with excessive food intake and metabolic disturbances. Therefore, we aimed to explore a relationship between insomnia, depressive symptoms and eating habits as well as metabolic parameters in bariatric surgery candidates. METHODS A total of 361 unrelated obese subjects were included in this study. Severity of sleep problems was measured with Athens Insomnia Scale (AIS) and the severity of depressive symptoms was assessed with the Beck Depression Inventory (BDI-II). Obstructive sleep apnea (OSA) was assessed by the Apnea Hypopnoea Index (AHI). Information was obtained about demographics, eating habits and lifestyle. Blood samples were collected to measure concentration of lipids (cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol), and glucose. RESULTS The median (interquartile range) score for AIS in the study participants was 5 (3-8) with a range of 0-24 and 47% (171) participants scored ≥6 (met criteria for diagnosis of insomnia). Statistically significant correlations were found between the AIS scores and serum triglycerides and glucose concentrations, and BDI-II total scores. The highest scores on AIS and BDI-II were found in participants with high frequency of snack food consumption, in physically inactive individuals as well as in those who self-reported eating at night or who declared more than 3 intense emotions associated with a desire-to-eat. Adjusted multivariate logistic regression analysis revealed that clinical insomnia was most strongly associated with daily consumption of snack foods, with the odds ratio of 3.26 (95% CI: 1.74-6.11), while depressive symptoms were strongly associated with both eating in response to ≥3 specific emotions with OR = 2.93 (95% CI: 1.26-6.78) as well as with daily consumption of snack foods with OR = 2.87 (95% CI: 1.16-5.14). CONCLUSIONS The results indicate that insomnia and depression in obese individuals are associated with eating habits, and suggest that in some patients these associations appears as major factors affecting obesity development.
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Affiliation(s)
- Małgorzata Wrzosek
- Department of Biochemistry and Pharmacogenomics, and Center for Preclinical Studies, Medical University of Warsaw, Banacha 1, 02–097 Warsaw, Poland
| | - Marcin Wojnar
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Ada Sawicka
- Department of Geriatrics, Internal Medicine and Metabolic Bone Diseases, Medical Centre of Postgraduate Education, Prof. W. Orlowski Hospital, Warsaw, Poland
| | - Marek Tałałaj
- Department of Geriatrics, Internal Medicine and Metabolic Bone Diseases, Medical Centre of Postgraduate Education, Prof. W. Orlowski Hospital, Warsaw, Poland
| | - Grażyna Nowicka
- Department of Biochemistry and Pharmacogenomics, and Center for Preclinical Studies, Medical University of Warsaw, Banacha 1, 02–097 Warsaw, Poland
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Altered white matter microstructure associated with mild and moderate depressive symptoms in young adults, a diffusion tensor imaging study. Neuroreport 2018; 29:685-689. [PMID: 29578926 DOI: 10.1097/wnr.0000000000001017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In the context of growing evidence supporting disturbed neural connectivity in the pathogenesis of depressive symptoms, we used the diffusion tensor imaging technique to investigate white matter disruptions in previously undiagnosed and hence treatment-naive young adults with mild and moderate depressive symptoms screened by Beck's Depression Inventory test compared with age-matched and sex-matched healthy controls. This is the first diffusion tensor imaging study to assess minor forms of depression. We hypothesized that subthreshold depressive symptoms share the same neural disruptions as major depressive disorder (MDD). Each group included 47 participants with a mean age of 20.1±1.1 years. The exploratory region of interest method was used to assess integrity (fractional anisotropy and mean diffusivity) in 48 regions of the brain based on Mori atlas. Data were recruited from the Southwest University Longitudinal Imaging Multimodal Brain Data Repository. The following pathways showed significant microstructural changes by means of reduced fractional anisotropy in the group with depressive symptoms compared with normal participants: pontine crossing tract; genu of the corpus callosum; posterior limb of the internal capsule (bilaterally); and anterior, posterior, and superior corona radiata (bilaterally). None of the above regions, but the middle cerebellar peduncle and the right superior fronto-occipital fasciculus were shown to differ significantly in the mean diffusivity values between the two groups. On the basis of the current results, our findings provide evidence that the white matter impairments in the interhemispheric connections and frontal-subcortical neural circuits may play a key role in the pathogenesis of depression in young adults. The similarity of neural underpinnings in MDD and minor depressive disorder in this study further proves that these two mood disorders exist in a continuum, and milder depressive symptoms can herald a major episode. Besides the high prevalence and great burden of subthreshold forms of depression on personal and social aspects of life, there is lack of knowledge of them and most studies have mainly focused on MDD. This study provides a new avenue in addressing neuropathology of depression, mainly in subtle forms that are almost always overlooked.
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Cunningham SC, Aizvera J, Wakim P, Felber L. Use of a self-reported psychosocial distress screening tool as a predictor of need for psychosocial intervention in a general medical setting. SOCIAL WORK IN HEALTH CARE 2018; 57:315-331. [PMID: 29461938 PMCID: PMC5856647 DOI: 10.1080/00981389.2018.1437499] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study describes the development of a self-reported psychosocial distress screening tool for a general medical population and criteria to predict the need for psychosocial intervention. The objectives were to develop criteria to determine which patients need in-person screening and establish criteria identifying patients who are more likely to require psychosocial interventions. The outcomes have bearing on reducing initial psychosocial screening workload for medical social workers in high volume medical settings. Furthermore, a criterion for scoring the self-reported tool can predict which patients will need further social work intervention. The results suggest criteria are a score on the adapted Distress Thermometer of five or greater, at least two negative emotions, and a lack of health insurance. The optimal criterion identified 36% (446/1228) of patients in need of in-person screening with the remaining 64% (782/1228) screened low risk through the tool, representing a significant workload reduction.
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Affiliation(s)
| | - Jeasmine Aizvera
- Social Work, National Institutes of Health Clinical Center, Bethesda, USA
| | - Paul Wakim
- Biostatistics and Clinical Epidemiology Service, National Institutes of Health, Bethesda USA
| | - Lisa Felber
- Social Work, National Institutes of Health Clinical Center, Bethesda, USA
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Enko D, Wagner H, Kriegshäuser G, Brandmayr W, Halwachs-Baumann G, Schnedl WJ, Zelzer S, Mangge H, Meinitzer A. Assessment of tryptophan metabolism and signs of depression in individuals with carbohydrate malabsorption. Psychiatry Res 2018; 262:595-599. [PMID: 28965810 DOI: 10.1016/j.psychres.2017.09.049] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 09/17/2017] [Accepted: 09/21/2017] [Indexed: 01/16/2023]
Abstract
This prospective cross-sectional study aimed to investigate the potential association between primary-adult lactose malabsorption, fructose malabsorption, tryptophan (TRP) metabolism and the presence of depressive signs. Overall 251 patients, who were referred for lactase gene C/T-13910 polymorphism genotyping and fructose hydrogen/methane breath testing, were included. All participants filled out the Beck Depression Inventory (BDI II). Serum concentrations of tryptophan (TRP), kynurenine (KYN), kynuric acid (KYNA), and TRP competing amino acids (leucine, isoleucine, valine, phenylalanine, tyrosine) were measured by high-pressure liquid-chromatography. Logistic regression analysis was performed with lactose malabsorption, fructose malabsorption and all potential biomarkers of TRP metabolism to assess the effect on signs of depression, defined as a BDI II score > 13. Primary-adult lactose malabsorption and fructose malabsorption was detected in 65 (25.90%) and 65 (25.90%) patients, respectively. Fructose malabsorption was significantly associated with BDI II score, whereas no such relationship was found for lactose malabsorption. Serum levels of TRP and TRP metabolites were no predictors of depression. The authors suggest to conduct further prospective longitudinal studies in order to get further insight of associations between carbohydrate malabsorption, biomarkers and mood disorders.
