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Sarmiento A, Dean OM, Kavanagh BE, Mohebbi M, Berk M, Dodd S, Cotton SM, Malhi GS, Ng CH, Turner A. The Influence of Personality Disorder Symptoms on Treatment Outcomes in Bipolar Disorder: A Secondary Analysis of a Randomised Controlled Trial: L'influence des symptômes du trouble de la personnalité sur les résultats du traitement dans le trouble bipolaire : Une analyse secondaire d'un essai randomisé contrôlé. Can J Psychiatry 2024; 69:275-287. [PMID: 37964558 PMCID: PMC10924579 DOI: 10.1177/07067437231213558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
OBJECTIVES Many people who are diagnosed with bipolar disorder also have comorbid personality disorder. Few studies have explored how personality disorder may influence pharmacological treatment outcomes. The aim of this study was to conduct a secondary analysis of data from a clinical trial of adjunctive nutraceutical treatments for bipolar depression, to determine whether maladaptive personality traits influence treatment outcomes. METHODS Scores on the Standardised Assessment of Personality - Abbreviated Scale screener were used to classify participants as having bipolar disorder with (n = 119) and without (n = 29) above threshold personality disorder symptoms (personality disorder). Outcome measures included: The Montgomery Åsberg Depression Rating Scale, Clinical Global Impressions and Improvement Severity Scales, Patient Global Impressions-Improvement scale, Bipolar Depression Rating Scale, Range of Impaired Functioning Tool, Social and Occupational Functioning Assessment Scale and Quality of Life and Enjoyment Scale (Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form). Generalised estimated equations examined the two-way interactions of personality disorder by time or treatment and investigated personality disorder as a non-specified predictor of outcomes. RESULTS Over time, the Patient Global Impressions-Improvement scores were significantly higher in those in the personality disorder group. No other significant differences in the two-way interactions of personality disorder by treatment group or personality disorder by time were found. Personality disorder was a significant but non-specific predictor of poorer outcomes on the Bipolar Depression Rating Scale, Range of Impaired Functioning Tool, and Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form, regardless of time or treatment group. CONCLUSIONS This study highlights the potential impact of maladaptive personality traits on treatment outcomes and suggests that the presence of comorbid personality disorder may confer additional burden and compromise treatment outcomes. This warrants further investigation as does the corroboration of these exploratory findings. This is important because understanding the impact of comorbid personality disorder on bipolar disorder may enable the development of effective psychological and pharmacotherapeutic options for personalised treatments.
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Affiliation(s)
- Alessandra Sarmiento
- IMPACT – The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Olivia M. Dean
- IMPACT – The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Bianca E. Kavanagh
- IMPACT – The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
- Deakin Rural Health, Deakin University, Warrnambool, VIC, Australia
| | - Mohammadreza Mohebbi
- Faculty of Health, Biostatistics Unit, Deakin University, Geelong, VIC, Australia
| | - Michael Berk
- IMPACT – The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Seetal Dodd
- IMPACT – The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Sue M. Cotton
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Gin S. Malhi
- Academic Department of Psychiatry, Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, NSW, Australia
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Chee H. Ng
- Professorial Unit, The Melbourne Clinic, Department of Psychiatry, The University of Melbourne, Richmond, VIC, Australia
| | - Alyna Turner
- IMPACT – The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
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Therrien F, Ward C, Chokka P, Habert J, Ismail Z, McIntyre RS, MacKenzie EM. Adjunctive Brexpiprazole for Patient Life Engagement in Major Depressive Disorder: A Canadian, Phase 4, Open-Label, Interventional Study: Brexpiprazole d'appoint pour l'engagement dans la vie des patients souffrant de trouble dépressif majeur: une étude interventionnelle canadienne ouverte de phase 4. Can J Psychiatry 2024:7067437241233965. [PMID: 38425284 DOI: 10.1177/07067437241233965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
