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Stubbeman WF, Yang J, Converse J, Gencosmanoglu M, Morales Ortega D, Morris J, Sobocinski A, Li V, Gunawardane G, Edelen Y, Khairkhah R, Perez J. Neuronavigated Right Orbitofrontal 20 Hz Theta Burst Transcranial Magnetic Stimulation Augmentation for Obsessive-Compulsive Disorder with Comorbid Depression and Anxiety Disorders: An Open-Label Study. Brain Sci 2024; 14:483. [PMID: 38790461 PMCID: PMC11120198 DOI: 10.3390/brainsci14050483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 04/23/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Despite the availability of pharmacotherapy and psychotherapy for treating obsessive-compulsive disorder (OCD), alternative approaches need to be explored due to the high likelihood of treatment resistance. Neuronavigated 20 Hz theta burst stimulation (TBS-20 Hz), targeting the bilateral dorsolateral prefrontal cortex (DLPFC) augmented with the right orbitofrontal cortex (ROFC), was tested for treating OCD comorbid with depression and anxiety disorders. METHODS A retrospective chart review was performed on fourteen patients treated for moderate-to-severe OCD in a private outpatient clinic. Twelve patients had comorbid major depressive disorder (MDD), and thirteen patients had either generalized anxiety disorder (GAD) or panic disorder (PD). Patients completed the Y-BOCS-SR, BDI-II, and BAI rating scales weekly, which were used to measure the changes in OCD, depression, and anxiety symptoms, respectively. RESULTS Neuronavigated TBS-20 Hz was sequentially applied to the right DLPFC (RDLPFC), left DLPFC (LDLPFC), and ROFC. A total of 64% (9/14) of patients achieved remission from OCD (Y-BOCS-SR ≤ 14) in an average of 6.1 weeks of treatment (SD = 4.0). A total of 58% (7/12) of patients remitted from MDD (BDI < 13) in an average of 4.1 weeks (SD = 2.8), and 62% (8/13) of patients remitted from GAD/PD (BAI < 8) in an average of 4.3 weeks (SD = 2.5). CONCLUSIONS The neuronavigated TBS-20 Hz sequential stimulation of RDLPFC and LDLPFC, followed by ROFC, significantly reduced OCD, MDD, and GAD/PD symptoms. Randomized sham controls are warranted to validate these results.
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Carraro E, Greco LC, Lizio A, Beretta M, Pozzi S, Casiraghi J, Becchiati S, Beshiri F, Frisoni MC, Iossa F, Heatwole C, Sansone V. The facioscapulohumeral muscular dystrophy - health index: Italian validation of a disease-specific measure of symptomatic burden. Disabil Rehabil 2024; 46:2130-2137. [PMID: 37194629 DOI: 10.1080/09638288.2023.2212181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 05/05/2023] [Indexed: 05/18/2023]
Abstract
PURPOSE The aim of this study was to adapt the Facioscapulohumeral Muscular Dystrophy - Health Index (FSHD-HI) to an Italian population affected by FSHD by translating, validating, and testing this instrument in an Italian cohort. MATERIALS AND METHODS Italian FSHD patients were interviewed regarding the form and content of the translated instrument. Subsequently, forty FSHD patients were recruited to test the reliability (Intraclass Correlation Coefficient, ICC for test-retest; and Cronbach's Alpha for Internal consistency), known groups (Mann-Whitney U test and Area Under the Curve, AUC) and concurrent validity (Pearson's and Spearman's Rank Correlation Coefficient) of the instrument by serially completing the FSHD-HI and an extensive set of tests measuring the neuromotor, psychological and cognitive functions, and perceived quality of life (QoL) aspects. RESULTS The Italian translation of the FSHD-HI and its subscales were highly relevant to patients, had a high internal consistency (Cronbach's Alpha = 0.90), optimal test-retest reliability (ICC= 0.95), and was significantly associated with motor function, respiratory function, and QoL assessments. CONCLUSIONS Overall, the Italian FSHD-HI is a valid and well-suited measurement of the multi-dimensional aspects of disease burden in FSHD patients.
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Affiliation(s)
- Elena Carraro
- The NEMO Clinical Center (NEuroMuscular Omnicenter - Fondazione Serena Onlus), Milan, Italy
| | - Lucia Catherine Greco
- The NEMO Clinical Center (NEuroMuscular Omnicenter - Fondazione Serena Onlus), Milan, Italy
- NeMO Lab, ASST Niguarda Cà Granda Hospital, Milan, Italy
| | - Andrea Lizio
- The NEMO Clinical Center (NEuroMuscular Omnicenter - Fondazione Serena Onlus), Milan, Italy
| | - Maria Beretta
- The NEMO Clinical Center (NEuroMuscular Omnicenter - Fondazione Serena Onlus), Milan, Italy
| | - Susanna Pozzi
- The NEMO Clinical Center (NEuroMuscular Omnicenter - Fondazione Serena Onlus), Milan, Italy
| | - Jacopo Casiraghi
- The NEMO Clinical Center (NEuroMuscular Omnicenter - Fondazione Serena Onlus), Milan, Italy
| | - Stefano Becchiati
- The NEMO Clinical Center (NEuroMuscular Omnicenter - Fondazione Serena Onlus), Milan, Italy
| | - Fatmira Beshiri
- The NEMO Clinical Center (NEuroMuscular Omnicenter - Fondazione Serena Onlus), Milan, Italy
| | - Maria Chiara Frisoni
- The NEMO Clinical Center (NEuroMuscular Omnicenter - Fondazione Serena Onlus), Milan, Italy
| | - Felicia Iossa
- The NEMO Clinical Center (NEuroMuscular Omnicenter - Fondazione Serena Onlus), Milan, Italy
| | - Chad Heatwole
- Department of Neurology, The University of Rochester Medical Center, Rochester, NY, USA
- The Center for Health and Technology, Rochester, New York, USA
| | - Valeria Sansone
- The NEMO Clinical Center (NEuroMuscular Omnicenter - Fondazione Serena Onlus), Milan, Italy
- Dept. Biomedical Sciences for Health, University of Milan, Italy
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Sayili U, Siddikoglu E, Turgut D, Arisli HE, Ceyhan B, Gunver MG, Ozel Yildiz S, Yurtseven E, Erginoz E. Does categorizing scale scores with cutoff points affect hypothesis-testing results? DISCOVER MENTAL HEALTH 2024; 4:14. [PMID: 38649587 PMCID: PMC11035512 DOI: 10.1007/s44192-024-00067-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 04/18/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND The aim of this study is to evaluate the hypothesis test results after categorizing the scale scores with cut-off points and to assess whether similar results would be obtained in that best represent the categories. METHODS This cross-sectional study was conducted between March 15 and 20, 2023 via the Lime Survey. The questionnaire included questions about the sociodemographic and life characteristics of the participants and the Beck Depression Inventory II (BDI-II). Four groups (minimal, mild, moderate, severe depression) were formed using the cutoff points. Data analysis was performed with all participants and referred to as the conventional analysis group. Then, six subanalysis groups were determined to best represent the groups formed according to the BDI-II. In each BDI-II category, six subanalysis groups were created, including those between Q1-Q3 (IQR group), including those within ± 1 std, including those between 5p-95p (90% of the sample), including those between 2.5p-97.5p (95% of the sample). In addition, 100 different samples were randomly selected containing 50% of each group. RESULTS Of the 1950 participants, 84.7% (n = 1652) were female and 15.3% (n = 298) were male. In terms of depression, it was observed that the significance varied in the analysis groups for sex (p = 0.039), medication use (p = 0.009) and age (p = 0.010) variables. However, these variables were not significant in some of the subanalysis groups. On the other hand, a p < 0.001 value was obtained for income, physical activity, health perception, body shape perception, life satisfaction, and quality of life variables in terms of depression in the conventional analysis group, and it was seen that the significance continued in all subanalysis groups. CONCLUSIONS Our findings showed that variables with p < 0.001 in the conventional analysis group maintained their significance in the other analysis groups. In addition, as the p value got closer to 0.05, we observed that the significance changed according to different cutoff points in the analysis groups. In addition, 50% randomly selected samples support these results. At the end of our study, we reached results that support the necessity of secondary tests in the evaluation of scales. Although further studies are needed, we anticipate that our study will shed light on other studies.
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Affiliation(s)
- Ugurcan Sayili
- Department of Biostatistics, Institute of Graduate Studies in Health Sciences, Istanbul University, Istanbul, Türkiye.
- Department of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Türkiye.
| | - Esin Siddikoglu
- Department of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Deniz Turgut
- Department of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Hamza Emre Arisli
- Department of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Betul Ceyhan
- Department of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Mehmet Guven Gunver
- Department of Biostatistics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye
| | - Sevda Ozel Yildiz
- Department of Biostatistics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye
| | - Eray Yurtseven
- Department of Biostatistics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye
| | - Ethem Erginoz
- Department of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Türkiye
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Velescu DR, Marc MS, Traila D, Pescaru CC, Hogea P, Suppini N, Crisan AF, Wellmann N, Oancea C. A Narrative Review of Self-Reported Scales to Evaluate Depression and Anxiety Symptoms in Adult Obstructive Sleep Apnea Patients. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:261. [PMID: 38399548 PMCID: PMC10889932 DOI: 10.3390/medicina60020261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 01/14/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: Obstructive sleep apnea (OSA) is a prevalent chronic condition that has been associated with mental disorders like depression and anxiety. This study intends to provide a practical overview of the most relevant self-reported and self-rating scales that assess depression and anxiety in OSA patients. Materials and Methods: A search for articles was performed using PubMed, Google Scholar, and Semantic Scholar using a combination of words for obstructive sleep apnea, depression, anxiety, and scales. The tools were ordered by type (screening and rating) and arranged chronologically according to the year of publication. Results: Three scales were identified for assessing depression, which were the Center for Epidemiologic Studies Depression Scale (CES-D), the Hospital Anxiety and Depression Scale (HADS-D), and the Patient Health Questionnaire-9 (PHQ-9). For rating depression, two scales were discussed: the Zung Self-Rating Depression Scale (SDS) and the Beck Depression Inventory (BDI), which has three versions (the BDI, the BDI-II, and the Fast Screen (BDI-FS)). For assessing anxiety, the Generalized Anxiety Disorder-7 (GAD-7) scale was identified. Two scales were reviewed for rating anxiety: the State-Trait Anxiety Inventory (STAI) and the Beck Anxiety Inventory (BAI). Each scale is accompanied by a brief description of its practicality and psychometric qualities and an analysis of its strengths and limitations. Conclusions: The findings of this review will contribute to the understanding of the importance of assessing mental health comorbidities in the context of OSA, ultimately guiding clinical practice and future research in this area.
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Affiliation(s)
- Diana Raluca Velescu
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (D.R.V.); (D.T.); (C.C.P.); (P.H.); (N.S.); (A.F.C.); (C.O.)
- Department of Infectious Diseases, Discipline of Pulmonology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Monica Steluta Marc
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (D.R.V.); (D.T.); (C.C.P.); (P.H.); (N.S.); (A.F.C.); (C.O.)
- Department of Infectious Diseases, Discipline of Pulmonology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Daniel Traila
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (D.R.V.); (D.T.); (C.C.P.); (P.H.); (N.S.); (A.F.C.); (C.O.)
- Department of Infectious Diseases, Discipline of Pulmonology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Camelia Corina Pescaru
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (D.R.V.); (D.T.); (C.C.P.); (P.H.); (N.S.); (A.F.C.); (C.O.)
- Department of Infectious Diseases, Discipline of Pulmonology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Patricia Hogea
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (D.R.V.); (D.T.); (C.C.P.); (P.H.); (N.S.); (A.F.C.); (C.O.)
- Department of Infectious Diseases, Discipline of Pulmonology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Noemi Suppini
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (D.R.V.); (D.T.); (C.C.P.); (P.H.); (N.S.); (A.F.C.); (C.O.)
- Department of Infectious Diseases, Discipline of Pulmonology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Alexandru Florian Crisan
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (D.R.V.); (D.T.); (C.C.P.); (P.H.); (N.S.); (A.F.C.); (C.O.)
- Research Center for the Assessment of Human Motion, Functionality and Disability (CEMFD), “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Norbert Wellmann
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Cristian Oancea
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (D.R.V.); (D.T.); (C.C.P.); (P.H.); (N.S.); (A.F.C.); (C.O.)
- Department of Infectious Diseases, Discipline of Pulmonology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
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D’Souza RS, Gupta M, Abd-Elsayed A. Measuring outcomes. SPINAL FUSION TECHNIQUES 2024:71-75. [DOI: 10.1016/b978-0-323-88223-1.00017-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Komorniak N, Kaczmarczyk M, Łoniewski I, Martynova-Van Kley A, Nalian A, Wroński M, Kaseja K, Kowalewski B, Folwarski M, Stachowska E. Analysis of the Efficacy of Diet and Short-Term Probiotic Intervention on Depressive Symptoms in Patients after Bariatric Surgery: A Randomized Double-Blind Placebo Controlled Pilot Study. Nutrients 2023; 15:4905. [PMID: 38068763 PMCID: PMC10707788 DOI: 10.3390/nu15234905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/04/2023] [Accepted: 11/08/2023] [Indexed: 12/18/2023] Open
Abstract
(1) Background: studies have shown that some patients experience mental deterioration after bariatric surgery. (2) Methods: We examined whether the use of probiotics and improved eating habits can improve the mental health of people who suffered from mood disorders after bariatric surgery. We also analyzed patients' mental states, eating habits and microbiota. (3) Results: Depressive symptoms were observed in 45% of 200 bariatric patients. After 5 weeks, we noted an improvement in patients' mental functioning (reduction in BDI and HRSD), but it was not related to the probiotic used. The consumption of vegetables and whole grain cereals increased (DQI-I adequacy), the consumption of simple sugars and SFA decreased (moderation DQI-I), and the consumption of monounsaturated fatty acids increased it. In the feces of patients after RYGB, there was a significantly higher abundance of two members of the Muribaculaceae family, namely Veillonella and Roseburia, while those after SG had more Christensenellaceae R-7 group, Subdoligranulum, Oscillibacter, and UCG-005. (4) Conclusions: the noted differences in the composition of the gut microbiota (RYGB vs. SG) may be one of the determinants of the proper functioning of the gut-brain microbiota axis, although there is currently a need for further research into this topic using a larger group of patients and different probiotic doses.
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Affiliation(s)
- Natalia Komorniak
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 71-460 Szczecin, Poland;
| | - Mariusz Kaczmarczyk
- Sanprobi sp. z o.o. sp. k., Kurza Stopka 5/C, 70-535 Szczecin, Poland; (M.K.); (I.Ł.)
| | - Igor Łoniewski
- Sanprobi sp. z o.o. sp. k., Kurza Stopka 5/C, 70-535 Szczecin, Poland; (M.K.); (I.Ł.)