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Affiliation(s)
- Dietmar Enko
- Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Steyr, Steyr, Austria; Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
| | - Helga Wagner
- Department of Applied Statistics, Johannes Kepler University Linz, Linz, Austria.
| | - Gernot Kriegshäuser
- Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Steyr, Steyr, Austria; Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
| | - Wolfgang Brandmayr
- Department of Psychiatry and Psychotherapeutic Medicine, General Hospital Steyr, Steyr, Austria.
| | | | | | - Sieglinde Zelzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
| | - Harald Mangge
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
| | - Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
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Association Between Severity of Depression and Cardiac Risk Factors Among Women Referred to a Cardiac Rehabilitation and Prevention Clinic. J Cardiopulm Rehabil Prev 2018; 38:291-296. [PMID: 29485527 DOI: 10.1097/hcr.0000000000000311] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Depression comorbid with cardiovascular disease is associated with higher rates of morbidity and mortality, with studies suggesting that this is especially true among women. This study examined depressive symptoms and their relationship to cardiac risk factors among women referred to a women's cardiac rehabilitation and primary prevention program. METHODS A secondary analysis of data collected between 2004 and 2014 for 1075 women who completed a baseline assessment at the Women's Cardiovascular Health Initiative, a women-only cardiac rehabilitation and prevention program in Toronto, Canada. Descriptive statistics for sociodemographic variables, quality of life (SF-36), and cardiac risk factors were stratified by depression symptom severity using cutoff scores from the Beck Depression Inventory-2nd version (BDI-II) and compared with analysis of variance and χ statistics. Prevalence of antidepressant use among those with moderate to high depressive symptoms was assessed as an indicator of under- or untreated depression. RESULTS Overall, 38.6% of women scored above the BDI-II cutoff for depression; 23.6% in the moderate or severe range. Socioeconomic status and quality of life decreased with increasing depression severity. Body mass index increased with depressive severity (P < .001), as did the percentage of individuals with below target age predicted fitness (P < .001). Only 39.0% of women in the moderate and severe BDI-II groups were taking antidepressants. CONCLUSION In this sample, we found a significant prevalence of untreated and undertreated depressive symptoms among women with, or at high risk of developing, cardiovascular disease. Additional strategies are needed to identify these patients early and link them to appropriate treatment.
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Ivezaj V, Barnes RD, Grilo CM. Validity and Clinical Utility of Subtyping by the Beck Depression Inventory in Women Seeking Gastric Bypass Surgery. Obes Surg 2018; 26:2068-2073. [PMID: 26762280 DOI: 10.1007/s11695-016-2047-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The Beck Depression Inventory (BDI) is commonly used in the screening and evaluation process with bariatric surgery candidates despite relatively limited psychometric evidence in this patient group. We examined the validity of the BDI and its clinical utility for subtyping women seeking gastric bypass surgery. METHODS One hundred twenty-four women evaluated for gastric bypass surgery were administered the Structured Clinical Interview for DSM-IV (SCID-I/P) and completed a self-report battery of psychosocial measures including the BDI. RESULTS Based on the SCID-I/P, 12.9 % (n = 16) met criteria for current mood disorder. Receiver operating characteristic (ROC) curve analysis revealed the BDI had a good area under the curve (0.788) for predicting SCID-I/P mood disorder diagnosis; BDI score of >15 optimized both sensitivity and specificity. Patients diagnosed with SCID-I/P mood disorders had significantly higher levels of eating disorder psychopathology, self-esteem, and shame, than those without mood disorders. Based on a BDI cut-off score of >15, 41.9 % (n = 52) were categorized as high-BDI and 58.1 % (n = 72) as low-BDI. Patients characterized as high-BDI also had significantly higher levels of all associated measures than those with low-BDI; effect sizes for the differences by BDI subtyping were generally 2-3 times greater than those observed when comparing SCID-I/P-based mood versus no mood disorder subgroups. CONCLUSIONS In women seeking gastric bypass surgery, the BDI demonstrated limited acceptability efficiency for identifying mood disorders with a cut-point score of >15. When identifying clinical severity, however, subtyping women by BDI scores of >15 may identify a significantly more disturbed subgroup than relying on a SCID-I/P-generated mood disorder diagnosis.
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Affiliation(s)
- Valentina Ivezaj
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA. .,Yale University School of Medicine, Program for Obesity, Weight, and Eating Research, 301 Cedar Street, 2nd Floor, New Haven, CT, 06519-1638, USA.
| | - Rachel D Barnes
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Carlos M Grilo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,Department of Psychology, Yale University, New Haven, CT, USA
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Darwish L, Beroncal E, Sison MV, Swardfager W. Depression in people with type 2 diabetes: current perspectives. Diabetes Metab Syndr Obes 2018; 11:333-343. [PMID: 30022843 PMCID: PMC6044353 DOI: 10.2147/dmso.s106797] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is associated with depressive symptoms, and comorbid depression in those with T2DM has been associated with adverse clinical profiles. Recognizing and addressing psychological symptoms remain significant clinical challenges in T2DM. Possible mediators of the reciprocal relationship between T2DM and depression may include physical activity levels, effectiveness of self-management, distress associated with a new T2DM diagnosis, and frailty associated with advanced diabetes duration. The latter considerations contribute to a "J-shaped" trajectory from the time of diagnosis. There remain significant challenges to screening for clinical risks associated with psychological symptoms in T2DM; poorer outcomes may be associated with major depressive episodes, isolated (eg, anhedonic), or subsyndromal depressive symptoms, depressive-like symptoms more specific to T2DM (eg, diabetes-related distress), apathy or fatigue. In this review, we discuss current perspectives on depression in the context of T2DM with implications for screening and management of these highly comorbid conditions.