OBJECTIVES To characterize the effects of adjunctive brexpiprazole on patient life engagement and depressive symptoms in patients with major depressive disorder (MDD) using patient-reported outcomes. METHODS An 8-week, Phase 4, open-label, interventional study was conducted at 15 Canadian trial sites between April 2021 and May 2022. Adult outpatients with MDD (at least moderately severe) and inadequate response to 1-2 antidepressants continued their current antidepressant and received oral adjunctive brexpiprazole 0.5-2 mg/day. Co-primary endpoints were change from baseline to Week 8 in Inventory of Depressive Symptomatology Self-Report (IDS-SR) 10-item Life Engagement subscale score, and IDS-SR 30-item total score. Safety was assessed by standard variables. RESULTS Of 122 enrolled patients, 120 (98.4%) were treated (mean [SD] dose: 1.2 [0.4] mg/day) and analyzed, and 111 (91.0%) completed the study. Statistically significant least squares mean improvements to Week 8 were observed on IDS-SR10 Life Engagement subscale score (baseline mean [SD]: 16.1 [4.7]; change [95% confidence interval]: -8.11 [-9.34, -6.88]; p < 0.001) and IDS-SR total score (baseline mean [SD]: 41.3 [9.8]; change [95% confidence interval]: -17.38 [-20.08, -14.68]; p < 0.001). Improvements were observed from Week 2, onwards. Treatment-emergent adverse events with incidence ≥5% were fatigue (n = 13, 10.8%), headache (n = 13, 10.8%), insomnia (n = 12, 10.0%), nausea (n = 9, 7.5%), tremor (n = 8, 6.7%), and weight increase (n = 7, 5.8%). Six patients (5.0%) discontinued due to adverse events. Mean (SD) change in body weight from baseline to last visit was +1.9 (3.4) kg. CONCLUSIONS Using an exploratory patient-reported outcome measure, patients with MDD and inadequate response to antidepressants who received open-label adjunctive brexpiprazole showed early and clinically meaningful improvement in patient life engagement, which should be further assessed in a prospective randomized controlled trial. Patient-rated depressive symptoms (on the validated 30-item IDS-SR) also improved. Adjunctive brexpiprazole was well tolerated, and no new safety signals were observed. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT04830215.
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Affiliation(s)
| | - Caroline Ward
- Otsuka Pharmaceutical Development & Commercialization Inc., Princeton, New Jersey, USA
| | - Pratap Chokka
- Chokka Center for Integrative Health, Edmonton, Alberta, Canada
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Jeffrey Habert
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Zahinoor Ismail
- Departments of Psychiatry, Clinical Neurosciences, and Community Health Sciences; Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
- Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Roger S McIntyre
- Department of Psychiatry and Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada
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Moinul D, Hao C, Dimitropoulos G, Taylor VH. Patient Perceptions of Microbiome-Based Therapies as Novel Treatments for Mood Disorders: A Mixed Methods Study: Perceptions des patients sur les thérapies basées sur le microbiome pour les troubles de l'humeur : une étude à méthodes mixtes. Can J Psychiatry 2024:7067437241234954. [PMID: 38414430 DOI: 10.1177/07067437241234954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
OBJECTIVE Medications are critical for treating major depressive disorder (MDD) and bipolar disorder (BD). Unfortunately, 30% to 40% of individuals do not respond well to current pharmacotherapy. Given the compelling growing body of research on the gut-brain axis, this study aims to assess patient perspectives regarding microbiome-based therapies (MBT) such as probiotics, prebiotics, dietary changes, or fecal microbiota transplantation (FMT) in the management of MDD and BD. METHODS This single-centred observational study used quantitative and qualitative assessments to examine patient perceptions of MBT. Participants diagnosed with MDD or BD completed an anonymous questionnaire obtaining demographics, prior medication history, and symptom burden. Self-assessment questionnaires specific to each diagnosis were also used: Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR), Altman Self-Rating Mania Scale (ASRM), and General Anxiety Disorder Questionnaire (GAD-7). A logistic regression model analysed the association of MBT acceptance with disorder type, QIDS-SR, and GAD-7 scores. A bootstrap method assessed the proportion of MBT acceptance. The qualitative assessment consisted of 30-minute interviews to elicit perceptions and attitudes towards MBT. RESULTS The qualitative assessment achieved information power with n = 20. Results from the 63-item MBT questionnaire (n = 43) showed probiotics (37.2%) as the top choice, followed by FMT (32.6%), dietary change (25.6%), and prebiotics (4.6%). A majority of participants (72.1%) expressed willingness to try MBT for their mood disorder, however, logistic regression analysis did not identify statistically significant predictors for MBT acceptance among disorder type, QIDS-SR, and GAD-7. CONCLUSION There is an increased focus on the gut microbiota's role in mood disorders' etiology and treatment. Promising research and patient interest underscore the necessity for exploring and educating on patient perspectives and the factors influencing attitudes towards MBT.