- Department of Biochemical Science, Pomeranian Medical University in Szczecin, 71-460 Szczecin, Poland
| | | | - Armen Nalian
- Department of Biology, Stephen F. Austin State University, Nacogdoches, TX 75962, USA; (A.M.-V.K.); (A.N.)
| | - Michał Wroński
- Department of Psychiatry, Pomeranian Medical University in Szczecin, 71-460 Szczecin, Poland;
| | - Krzysztof Kaseja
- Department of General Surgery and Transplantation, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland;
| | - Bartosz Kowalewski
- Independent Provincial Public Hospital Complex in Szczecin-Zdunowo, 70-891 Szczecin, Poland;
| | - Marcin Folwarski
- Division of Clinical Nutrition and Dietetics, Medical University of Gdańsk, 80-211 Gdańsk, Poland;
| | - Ewa Stachowska
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 71-460 Szczecin, Poland;
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Naser Moghadasi A, Ashtari F, Baghbanian SM, Shaygannejad V, Anjidani N, Ghadiri F, Sedighi B, Saeidi M, Amirifard H, Ayromlou H, Beladi Moghadam N, Ranjbar MB, Nazeri M, Niknam Z, Faraji F, Afsorde A, Sahraian MA. Safety and Effectiveness of Cinnomer ® on Disease Characteristics, Depression, and Quality of Life of Patients with Multiple Sclerosis: A Phase IV, Post-marketing, Prospective, Multicenter Study. ARCHIVES OF IRANIAN MEDICINE 2023; 26:647-653. [PMID: 38310425 PMCID: PMC10864943 DOI: 10.34172/aim.2023.95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 09/19/2023] [Indexed: 02/05/2024]
Abstract
BACKGROUND Every patient diagnosed with definite multiple sclerosis (MS) should begin disease modifying therapies. Cinnomer® contains 40 mg glatiramer acetate (GA) and is available in prefilled syringes and autoinjector devices. METHODS A phase IV multicenter study was conducted to explore the safety and effectiveness of Cinnomer® in the treatment of MS. Study-related data were collected for 14 months. RESULTS Totally, 368 Iranian relapsing-remitting MS patients in nine cities were enrolled. The patients were either treatment naïve (n=191) or switchers (n=177). Cinnomer® treatment was associated with a significant reduction in annual relapse rate (ARR) (RR: 0.65, 95% CI: 0.43, 0.98). Final mean Expanded Disability Status Scale (EDSS) scores showed improvement from baseline (difference: -0.21, 95% confidence interval (CI): -0.34, -0.08). There was a significant decrease in gad-enhancing lesions during treatment (difference: -0.38, 95% CI: -0.64, -0.12). The mean score for the depression measure (21-item BDI-II questionnaire) significantly improved (difference: -2.39, 95% CI: -3.74, -1.03). There was a significant change in the "psychological well-being" dimension (P=0.02) (in line with BDI-II scores) and "rejection" MusiQoL dimensions (P=0.04). The adverse events documented throughout the study were not unexpected for GA and were principally not serious. CONCLUSION Safety measures were in line with the known profiles of GA. The results suggest that Cinnomer® is effective with respect to clinical outcomes and from the patient's perspective and in reducing MRI-measured MS activity.
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Affiliation(s)
- Abdorreza Naser Moghadasi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereshteh Ashtari
- Isfahan University of Medical sciences, Kashani Comprehensive MS Center, Isfahan, Iran
| | - Seyed Mohammad Baghbanian
- Multiple Sclerosis Fellowship, Neurology Department, Boualicina Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Vahid Shaygannejad
- Isfahan University of Medical sciences, Kashani Comprehensive MS Center, Isfahan, Iran
| | | | - Fereshteh Ghadiri
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnaz Sedighi
- Neurology Research Center, Kerman University of Medical Science, Kerman, Iran
| | - Morteza Saeidi
- Department of Neurology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamed Amirifard
- Department of Neurology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Hormoz Ayromlou
- Neurology Department, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nahid Beladi Moghadam
- Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Masoume Nazeri
- Clinical Neurology Research Center, Department of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Fardin Faraji
- Department of Neurology, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | | | - Mohammad Ali Sahraian
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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Liu J, Zhang X, Zhong Y, Liu X. The prevalence of depression, anxiety, and sleep disturbances in patients with neuromyelitis optica spectrum disorders (NMOSD): A systematic review and meta-analysis. Mult Scler Relat Disord 2023; 79:105007. [PMID: 37717305 DOI: 10.1016/j.msard.2023.105007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 09/02/2023] [Accepted: 09/11/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVE To estimate pooled prevalence of depression, anxiety, and sleep disturbances in neuromyelitis optica spectrum disorders (NMOSD) cases. METHODS Electronic database of PubMed (MEDLINE), the Cochrane Central Register of Controlled Trials (CENTRAL), Embase and Web of Science ware systematically searched to identify relevant studies published not later than June 10, 2022. Specifically, original articles that reported the prevalence of depression, anxiety and sleep disturbances were selected. All pooled prevalence and 95 % confidence intervals (CIs) were calculated using a random-effects model. Publication bias was examined using funnel plots, and sensitivity analysis was used to explore the stability of the pooled results. RESULTS A total of 31 studies involving 4213 participants were included in this review. The pooled prevalence of depression was 40 % (95 % CI: 32-49 %), the pooled prevalence of anxiety was 45 % (95 % CI: 24-66 %), and the pooled prevalence of sleeping disturbances was 55 % (95 % CI: 46-64 %). The depression and anxiety prevalence estimates varied based on different screening tools. CONCLUSIONS There is a high prevalence of depression, anxiety, and sleep disturbances among NMOSD. These findings underscore the importance of regular monitoring of psychological status in NMOSD as well as the need for preventive approaches, early diagnosis, and intervention to improve medical and psychosocial outcomes.
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Affiliation(s)
- Jianyi Liu
- The First People's Hospital of Changde City, Changde, China.
| | - Xiaobo Zhang
- The First People's Hospital of Changde City, Changde, China
| | - Yi Zhong
- The First People's Hospital of Changde City, Changde, China
| | - Xianglin Liu
- The First People's Hospital of Changde City, Changde, China.
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Kiani Z, Fakari FR, Hakimzadeh A, Hajian S, Fakari FR, Nasiri M. Prevalence of depression in infertile men: a systematic review and meta-analysis. BMC Public Health 2023; 23:1972. [PMID: 37821902 PMCID: PMC10568846 DOI: 10.1186/s12889-023-16865-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Generally, infertile men hide their depression, which can threaten their health and lower their quality of life. Given the role of depression and its impact on people's health, this systematic review and meta-analysis aimed to investigate the prevalence of depression in infertile men. METHODS This research is a systematic review and meta-analysis based on preferred reporting items for systematic reviews and meta-analyses (PRISMA). Using the keywords of "Depression", "Emotional Depression", "Infertility", "Prevalence", and "Epidemiology", all English language articles were searched in international databases (PubMed, Cochran library, Web of sciences, Scopus, Embase, PsyINFO, and Google scholar) by two reviewers independently and without considering the time limit until September 2022. Title, abstract, full text and quality of each study were evaluated by two reviewers independently using the Newcastle-Ottawa Scale checklist. The results were analyzed using programming language and R software, and I2 test and Egger's Test were used to check heterogeneity and publication bias, respectively. RESULTS Twenty-two studies were included in the systematic part of this study; and 8 different measurement tools were used to identify depression. Then, based on the possibility of meta-analysis, 18 studies were included in 4 subgroups. Given the heterogeneity of the articles, random effect model was used. The overall prevalence of depression in infertile men was 18.30%. The lowest and highest overall prevalence of depression in men was reported to be 14.04% and 23.63% in the Zung Self-Rating Depression Scale (ZDS) and the Depression Anxiety Stress Scales (DASS) tools, respectively. The overall prevalence of depression among infertile men was reported to be 18.55% and 16.75% using the Beck Depression Inventory (BDI) and the Hospital Anxiety and Depression Scale (HADS) tools, respectively. CONCLUSION Based on the findings of this study, the significant prevalence of depression in infertile men requires a specific attention and planning. The study revealed varying degrees of depression among infertile men, emphasizing the importance of assessing their mental health, specifically in terms of depression, during infertility treatments as a hidden variable. It is strongly recommended to develop training programs for health service providers to effectively utilize diagnostic tools in this particular field.
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Affiliation(s)
- Zahra Kiani
- Midwifery and Reproductive Health Research Center, ShahidBeheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Rashidi Fakari
- Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atena Hakimzadeh
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepideh Hajian
- Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzaneh Rashidi Fakari
- Department of Midwifery, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Malihe Nasiri
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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10
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Jung SH, Oh JS, Lee SY, Jeong HY. Cortical thickness of the rostral anterior cingulate gyrus is associated with frailty in patients with end-stage renal disease undergoing hemodialysis in Korea: a cross-sectional study. JOURNAL OF YEUNGNAM MEDICAL SCIENCE 2023; 40:381-387. [PMID: 37095687 PMCID: PMC10626304 DOI: 10.12701/jyms.2022.00941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/23/2023] [Accepted: 01/29/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND Frailty is defined as a condition of being weak and delicate, and it represents a state of high vulnerability to adverse health outcomes. Recent studies have suggested that the cingulate gyrus is associated with frailty in the elderly population. However, few imaging studies have explored the relationship between frailty and the cingulate gyrus in patients with end-stage renal disease (ESRD) undergoing hemodialysis. METHODS Eighteen right-handed patients with ESRD undergoing hemodialysis were enrolled in the study. We used the FreeSurfer software package to estimate the cortical thickness of the regions of interest, including the rostral anterior, caudal anterior, isthmus, and posterior cingulate gyri. The Beck Depression Inventory, Beck Anxiety Inventory, and laboratory tests were also conducted. RESULTS The cortical thickness of the right rostral anterior cingulate gyrus (ACG) was significantly correlated with the Fried frailty index, age, and creatinine level. Multiple regression analysis indicated that the cortical thickness of the right rostral ACG was associated with frailty after controlling for age and creatinine level. CONCLUSION Our results indicate that the cortical thickness of the rostral ACG may be associated with frailty in patients with ESRD on hemodialysis and that the rostral ACG may play a role in the frailty mechanism of this population.
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Affiliation(s)
- Sang Hyun Jung
- Division of Nephrology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Jong Soo Oh
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - So-Young Lee
- Division of Nephrology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Hye Yun Jeong
- Division of Nephrology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
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11
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Mar Htwe Z, Lae Phyu W, Zar Nyein Z, Aye Kyi A. Correlation between depression and perceived stigma among people living with epilepsy. Epilepsy Behav 2023; 146:109372. [PMID: 37542748 DOI: 10.1016/j.yebeh.2023.109372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 07/24/2023] [Accepted: 07/24/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND Epilepsy is characterized by recurrent seizures that happen in men and women of all ages. Comorbid depression is common with epilepsy due to its social stigma. This study aimed to describe the correlation between depression and perceived stigma among people living with epilepsy. METHODS It was a cross-sectional descriptive study conducted with 96 people with epilepsy using the convenience sampling method. Fisher's exact test was used to analyze the association between sociodemographic data, levels of depression, and perceived stigma. Pearson's correlation coefficient was used to analyze the relationship between depression and perceived stigma. RESULTS Twenty-three percent of respondents were found to be depressed, in that 16.7% were mildly depressed, 4.2% were moderately depressed, and 2.1% were severely depressed. Perceived stigma was found in 85.5%, of which 74% were moderately stigmatized and 11.5% were highly stigmatized. This study revealed a significant positive relationship between depression and perceived stigma (r = 0.21) at the p = 0.04 level. CONCLUSION It highlights the correlation between perceived stigma and depression; if the patients felt stigmatized by epilepsy, they had a higher chance of having depression. Healthcare providers need to strengthen awareness in society for stigma reduction and early recognition of comorbid depression.
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Affiliation(s)
- Zin Mar Htwe
- Department of Mental Health Nursing, University of Nursing (Yangon), Myanmar.
| | - Win Lae Phyu
- Department of Mental Health Nursing, University of Nursing (Yangon), Myanmar
| | - Zar Zar Nyein
- Department of Mental Health Nursing, University of Nursing (Yangon), Myanmar
| | - Aye Aye Kyi
- Department of Mental Health Nursing, University of Nursing (Yangon), Myanmar
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12
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Reutimann S, Milanovic D, Gulewitsch MD, Augsburger M. Preliminary validation of the Klenico diagnostic software self-report module through comparison with the diagnostic gold standard in an outpatient routine clinical sample. Health Psychol Behav Med 2023; 11:2244576. [PMID: 37663014 PMCID: PMC10469457 DOI: 10.1080/21642850.2023.2244576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/27/2023] [Indexed: 09/05/2023] Open
Abstract
Background Inaccuracy in current diagnostic procedures for mental disorders can lead to misdiagnosis and increase the burden on the healthcare system. Therefore, Klenico, a diagnostic software designed to support comprehensive and efficient clinical diagnostic procedures that is easy to apply in everyday clinical practice, was developed. This study aimed to take the first step toward validating the Klenico self-report module. Methods Data of 115 patients from a German psychotherapeutic outpatient clinic were included in this study. Criterion validity was tested by comparing Klenico with the diagnoses based on the structured clinical interview for DSM-IV (SCID). Construct validity was investigated by comparing Klenico with commonly used self-reporting questionnaires. Results The results showed that most of the Klenico disorder domains were able to differentiate between corresponding diagnoses and other diagnoses, confirming criterion validity. Construct validity was demonstrated by high correlations with the compared convergent questionnaire scales and non-significant or low correlations with most of the divergent scales. Conclusions These preliminary results demonstrate the psychometric properties of the Klenico self-report module and imply that the Klenico system has high potential to improve the accuracy of diagnostic procedures in everyday clinical practice.
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Affiliation(s)
- Stefan Reutimann
- Klenico Health AG, University of Zurich Startup, Zürich, Switzerland
| | - David Milanovic
- Klenico Health AG, University of Zurich Startup, Zürich, Switzerland
| | - Marco D. Gulewitsch
- Department of Psychology, Faculty of Science, University of Tübingen, Tübingen, Germany
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13
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Chaturvedi S, Yu J, Brown J, Wei A, Selvakumar S, Gerber GF, Moliterno AR, Streiff MB, Kraus P, Logue CM, Yui JC, Naik RP, Latif H, Lanzkron SM, Braunstein EM, Brodsky RA, Gottesman RF, Lin DD. Silent cerebral infarction during immune TTP remission: prevalence, predictors, and impact on cognition. Blood 2023; 142:325-335. [PMID: 37216688 PMCID: PMC10447499 DOI: 10.1182/blood.2023019663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/05/2023] [Accepted: 04/25/2023] [Indexed: 05/24/2023] Open
Abstract
Immune thrombotic thrombocytopenic purpura (iTTP) survivors have increased risk of cardiovascular disease, including strokes, and report persistent cognitive difficulties during remission. We conducted this prospective study involving iTTP survivors during clinical remission to determine the prevalence of silent cerebral infarction (SCI), defined as magnetic resonance imaging (MRI) evidence of brain infarction without corresponding overt neurodeficits. We also tested the hypothesis that SCI is associated with cognitive impairment, assessed using the National Institutes of Health ToolBox Cognition Battery. For cognitive assessments, we used fully corrected T scores adjusted for age, sex, race, and education. Based on the diagnostic and statistical manual 5 criteria, we defined mild and major cognitive impairment as T scores with a 1 or 2 standard deviation (SD) and >2 SD below the mean on at least 1 test, respectively. Forty-two patients were enrolled, with 36 completing MRIs. SCI was present in 50% of the patients (18), of which 8 (44.4%) had prior overt stroke including during acute iTTP. Patients with SCI had higher rates of cognitive impairment (66.7% vs 27.7%; P = .026), including major cognitive impairment (50% vs 5.6%; P = .010). In separate logistic regression models, SCI was associated with any (mild or major) cognitive impairment (odds ratio [OR] 10.5 [95% confidence interval (95% CI), 1.45-76.63]; P = .020) and major cognitive impairment (OR 7.98 [95% CI, 1.11-57.27]; P = .039) after adjusting for history of stroke and Beck depression inventory scores. MRI evidence of brain infarction is common in iTTP survivors; the strong association of SCI with impaired cognition suggests that these silent infarcts are neither silent nor innocuous.