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Affiliation(s)
- Lina Darwish
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada,
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada,
- Cardiac Rehabilitation Program, University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada,
- Canadian Partnership for Stroke Recovery, Toronto, ON, Canada,
| | - Erika Beroncal
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada,
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada,
- Cardiac Rehabilitation Program, University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada,
| | - Ma Veronica Sison
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada,
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada,
- Cardiac Rehabilitation Program, University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada,
| | - Walter Swardfager
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada,
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada,
- Cardiac Rehabilitation Program, University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada,
- Canadian Partnership for Stroke Recovery, Toronto, ON, Canada,
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Zhou Q, Li N. The impact of major physical diseases and its outcomes on depressive symptoms among Chinese population. J Ment Health 2017; 28:148-152. [PMID: 29256317 DOI: 10.1080/09638237.2017.1417561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Depression was common among people with physical diseases. Evidence was lacked on the impact of outcomes of physical diseases on mental health. AIM Using a national representative data of the China Health and Retirement Longitudinal Study, we aimed to explore the impact of major physical diseases and its outcomes on mental health among Chinese population. METHODS Using a multi-stage cluster sampling design, the CHARLS survey collected information of 19 549 subjects in the 2013/2014 follow-up survey. Depressive symptoms were measured by the 10-item version of the Center for Epidemiological Studies Depression (CES-D). RESULTS The prevalence rate of depressive symptoms in the study population was 21.2%. Major physical diseases were significantly associated with depressive symptoms. Compared to people who did not experience major physical diseases, participants who fully recovered after hospitalization were at similar level of developing depressive symptoms (OR = 1.16), participants who experienced major physical diseases but were not admitted to hospitals were more likely to develop depressive symptoms (OR = 2.14), and those who discharged from hospitals without recovery were also more likely to have depressive symptoms (OR = 2.24). CONCLUSIONS Screening for depression among hospitalized population and training among general practitioners were necessary. During hospitalization, collaborative care for both physical and mental health could be beneficial.
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Affiliation(s)
- Qin Zhou
- a School of Public Administration , University of International Business and Economics , Beijing , China and
| | - Ning Li
- b Institute of Population Research, Peking University , Beijing , China
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Uchino K, Shiraishi M, Tanaka K, Akamatsu M, Hasegawa Y. Impact of inability to turn in bed assessed by a wearable three-axis accelerometer on patients with Parkinson's disease. PLoS One 2017; 12:e0187616. [PMID: 29121638 PMCID: PMC5679594 DOI: 10.1371/journal.pone.0187616] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 10/23/2017] [Indexed: 11/23/2022] Open
Abstract
Background Difficulty turning over in bed is a common night-time symptom in Parkinson’s disease (PD). We aimed to quantitatively evaluate overnight turnover movements using a three-axis accelerometer and to investigate whether inability to turn in bed is related to daytime sleepiness, sleep quality, and depressive mood in PD patients. Methods We examined 64 patients with PD (mean age, 73.3±8.21 years; modified Hoehn-Yahr [mH-Y] stage, 3.0±1.0; disease duration, 7.2±6.3 years; unified Parkinson's disease rating scale [UPDRS], 36.9±18.3). Overnight monitoring of turnover movements using a wearable three-axis accelerometer was performed in all patients. Nocturnal kinetic parameters including total time recumbent, total time supine, number of turnover movements, and mean interval between turnover movements were obtained. Daytime immobility was assessed using the Barthel index (B-I), UPDRS, and mH-Y stage. Patients were also assessed with the Epworth Sleepiness Scale (ESS), Parkinson’s Disease Sleep Scale-2 (PDSS-2), and Beck Depression Inventory (BDI). Results Number of turnover movements in bed correlated negatively with disease duration (r = -0.305; p<0.05), L-dopa-equivalent dose (r = -0.281; p<0.05), mH-Y staging (r = -0.336; p<0.01), total score of UPDRS (r = -0.386; p<0.01) and positively with B-I score (r = 0.365; p<0.01). Number of turnover movements in bed was generally inconsistent with awareness of turnover movement impairment as evaluated by PDSS-2 Item 9 scores, but patients who were never aware of impaired turnover movements showed ≥5 turnover movements overnight. Multivariate logistic regression analyses revealed no correlations between number of nocturnal turnover movements in bed and BDI, ESS, or PDSS-2. Use of anti-psychotic drugs was associated with ESS (p = 0.045). UPDRS was associated with PDSS-2 (p = 0.016). Conclusion Decreased number of turnover movements may not be a direct determinant of daytime sleepiness, sleep disorders, or depressive mood in PD patients. Use of anti-psychotic drugs and higher UPDRS score are factors significantly associated with daytime sleepiness and uncomfortable sleep, respectively.
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Affiliation(s)
- Kenji Uchino
- Department of Neurology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
- * E-mail:
| | - Makoto Shiraishi
- Department of Neurology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Keita Tanaka
- Department of Neurology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Masashi Akamatsu
- Department of Neurology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Yasuhiro Hasegawa
- Department of Neurology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
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Kang EK, Lee KS, Lee SH. Reduced Cortical Thickness in the Temporal Pole, Insula, and Pars Triangularis in Patients with Panic Disorder. Yonsei Med J 2017; 58:1018-1024. [PMID: 28792148 PMCID: PMC5552629 DOI: 10.3349/ymj.2017.58.5.1018] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 03/31/2017] [Accepted: 05/09/2017] [Indexed: 01/22/2023] Open
Abstract
PURPOSE Recent neuroimaging findings have revealed that paralimbic and prefrontal regions are involved in panic disorder (PD). However, no imaging studies have compared differences in cortical thickness between patients with PD and healthy control (HC) subjects. MATERIALS AND METHODS Forty-seven right-handed patients with PD who met the diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders-4th edition-text revision, and 30 HC subjects were enrolled. We used the FreeSurfer software package for estimating the cortical thickness of regions of interest, including the temporal pole, insula, and pars triangularis (mid-ventrolateral prefrontal cortex). RESULTS Cortical thickness of the temporal pole (p=0.033, right), insula (p=0.017, left), and pars triangularis (p=0.008, left; p=0.025, right) in patients with PD was significantly lower, compared with HC subjects (Benjamini-Hochberg false discovery rate correction). Exploratory analysis revealed a significant negative correlation between the cortical thickness of the right temporal pole and Beck Depression Inventory scores (r=-0.333, p=0.027) in patients with PD and positive correlations between the cortical thickness of the left pars triangularis and Panic Disorder Severity Scale (r=0.429, p=0.004), Anxiety Sensitivity Index-Revised (r=0.380, p=0.011), and Beck Anxiety Inventory (r=0.421, p=0.004) scores using Pearson's correlation. CONCLUSION Ours study is the first to demonstrate cortical thickness reduction in the temporal pole, insula, and pars triangularis in patients with PD, compared with the HC subjects. These findings suggest that reduced cortical thickness could play an important role in the pathophysiology of PD.
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Affiliation(s)
- Eun Kyoung Kang
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Kang Soo Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Sang Hyuk Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
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133
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Schuling R, Huijbers M, Jansen H, Metzemaekers R, Den Brink EV, Koster F, Van Ravesteijn H, Speckens A. The Co-creation and Feasibility of a Compassion Training as a Follow-up to Mindfulness-Based Cognitive Therapy in Patients with Recurrent Depression. Mindfulness (N Y) 2017; 9:412-422. [PMID: 29599848 PMCID: PMC5866843 DOI: 10.1007/s12671-017-0783-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The aim of this study was to assess the feasibility, acceptability and preliminary effectiveness of Mindfulness - Based Compassionate Living (MBCL) as a follow-up intervention to Mindfulness Based Cognitive Therapy in adults with recurrent depression. We conducted an uncontrolled study in 17 patients with recurrent depression, in two successive groups. The first group contained novices to compassion training (N = 14); in the second group, ten of these participated again, in addition to three new participants (N = 13). The overall group contained 15 females and 2 males, aged between 37 and 71. The MBCL program was qualitatively evaluated using post-intervention focus group interviews in both groups. In addition, self-report questionnaires assessing depressive symptoms, worry and both self-compassion and mindfulness skills were administered before and after MBCL. No patients dropped out of the intervention. Average attendance was 7.52 (SD 0.73) out of eight sessions. Helpful elements were theory on the emotion regulation systems, practicing self-compassion explicitly and embodiment of a compassionate attitude by the teachers. Unhelpful elements were the lack of a clear structure, lack of time to practice compassion for self and the occurrence of the so-called back draft effect. We adapted the program in accordance with the feedback of the participants. Preliminary results showed a reduction in depressive symptoms in the second group, but not in the first group, and an increase in self-compassion in both groups. Worry and overall mindfulness did not change. MBCL appears to be feasible and acceptable for patients suffering from recurrent depressive symptoms who previously participated in MBCT. Selection bias may have been a factor as only experienced and motivated participants were used; this, however, suited our intention to co-create MBCL in close collaboration with knowledgeable users. Examination of the effectiveness of MBCL in a sufficiently powered randomised controlled trial is needed.
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Affiliation(s)
- Rhoda Schuling
- Radboudumc Centre for Mindfulness, P.O. Box 9101, (huispost 966), 6500 HB Nijmegen, The Netherlands
| | - Marloes Huijbers
- Radboudumc Centre for Mindfulness, P.O. Box 9101, (huispost 966), 6500 HB Nijmegen, The Netherlands
| | - Hetty Jansen
- Radboudumc Centre for Mindfulness, P.O. Box 9101, (huispost 966), 6500 HB Nijmegen, The Netherlands
| | - Renée Metzemaekers
- Radboudumc Centre for Mindfulness, P.O. Box 9101, (huispost 966), 6500 HB Nijmegen, The Netherlands
| | | | - Frits Koster
- Centre for Integral Psychiatry, Hereweg 80, 9725 AG Groningen, The Netherlands
| | - Hiske Van Ravesteijn
- Radboudumc Centre for Mindfulness, P.O. Box 9101, (huispost 966), 6500 HB Nijmegen, The Netherlands
| | - Anne Speckens
- Radboudumc Centre for Mindfulness, P.O. Box 9101, (huispost 966), 6500 HB Nijmegen, The Netherlands
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Abstract
Major depression is a common condition seen in the primary care setting, often presenting with somatic symptoms. It is potentially a chronic illness with considerable morbidity, and a high rate of relapse and recurrence. Major depression has a bidirectional relationship with chronic diseases, and a strong association with increased age and coexisting mental illnesses (e.g. anxiety disorders). Screening can be performed using clinical tools for major depression, such as the Patient Health Questionaire-2, Patient Health Questionaire-9 and Beck Depression Inventory, so that timely treatment can be initiated. An accurate diagnosis of major depression and its severity is essential for prompt treatment to reduce morbidity and mortality. This is the first of a series of articles that illustrates the approach to the management of major depression in primary care. Our next articles will cover suicide risk assessment in a depressed patient and outline the basic principles of management and treatment modalities.
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Affiliation(s)
| | - Choon How How
- Care and Health Integration, Changi General Hospital, Singapore
| | - Yin Ping Ng
- Penang Medical College, Penang, Malaysia.,Penang Adventist Hospital, Penang, Malaysia
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135
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Delibasic M, Mohamedali B, Dobrilovic N, Raman J. Pre-transplant depression as a predictor of adherence and morbidities after orthotopic heart transplantation. J Cardiothorac Surg 2017; 12:62. [PMID: 28743270 PMCID: PMC5526318 DOI: 10.1186/s13019-017-0626-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 07/13/2017] [Indexed: 12/15/2022] Open
Abstract
Background Psychosocial factors are useful predictors of adverse outcomes after solid organ transplantation. Although depression is a known predictor of poor outcomes in patients who undergo orthotopic heart transplantation (OHT) and is actively screened for during pre-transplant evaluation, the effects of early identification of this entity on post-transplant outcomes are not clearly understood. The purpose of this study was to evaluate the impact of pre-transplant depression on outcomes after OHT. Method In this retrospective study, 51 patients that underwent psychosocial evaluation performed by a social worker prior to the transplant and followed up in our center post-transplant were enrolled. Patients were stratified by the presence/absence of depression during the initial encounter. Primary end-points were overall survival, 1st-year hospitalizations, overall hospitalizations, rejections, and compliance with medications and outpatient appointments. Results Depressed patients were 3.5 times more likely to be non-compliant with medications; RR = 3.5, 95% CI (1.2,10.2), p = 0.046 and had higher incidence of first year hospitalizations (4.7 ± 3.1 vs. 2.2 ± 1.9, p = 0.046), shorter time to first hospitalization 25 days (IQR 17–39) vs. 100 days (IQR 37–229), p = 0.001. Patients with depression also had higher overall hospitalizations (8.3 ± 4.4 vs. 4.6 ± 4.2, p = 0.025,) and higher number of admissions for infections (2.8 ± 1.3 vs. 1.5 ± 1.4, p = 0.018) compared to patients without depression. There were no statistically significant differences in total number of rejections or compliance with outpatient appointments. Kaplan-Meier survival analysis did not reveal differences between the two groups (mean 3705 vs. 3764 days, log-rank p = 0.52). Conclusion Depression was a strong predictor of poor medication compliance and higher rates of hospitalization in transplant recipients. No difference in survival between depressed and non-depressed patients after OHT was noted.
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Affiliation(s)
- Maja Delibasic
- Department of Internal Medicine, Mercy Hospital, Chicago, IL, USA
| | - Burhan Mohamedali
- Departments of Internal Medicine, Rush University Medical Center, Il, Chicago, 60612, USA
| | - Nikola Dobrilovic
- Cardiovascular and Thoracic Surgery, Rush University Medical Center, Rush University Medical Center, 1725 W Harrison, Suite 1156 POB, Chicago, IL, 60612, USA.
| | - Jaishankar Raman
- Cardiovascular and Thoracic Surgery, Rush University Medical Center, Rush University Medical Center, 1725 W Harrison, Suite 1156 POB, Chicago, IL, 60612, USA
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136
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Reduced Anxiety and Depression in Patients With Advanced Heart Failure After Left Ventricular Assist Device Implantation. PSYCHOSOMATICS 2017; 58:406-414. [DOI: 10.1016/j.psym.2017.02.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 02/06/2017] [Accepted: 02/07/2017] [Indexed: 11/19/2022]
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137
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Mansour ZM, Lepping RJ, Honea RA, Brooks WM, Yeh HW, Burns JM, Sharma NK. Structural Brain Imaging in People With Low Back Pain. Spine (Phila Pa 1976) 2017; 42:726-732. [PMID: 27879564 PMCID: PMC5425308 DOI: 10.1097/brs.0000000000001915] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVE The aim of this study was to determine whether low back pain (subacute and chronic) is related to differences in brain volume. SUMMARY OF BACKGROUND DATA Inconsistent findings have been reported about the effect of chronic low back pain on brain volume, and the effect of subacute low back pain on brain volume has not been sufficiently investigated. METHODS A total of 130 participants were included (23 subacute and 68 chronic low back pain; 39 healthy controls). The main outcome measure was whole and regional brain volume. Clinical outcome measures included pain duration, pain intensity, fear avoidance belief questionnaire, Oswestry Disability Index, and Beck's Depression Inventory. RESULTS Decrease in brain volume in several regions was observed in chronic low back pain when compared with health subjects; however, after correcting for multiple comparisons, no significant differences were detected between any of the three groups in whole-brain volume. Regionally, we detected less gray matter volume in two voxels in the middle frontal gyrus in chronic low back pain participants compared with healthy controls. None of the clinical outcome measures were correlated with brain volume measurements. CONCLUSION Low back pain (subacute or chronic) is not related to significant differences in brain volume after correction for multiple comparisons. The effect size was too small to detect possible subtle changes unless much larger sample sizes are examined, or it is possible that low back pain does not affect brain volume. LEVEL OF EVIDENCE 5.