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Affiliation(s)
- Shruti Chaturvedi
- Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jia Yu
- Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jenna Brown
- Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Aria Wei
- Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Sruthi Selvakumar
- Nova Southeastern University College of Allopathic Medicine, Davie, FL
| | - Gloria F. Gerber
- Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Alison R. Moliterno
- Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Michael B. Streiff
- Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Peggy Kraus
- Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Claire M. Logue
- Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jennifer C. Yui
- Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Rakhi P. Naik
- Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Hira Latif
- Division of Hematology and Oncology, MedStar Georgetown University Hospital Center, Washington, DC
| | - Sophie M. Lanzkron
- Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Evan M. Braunstein
- Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Robert A. Brodsky
- Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Rebecca F. Gottesman
- Stroke, Cognition and Neuroepidemiology Section, National Institute of Neurological Disease and Stroke Intramural Research Program, Bethesda, MD
| | - Doris D. Lin
- Division of Neuroradiology, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD
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14
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Huang FF, Chen WT, Shiu C, Yang JP, Zhao H. Relationships between spirituality and mental stress in people living with HIV in China: A cross-sectional study. Ment Health Relig Cult 2023; 26:276-289. [PMID: 37974904 PMCID: PMC10651058 DOI: 10.1080/13674676.2023.2219620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 05/24/2023] [Indexed: 11/19/2023]
Abstract
There are limited reports on the relationship between spirituality and mental stress in PLWH in China, who may be subject to anti-religious pressures from the government. In this study, we aimed to understand whether spirituality influences Chinese PLWH's mental stress and, if so, at what level. We recruited 200 PLWHs from Beijing's Ditan Hospital to complete a cross-sectional survey inquiring about their practice of spirituality as well as their level of mental stress. The study found that PLWH who presented with a mid-level of spirituality have the highest mental stress when compared to those who have a low level of spiritual beliefs or a high level of spiritual beliefs. This study points to the utility of healthcare providers taking PLWH's potential spirituality into consideration, perhaps in particular for those with a moderate level of spirituality, in order to provide the most comprehensive care possible.
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Affiliation(s)
- Fei Fei Huang
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Wei-Ti Chen
- School of Nursing, University of California Los Angeles, Los Angeles, CA, USA
| | - Chengshi Shiu
- National Taiwan University, Department of Social Work, Taipei, Taiwan
| | - Joyce P. Yang
- Department of Psychology, University of San Francisco, San Francisco, CA, USA
| | - Hongxin Zhao
- Beijing Ditan Hospital, Capital Medical University, Beijing, China
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15
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Cho LL, Jones AA, Gao C, Leonova O, Vila-Rodriguez F, Buchanan T, Lang DJ, MacEwan GW, Procyshyn RM, Panenka WJ, Barr AM, Thornton AE, Gicas KM, Honer WG, Barbic SP. Rasch analysis of the beck depression inventory in a homeless and precariously housed sample. Psychiatry Res 2023; 326:115331. [PMID: 37437487 DOI: 10.1016/j.psychres.2023.115331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 07/01/2023] [Accepted: 07/02/2023] [Indexed: 07/14/2023]
Abstract
The approach to analysis of and interpretation of findings from the Beck Depression Inventory (BDI), a self-report questionnaire, depends on sample characteristics. To extend work using conventional BDI scoring, the BDI's suitability in assessing symptom severity in a homeless and precariously housed sample was examined using Rasch analysis. Participants (n=478) recruited from an impoverished neighbourhood in Vancouver, Canada, completed the BDI. Rasch analysis using the partial credit model was done, and the structural validity, unidimensionality, and reliability of the BDI were studied. A receiver operating characteristic curve determined a Rasch cut-off score consistent with clinical depression, and Rasch scores were correlated with raw scores. Good fit to the Rasch model was observed after rescoring all items and removing Item 19 (Weight Loss), and unidimensionality and reliability were satisfactory. Item 9 (Suicidal Wishes) represented the most severe symptom. Rasch-based scores detected clinical depression with moderate sensitivity and specificity, and were positively correlated with conventional scores. The BDI in a community-based sample of homeless and precariously housed adults satisfied Rasch model expectations in a 20-item format, and is suitable for assessing symptom severity. Future research on depression in similar samples may reveal more information on using specific symptoms to determine clinical significance.
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Affiliation(s)
- Lianne L Cho
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; BC Mental Health and Substance Use Services Research Institute, Vancouver, British Columbia, Canada
| | - Andrea A Jones
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Chloe Gao
- Department of Occupational Science and Occupational Therapy, University of British Columbia, T325 - 2211 Wesbrook Mall, Vancouver, British Columbia, Canada
| | - Olga Leonova
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Fidel Vila-Rodriguez
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tari Buchanan
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Donna J Lang
- BC Mental Health and Substance Use Services Research Institute, Vancouver, British Columbia, Canada; Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - G William MacEwan
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ric M Procyshyn
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; BC Mental Health and Substance Use Services Research Institute, Vancouver, British Columbia, Canada
| | - William J Panenka
- BC Mental Health and Substance Use Services Research Institute, Vancouver, British Columbia, Canada; Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alasdair M Barr
- BC Mental Health and Substance Use Services Research Institute, Vancouver, British Columbia, Canada; Department of Anesthesia, Pharmacology & Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Allen E Thornton
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Kristina M Gicas
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - William G Honer
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; BC Mental Health and Substance Use Services Research Institute, Vancouver, British Columbia, Canada
| | - Skye P Barbic
- Department of Occupational Science and Occupational Therapy, University of British Columbia, T325 - 2211 Wesbrook Mall, Vancouver, British Columbia, Canada.
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do Nascimento RLF, Fajardo-Bullon F, Santos E, Landeira-Fernandez J, Anunciação L. Psychometric Properties and Cross-Cultural Invariance of the Beck Depression Inventory-II and Beck Anxiety Inventory among a Representative Sample of Spanish, Portuguese, and Brazilian Undergraduate Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6009. [PMID: 37297613 PMCID: PMC10252305 DOI: 10.3390/ijerph20116009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/08/2023] [Accepted: 05/18/2023] [Indexed: 06/12/2023]
Abstract
Clinical psychologists often use the Beck Depression Inventory, 2nd edition (BDI-II), and Beck Anxiety Inventory (BAI) to aid in the diagnosis of mental health issues and verify the effectiveness of treatments. Despite this common practice, studies that implement a cross-cultural design to check psychometric properties and the invariance of these scales are still scarce in the literature, which can lead to biased results that prevent comparisons among different groups. The present study investigated the internal structure of both tools and their level of invariance. From a representative sample of undergraduate students from Spain (n = 1216), Portugal (n = 426), and Brazil (n = 315), Confirmatory Factor Analysis and Multigroup Confirmatory Factor Analysis were performed. The results revealed suitable fit indices for the two-factor structure of the BDI-II and BAI, assessed by Confirmatory Factor Analysis procedures. Additionally, the two-factor model of the BDI-II reached invariant properties at three levels, whereas the structural model of the BAI did not. Altogether, these results suggest using the BDI-II in this group in these three countries and imply that BAI scores should be interpreted cautiously.
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Affiliation(s)
| | - Fernando Fajardo-Bullon
- Department of Psychology, Faculty of Education and Psychology, University of Extremadura, 06006 Badajoz, Spain
| | - Eduardo Santos
- Department of Psychology, Faculty of Psychology and Educational Sciences, University of Coimbra, 3004-531 Coimbra, Portugal
| | - J. Landeira-Fernandez
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro 22453-900, Brazil
| | - Luis Anunciação
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro 22453-900, Brazil
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17
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Askaryzadeh Mahani M, Ghasemi M, Arab M, Baniasadi Z, Omidi A, Irani PS. The correlation between caregiver burden with depression and quality of life among informal caregivers of hemodialysis and thalassemia patients during the COVID-19 pandemic: a cross-sectional study. BMC Nurs 2023; 22:183. [PMID: 37246222 DOI: 10.1186/s12912-023-01351-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/23/2023] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Lifelong provision of care to chronically ill patients increase the risk of physical and mental diseases in informal caregivers and adversely affects their quality of life. The present study examined the correlation between caregiver burden, depression, and quality of life among the informal caregivers of thalassemia and hemodialysis patients during the COVID-19 pandemic in southeastern Iran. METHODS This cross-sectional correlational study used convenience sampling to select 200 informal caregivers involved in providing direct care for patients undergoing hemodialysis (n = 70) and patients with thalassemia (130) for at least 6 months. A demographic questionnaire, Beck's Depression Inventory (BDI), the Quality-Of-Life Questionnaire (SF-36), and the Zarit Burden Interview were used to collect data in 2021. The data were analyzed with SPSS software (version 19) using frequency, percentage, independent samples t-test, ANOVA, and multivariate regression analysis. RESULTS Most of the informal caregivers of the thalassemia and hemodialysis patients (58% and 43%) reported moderate levels of caregiver burden. There were significant correlations between the caregiver burden and depression (P < 0.0001) and between the caregiver burden and the quality of life (P < 0.009). The level of depression in informal caregivers of patients undergoing hemodialysis was higher than that of the informal caregivers of patients with thalassemia, but the quality of life in the informal caregivers of the patient's undergoing hemodialysis was higher than that of the informal caregivers of the patients with thalassemia. CONCLUSION Considering the significant correlations between caregiver burden, depression, and quality of life in this study, healthcare providers are recommended to develop educational and supportive interventions to meet informal caregivers' needs, mitigate their emotional distress, fears, and concerns, and prevent caregiver burden in times of greater uncertainty.
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Affiliation(s)
- Maryam Askaryzadeh Mahani
- Student Research Committee, Razi faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.
| | | | | | | | - Ali Omidi
- School of Nursing ad Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parichehr Sabaghzadeh Irani
- Student Research Committee, Razi faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
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Sousa-Santos N, Fialho M, Madeira T, Clara C, Veiga S, Martins R, Barros N, Santos G, Santos O, Almeida C, Ganança L, Campos RC, Camolas J, da Silva AP, Guarino MPS, Heitor MJ. Nutritional counselling in adults promoting adherence to the Mediterranean diet as adjuvant in the treatment of major depressive disorder (INDEPT): a randomized open controlled trial study protocol. BMC Psychiatry 2023; 23:227. [PMID: 37016319 PMCID: PMC10074649 DOI: 10.1186/s12888-023-04705-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 03/21/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Major Depressive Disorder (MDD) is a leading cause of disability worldwide. Approximately one-third of patients with MDD do not respond to treatment, and often exhibit elevated inflammation biomarkers, which are associated with worse prognosis. Previous research has linked healthier dietary patterns, such as the Mediterranean Diet (MedDiet), with a lower risk of MDD and symptoms of depression, potentially due to their anti-inflammatory properties. The aim of this study is to evaluate the effectiveness of a nutritional counselling intervention promoting MedDiet to alleviate symptoms of depression in adults recently diagnosed with MDD and presenting with elevated inflammation biomarkers. METHODS This study is a randomized controlled trial (RCT) that will recruit adults from outpatient clinics, between the ages of 18 and 70 years who have been diagnosed with MDD and are currently receiving treatment with the first prescribed antidepressant, and who exhibit elevated inflammation biomarkers (interleukin-6 and/or C-reactive protein). The control group will receive treatment-as-usual (TAU) only. The primary outcome of the study will be the change in symptoms of depression, as measured by the Beck Depression Inventory 2 (BDI-II), after 12 weeks of intervention. Data analysis will follow an intention-to-treat approach. Secondary outcomes will include changes in inflammation biomarkers, quality of life, adherence to the MedDiet, and cost-effectiveness of nutritional counselling. All outcomes will be assessed at baseline, after the 12-week intervention, and at 6- and 12-months post-baseline. DISCUSSION This study will be the first RCT to evaluate the effect of a nutritional intervention with anti-inflammatory properties, as an adjuvant in the treatment of MDD, in individuals diagnosed with MDD and elevated inflammation biomarkers. The results of this study may contribute to the development of more effective and personalized interventions for MDD patients with elevated inflammation biomarkers.
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Affiliation(s)
- Nuno Sousa-Santos
- Center for Innovative Care and Health Technology (ciTechcare), Instituto Politécnico, Leiria - R. de Santo André, Leiria, 2410, Portugal.
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa - Av, Lisboa, 1649-028, Portugal.