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Affiliation(s)
- Zaid M. Mansour
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, Kansas, 66160
| | - Rebcca J. Lepping
- Hoglund Brian Imaging Center, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, Kansas, 66160
| | - Robyn A. Honea
- Alzheimer’s Research Disease Center, University of Kansas School of Medicine, Kansas City, Kansas, 66160
| | - William M. Brooks
- Hoglund Brian Imaging Center, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, Kansas, 66160
| | - Hung-Wen Yeh
- Department of Biostatistics, University of Kansas Medical Center, Kansas City, Kansas, 66160
| | - Jeffrey M. Burns
- Alzheimer’s Research Disease Center, University of Kansas School of Medicine, Kansas City, Kansas, 66160
- Department of Neurology, University of Kansas School of Medicine, Kansas City, Kansas, 66160
| | - Neena K. Sharma
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, Kansas, 66160
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138
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Chaturvedi S, Clancy M, Schaefer N, Oluwole O, McCrae KR. Depression and post-traumatic stress disorder in individuals with hereditary hemorrhagic telangiectasia: A cross-sectional survey. Thromb Res 2017; 153:14-18. [PMID: 28314138 PMCID: PMC5420428 DOI: 10.1016/j.thromres.2017.03.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 03/01/2017] [Accepted: 03/06/2017] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Hereditary hemorrhagic telangiectasia (HHT) is characterized by frequent severe bleeding, particularly epistaxis, and life-threatening complications including stroke, brain abscess and heart failure. The psychological impact of HHT is not known. We conducted this cross sectional study to determine the prevalence of depression and post-traumatic stress disorder (PTSD) related to HHT. METHODS A survey tool comprising demographic and clinical information and two validated self-administered questionnaires, the PTSD checklist for DSM-5 (PCL-5) and Beck Depression Inventory-II (BDI-II), was distributed to individuals with HHT. Associations with clinical and demographic variables with depression and PTSD were evaluated in a logistic regression model. RESULTS A total of 222 individuals responded to the survey. Of these, 185 completed either the BDI II or PCL-5 and were included in the analysis. Median age was 54years and 142 (76.8%) were female. An existing diagnosis of depression, anxiety disorder and PTSD was present in 81 (43.8%), 59 (31.9%) and 16(8.6%) respondents, respectively. BDI-II scores>13 indicating at least mild depressive symptoms were present in 142 (88.7%) patients and 52 (28.1%) patients had a positive screen for PTSD (PCL-5 score≥38). On multivariable analysis, depression [OR 2.17 (95% CI 1.045-4.489), p=0.038], anxiety disorder [OR 2.232 (95% CI 1.066-4.676), p=0.033], and being unemployed [OR 2.234 (95% CI 1.46-4.714), p=0.019) were associated with PTSD. CONCLUSION We report a high prevalence of depressive and PTSD symptoms in individuals with HHT. While selection bias may lead to overestimation of prevalence in this study, our results are concerning and clinicians should remain vigilant for signs of psychological distress and consider screening for these disorders.
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Affiliation(s)
- Shruti Chaturvedi
- Division of Hematology and Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | | | | | - Olalekan Oluwole
- Division of Hematology and Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Keith R McCrae
- Department of Cellular and Molecular Medicine, Cleveland Clinic, United States; Hematologic Oncology and Blood Disorders, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH, United States.
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139
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Chaturvedi S, Oluwole O, Cataland S, McCrae KR. Post-traumatic stress disorder and depression in survivors of thrombotic thrombocytopenic purpura. Thromb Res 2017; 151:51-56. [DOI: 10.1016/j.thromres.2017.01.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 12/19/2016] [Accepted: 01/05/2017] [Indexed: 12/21/2022]
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140
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Kanmogne GD, Qiu F, Ntone FE, Fonsah JY, Njamnshi DM, Kuate CT, Doh RF, Kengne AM, Tagny CT, Nchindap E, Kenmogne L, Mbanya D, Cherner M, Heaton RK, Njamnshi AK. Depressive symptoms in HIV-infected and seronegative control subjects in Cameroon: Effect of age, education and gender. PLoS One 2017; 12:e0171956. [PMID: 28231258 PMCID: PMC5322951 DOI: 10.1371/journal.pone.0171956] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 01/27/2017] [Indexed: 12/03/2022] Open
Abstract
Depression is a leading cause of HIV/AIDS disease burden; it worsens health outcomes and quality of life. Addressing this problem requires accurate quantification of the extra burden of depression to HIV/AIDS in a given population, and knowledge of the baseline depression prevalence in the general population. There has been no previous study of depression in the general Cameroonian population. The current study attempts to address that important need. We used the Beck Depression Inventory-II to assess the prevalence and severity of depressive symptoms in 270 HIV-infected and seronegative Cameroonians. Univariate analyses showed a trend toward higher depressive symptoms among cases, compared to controls (p = 0.055), and among older subjects (>40 years), compared to younger subjects (≤40 years) (p = 0.059). Analysis of depression severity showed that 33.73% of cases had moderate-to-severe depressive symptoms, compared to 19.8% of controls (p<0.01). However, multivariable negative binomial regression analyses showed no effect of age, HIV status, CD4 levels, viral loads, ART, or opportunistic infections on the risk of depressive symptoms. Both univariate and multivariable regression analyses showed significantly higher risk of depressive symptoms among females compared to males; this was significant for both female controls and female cases. Female cases had significantly higher CD4 cell counts and lower viral loads, compared to males. Both univariate and multivariable regression analyses showed that lower education (≤10 years) was associated with increased risk of depressive symptoms. This study shows a high prevalence of depressive symptoms among seronegative controls and HIV-infected Cameroonians. Integrating care for mental disorders such as depression into primary health care and existing HIV/AIDS treatment programs in Cameroon may improve the wellbeing of the general population and could lower the HIV/AIDS burden.