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, Av. Professor Egas Moniz, Lisboa, 1649-028, Portugal.
| | - Mónica Fialho
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa - Av, Lisboa, 1649-028, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, Av. Professor Egas Moniz, Lisboa, 1649-028, Portugal
| | - Teresa Madeira
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa - Av, Lisboa, 1649-028, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, Av. Professor Egas Moniz, Lisboa, 1649-028, Portugal
- Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Edifício Egas Moniz, ala C, piso 2, Lisboa, 1649-028, Portugal
| | - Cátia Clara
- Center for Innovative Care and Health Technology (ciTechcare), Instituto Politécnico, Leiria - R. de Santo André, Leiria, 2410, Portugal
| | - Sofia Veiga
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa - Av, Lisboa, 1649-028, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, Av. Professor Egas Moniz, Lisboa, 1649-028, Portugal
| | - Raquel Martins
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa - Av, Lisboa, 1649-028, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, Av. Professor Egas Moniz, Lisboa, 1649-028, Portugal
| | - Neuza Barros
- Center for Innovative Care and Health Technology (ciTechcare), Instituto Politécnico, Leiria - R. de Santo André, Leiria, 2410, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa - Av, Lisboa, 1649-028, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, Av. Professor Egas Moniz, Lisboa, 1649-028, Portugal
| | - Gabriela Santos
- Center for Innovative Care and Health Technology (ciTechcare), Instituto Politécnico, Leiria - R. de Santo André, Leiria, 2410, Portugal
| | - Osvaldo Santos
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa - Av, Lisboa, 1649-028, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, Av. Professor Egas Moniz, Lisboa, 1649-028, Portugal
| | - Carolina Almeida
- Serviço de Psiquiatria e Saúde Mental, Centro Hospitalar de Leiria - Hospital de Santo André, R. de Santo André, Leiria, 2410-197, Portugal
| | - Licínia Ganança
- Departamento de Psiquiatria e Saúde Mental, Clínica Universitária de Psiquiatria e Psicologia Médica, Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal
| | - Rui C Campos
- Comprehensive Health Research Center, Department of Psychology, School of Social Sciences, University of Évora, Évora, Portugal
| | - José Camolas
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa - Av, Lisboa, 1649-028, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, Av. Professor Egas Moniz, Lisboa, 1649-028, Portugal
- Centro Hospitalar Universitário Lisboa Norte, EPE, Hospital de Santa Maria, Av. Prof. Egas Moniz MB, Lisboa, 1649-028, Portugal
- Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Edifício Egas Moniz, ala C, piso 2, Lisboa, 1649-028, Portugal
- Faculdade de Medicina da Universidade Católica Portuguesa - Estr. Octávio Pato, Rio de Mouro, Sintra, 2635-631, Portugal
| | - Alda Pereira da Silva
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa - Av, Lisboa, 1649-028, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, Av. Professor Egas Moniz, Lisboa, 1649-028, Portugal
- Clínica Universitária de Medicina Geral e Familiar, Faculdade Medicina Universidade de Lisboa, Av. Prof. Egas Moniz MB, Lisboa, 1649-028, Portugal
| | - Maria Pedro Sucena Guarino
- Center for Innovative Care and Health Technology (ciTechcare), Instituto Politécnico, Leiria - R. de Santo André, Leiria, 2410, Portugal
| | - Maria João Heitor
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa - Av, Lisboa, 1649-028, Portugal
- Faculdade de Medicina da Universidade Católica Portuguesa - Estr. Octávio Pato, Rio de Mouro, Sintra, 2635-631, Portugal
- Departamento de Psiquiatria e Saúde Mental, Hospital Beatriz Ângelo, Av. Carlos Teixeira 3, Loures, 2674-514, Portugal
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Criterion and construct validity of the Beck Depression Inventory (BDI-II) to measure depression in patients with cancer: The contribution of somatic items. Int J Clin Health Psychol 2023; 23:100350. [DOI: 10.1016/j.ijchp.2022.100350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 10/25/2022] [Indexed: 11/27/2022] Open
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The moderating roles of self-efficacy and depression in dual-task walking in multiple sclerosis: A test of self-awareness theory. J Int Neuropsychol Soc 2023; 29:274-282. [PMID: 35465869 DOI: 10.1017/s1355617722000200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Multiple sclerosis (MS) is a debilitating neurological disease associated with a variety of psychological, cognitive, and motoric symptoms. Walking is among the most important functions compromised by MS. Dual-task walking (DTW), an everyday activity in which people walk and engage in a concurrent, discrete task, has been assessed in MS, but little is known about how it relates to other MS symptoms. Self-awareness theory suggests that DTW may be a function of the interactions among psychological, cognitive, and motor processes. METHOD Cognitive testing, self-report assessments for depression and falls self-efficacy (FSE), and walk evaluations [DTW and single-task walk (STW)] were assessed in seventy-three people with MS in a clinical care setting. Specifically, we assessed whether psychological factors (depression and FSE) that alter subjective evaluations regarding one's abilities would moderate the relationships between physical and cognitive abilities and DTW performance. RESULTS DTW speed is related to diverse physical and cognitive predictors. In support of self-awareness theory, FSE moderated the relationship between STW and DTW speeds such that lower FSE attenuated the strength of the relationship between them. DTW costs - the change in speed normalized by STW speed - did not relate to cognitive and motor predictors. DTW costs did relate to depressive symptoms, and depressive symptoms moderated the effect of information processing on DTW costs. CONCLUSIONS Findings indicate that an interplay of physical ability and psychological factors - like depression and FSE - may enhance understanding of walking performance under complex, real-world, DTW contexts.
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21
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[Recommendations for individual comorbidity risk assessment in adult patients with psoriasis]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2023; 74:350-355. [PMID: 36811642 PMCID: PMC10169877 DOI: 10.1007/s00105-023-05116-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/20/2023] [Indexed: 02/24/2023]
Abstract
It has long been known that chronic inflammatory systemic diseases, such as psoriasis, pose a high risk of developing comorbidities. In everyday clinical practice, it is therefore of particular importance to identify patients who have an individually increased risk profile. In patients with psoriasis, the comorbidity patterns "metabolic syndrome", "cardiovascular comorbidity" and "mental illness" were identified as particularly relevant in epidemiological studies depending on the duration and severity of the disease. In the everyday care of patients with psoriasis in dermatological practice, the use of an interdisciplinary checklist for risk analysis and the initiation of professional follow-up care has proven valuable. On the basis of an existing checklist, the contents were critically evaluated by an interdisciplinary group of experts and a guideline-oriented update was prepared. In the opinion of the authors, the new analysis sheet represents a practicable, factually focused and updated tool for comorbidity risk assessment in patients with moderate and severe psoriasis.
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22
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Jacobson MM, Gardner AM, Handley CE, Smith MW, Christensen WF, Hancock CR, Joseph PV, Larson MJ, Martin CK, LeCheminant JD. Body shape perception in men and women without obesity during caloric restriction: a secondary analysis from the CALERIE study. Eat Weight Disord 2023; 28:20. [PMID: 36805838 PMCID: PMC9941245 DOI: 10.1007/s40519-023-01548-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 02/02/2023] [Indexed: 02/23/2023] Open
Abstract
OBJECTIVE To examine body shape perception in 218 adults without obesity or history of eating disorders during caloric restriction (CR). METHODS Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE) is a 2-year, randomized clinical trial using a 2:1 assignment (CR, 25% reduction in calories; Control, typical diet). For this secondary analysis, we examined perceived body shape using the Body Shape Questionnaire (BSQ). Analyses of BSQ scores are reported by group, over time, by sex, and by BMI. Data for body fat percentage, symptoms of depression, food cravings, maximal oxygen consumption, and stress were analyzed for their association with BSQ scores. RESULTS Compared to control, CR reduced BSQ scores. Women tended to have greater concern with body shape than men across all measurement times. There was no difference in change in BSQ scores at 12 or 24 months between those with a BMI < 25 kg/m2 or ≥ 25 kg/m2. Change in body fat percentage was most correlated with change in BSQ score from 0 to 12 (r = 0.39) and 0-24 months (r = 0.38). For change in BSQ score, Akaike/ Bayesian information criterion (AIC/BIC) found that the model of best fit included the following three change predictors: change in body fat percentage, depression symptoms, and food cravings. For 0-12 months, AIC/BIC = 1482.0/1505.6 and for 0-24 months AIC/BIC = 1364.8/1386.5. CONCLUSIONS CR is associated with reduced concern for body shape in men and women without obesity and with no history of eating disorders. Body shape perception among this sample was complex and influenced by multiple factors. LEVEL OF EVIDENCE Level I, randomized controlled trial.
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Affiliation(s)
- Maci M Jacobson
- Department of Neuroscience and Psychiatry, University of Utah, 383 Colorow Drive, Salt Lake City, UT, 84108, USA.
| | - Alexis M Gardner
- Department of Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, UT, 84602, USA
| | - Camilla E Handley
- Department of Statistics, Brigham Young University, Provo, UT, 84602, USA
| | - Michael W Smith
- Department of Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, UT, 84602, USA
| | | | - Chad R Hancock
- Department of Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, UT, 84602, USA
| | - Paule V Joseph
- Division of Intramural Research, National Institute of Alcohol Abuse and Alcoholism and National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Michael J Larson
- Department of Psychology and Neuroscience Center, Brigham Young University, Provo, UT, 84602, USA
| | - Corby K Martin
- Pennington Biomedical Research Center, Baton Rouge, LA, 70808, USA
| | - James D LeCheminant
- Department of Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, UT, 84602, USA
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Zhang W, Sun T, Wang S, Zhang J, Yang M, Li Z. Influence of preoperative depression on clinical outcomes after cervical laminoplasty: A retrospective study. Front Surg 2023; 9:1098043. [PMID: 36700019 PMCID: PMC9869422 DOI: 10.3389/fsurg.2022.1098043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 12/14/2022] [Indexed: 01/11/2023] Open
Abstract
Background Depression is a highly prevalent mental disorder, and we found that patients with preoperative depression had worse postoperative improvement in lumbar fusion. Are mental factors related to the prognosis of laminoplasty? Objective To analyze the relationship between depression and clinical outcomes after laminoplasty for the treatment of multilevel CSM. Methods In this retrospective study, 115 patients with multilevel cervical spondylotic myelopathy (CSM), who underwent laminoplasty and were followed up for more than 1 year, were enrolled in this study from October 2018 to October 2021. Patients with the scores of 21-item Beck Depression Inventory (BDI) ≥ 15 or Hamilton Depression Scale-24 (HAMD-24) > 20 were included in the depression group. The clinical outcomes were evaluated by the changes and recovery rate (RR) of Japanese Orthopaedic Association Scores (JOA) and Neck Disability Index (NDI) respectively. Univariate and multiple linear regression analyses were performed to reveal the relationship between preoperative depressive states and clinical outcomes. Results Fourteen patients were diagnosed with depression by BDI and twenty-nine by HAMD-24. Between the depression group and the non-depression group, the age, gender, smoking history, and duration of symptoms were statistically significant (P < 0.05). Multiple linear regression showed that the BDI scores had a negative relationship with the changes and RR of JOA and NDI, and the HAMD-24 scores had a negative relationship with the changes and RR of JOA. Conclusions Preoperative depression in patients with multilevel CSM can lead to worse prognosis. In order to improve the curative effect of the operation, we should pay attention to the psychological state monitoring and intervention of patients before they receive laminoplasty.
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Affiliation(s)
- Wentao Zhang
- Department of Orthopaedics, First Affiliated Hospital of Dalian Medical University, Dalian, China.,Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopaedic Diseases, Dalian, China
| | - Tianze Sun
- Department of Orthopaedics, First Affiliated Hospital of Dalian Medical University, Dalian, China.,Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopaedic Diseases, Dalian, China
| | - Shiyuan Wang
- Department of Medical Engineering, The 967th Hospital of Chinese People's Liberation Army, Dalian, China
| | - Jing Zhang
- Department of Orthopaedics, First Affiliated Hospital of Dalian Medical University, Dalian, China.,Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopaedic Diseases, Dalian, China
| | - Ming Yang
- Department of Orthopedics, Southwest Hospital, Army Medical University, Chongqing, China
| | - Zhonghai Li
- Department of Orthopaedics, First Affiliated Hospital of Dalian Medical University, Dalian, China.,Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopaedic Diseases, Dalian, China
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The efficacy of therapist-supported acceptance and commitment therapy-based bibliotherapy for psychological distress after stroke: a single-case multiple-baseline study. Behav Cogn Psychother 2023; 51:87-104. [PMID: 36214628 DOI: 10.1017/s135246582200042x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Psychological distress is common after stroke, and affects recovery. However, there are few evidence-based psychological treatments. This study evaluates a bibliotherapy-based approach to its amelioration. AIMS To investigate a stroke-specific self-management book, based on acceptance and commitment therapy (ACT), as a therapist-supported intervention for psychological distress after stroke. METHOD The design was a single case, randomised non-concurrent multiple-baseline design (MBD). Sixteen stroke survivors, eight males and eight females (mean age 60.6 years), participated in an MBD with three phases: A (randomised-duration baseline); B (intervention); and follow-up (at 3 weeks). During the baseline, participants received therapist contact only. In the bibliotherapy intervention, participants received bi-weekly therapist support. The primary measures of psychological distress (General Health Questionaire-12; GHQ-12) and quality of life (Satisfaction with Life Scale; SWLS) were completed weekly. Secondary measures of mood, wellbeing and illness impact were completed pre- and post-intervention. RESULTS Omnibus whole-group TAU-U analysis was statistically significant for each primary measure with a moderate effect size on both (0.6 and 0.3 for GHQ-12 and SWLS, respectively). Individual TAU-U analyses demonstrated that the majority of individuals exhibited positive change. All the secondary measures showed significant pre-post improvements. Eighty-one per cent of participants reported the book was helpful and 81% also found the ACT-based sections helpful. Relative risk calculations showed finding the book helpful was associated with improvement in GHQ-12 and SWLS scores. CONCLUSIONS ACT-based bibliotherapy, with therapist support, is a promising intervention for psychological difficulties after stroke.
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Association between Fecal Microbiota, SCFA, Gut Integrity Markers and Depressive Symptoms in Patients Treated in the Past with Bariatric Surgery-The Cross-Sectional Study. Nutrients 2022; 14:nu14245372. [PMID: 36558532 PMCID: PMC9781380 DOI: 10.3390/nu14245372] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/10/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
(1) Background: Depressive symptoms often appear after surgical treatment. (2) Methods: We involved 41 adults who underwent bariatric surgery a minimum of 6 months before the study and had the Beck scale ≥12. We analysed patients' mental state, gut barrier markers, faecal short chain fatty acids, and microbiota. (3) Results: Gut microbiota composition differed significantly among patients undergoing two different types of surgery (F = 1.64, p = 0.00002). Additionally, we discovered an association between short chain fatty acids and the Beck scale (F = 1.22, p = 0.058). The rearrangement of bacterial metabolites may be due to the patients' use of increased dietary protein, with insufficient intake of products containing vegetable fiber (Diet Quality Index (DQI-I )adequacy 22.55 (±3.46) points). (4) Conclusions: Bariatric surgery affects the gut microbiota, which may play an important role in the development of depressive and gastrointestinal symptoms in patients after bariatric surgery. Low fiber consumption and increased levels of faecal isobutyric acid may lead to intestinal inflammation. There is a need for further research on this topic including a larger sample size.