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Affiliation(s)
- Georgette D. Kanmogne
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
- * E-mail:
| | - Fang Qiu
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
| | - Félicien E. Ntone
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Julius Y. Fonsah
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Department of Neurology, Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Dora M. Njamnshi
- HIV-Day Care Service, Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Callixte T. Kuate
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Roland F. Doh
- Department of Neurology, Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Anne M. Kengne
- Department of Neurology, Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Claude T. Tagny
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Yaoundé University Teaching Hospital, Yaoundé, Cameroon
| | | | | | - Dora Mbanya
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Yaoundé University Teaching Hospital, Yaoundé, Cameroon
| | - Mariana Cherner
- HIV Neurobehavioral Research Center, School of Medicine, University of California San Diego, San Diego, California, United States of America
| | - Robert K. Heaton
- Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, San Diego, California, United States of America
| | - Alfred K. Njamnshi
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Department of Neurology, Yaoundé Central Hospital, Yaoundé, Cameroon
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141
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Bock K, Bendstrup E, Hilberg O, Løkke A. Screening tools for evaluation of depression in Chronic Obstructive Pulmonary Disease (COPD). A systematic review. Eur Clin Respir J 2017; 4:1332931. [PMID: 28649311 PMCID: PMC5475296 DOI: 10.1080/20018525.2017.1332931] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 05/08/2017] [Indexed: 01/13/2023] Open
Abstract
Background: Anxiety and depression are common comorbid disorders in patients with chronic obstructive pulmonary disease (COPD), though estimates of their prevalence vary considerably. Depressive symptoms/depression are important comorbidities in COPD and an increasing interest is shown to these disorders. Depression may lead to reduced quality of life and increased morbidity and mortality. These statements underline the importance of implementing the use of screening instruments for depressive symptoms in a clinical setting. This systematic review evaluates four commonly used screening tools for depression in COPD. Furthermore we assess the prevalence of depression in COPD in the evaluated studies. Design: A literature search identified studies dealing with screening for depression in patients with COPD. We focused on the instruments: Beck Depression Inventory, Geriatric depression scale, Centre for Epidemiological Studies scale on Depression and Hospital and Anxiety Depression Scale. Results: Overall prevalence of depression was 30%. Demographic variations and severity of COPD influenced prevalence. The inter-prevalence of the four screening tools was consistent. We found a low variation between studies using the same tool. Few studies used control groups or compared the screening tool to a psychiatrist evaluation. Conclusions: This article calls for further investigation of the association between COPD and depressive symptoms. The subject is highly relevant for everyday life of patients with COPD and attention needs to be drawn to this issue in both an out- and in-patients.
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Affiliation(s)
- K. Bock
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus C, Denmark
| | - E. Bendstrup
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus C, Denmark
| | - O. Hilberg
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus C, Denmark
| | - A. Løkke
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus C, Denmark
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142
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Petrovic D, Perovic M, Lazovic B, Pantic I. Association between walking, dysphoric mood and anxiety in late pregnancy: A cross-sectional study. Psychiatry Res 2016; 246:360-363. [PMID: 27770714 DOI: 10.1016/j.psychres.2016.10.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 07/27/2016] [Accepted: 10/06/2016] [Indexed: 11/19/2022]
Abstract
Relationship between physical activity and mental disorders in late pregnancy is unclear. In this work, we demonstrate that there is a significant association between the time spent on walking and symptoms of depression and anxiety in antenatal period. The cross-sectional study was done on a sample of 200 healthy women in 9th month of physiological pregnancy at Health center Kraljevo, Serbia during 2015. Each participant was given a questionnaire consisting of general questions regarding physical activity, pregnancy, and other parameters. Also, each participant completed a Beck depression inventory (BDI) and Zung anxiety scale (ZAS). There was a statistically significant negative correlation (p<0.05) between the BDI score and the daily time spent on walking. There was also a strong positive connection between the daily time spent on walking and level of anxiety (p<0.01). To our knowledge this is the first study to jointly test the relationship between scores of Beck depression inventory and Zung anxiety scale, and time spent on walking as physical activity in antenatal period. The results represent the basis for further research in the field of gynecological psychology, psychiatry and behavioral physiology.
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Affiliation(s)
- Danica Petrovic
- Health Center Studenica, Jug Bogdanova 112, RS-36000 Kraljevo, Serbia
| | - Milan Perovic
- Clinic for Gynecology and Obstetrics "Narodni front", School of Medicine, University of Belgrade, Kraljice Natalije 62, 11000 Belgrade, Serbia
| | - Biljana Lazovic
- Clinical Hospital Center Zemun, School of Medicine, University of Belgrade, Vukova 9, 11000 Belgrade, Serbia
| | - Igor Pantic
- Institute of Medical Physiology, School of Medicine, University of Belgrade, Visegradska 26/II, RS-11129 Belgrade, Serbia.
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143
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[Unsatisfactory response: definition and involvement]. Encephale 2016; 42:1S31-8. [PMID: 26879255 DOI: 10.1016/s0013-7006(16)30017-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In the treatment of unipolar depression, treatment response is a key issue in terms of evolution and prognosis. Within this concept, the inadequate response includes the worsening, the lack of response, partial response and poor tolerance. This lack of response may be related to intrinsic factors to the individual, but also to more extrinsic environmental factors. In this review, we explore this concept through its links with adherence and treatment duration. In this field, the concept of early response can be a powerful indicator of therapeutic response, which conditions the prescription of antidepressants beyond the strict framework of the sufficient period of 4 to 6 weeks. In addition to its impact on prognosis, the literature data show that the insufficient response is a significant burden in terms of medical and economic cost, and somatic comorbidity; and justifies a systematic identification of this dimension. Therefore self-reports (QIDS; BDI) will be preferred to the clinician-rated depression symptom rating scales (MADRS, HAMD) that require a specific training. Identifying predictors of non-response would be an attractive target for prescribers but the results to date are not operative.
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144
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Kingston REF, Marel C, Mills KL. A systematic review of the prevalence of comorbid mental health disorders in people presenting for substance use treatment in Australia. Drug Alcohol Rev 2016; 36:527-539. [PMID: 27786426 DOI: 10.1111/dar.12448] [Citation(s) in RCA: 98] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 04/25/2016] [Accepted: 05/24/2016] [Indexed: 11/29/2022]
Abstract
ISSUES The aim of this paper was to conduct a systematic review of the prevalence of comorbid mental health conditions in people accessing treatment for substance use in Australia. APPROACH A systematic review identified studies meeting the following eligibility criteria: reporting original data published in English; sample presenting for substance use treatment in Australia; assessing the prevalence of mental health and substance use conditions and reporting the percentage of participants with co-occurring mental health and substance use conditions. A narrative analysis was conducted because of the heterogeneity of methods used to assess key outcome variables and small number of studies assessing particular mental health outcomes. The abstracts of 1173 records were screened, and 59 full articles were assessed for eligibility. Eighteen studies were included in the review. KEY FINDINGS Prevalence estimates of current mental disorders in substance use treatment clients varied (47 to 100%). Mood and anxiety disorders were particularly prevalent, with the prevalence of current depression ranging from 27 to 85% and current generalised anxiety disorder ranging from 1 to 75%. IMPLICATIONS The high prevalence of mood and anxiety disorders in substance use treatment settings indicates a need for clinicians to screen and assess for these disorders as part of routine clinical care, and be familiar with evidence-based management and treatment strategies. CONCLUSION Although further studies are required to determine the prevalence of the full range of mental health disorders in this population, these findings emphasise the high prevalence of comorbid mental disorders are among individuals accessing substance use treatment in Australia. [Kingston REF, Marel C, Mills KL. A systematic review of the prevalence of comorbid mental health disorders in people presenting for substance use treatment in Australia. Drug Alcohol Rev 2017;36:527-539].
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Affiliation(s)
- Rosemary E F Kingston
- Centre of Research Excellence in Mental Health and Substance Use, University of New South Wales, Sydney, Australia.,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Christina Marel
- Centre of Research Excellence in Mental Health and Substance Use, University of New South Wales, Sydney, Australia.,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Katherine L Mills
- Centre of Research Excellence in Mental Health and Substance Use, University of New South Wales, Sydney, Australia.,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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Schellekens MPJ, van den Hurk DGM, Prins JB, Molema J, van der Drift MA, Speckens AEM. The suitability of the Hospital Anxiety and Depression Scale, Distress Thermometer and other instruments to screen for psychiatric disorders in both lung cancer patients and their partners. J Affect Disord 2016; 203:176-183. [PMID: 27295374 DOI: 10.1016/j.jad.2016.05.044] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 04/13/2016] [Accepted: 05/22/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Lung cancer patients and their partners report high rates of distress. Although distress is of importance, psychiatric disorders might be more important in terms of prognostic value and additional psychological treatment. This study examined the suitability of the Hospital Anxiety and Depression Scale (HADS), Distress Thermometer (DT), Beck Depression Inventory (BDI-II) and State subscale of State Trait Anxiety Inventory (STAI-S) to screen for psychiatric disorders in lung cancer patients and partners. METHODS A consecutive sample of lung cancer patients and partners completed the screening instruments. The Structured Clinical Interview DSM-IV (SCID-I) was used to diagnose psychiatric axis I disorders. RESULTS In 144 patients, overall ability of HADS total score (HADS-T) screening for patients with psychiatric disorders was good, whereas DT appeared less suitable. In 98 partners, the performance of HADS-T was good. Although no instrument was successful in identifying psychiatric disorders, HADS-T came closest with a fair performance in patients and partners. LIMITATIONS Several patients and partners declined participation because they perceived participation as too distressing. As decliners possibly have the highest rates of disorders, our findings might underestimate the prevalence of psychiatric disorders. A low prevalence negatively affects the positive predictive value and complicates efficient screening for psychiatric disorders. CONCLUSION The HADS-T appears to be a suitable screening instrument for ruling out those lung cancer patients and partners without a psychiatric disorder. Regarding identifying those with a psychiatric disorder, HADS-T should be used to refer both patients and partners for further diagnostics and treatment to a psychiatrist/psychologist.
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Affiliation(s)
- Melanie P J Schellekens
- Department of Psychiatry, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Desiree G M van den Hurk
- Department of Pulmonary Diseases, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Judith B Prins
- Department of Medical Psychology, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Johan Molema
- Department of Pulmonary Diseases, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Miep A van der Drift
- Department of Pulmonary Diseases, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Anne E M Speckens
- Department of Psychiatry, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
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146
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Colgecen E, Celikbilek A, Keskin DT. Cognitive Impairment in Patients with Psoriasis: A Cross-Sectional Study Using the Montreal Cognitive Assessment. Am J Clin Dermatol 2016; 17:413-9. [PMID: 27003581 DOI: 10.1007/s40257-016-0187-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Psoriasis is a multisystem chronic inflammatory disorder that is thought to be associated with cognitive impairment. AIMS We aimed to investigate cognitive performance using the Montreal Cognitive Assessment (MoCA) in patients with psoriasis. METHODS In total, 77 patients with psoriasis and 83 age- and sex-matched control subjects were enrolled in this prospective cross-sectional study. Physical and/or histopathological findings were used to diagnose psoriasis vulgaris, and patients with psoriasis were evaluated according to disease characteristics, including duration, severity, onset age, medical treatment, and cosmetic involvement. All participants provided sociodemographic data and completed the Beck Depression Inventory. Cognitive functions were evaluated using the MoCA tool. RESULTS The MoCA scores were significantly lower in the psoriasis group than in the control group (p = 0.004). More psoriasis patients than control subjects presented with deficits in visuospatial domain (p = 0.037) and executive functioning (p = 0.010). In the multivariate model, the presence of psoriasis (odds ratio [OR] 3.64; 95 % confidence interval [CI] 1.65-8.02; p = 0.001), education level (3.74; 95 % CI 1.65-8.48; p = 0.002), and area of residence (3.56; 95 % CI 1.61-7.87; p = 0.002) were found to be independently associated with cognitive impairment in patients with psoriasis and control subjects. On the other hand, no correlations were observed between disease characteristics and cognitive impairment in patients with psoriasis vulgaris (p > 0.05). CONCLUSIONS The results suggest that psoriasis patients might have early or subtle cognitive impairment, including visuospatial domain and executive functioning.
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147
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A parallel-group, randomized controlled trial into the effectiveness of Mindfulness-Based Compassionate Living (MBCL) compared to treatment-as-usual in recurrent depression: Trial design and protocol. Contemp Clin Trials 2016; 50:77-83. [PMID: 27451354 DOI: 10.1016/j.cct.2016.07.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 07/14/2016] [Accepted: 07/17/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND Mindfulness Based Cognitive Therapy (MBCT) has been shown to reduce the risk of relapse in patients with recurrent depression, but relapse rates remain high. To further improve outcome for this group of patients, follow-up interventions may be needed. Compassion training focuses explicitly on developing self-compassion, one of the putative working mechanisms of MBCT. No previous research has been done on the effectiveness of compassion training following MBCT in patients with recurrent depression. AIMS To investigate the effectiveness of Mindfulness-Based Compassionate Living (MBCL) in reducing (residual) depressive symptoms in patients with recurrent depression who previously participated in MBCT. METHODS/DESIGN A randomized controlled trial comparing MBCL in addition to treatment as usual (TAU) with TAU only, in patients suffering from recurrent depressive episodes who completed an MBCT course in the past. Assessments will take place at baseline, post-treatment and at six months follow-up. After the control period, patients randomized to the TAU condition will be offered MBCL as well. OUTCOME MEASURES Primary outcome measure is severity of depressive symptoms according to the Beck Depression Inventory-II (BDI-II) at post-treatment. Secondary outcome measures are presence or absence of DSM-IV depressive disorder, rumination, self-compassion, mindfulness skills, positive affect, quality of life, experiential avoidance and fear of self-compassion. DISCUSSION Our study is the first randomized controlled trial to examine the effectiveness of compassion training following MBCT in a recurrently depressed population. TRIAL REGISTRATION ClinicalTrials.gov: NCT02059200, registered 30 January 2014.
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148
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Walton DM, Putos J, Beattie T, MacDermid JC. Confirmatory factor analysis of 2 versions of the Brief Pain Inventory in an ambulatory population indicates that sleep interference should be interpreted separately. Scand J Pain 2016; 12:110-116. [DOI: 10.1016/j.sjpain.2016.05.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 03/24/2016] [Accepted: 05/05/2016] [Indexed: 11/29/2022]
Abstract
Abstract
Background
The Brief Pain Inventory (BPI-SF) is a widely-used generic pain interference scale, however its factor structure remains unclear. An expanded 10-item version of the Interference subscale has been proposed, but the additional value of the 3 extra items has not been rigorously evaluated. The purpose of this study was to evaluate and contrast the factorial and concurrent validity of the original 7-item and 10-item versions of the BPI-SF in a large heterogeneous sample of patients with chronic pain.