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Kaviani M, Nikooyeh B, Etesam F, Behnagh SJ, Kangarani HM, Arefi M, Yaghmaei P, Neyestani TR. Effects of vitamin D supplementation on depression and some selected pro-inflammatory biomarkers: a double-blind randomized clinical trial. BMC Psychiatry 2022; 22:694. [PMID: 36368945 PMCID: PMC9651884 DOI: 10.1186/s12888-022-04305-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 10/13/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Both augmented inflammatory reaction and low vitamin D status are associated with depression but the magnitude of their relationships is unclear. This study was, therefore, conducted to evaluate the effects of vitamin D supplementation on serum 25(OH)D concentration, depression severity and some pro-inflammatory biomarkers in patients with mild to moderate depression. METHODS An 8-week double-blind randomized clinical trial (RCT) was performed on 56 (18-60 yrs) patients with mild to moderate depression, randomly assigned to intervention (50,000 IU cholecalciferol 2wks-1) and control (placebo) groups. Serum 25(OH)D, intact parathyroid hormone (iPTH), interlukin (IL)-1β, IL-6, high-sensitivity C-reactive protein (hs-CRP) and depression severity (Beck Depression Inventory-II) (BDI-II)) were initially and finally assessed. RESULTS At the end point, statistically significant changes were observed only in intervention group as compared with controls including increased 25(OH)D concentration (+ 40.83 ± 28.57 vs. + 5.14 ± 23.44 nmol L-1, P < 0.001) and decreased depression severity (-11.75 ± 6.40 vs. -3.61 ± 10.40, P = 0.003). No significant within- or between group differences were observed in serum IL-1β, IL-6 and hs-CRP concentrations. CONCLUSION Increased circulating 25(OH)D concentrations following 8-week vitamin D supplementation (50,000 IU 2wks-1) resulted in a significant decrease in BDI-II scores in patients with mild to moderate depression. However, this effect was independent of the serum concentrations of the studied inflammatory biomarkers. TRIAL REGISTRATION The clinical trial registration code was obtained from the Iranian Registry of Clinical Trials (date of registration: 17/09/2018, registration number: IRCT20170926036425N1) and ClinicalTrials.gov (date of registration: 04/12/2018, registration number: NCT03766074).
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Affiliation(s)
- Mina Kaviani
- grid.419697.40000 0000 9489 4252Department of Science Translation and Public Food and Nutrition Education, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, No.7- Shahid Hafezi (West Arghavan) St., Farahzadi Blvd., Sanat Sq. Shahrak Qods (Gharb), Tehran, 1981619573 Iran
| | - Bahareh Nikooyeh
- grid.419697.40000 0000 9489 4252Laboratory of Nutrition Research, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, No.7- Shahid Hafezi (West Arghavan) St., Farahzadi Blvd, Sanat Sq. Shahrak Qods (Gharb), Tehran, 1981619573 Iran
| | - Farnaz Etesam
- grid.414574.70000 0004 0369 3463Imam Khomeini Hospital Complex, Tohid Sq, Tehran, 1419733141 Iran
| | | | | | | | - Parichehreh Yaghmaei
- grid.411463.50000 0001 0706 2472Department of Biology, Faculty of Basic Sciences, Science and Research Branch, Islamic Azad University, Daneshgah Blvd, Simon Bulivar Blvd, Tehran, 1477893855 Iran
| | - Tirang R. Neyestani
- grid.419697.40000 0000 9489 4252Laboratory of Nutrition Research, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, No.7- Shahid Hafezi (West Arghavan) St., Farahzadi Blvd, Sanat Sq. Shahrak Qods (Gharb), Tehran, 1981619573 Iran
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Amaro-Gahete FJ, Jurado J, Cisneros A, Corres P, Marmol-Perez A, Osuna-Prieto FJ, Fernández-Escabias M, Salcedo E, Hermán-Sánchez N, Gahete MD, Aparicio VA, González-Callejas C, Mirón Pozo B, R. Ruiz J, Nestares T, Carneiro-Barrera A. Multidisciplinary Prehabilitation and Postoperative Rehabilitation for Avoiding Complications in Patients Undergoing Resection of Colon Cancer: Rationale, Design, and Methodology of the ONCOFIT Study. Nutrients 2022; 14:4647. [PMID: 36364908 PMCID: PMC9656780 DOI: 10.3390/nu14214647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/24/2022] [Accepted: 10/31/2022] [Indexed: 08/25/2023] Open
Abstract
ONCOFIT is a randomized clinical trial with a two-arm parallel design aimed at determining the influence of a multidisciplinary Prehabilitation and Postoperative Program (PPP) on post-surgery complications in patients undergoing resection of colon cancer. This intervention will include supervised physical exercise, dietary behavior change, and psychological support comparing its influence to the standard care. Primary and secondary endpoints will be assessed at baseline, at preoperative conditions, at the end of the PPP intervention (after 12 weeks) and 1-year post-surgery, and will include: post-surgery complications (primary endpoint); prolonged hospital length of stay; readmissions and emergency department call within 1-year after surgery; functional capacity; patient reported outcome measures targeted; anthropometry and body composition; clinical/tumor parameters; physical activity levels and sedentariness; dietary habits; other unhealthy habits; sleep quality; and fecal microbiota diversity and composition. Considering the feasibility of the present intervention in a real-life scenario, ONCOFIT will contribute to the standardization of a cost-effective strategy for preventing and improving health-related consequences in patients undergoing resection of colon cancer with an important clinical and economic impact, not only in the scientific community, but also in clinical practice.
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Affiliation(s)
- Francisco J. Amaro-Gahete
- PROFITH (PROmoting FITness and Health through Physical Activity) Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18007 Granada, Spain
- Department of Physiology, Faculty of Medicine, EFFECTS-262 Research Group, University of Granada, 18016 Granada, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Javier Jurado
- Service of Surgery, Hospital Universitario Clínico San Cecilio, 18016 Granada, Spain
| | - Andrea Cisneros
- Service of Surgery, Hospital Universitario Clínico San Cecilio, 18016 Granada, Spain
| | - Pablo Corres
- Department of Physical Education and Sport, Faculty of Education and Sport-Physical Activity and Sport Sciences Section, University of the Basque Country (UPV/EHU), 01007 Vitoria-Gasteiz, Spain
| | - Andres Marmol-Perez
- PROFITH (PROmoting FITness and Health through Physical Activity) Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18007 Granada, Spain
| | - Francisco J. Osuna-Prieto
- PROFITH (PROmoting FITness and Health through Physical Activity) Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18007 Granada, Spain
- Department of Analytical Chemistry, University of Granada, 18071 Granada, Spain
| | - Manuel Fernández-Escabias
- PROFITH (PROmoting FITness and Health through Physical Activity) Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18007 Granada, Spain
| | - Estela Salcedo
- Service of Clinical Psychology, Hospital Universitario Clínico San Cecilio, 18016 Granada, Spain
| | - Natalia Hermán-Sánchez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Maimónides Biomedical Research Institute of Córdoba, 14004 Córdoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Córdoba, 14004 Córdoba, Spain
- Reina Sofía University Hospital, 14004 Córdoba, Spain
| | - Manuel D. Gahete
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Maimónides Biomedical Research Institute of Córdoba, 14004 Córdoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Córdoba, 14004 Córdoba, Spain
- Reina Sofía University Hospital, 14004 Córdoba, Spain
| | - Virginia A. Aparicio
- Department of Physiology, Faculty of Pharmacy, University of Granada, 18016 Granada, Spain
- Centro de Investigación Biomédica (CIBM), Instituto de Nutrición y Tecnología de los Alimentos “José Mataix” (INYTA), Universidad de Granada, 18016 Granada, Spain
| | | | - Benito Mirón Pozo
- Service of Surgery, Hospital Universitario Clínico San Cecilio, 18016 Granada, Spain
| | - Jonatan R. Ruiz
- PROFITH (PROmoting FITness and Health through Physical Activity) Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18007 Granada, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Instituto de Investigación Biosanitaria, ibs.Granada, 18016 Granada, Spain
| | - Teresa Nestares
- Department of Physiology, Faculty of Pharmacy, University of Granada, 18016 Granada, Spain
- Centro de Investigación Biomédica (CIBM), Instituto de Nutrición y Tecnología de los Alimentos “José Mataix” (INYTA), Universidad de Granada, 18016 Granada, Spain
| | - Almudena Carneiro-Barrera
- PROFITH (PROmoting FITness and Health through Physical Activity) Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18007 Granada, Spain
- Department of Psychology, Universidad Loyola Andalucía, 41007 Seville, Spain
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The impact of comorbid spinal pain in depression on work participation and clinical remission following brief or short psychotherapy. Secondary analysis of a randomized controlled trial with two-year follow-up. PLoS One 2022; 17:e0273216. [PMID: 35994437 PMCID: PMC9394798 DOI: 10.1371/journal.pone.0273216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 07/08/2022] [Indexed: 11/27/2022] Open
Abstract
Objectives This explorative study analyses the influence of baseline comorbid long-lasting spinal pain (CSP) on improvement of long term work participation and clinical remission of mental health illness following either brief coping-focussed or short-term psychotherapy for depression. Whether type of treatment modifies outcome with or without CSP is also analysed. Design A secondary post hoc subgroup analysis of a pragmatic randomised controlled trial. Interventions Brief or standard short psychotherapy. Methods Based on baseline assessment, the sample was subdivided into a subgroup with and a subgroup without CSP. Work participation and clinical remission of depression and anxiety were assessed as treatment outcome at two-year follow-up. Simple and multivariate logistic regression analyses, across the intervention arms, were applied to evaluate the impact of CSP on treatment outcome. Selected baseline variables were considered as potential confounders and included as variates if relevant. The modifying effect of CSP on treatment outcome was evaluated by including intervention modality as an interaction term. Main results Among the 236 participants with depressive symptoms, 83 participants (35%) were identified with CSP. In simple logistic regression analysis, CSP reduced improvements on both work participation and clinical remission rate. In the multivariate analysis however, the impact of CSP on work participation and on clinical remission were not significant after adjusting for confounding variables. Reduction of work participation was mainly explained by the higher age of the CSP participants and the reduced clinical remission by the additional co-occurrence of anxiety symptoms at baseline. The occurrence of CSP at baseline did not modify long term outcome of brief compared to short psychotherapy. Conclusions CSP at baseline reduced work participation and worsened remission of mental health symptoms two-year following psychotherapy. Older age and more severe baseline anxiety are associated to reduced effectiveness. Type of psychotherapy received did not contribute to differences.
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Ríos-León M, Valera-Calero JA, Ortega-Santiago R, Varol U, Fernández-de-las-Peñas C, Plaza-Manzano G. Analyzing the Interaction between Clinical, Neurophysiological and Psychological Outcomes Underlying Chronic Plantar Heel Pain: A Network Analysis Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10301. [PMID: 36011936 PMCID: PMC9408584 DOI: 10.3390/ijerph191610301] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
Plantar heel pain (PHP) is one of the most common foot pain conditions in adults. Several biological and psychological factors could be involved in chronic PHP in a complex matrix. However, reciprocal interactions between these factors are unknown. The aim of the present study was to use network analysis to quantify potential multivariate relationships between pain-related, function, clinical, mechanosensitivity, psychological, and health-related variables in individuals with PHP. Demographic (age, gender), pain-related (pain intensity), function, clinical (myofascial trigger points [TrPs]), mechanosensitivity (pressure pain thresholds), psychological (Beck Depression Inventory), and health-related variables (EQ-5D-5L) were collected in 81 PHP patients. Network connectivity analysis was conducted to quantify the adjusted correlations between the modeled variables and to assess their centrality indices. The connectivity network showed local associations between pain-related variables, foot function, and mechanosensitivity. Additionally, associations between quality of life, depression, and pain-related variables were found, while TrPs was associated with quality of life and mechanosensitivity. The node with the highest strength centrality was the worst pain intensity, while mechanosensitivity and worst pain intensity showed the highest closeness and betweenness centrality. This is the first study to apply network modeling to understand the connections between pain-related, function, clinical, mechanosensitivity, psychological, and health-related variables in PHP. The role of pain severity and mechanosensitivity is highlighted and supported by the network. Thus, this study reveals potential factors that could be the target in the management of PHP, promoting a comprehensive and effective therapeutic approach.
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Affiliation(s)
- Marta Ríos-León
- Hospital Nacional de Parapléjicos, SESCAM, 45004 Toledo, Spain
| | - Juan Antonio Valera-Calero
- Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Villanueva de la Cañada, 28692 Madrid, Spain
- VALTRADOFI Research Group, Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Villanueva de la Cañada, 28692 Madrid, Spain
| | - Ricardo Ortega-Santiago
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
| | - Umut Varol
- VALTRADOFI Research Group, Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Villanueva de la Cañada, 28692 Madrid, Spain
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
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Kabbara A, Robert G, Khalil M, Verin M, Benquet P, Hassan M. An electroencephalography connectome predictive model of major depressive disorder severity. Sci Rep 2022; 12:6816. [PMID: 35473962 PMCID: PMC9042869 DOI: 10.1038/s41598-022-10949-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 04/05/2022] [Indexed: 11/21/2022] Open
Abstract
Emerging evidence showed that major depressive disorder (MDD) is associated with disruptions of brain structural and functional networks, rather than impairment of isolated brain region. Thus, connectome-based models capable of predicting the depression severity at the individual level can be clinically useful. Here, we applied a machine-learning approach to predict the severity of depression using resting-state networks derived from source-reconstructed Electroencephalography (EEG) signals. Using regression models and three independent EEG datasets (N = 328), we tested whether resting state functional connectivity could predict individual depression score. On the first dataset, results showed that individuals scores could be reasonably predicted (r = 0.6, p = 4 × 10-18) using intrinsic functional connectivity in the EEG alpha band (8-13 Hz). In particular, the brain regions which contributed the most to the predictive network belong to the default mode network. We further tested the predictive potential of the established model by conducting two external validations on (N1 = 53, N2 = 154). Results showed statistically significant correlations between the predicted and the measured depression scale scores (r1 = 0.52, r2 = 0.44, p < 0.001). These findings lay the foundation for developing a generalizable and scientifically interpretable EEG network-based markers that can ultimately support clinicians in a biologically-based characterization of MDD.
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Affiliation(s)
- Aya Kabbara
- Lebanese Association for Scientific Research, Tripoli, Lebanon
- MINDig, F-35000, Rennes, France
| | - Gabriel Robert
- Academic Department of Psychiatry, Centre Hospitalier Guillaume Régnier, Rennes, France
- Empenn, U1228, IRISA, UMR 6074, Rennes, France
- Comportement et Noyaux Gris Centraux, EA 4712, CHU Rennes, Université de Rennes 1, 35000, Rennes, France
| | - Mohamad Khalil
- Azm Center for Research in Biotechnology and Its Applications, EDST, Tripoli, Lebanon
- CRSI Research Center, Faculty of Engineering, Lebanese University, Beirut, Lebanon
| | - Marc Verin
- Comportement et Noyaux Gris Centraux, EA 4712, CHU Rennes, Université de Rennes 1, 35000, Rennes, France
- Univ Rennes, Inserm, LTSI-U1099, F-35000, Rennes, France
| | - Pascal Benquet
- Univ Rennes, Inserm, LTSI-U1099, F-35000, Rennes, France
| | - Mahmoud Hassan
- MINDig, F-35000, Rennes, France.
- School of Science and Engineering, Reykjavik University, Reykjavik, Iceland.
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Aristi G, Kamintsky L, Ross M, Bowen C, Calkin C, Friedman A, Hashmi JA. Symptoms reported by Canadians posted in Havana are linked with reduced white matter fibre density. Brain Commun 2022; 4:fcac053. [PMID: 35505689 PMCID: PMC9050567 DOI: 10.1093/braincomms/fcac053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 12/09/2021] [Accepted: 03/03/2022] [Indexed: 11/24/2022] Open
Abstract
Diplomats representing the USA have reported with unusual neurologic symptoms and MRI changes after being posted in Havana, Cuba between late 2016 and 2018. Here, we examined white matter microstructure and network connectivity of individuals stationed in Havana, using diffusion-weighted MRI, fixel-based analysis and structural connectomics as implemented in MRtrix3. MRI data acquisition and clinical assessments were done in a total of 24 diplomats and their family members and 40 healthy controls. The diplomat data were grouped into an exposed cohort (n = 16) and an unexposed cohort (n = 10), and among these, two individuals were assessed before and after potential exposure. Fixel-based analysis revealed a reduction in fibre density in two specific regions: the fornix and the splenium, in exposed individuals, relative to unexposed individuals and healthy controls. Post hoc analyses showed the effect remained present (P < 0.05) in both regions when comparing exposed and unexposed diplomats; and reduced fibre density was correlated with longer time period stationed in Cuba after age correction. Reduction of fibre density was also found to be linked with clinical symptoms of persistent migraine, tinnitus, sound sensitivity and fatigue. Network statistical comparisons revealed decreased structural connectivity in two distinct networks, comprising subcortical and cortical systems in exposed individuals, relative to unexposed and normative data. While the cause for the differences between the groups remains unknown, our results reveal region-specific white matter injury, that is, significantly correlated with clinical symptoms.
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Affiliation(s)
- Guillermo Aristi
- Department of Anesthesia, Pain Management & Perioperative Medicine, Dalhousie University, Nova Scotia Health Authority, Halifax, Canada, B3H 1V7
| | - Lyna Kamintsky
- Department of Medical Neuroscience, Dalhousie University, NSHA, Halifax, Canada, B3H 1V7
| | - Margaux Ross
- Department of Psychiatry, Dalhousie University, NSHA, Halifax, Canada, B3H 1V7
| | - Chris Bowen
- Department of Diagnostic Radiology, Dalhousie University, NSHA, Halifax, Canada, B3H 1V7
| | - Cynthia Calkin
- Department of Psychiatry, Dalhousie University, NSHA, Halifax, Canada, B3H 1V7
| | - Alon Friedman
- Department of Medical Neuroscience, Dalhousie University, NSHA, Halifax, Canada, B3H 1V7
| | - Javeria A. Hashmi
- Department of Anesthesia, Pain Management & Perioperative Medicine, Dalhousie University, Nova Scotia Health Authority, Halifax, Canada, B3H 1V7
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Avinir A, Dar S, Taler M, Haj O, Gothelf D, Kopylov U, Ben-Horin S, Mekori-Domachevsky E. Keeping it simple: mental health assessment in the Gastroenterology Department - using the Hospital Anxiety and Depression Scale (HADS) for IBD patients in Israel. Therap Adv Gastroenterol 2022; 15:17562848211066439. [PMID: 35251306 PMCID: PMC8891839 DOI: 10.1177/17562848211066439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 11/24/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Depression and anxiety are common among inflammatory bowel disease (IBD) patients. Not only do they worsen quality of life, but also worsen the prognosis of the IBD. Yet, there are no widely accepted guidelines for screening for depression or anxiety in this population. The Hospital Anxiety and Depression Scale (HADS) is a self-administered questionnaire designed to measure anxiety and depression in the physically ill. The purpose of this study was to establish the utility of the HADS as a screening tool in IBD patients. METHODS Seventy-nine IBD patients (age 29.86 ± 8.36, 51.9% female, 77.2% Crohn's disease) were recruited consecutively at the day treatment unit, Gastroenterology Department, Sheba Medical Center. They were asked to complete the HADS, the Beck Depression Inventory (BDI), and the State-Trait Anxiety Inventory (STAI). The scores of the HADS depression and anxiety subscales were correlated with the BDI and STAI scores, and the rates of above-threshold scores were calculated and compared between the three questionnaires and findings from previous studies. RESULTS The two HADS subscales significantly correlated with and the BDI (rs = .69, p < 0.001) and STAI state and trait anxiety (rs = .853, p < 0.001; r s = .744, p < 0.001, respectively). The usual HADS cut-off scores yielded adequate rate of anxiety but lower than expected depression rates. CONCLUSIONS Our findings suggest the HADS as a valid screening tool for anxiety and depression in IBD patients. We recommend administering it routinely in gastrointestinal (GI) follow-ups using a lower cut-off score for depression than anxiety (greater than 7 vs greater than 11, respectively).
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Affiliation(s)
- Asia Avinir
- Child and Adolescent Psychiatry Division, Safra Children’s Hospital, Sheba Medical Center, Ramat Gan, Israel
| | - Shira Dar
- Pediatric Molecular Psychiatry Laboratory, Sheba Medical Center, Ramat Gan, Israel
| | - Michal Taler
- Pediatric Molecular Psychiatry Laboratory, Sheba Medical Center, Ramat Gan, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ola Haj
- Gastroenterology Department, Sheba Medical Center, Ramat Gan, Israel
| | - Doron Gothelf
- Child and Adolescent Psychiatry Division, Safra Children’s Hospital, Sheba Medical Center, Ramat Gan, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelSagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Uri Kopylov
- Gastroenterology Department, Sheba Medical Center, Ramat Gan, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shomron Ben-Horin
- Gastroenterology Department, Sheba Medical Center, Ramat Gan, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Kirk MA, Taha B, Dang K, McCague H, Hatzinakos D, Katz J, Ritvo P. A Web-Based Cognitive Behavioral Therapy, Mindfulness Meditation, and Yoga Intervention for Posttraumatic Stress Disorder: Single-Arm Experimental Clinical Trial. JMIR Ment Health 2022; 9:e26479. [PMID: 34499613 PMCID: PMC8922150 DOI: 10.2196/26479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 06/16/2021] [Accepted: 07/07/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is a debilitating, undertreated condition. The web-based delivery of cognitive behavioral therapy supplemented with mindfulness meditation and yoga is a viable treatment that emphasizes self-directed daily practice. OBJECTIVE This study aims to examine the effectiveness of a web-based cognitive behavioral therapy, mindfulness, and yoga (CBT-MY) program designed for daily use. METHODS We conducted an 8-week, single-arm, experimental, registered clinical trial on adults reporting PTSD symptoms (n=22; aged 18-35 years). Each participant received web-based CBT-MY content and an hour of web-based counseling each week. Pre-post outcomes included self-reported PTSD symptom severity, depression, anxiety, chronic pain, and mindfulness. Pre-post psychophysiological outcomes included peak pupil dilation (PPD) and heart rate variability (HRV). HRV and PPD were also compared with cross-sectional data from a non-PTSD comparison group without a history of clinical mental health diagnoses and CBT-MY exposure (n=46). RESULTS Pre-post intention-to-treat analyses revealed substantial improvements in PTSD severity (d=1.60), depression (d=0.83), anxiety (d=0.99), and mindfulness (d=0.88). Linear multilevel mixed models demonstrated a significant pre-post reduction in PPD (B=-0.06; SE=0.01; P<.001; d=0.90) but no significant pre-post change in HRV (P=.87). Overall, participants spent an average of 11.53 (SD 22.76) min/day on self-directed mindfulness practice. CONCLUSIONS Web-based CBT-MY was associated with clinically significant symptom reductions and significant PPD changes, suggesting healthier autonomic functioning. Future randomized controlled trials are needed to further examine the gains apparent in this single-arm study. TRIAL REGISTRATION ClinicalTrials.gov NCT03684473; https://clinicaltrials.gov/ct2/show/NCT03684473.
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Affiliation(s)
- Megan A Kirk
- School of Kinesiology and Health Sciences, York University, Toronto, ON, Canada.,Yale Center for Emotional Intelligence, Yale School of Medicine, Yale University, New Haven, CT, United States
| | - Bilal Taha
- Department of Electrical and Computer Engineering, Faculty of Applied Science and Engineering, University of Toronto, Toronto, ON, Canada
| | - Kevin Dang
- School of Kinesiology and Health Sciences, York University, Toronto, ON, Canada
| | - Hugh McCague
- Institute for Social Research, York University, Toronto, ON, Canada
| | - Dimitrios Hatzinakos
- Department of Electrical and Computer Engineering, Faculty of Applied Science and Engineering, University of Toronto, Toronto, ON, Canada
| | - Joel Katz
- Department of Psychology, York University, Toronto, ON, Canada
| | - Paul Ritvo
- School of Kinesiology and Health Sciences, York University, Toronto, ON, Canada.,Department of Psychology, York University, Toronto, ON, Canada
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Salas-Zárate R, Alor-Hernández G, Salas-Zárate MDP, Paredes-Valverde MA, Bustos-López M, Sánchez-Cervantes JL. Detecting Depression Signs on Social Media: A Systematic Literature Review. Healthcare (Basel) 2022; 10:healthcare10020291. [PMID: 35206905 PMCID: PMC8871802 DOI: 10.3390/healthcare10020291] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/21/2022] [Accepted: 01/29/2022] [Indexed: 01/14/2023] Open
Abstract
Among mental health diseases, depression is one of the most severe, as it often leads to suicide; due to this, it is important to identify and summarize existing evidence concerning depression sign detection research on social media using the data provided by users. This review examines aspects of primary studies exploring depression detection from social media submissions (from 2016 to mid-2021). The search for primary studies was conducted in five digital libraries: ACM Digital Library, IEEE Xplore Digital Library, SpringerLink, Science Direct, and PubMed, as well as on the search engine Google Scholar to broaden the results. Extracting and synthesizing the data from each paper was the main activity of this work. Thirty-four primary studies were analyzed and evaluated. Twitter was the most studied social media for depression sign detection. Word embedding was the most prominent linguistic feature extraction method. Support vector machine (SVM) was the most used machine-learning algorithm. Similarly, the most popular computing tool was from Python libraries. Finally, cross-validation (CV) was the most common statistical analysis method used to evaluate the results obtained. Using social media along with computing tools and classification methods contributes to current efforts in public healthcare to detect signs of depression from sources close to patients.
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Affiliation(s)
- Rafael Salas-Zárate
- Tecnológico Nacional de México/I. T. Orizaba, Av. Oriente 9 No. 852, Col. Emiliano Zapata, Orizaba 94320, Veracruz, Mexico;
| | - Giner Alor-Hernández
- Tecnológico Nacional de México/I. T. Orizaba, Av. Oriente 9 No. 852, Col. Emiliano Zapata, Orizaba 94320, Veracruz, Mexico;
- Correspondence: ; Tel.: +52-(272)-725-7056
| | - María del Pilar Salas-Zárate
- Tecnológico Nacional de México/I.T.S. Teziutlán, Fracción I y II S/N, Aire Libre, Teziutlán 73960, Puebla, Mexico; (M.d.P.S.-Z.); (M.A.P.-V.)
| | - Mario Andrés Paredes-Valverde
- Tecnológico Nacional de México/I.T.S. Teziutlán, Fracción I y II S/N, Aire Libre, Teziutlán 73960, Puebla, Mexico; (M.d.P.S.-Z.); (M.A.P.-V.)
| | - Maritza Bustos-López
- Centro de Investigación en Inteligencia Artificial/Universidad Veracruzana, Sebastián Camacho 5, Zona Centro, Centro, Xalapa-Enríquez 91000, Veracruz, Mexico;
| | - José Luis Sánchez-Cervantes
- CONACYT-Tecnológico Nacional de México/I. T. Orizaba, Av. Oriente 9 No. 852, Col. Emiliano Zapata, Orizaba 94320, Veracruz, Mexico;
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D'Alessandro EG, da Silva AV, Cecatto RB, de Brito CMM, Azevedo RS, Lin CA. Acupuncture for Climacteric-Like Symptoms in Breast Cancer Improves Sleep, Mental and Emotional Health: A Randomized Trial. Med Acupunct 2022; 34:58-65. [PMID: 35251438 PMCID: PMC8886926 DOI: 10.1089/acu.2021.0073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Objective: Breast cancer is the most prevalent malignant neoplasm in women. Optimal treatment frequently includes a hormonal-blockage phase maintained for 5-10 years. Pharmacologic agents used for this blockage induce many climacteric-like symptoms, which often exact a heavy toll on patients' quality of life. Acupuncture has had promising results for treating climacteric-like symptoms induced by hormonal blockage, but there is no evidence of efficacy for controlling hot flashes. Materials and Methods: This trial used acupuncture to treat the climacteric-like symptoms of patients with breast cancer, focusing on the mental, physical, and genitourinary symptoms and sleep disturbances, to determine the influence of acupuncture treatment. The randomized placebo-controlled trial, at a university-based cancer center, with blinded data collectors, compared an Acupuncture group (A), a Sham-Acupuncture group (S), and a Wait-List Control group (C). The patients were receiving tamoxifen. Group A had 10 weekly sessions of manual Acupuncture; Group S had 10 weekly sessions of Sham Acupuncture; and Group C spent 10 weeks on a Wait-List. The main outcome measures were the Beck Depression Inventory-II (BDI-II), the Pittsburgh Sleep Quality Index (PSQI), and the Menopause Rating Scale (MRS). Results: Primary analysis revealed differences among the groups' improvements in scores for the 3 questionnaires (P < 0.001), The A group had significant improvements on the BDI-II (P < 0.001), PSQI (P < 0.002), and MRS (P < 0.004) compared to the S group in a post hoc analysis. Conclusions: Acupuncture improved sleep, and mental and emotional distress symptoms induced by hormonal blockage in patients with breast cancer. Clinical Trial: This trial was registered at CAAE as trial #: 37758414.8.0000.0065.
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Affiliation(s)
- Eduardo Guilherme D'Alessandro
- Department of Internal Medicine, Instituto do Câncer do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Address correspondence to: Eduardo Guilherme D'Alessandro, MD, Rua dos Miranhas, 117—Vila Madalena, São Paulo—SP—CEP 05434-040, Brazil
| | - Alexandre Valotta da Silva
- Department of Medical Acupuncture, Santa Casa de Misericórdia de Bragança Paulista, Bragança Paulista, Brazil
| | - Rebeca Boltes Cecatto
- Rehabilitation Service, Instituto do Câncer do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Christina May Moran de Brito
- Rehabilitation Service, Instituto do Câncer do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Chin An Lin
- Department of Internal Medicine, The University of São Paulo Faculty of Medicine, São Paulo, Brazil
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Kelly RM, Healy U, Sreenan S, McDermott J, Coogan AN. An exploratory study of associations between sleep timing variability and cardiometabolic health in middle-aged adults with type 2 diabetes mellitus. Chronobiol Int 2022; 39:569-578. [PMID: 35016570 DOI: 10.1080/07420528.2021.2005083] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Sleep is increasingly recognised as an important risk factor for metabolic disease, and as an important influence on severity in established metabolic disease. Recent evidence suggests that sleep timing variability (the day-to-day fluctuations of sleep timing) may be an important factor in metabolic diseases such as type 2 diabetes mellitus. In the current study, we explore the associations between measures of sleep timing variability and cardiometabolic measures in a group of healthy middle-aged adults with and without type 2 diabetes mellitus. Healthy controls (N = 27) and adults with well-controlled uncomplicated type 2 diabetes mellitus (N = 30) wore actiwatches for an average of 9 days for objective assessment of sleep timing parameters, and also underwent a detailed clinical assessment. We found greater self-reported social jetlag in the diabetes group, but no groupwise differences in measures of sleep timing variability. In the diabetes patients, HbA1c levels were inversely correlated with variability in the time of sleep onset and midsleep, and with sleep duration. HOMA-IR did not correlate with any sleep timing variability measure, nor were there associations between sleep timing variability and other metabolic biomarkers (cholesterol, LDL, HDL, triglycerides and uric acid). Systolic blood pressure was inversely correlated with actigraphically defined social jetlag in both the control and diabetes groups. The results of this study indicate associations between sleep timing variability and HbA1c, but the direction of these relationships is at variance with some other recent reports. Our results indicate a need for future hypothesis-testing studies to further explore the impact of sleep timing variance on metabolic health.