Methods
Exploratory and confirmatory factor analyses were conducted on independent subsets of the sample, and concurrent correlations with scales capturing similar constructs were evaluated.
Results
Two independent exploratory factor analyses (n = 500 each) supported a single interference factor in both the 7- and 10-item versions, while confirmatory factor analysis (N =1000) suggested that a 2-factor structure (Physical and Affective) provided better fit. A 3-factor model, where sleep interference was the third factor, improved in model fit further. There was no significant difference in model fit between the 7- and 10-item versions. Concurrent associations with measures of general health, pain intensity and pain-related cognitions were all in the anticipated direction and magnitude and were not different by version of the BPI-SF.
Conclusions and implications
The addition of 3 extra items to the original 7-item Interference subscale of the BPI-SF did not improve psychometric properties. The combined results lead us to endorse a 3-factor structure (Physical, Affective, and Sleep Interference) as the more statistically and conceptually sound option.
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Affiliation(s)
- David M. Walton
- School of Physical Therapy , The University of Western Ontario , London , Canada
| | - Joseph Putos
- School of Physical Therapy , The University of Western Ontario , London , Canada
| | - Tyler Beattie
- School of Physical Therapy , The University of Western Ontario , London , Canada
| | - Joy C. MacDermid
- School of Physical Therapy , The University of Western Ontario , London , Canada
- School of Physical Therapy , McMaster University , Hamilton , Canada
- The Hand and Upper Limb Centre , St. Joseph's Hospital , London , Canada
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149
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Plourde A, Moullec G, Bacon SL, Suarthana E, Lavoie KL. Optimizing screening for depression among adults with asthma. J Asthma 2016; 53:736-43. [PMID: 27159640 DOI: 10.3109/02770903.2016.1145692] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The Beck Depression Inventory II (BDI-II) is one of the most frequently used tools to screen for depression in patients with chronic diseases such as cardiovascular disease and asthma. However, its original cut-off score has not been validated in adult asthmatics. The present study aimed to determine the optimal BDI-II cut-off score and to verify the impact of various patient sociodemographic and clinical characteristics on performance accuracy of the BDI-II. METHODS A total of 801 adult asthmatic outpatients (mean ± SD, age 49 ± 14 years, 60% female) completed the BDI-II and a structured psychiatric interview (used as the standard referent to determine presence of major depressive disorder [MDD]). The sensitivity and specificity of the BDI-II were computed to determine the optimal cut-off score for identifying MDD. The optimal cut-off scores were also verified across covariate subgroups (e.g., sex, age, smoking status, asthma control levels). RESULTS According to the structured psychiatric interview, 108 (13%) patients had current MDD. The overall optimal BDI-II cut-off score was 12 (sensitivity = 85%, specificity = 79%). However, subgroup analyses revealed that this score could range from 11 to 15 depending on the characteristics of the individual. CONCLUSIONS Results suggest that the BDI-II is an appropriate screening tool for MDD in asthma populations. However, the cut-off score is influenced by the sociodemographic and clinical characteristics of patients. These findings highlight the importance of validating generic questionnaires for depression in specific populations in order to improve the accuracy of their usage.
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Affiliation(s)
- Annik Plourde
- a Montreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montréal , Montréal , Quebec , Canada.,b Department of Psychology , Université du Québec à Montréal (UQAM) , Montréal , Quebec , Canada.,c Research Centre, Hôpital du Sacré-Cœur de Montréal , Montréal , Quebec , Canada
| | - Gregory Moullec
- c Research Centre, Hôpital du Sacré-Cœur de Montréal , Montréal , Quebec , Canada.,e Department of Preventive and Social Medicine , Faculty of Medicine, University of Montréal , Montréal , Quebec , Canada.,f Department of Psychoeducation and Psychology , Université du Québec en Outaouais (UQO) , Quebec , Canada
| | - Simon L Bacon
- a Montreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montréal , Montréal , Quebec , Canada.,c Research Centre, Hôpital du Sacré-Cœur de Montréal , Montréal , Quebec , Canada.,d Department of Exercise Science , Concordia University , Montréal , Quebec , Canada
| | - Eva Suarthana
- c Research Centre, Hôpital du Sacré-Cœur de Montréal , Montréal , Quebec , Canada.,e Department of Preventive and Social Medicine , Faculty of Medicine, University of Montréal , Montréal , Quebec , Canada.,g Technology Assessment Unit, McGill University Health Center , Montréal , Quebec , Canada
| | - Kim L Lavoie
- a Montreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montréal , Montréal , Quebec , Canada.,b Department of Psychology , Université du Québec à Montréal (UQAM) , Montréal , Quebec , Canada.,c Research Centre, Hôpital du Sacré-Cœur de Montréal , Montréal , Quebec , Canada
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150
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Duarte-Guerra LS, Gorenstein C, Paiva-Medeiros PF, Santo MA, Lotufo Neto F, Wang YP. Clinical utility of the Montgomery-Åsberg Depression Rating Scale for the detection of depression among bariatric surgery candidates. BMC Psychiatry 2016; 16:119. [PMID: 27138750 PMCID: PMC4852448 DOI: 10.1186/s12888-016-0823-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 04/21/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Clinical assessment of depression is an important part of pre-surgical assessment among individuals with morbid obesity. However, there is no agreed-upon instrument to identify mood psychopathology in this population. We examined the reliability and criterion validity of the clinician-administered Montgomery-Åsberg Depression Rating Scale (MADRS) and the utility of a short version for bariatric surgery candidates. METHODS The sample was 374 patients with obesity, consecutively recruited from the waiting list of a bariatric surgery clinic of University Hospital, Brazil: women 80%, mean BMI 47 kg/m(2), mean age 43.0 years. The 10-item MADRS was analyzed against the SCID-I. Items that showed small relevance to sample's characteristics and contribution to data variability were removed to develop the short 5-item version of scale. We calculated the sensitivity and specificity of cutoff points of both versions MADRS, and values were plotted as a receiver operating characteristic curve. RESULTS For the 10-item MADRS, the Cronbach's alpha coefficient was 0.93. When compared against SCID-I, the best cut-off threshold was 13/14, yielding sensitivity of 0.81 and specificity 0.85. Following items were removed: reduced appetite, reduced sleep, concentration difficulties, suicide thought and lassitude. The 5-item version showed an alpha coefficient of 0.94 and a best cut-off threshold of 10/11, yielding sensitivity of 0.81 and specificity 0.87. Similar overall ability to discriminate depression of almost 90% was found for both 10-item and 5-item MADRS. CONCLUSION The MADRS is a reliable and valid instrument to assess depressive symptoms among treatment-seeking bariatric patients. Systematic application of the abbreviated version of the MADRS can be recommended for enhancing the clinical detection of depression during perioperative period.
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Affiliation(s)
| | - Clarice Gorenstein
- Department and Institute of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, Brazil
- Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | | | - Marco Aurélio Santo
- Department of Surgery, University of São Paulo Medical School, São Paulo, Brazil
| | - Francisco Lotufo Neto
- Department and Institute of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, Brazil
| | - Yuan-Pang Wang
- Department and Institute of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, Brazil.
- Instituto & Departamento de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Rua Dr. Ovídio Pires de Campos. no. 785, 05403-010, São Paulo, Brazil.
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