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Affiliation(s)
- Rachael M Kelly
- Department of Psychology, Maynooth University, National University of Ireland Maynooth, Kildare, Ireland
| | - Ultan Healy
- Academic Department of Endocrinology and Diabetes, Connolly Hospital Blanchardstown, Dublin, Ireland
| | - Seamus Sreenan
- Academic Department of Endocrinology and Diabetes, Connolly Hospital Blanchardstown, Dublin, Ireland
| | - John McDermott
- Academic Department of Endocrinology and Diabetes, Connolly Hospital Blanchardstown, Dublin, Ireland
| | - Andrew N Coogan
- Department of Psychology, Maynooth University, National University of Ireland Maynooth, Kildare, Ireland
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Sachdeva D, Kaur H, Avasthi A, Grover S. Effectiveness of adjunctive telemode mindfulness-based cognitive therapy on symptom severity and quality of life in patients with depression. JOURNAL OF MENTAL HEALTH AND HUMAN BEHAVIOUR 2022. [DOI: 10.4103/jmhhb.jmhhb_28_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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OUP accepted manuscript. PAIN MEDICINE 2022; 23:1613-1620. [DOI: 10.1093/pm/pnac018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 12/03/2021] [Accepted: 01/20/2022] [Indexed: 11/14/2022]
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Capdevila-Gaudens P, García-Abajo JM, Flores-Funes D, García-Barbero M, García-Estañ J. Depression, anxiety, burnout and empathy among Spanish medical students. PLoS One 2021; 16:e0260359. [PMID: 34855803 PMCID: PMC8638989 DOI: 10.1371/journal.pone.0260359] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 11/09/2021] [Indexed: 12/30/2022] Open
Abstract
Medical Education studies suggest that medical students experience mental distress in a proportion higher than in the rest of the population In the present study, we aimed to conduct a nationwide analysis of the prevalence of mental health problems among medical students. The study was carried out in 2020 in all 43 medical schools in Spain, and analyzes the prevalence of depression, anxiety, empathy and burnout among medical students (n = 5216). To measure these variables we used the Beck Depression Inventory Test for assessing depression, the Maslach Burnout Inventory Survey for Students was used for burnout, the State-Trait Anxiety Inventory (STAI) was used to assess anxiety state and trait and the Jefferson Empathy Scale 12 to obtain empathy scores. In relation to depression, the data indicate an overall prevalence of 41%, with 23.4% of participants having moderate to severe levels, and 10% experiencing suicidal ideation. Burnout prevalence was 37%, significantly higher among 6th year than among 1st year students. Anxiety levels were consistent with those reported previously among medical students (25%), and were higher than in the general population for both trait and state anxiety. The prevalence of trait anxiety was higher among women. Empathy scores were at the top end of the scale, with the highest-scoring group (>130) containing a greater percentage of women. Similarly to those published previously for other countries, these results provide a clear picture of the mental disorders affecting Spanish medical students. Medicine is an extremely demanding degree and it is important that universities and medical schools view this study as an opportunity to ensure conditions that help minimize mental health problems among their students. Some of the factors underlying these problems can be prevented by, among other things, creating an environment in which mental health is openly discussed and guidance is provided. Other factors need to be treated medically, and medical schools and universities should therefore provide support to students in need through the medical services available within their institutions.
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Affiliation(s)
- Patricia Capdevila-Gaudens
- 6th Year Student at Pompeu Fabra University, Spanish Council of Medical Students (CEEM), Barcelona, Spain
| | - J. Miguel García-Abajo
- 6th Year Student at the Autonomous University of Madrid, Spanish Council of Medical Students (CEEM), Madrid, Spain
| | - Diego Flores-Funes
- University Expert in Statistics and Specialist in General Surgery and Digestive System, Murcia Health Service, Murcia, Spain
| | - Mila García-Barbero
- Former Chairwoman of the Spanish Society of Medical Education (SEDEM), University Miguel Hernandez, Alicante, Spain
| | - Joaquín García-Estañ
- SEDEM and Center of Studies on Medical Education, University of Murcia, Murcia, Spain
- * E-mail:
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Cho LL, Jones AA, Barbic S, Leonova O, Vila-Rodriguez F, Buchanan T, Lang DJ, William MacEwan G, Procyshyn RM, Panenka WJ, Barr AM, Thornton AE, Gicas KM, Honer WG. Psychometric properties and correlates of the Beck Depression Inventory in a community-based and homeless or precariously housed sample. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Shoman Y, Majery N, Otelea M, Lambreghts C, Guseva Canu I. How to identify the most suitable questionnaires and rating scales for your clinical practice or research? Int J Clin Pract 2021; 75:e14895. [PMID: 34541756 PMCID: PMC9285901 DOI: 10.1111/ijcp.14895] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 08/10/2021] [Accepted: 09/17/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Selection of the most suitable instrument for a health outcome or exposure assessment is challenging, as there are many different instruments and their versions, most with unknown validity. AIMS To develop guidelines facilitating the search for the most suitable instrument. MATERIALS AND METHODS Based on our experience, we formalised a five-step process. The first step is the search for systematic reviews of available instruments validity in COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN), International prospective register of systematic reviews (PROSPERO), or conventional (eg, Medline and Web of Science) databases. If there is no systematic review, the clinician should look for original validation studies and assess them critically. We presented two alternatives of this assessment: qualitative using COSMIN and quantitative using our methodological framework. The latter helps to decide upon the instrument validity completeness and interpret the statistical results from original studies objectively. This process was then transformed into guidelines, which were tested by three external clinicians to select the most appropriate instrument to measure depression, occupational stress and daily fatigue. RESULTS The guidelines were proved to facilitate the instrument search and selection, practical and time-saving. DISCUSSION The guidelines assessment highlighted that clinicians should check whether the instrument that they are looking for was developed for screening or diagnosing purposes, whether it can be self-administered or not, and for which setting it was validated (academic vs clinical). CONCLUSION These guidelines facilitate the objective choice of the most suitable instrument in clinical practice by making the search simple, systematic and time-effective.
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Affiliation(s)
- Yara Shoman
- Center of primary care and public health (Unisanté)University of LausanneLausanneSwitzerland
| | - Nicole Majery
- Service de Santé au Travail Multisectoriel (STM)StrassenLuxembourg
| | - Marina Otelea
- Carol DavilaUniversity of Medicine and PharmacyBucharestRomania
| | - Charlotte Lambreghts
- Department of Primary Care and Public HealthUniversity of LeuvenLeuvenBelgium
- IDEWEExternal Service for Prevention and Protection at WorkHeverleeBelgium
| | - Irina Guseva Canu
- Center of primary care and public health (Unisanté)University of LausanneLausanneSwitzerland
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Núñez-Cortés R, Cruz-Montecinos C, Torres-Castro R, Tapia C, Püschel TA, Pérez-Alenda S. Effects of Cognitive and Mental Health Factors on the Outcomes Following Carpal Tunnel Release: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2021; 103:1615-1627. [PMID: 34861234 DOI: 10.1016/j.apmr.2021.10.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/10/2021] [Accepted: 10/18/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To determine the effects of the cognitive and mental health factors on the outcomes after carpal tunnel release (CTR). DATA SOURCES Embase, PubMed/MEDLINE, Web of Science, Cumulative Index to Nursing and Allied Health, and Cochrane Central Register of Controlled Trials databases from inception to August 14, 2021. STUDY SELECTION Randomized controlled trials and observational studies of patients with CTR were included. The included studies aimed to determine the effect of the cognitive (catastrophic thinking, kinesiophobia, self-efficacy) or mental health factors (symptoms of anxiety and depression) on the outcomes at least 3 months post CTR. DATA EXTRACTION Two independent reviewers performed data extraction and assessed the risk of bias. Data were extracted using a standardized protocol and reporting forms. The risk of bias of the included studies was assessed using the Quality in Prognosis Studies risk-of-bias tool. Random-effects models were used for meta-analysis. DATA SYNTHESIS A total of 15 studies involving 2599 patients were included in this systematic review. The majority of studies indicate a significant association between the cognitive or mental health factors and outcomes after CTR. Quantitative analysis showed a moderate association of symptoms of depression on symptom severity (n=531; r=0.347; 95% CI, 0.205-0.475; P≤.0001), function (n=386; r=0.307; 95% CI, 0.132-0.464; P=.0008), and pain (n=344; r=0.431; 95% CI, 0.286-0.558; P≤.0001). In general, the risk of bias in the included studies was low. CONCLUSIONS This systematic review and meta-analysis showed that symptoms of depression have a moderate association with symptom severity, function, and pain after CTR. Symptoms of anxiety, catastrophic thinking, and self-efficacy are also important indicators of poor postsurgery outcomes. Physicians, physical therapists, and occupational therapists should consider evaluating these variables in patients undergoing CTR.
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Affiliation(s)
- Rodrigo Núñez-Cortés
- Department of Physiotherapy, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), University of Valencia, Valencia, Spain; Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; International Physiotherapy Research Network (PhysioEvidence), Barcelona, Spain
| | - Carlos Cruz-Montecinos
- Department of Physiotherapy, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), University of Valencia, Valencia, Spain; Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; Division of Research, Devolvement and Innovation in Kinesiology, Kinesiology Unit, San José Hospital, Santiago, Chile
| | - Rodrigo Torres-Castro
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; International Physiotherapy Research Network (PhysioEvidence), Barcelona, Spain
| | - Claudio Tapia
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Thomas A Püschel
- Ecology and Evolutionary Biology Division, School of Biological Sciences, University of Reading, Reading, United Kingdom; Primate Models for Behavioural Evolution Lab, Institute of Cognitive and Evolutionary Anthropology, School of Anthropology, University of Oxford, Oxford, United Kingdom
| | - Sofía Pérez-Alenda
- Department of Physiotherapy, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), University of Valencia, Valencia, Spain.
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Maglia M, Caponnetto P, Polosa R, Russo C, Santisi G. Impact of a soft tip nicotine-free harmless cigarette as part of a smoking cessation program with psychological support and varenicline: an integrated workplace smoking cessation intervention. Health Psychol Res 2021; 9:24506. [PMID: 34746480 DOI: 10.52965/001c.24506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 11/06/2022] Open
Abstract
Cigarette consumption in the general population has shown a sustained decline over the past 20 years, but despite this, it is essential to monitor consumption among smokers at their workplace. There is an association between cigarette addiction and work-related stressors, with high prevalence rates for smokers, at least double those of other adults. This two-group randomized clinical trial compared the 12-week combined effect of psychological support and varenicline associated with the use or not of a nicotine-free inhaler with a soft mouthpiece (QuitGo™) on the 4 to 24-week cessation rate in enrolled smokers to a smoking cessation program promoted by our research group. The results of the logistic model analysis showed that the likelihood of quitting successfully at week 24 was significantly higher in the QuitGO™ group than in the control group for participants with high behavioral dependence as assessed by Glover-Nilsson Smoking Behavioral Questionnaire-GN-SBQ (OR = 8.55; CI at 95% = 1.75-43.20). The data presented suggest that the soft tip nicotine-free harmless cigarette may be helpful for smokers and those with work-related stress symptoms who recognize the need to have a gesture in the traditional cigarette smoking ritual.
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Foley ÉM, Parkinson JT, Kappelmann N, Khandaker GM. Clinical phenotypes of depressed patients with evidence of inflammation and somatic symptoms. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2021; 8:100079. [PMID: 34729541 PMCID: PMC7611902 DOI: 10.1016/j.cpnec.2021.100079] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Whether depressed patients with evidence of inflammation are more appropriate candidates for immunotherapies is being tested in several clinical trials, which are selecting patients based on elevated C-reactive protein (CRP) and inflammation-related symptoms. However, studies of the clinical and phenotypic profile of depressed patients with elevated CRP are relatively scarce. We have investigated detailed clinical characteristics of 84 depressed patients, grouped as those with (CRP≥3 mg/L) and without (CRP<3 mg/L) inflammation. All patients met the International Classification of Diseases 10th Revision criteria for current depressive episode and had somatic symptoms of depression. We report that depressed patients with inflammation are more likely to be older (P=0.04), have higher body mass index (P<0.01), and be on non-selective serotonin reuptake inhibitor antidepressants (P=0.04). After adjusting for potential confounders, the inflammation group had higher depression severity (adjusted mean difference, 8.82; 95% CI, 3.91–13.72), somatic symptoms (adjusted mean difference, 3.25; 95% CI, 1.58–4.92), state anxiety (adjusted mean difference, 9.25; 95% CI, 3.82–14.67), perceived stress (adjusted mean difference, 4.58; 95% CI, 1.98–7.18), and fatigue (adjusted mean difference, 9.71; 95% CI, 3.09–6.33), but not anhedonia. The inflamed group also had poorer quality of life (adjusted mean difference, −0.18; 95% CI, −0.32–0.05). At individual depressive symptom level, the inflammation group had increased guilty feelings (adjusted odds ratio [OR], 7.28; 95% CI, 2.09–31.17), pessimism (adjusted OR, 5.38; 95% CI, 1.53–22.73), concentration difficulties (adjusted OR, 4.56; 95% CI, 1.32–19.02), and indecisiveness (adjusted OR, 4.21; 95% CI, 1.15–18.54). Our findings highlight the clinical features associated with inflammation in depressed patients with somatic symptoms, including poor quality of life, supporting the need for intervention targeting this group. These results could also aid patient and outcome selection in future clinical trials testing immunotherapies in depression. Replication of these findings in larger samples is required. We studied clinical features of depressed patients with somatic symptoms with/without evidence of inflammation . Elevated CRP (≥3mg/L) was associated with higher age, higher BMI, and non-SSRI treatment. Elevated CRP (≥3mg/L) was associated with higher depression severity, fatigue, state anxiety, and stress. Elevated CRP (≥3mg/L) was associated with poorer subjective wellbeing and quality of life. Elevated CRP (≥3mg/L) was associated with both somatic and psychological symptoms of depression.
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Affiliation(s)
- Éimear M Foley
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Joel T Parkinson
- Department of Psychiatry, University of Cambridge, Cambridge, UK.,Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
| | - Nils Kappelmann
- Department of Research in Translational Psychiatry, Max-Planck-Institute of Psychiatry, Munich, Germany.,International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - Golam M Khandaker
- Department of Psychiatry, University of Cambridge, Cambridge, UK.,MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK.,Avon and Wiltshire Mental Health Partnership NHS Trust, Bristol, UK
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Avadhani R, Thompson RE, Carhuapoma L, Yenokyan G, McBee N, Lane K, Ostapkovich N, Stadnik A, Awad IA, Hanley DF, Ziai WC. Post-Stroke Depression in Patients with Large Spontaneous Intracerebral Hemorrhage. J Stroke Cerebrovasc Dis 2021; 30:106082. [PMID: 34517296 PMCID: PMC8532502 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106082] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/30/2021] [Accepted: 08/24/2021] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVES To determine factors associated with post-stroke depression (PSD) and relationship between PSD and functional outcomes in spontaneous intracerebral hemorrhage (ICH) using prospective data from a large clinical trial. MATERIALS AND METHODS MISTIE III, a randomized, multicenter, placebo-controlled trial, was conducted to determine if minimally invasive surgery with thrombolysis improves outcome compared to standard medical care. Our primary outcome was post-stroke depression at 180 days. Secondary outcomes were change in blinded assessment of modified Rankin Scale (mRS) from 30 to 180 days, and from 180 to 365 days. Logistic regression models were used to assess the relationship between PSD and outcomes. RESULTS Among 379 survivors at day 180, 308 completed Center for Epidemiologic Studies Depression Scale, of which 111 (36%) were depressed. In the multivariable analysis, female sex (Adjusted Odds Ratio [AOR], 95% Confidence Interval [CI]: 1.93 [1.07-3.48]), Hispanic ethnicity (3.05 [1.19-7.85]), intraventricular hemorrhage (1.88 [1.02-3.45]), right-sided lesions (3.00 [1.43-6.29]), impaired mini mental state examination at day 30 (2.50 [1.13-5.54]), and not being at home at day 30 (3.17 [1.05-9.57]) were significantly associated with higher odds of PSD. Patients with PSD were significantly more likely to have unchanged or worsening mRS from day 30 to 180 (42.3% vs. 25.9%; p=0.004), but not from day 180 to 365. CONCLUSIONS We report high burden of PSD in patients with large volume ICH. Impaired cognition and not living at home may be more important than physical limitations in predicting PSD. Increased screening of high-risk post-stroke patients for depression, especially females and Hispanics may be warranted.
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Affiliation(s)
- Radhika Avadhani
- Division of Brain Injury Outcomes, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Richard E Thompson
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lourdes Carhuapoma
- Division of Neurocritical Care, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Gayane Yenokyan
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nichol McBee
- Division of Brain Injury Outcomes, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Karen Lane
- Division of Brain Injury Outcomes, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Noeleen Ostapkovich
- Division of Brain Injury Outcomes, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Agnieszka Stadnik
- Department of Neurosurgery, University of Chicago Pritzker School of Medicine, Chicago, IL, USA
| | - Issam A Awad
- Department of Neurosurgery, University of Chicago Pritzker School of Medicine, Chicago, IL, USA
| | - Daniel F Hanley
- Division of Brain Injury Outcomes, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Wendy C Ziai
- Division of Brain Injury Outcomes, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Division of Neurocritical Care, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Reins JA, Buntrock C, Zimmermann J, Grund S, Harrer M, Lehr D, Baumeister H, Weisel K, Domhardt M, Imamura K, Kawakami N, Spek V, Nobis S, Snoek F, Cuijpers P, Klein JP, Moritz S, Ebert DD. Efficacy and Moderators of Internet-Based Interventions in Adults with Subthreshold Depression: An Individual Participant Data Meta-Analysis of Randomized Controlled Trials. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 90:94-106. [PMID: 32544912 DOI: 10.1159/000507819] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 04/04/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Evidence on effects of Internet-based interventions to treat subthreshold depression (sD) and prevent the onset of major depression (MDD) is inconsistent. OBJECTIVE We conducted an individual participant data meta-analysis to determine differences between intervention and control groups (IG, CG) in depressive symptom severity (DSS), treatment response, close to symptom-free status, symptom deterioration and MDD onset as well as moderators of intervention outcomes. METHODS Randomized controlled trials were identified through systematic searches via PubMed, PsycINFO, Embase and Cochrane Library. Multilevel regression analyses were used to examine efficacy and moderators. RESULTS Seven trials (2,186 participants) were included. The IG was superior in DSS at all measurement points (posttreatment: 6-12 weeks; Hedges' g = 0.39 [95% CI: 0.25-0.53]; follow-up 1: 3-6 months; g = 0.30 [95% CI: 0.15-0.45]; follow-up 2: 12 months, g = 0.27 [95% CI: 0.07-0.47], compared with the CG. Significantly more participants in the IG than in the CG reached response and close to symptom-free status at all measurement points. A significant difference in symptom deterioration between the groups was found at the posttreatment assessment and follow-up 2. Incidence rates for MDD onset within 12 months were lower in the IG (19%) than in the CG (26%). Higher initial DSS and older age were identified as moderators of intervention effect on DSS. CONCLUSIONS Our findings provide evidence for Internet-based interventions to be a suitable low-threshold intervention to treat individuals with sD and to reduce the incidence of MDD. This might be particularly true for older people with a substantial symptom burden.
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Affiliation(s)
- Jo Annika Reins
- Department of Health Psychology and Applied Biological Psychology, Institute of Psychology, Leuphana University Lueneburg, Lueneburg, Germany
| | - Claudia Buntrock
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | | | - Simon Grund
- Leibniz Institute for Science and Mathematics Education, University of Kiel, Kiel, Germany
| | - Mathias Harrer
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Dirk Lehr
- Department of Health Psychology and Applied Biological Psychology, Institute of Psychology, Leuphana University Lueneburg, Lueneburg, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Kiona Weisel
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Matthias Domhardt
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Kotaro Imamura
- Department of Mental Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Viola Spek
- Fontys University of Applied Sciences, Eindhoven, The Netherlands
| | - Stephanie Nobis
- Institute of Psychology, Leuphana University Lueneburg, Lueneburg, Germany
| | - Frank Snoek
- Department of Medical Psychology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jan Philipp Klein
- Department of Psychiatry and Psychotherapy, Luebeck University, Luebeck, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - David Daniel Ebert
- Department of Medical Psychology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands,
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Sowers KL, Gayda-Chelder CA, Galantino ML. Self-reported cognitive impairment in individuals with Primary Immunodeficiency Disease. Brain Behav Immun Health 2021; 9:100170. [PMID: 34589905 PMCID: PMC8474660 DOI: 10.1016/j.bbih.2020.100170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 10/25/2020] [Accepted: 10/27/2020] [Indexed: 11/18/2022] Open
Abstract
Individuals with Primary Immunodeficiency Disease (PID) have increased risk for infection, autoimmune conditions, and inflammatory disorders. Cognitive impairment, also referred to as brain fog, has been recognized in other medical conditions and as a side-effect of treatments; however, it has not been previously reported in individuals with PID. The phenomenon of brain fog is recognized in other autoimmune or inflammatory conditions, including lupus, multiple sclerosis, chronic fatigue syndrome, and has resulted from chemotherapy treatment for cancer. This research investigates the self-reported memory function of individuals with a diagnosis of PID. Respondents completed a survey which used reliable and valid questionnaires: Memory Functioning Questionnaire, Beck’s Depression Inventory II, and Beck’s Anxiety Inventory. Of the 292 completed surveys, 133 did not report any comorbid neurological diagnosis or incident of concussion (both of which could influence perceived memory function). When compared to normative scores, the respondents in this study were found to have significantly greater perceived memory impairment. The respondents had a significant higher score for anxiety and depression as compared to non-anxious and non-depressed normative values. This study finds that individuals with a diagnosis of PID have a greater degree of perceived memory impairment, or brain fog, in addition to greater levels of anxiety and depression. Individuals with a diagnosis of PID would benefit from prospective surveillance through a comprehensive neuropsychological assessment to track cognitive status and implement corrective measures, should any decline be identified.
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Affiliation(s)
- Kerri L. Sowers
- Stockton University, 101 Vera King Farris Drive, Galloway, NJ, 08205, USA
- Corresponding author.
| | | | - Mary Lou Galantino
- Stockton University, University of Pennsylvania, University of Witwatersrand, Johannesburg, South Africa
- 101 Vera King Farris Drive, Galloway, NJ, 08205, USA
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Christensen SWM, Bellosta-López P, Doménech-García V, Herrero P, Palsson TS. Changes in Pain Sensitivity and Conditioned Pain Modulation During Recovery From Whiplash-associated Disorders. Clin J Pain 2021; 37:730-739. [PMID: 34334693 DOI: 10.1097/ajp.0000000000000970] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 07/19/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The objective of this study was to investigate the pain-sensory profile of patients with whiplash-associated disorders (WADs) prior and post 2 weeks of standardized rehabilitation and after a 6-month follow-up. MATERIALS AND METHODS Twenty-two WAD participants (grade II; 14 women) and 22 sex-matched and age-matched healthy pain-free controls were enrolled. Pressure pain thresholds (PPTs) were assessed at local and distal muscles. Conditioned pain modulation (CPM) of PPTs was assessed using cuff pressure around the upper arm. Referred area of pain following supra-threshold pressure stimulation of the infraspinatus muscle was recorded on a body chart. Psychometric variables (pain intensity, area of perceived pain, pain catastrophizing, kinesiophobia, sleep problems, and depression level) were assessed. WAD group additionally completed the Neck Disability Index. RESULTS The WAD group demonstrated lower local PPTs compared with controls at all time points (P<0.05) and lower distal PPTs at baseline and at 2 weeks when compared with 6 months (within-group) (P<0.05). The WAD group had a reduced CPM response and larger induced referred pain areas compared with controls (P<0.05), while no within-group changes were observed at any time point. The WAD group reported higher pain intensity and perceived area of pain compared with controls at all time points (P<0.05) and a mean Neck Disability Index score of 41% at baseline, 16% at 2 weeks, and 4% at 6 months. Furthermore, the WAD group reported improvements in all other psychometric variables (P<0.05), although only pain catastrophizing levels were comparable to controls at 2 weeks. DISCUSSION PPTs but not CPM improved in the WAD group and were comparable to controls following 2 weeks following standardized rehabilitation, indicating that normalization of CPM may not be required to recover from WAD.
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Affiliation(s)
- Steffan W M Christensen
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University
- Department of Physiotherapy, University College of Northern Denmark, Aalborg, Denmark
| | | | | | - Pablo Herrero
- Health Sciences Faculty, San Jorge University, Villanueva de Gállego
- Department of Physiatry and Nursing, Health Sciences Faculty, University of Zaragoza, Zaragoza, Spain
| | - Thorvaldur S Palsson
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University
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von Glischinski M, von Brachel R, Thiele C, Hirschfeld G. Not sad enough for a depression trial? A systematic review of depression measures and cut points in clinical trial registrations. J Affect Disord 2021; 292:36-44. [PMID: 34091381 DOI: 10.1016/j.jad.2021.05.041] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/21/2021] [Accepted: 05/24/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Patient reported outcomes are central to the evaluation of behavioral, drug, or somatic interventions focusing depression. Continuous measures are mostly interpreted with cut points that serve as inclusion criteria and define remission. The present review provides an overview of measures (BDI; BDI-II; CESD; HADS; HAMD-17; MADRS; PHQ-9; QIDS) and cut points in clinical trials on depression and tests for systematic differences concerning varying types of interventions. METHODS We analyzed 2632 trials registered via clinicaltrials.gov registered between 2000/01/01 - 2019/12/31 that used one or more pre-specified measures of depression of which 1600 reported cut points for either inclusion of participants or the definition of clinical remission. RESULTS The included studies more often used clinician-administered scales than self-report questionnaires as criterion for the inclusion of study participants and for the definition of clinical remission. Clinician administered scales are dominating in drug trials, while self-report questionnaires are primarily used in behavioral trials. This trend accelerated during the last 20 years. Compared to studies on behavioral therapies, studies with drug or other interventions used higher cut points to include patients. Comparisons between the interventions revealed highly significant differences in the used cut points of MADRS, HAMD-17 and PHQ-9. CONCLUSIONS Choice of measure and cut points is an important aspect of trial design and should be homogenized in order to make trials of different types of interventions more readily comparable. Similarly, systematic differences between treatment types in how patients are included and how remission is defined also hamper the comparisons between different treatment modalities.
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Affiliation(s)
| | - Ruth von Brachel
- Ruhr-University Bochum, Universitätsstraße 150, 44801 Bochum, Germany
| | - Christian Thiele
- University of Applied Sciences Bielefeld, Interaktion 1, 33619 Bielefeld, Germany
| | - Gerrit Hirschfeld
- University of Applied Sciences Bielefeld, Interaktion 1, 33619 Bielefeld, Germany
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Liew BXW, de-la-Llave-Rincón AI, Arias-Buría JL, Ortega-Santiago R, Fernández-de-Las-Peñas C. Understanding the Psychophysiological Mechanisms Related to Widespread Pressure Pain Hyperalgesia Underpinning Carpal Tunnel Syndrome: A Network Analysis Approach. PAIN MEDICINE 2021; 22:2708-2717. [PMID: 34343327 DOI: 10.1093/pm/pnab241] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Current evidence suggests that carpal tunnel syndrome (CTS) involves widespread pressure pain sensitivity as manifestion of central sensitization. This study aimed to quantify mechanisms driving widespread pressure pain hyperalgesia in CTS by using network analysis. DESIGN Cross-sectional. SETTING Urban hospital. SUBJECTS 120 women with CTS who participated in a previous randomized clinical trial. METHODS Pain intensity, related-function, symptom's severity, depressive levels, and pressure pain threshold (PPTs) over median, radial and ulnar nerves, the cervical spine, the carpal tunnel, and the tibialis anterior were collected. Network analysis was used to quantify the adjusted correlations between the modelled variables, and to determine the centrality indices of each variable (i.e., the degree of connection with other symptoms in the network). RESULTS The estimated network showed several local associations between clinical variables and the psychophysical outcomes separately. The edges with the strongest weights were between PPT over the median and radial nerves (ρ: 0.34), function and depressive levels (ρ: 0.30), and PPT over the carpal tunnel and tibialis anterior (ρ: 0.29). The most central variables were PPT over the tibialis anterior (the highest Strength centrality), and PPT over the carpal tunnel (the highest Closeness and Betweenness centrality). CONCLUSIONS This is the first study to apply network analysis to understand the multivariate mechanisms of individuals with CTS. Our findings support a model where clinical, depression, and widespread pressure pain sensitivity are connected, albeit within separate clusters. Clinical implications of current findings, such as developing treatments targeting these mechanisms, are also discussed.
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Affiliation(s)
- Bernard X W Liew
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, United Kingdom
| | - Ana I de-la-Llave-Rincón
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - José L Arias-Buría
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Ricardo Ortega-Santiago
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
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