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Affiliation(s)
- Dina Moinul
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Chenhui Hao
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Valerie H Taylor
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Segev-Jacubovski O. Functional Ability, Psychological Factors, and Rehabilitation Outcomes After Elective Total Hip Replacement. Can J Occup Ther 2023; 90:405-412. [PMID: 37072927 PMCID: PMC10647893 DOI: 10.1177/00084174231168018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
Background. The role of positive psychological factors in acute rehabilitation after total hip replacement (THR) is unclear. Purpose. (a) Examine the trajectory of functional ability among older adults after THR from presurgery to discharge from acute rehabilitation and (b) determine which physical and psychological factors at admission would predict functional ability at discharge and length of stay in rehabilitation. Methods. This prospective cohort study included 30 participants (age M = 76.20 years) from an inpatient geriatric rehabilitation center. They completed the Geriatric Depression Scale and Positive Affect questionnaire. The FIM® Motor domain of Functional Independent Measure (mFIM) was recorded presurgery, at admission, and upon discharge. Findings. Functional ability improved at discharge; however, the presurgery functional ability was not regained. Positive affect explained the length of stay in rehabilitation above and beyond the presurgery mFIM. Implications. Occupational therapists should improve ways to enhance self-care and positive affect in acute rehabilitation.
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Affiliation(s)
- Orit Segev-Jacubovski
- Orit Segev-Jacubovski, Occupational Therapy Department, Ariel University, 35 Nizanim st, Hod-Hasharon, Israel.
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Vitte L, Devouche E, Apter G. [Fatherhood in the mother-baby unit: the experience of the Panda unit]. Soins Pediatr Pueric 2023; 44:31-37. [PMID: 37813519 DOI: 10.1016/j.spp.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Mother-baby units offer a care environment that is conducive to better care for fathers. However, these units still need to evolve in terms of organization and attitude to care. The systematic use of pre- and postnatal interviews is an interesting approach to consider.
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Affiliation(s)
- Lisa Vitte
- Groupe hospitalier du Havre, Université Rouen-Normandie, BP 24, 76083 Le Havre cedex, France.
| | - Emmanuel Devouche
- Groupe hospitalier du Havre, Université Rouen-Normandie, BP 24, 76083 Le Havre cedex, France; Laboratoire psychopathologie et processus de santé (EA4057), Université Paris Cité, 71 avenue Édouard-Vaillant, 92774 Boulogne-Billancourt cedex, France
| | - Gisèle Apter
- Groupe hospitalier du Havre, Université Rouen-Normandie, BP 24, 76083 Le Havre cedex, France
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Tang TS, Vesco AT, Fraser EG. Disruptions in Lifestyle Habits and Access to Social Support in the Time of COVID-19: Associations With Diabetes Distress and Depression Among Adults With Type 1 Diabetes Living in British Columbia. Can J Diabetes 2023; 47:497-502. [PMID: 37116655 PMCID: PMC10132832 DOI: 10.1016/j.jcjd.2023.04.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/30/2023] [Accepted: 04/21/2023] [Indexed: 04/30/2023]
Abstract
OBJECTIVES In this study, we examined rates of diabetes distress and depressive symptoms in adults with type 1 diabetes (T1D) during the COVID-19 lockdown and its association with disruptions in lifestyle habits and access to social support. METHODS This cross-sectional investigation included a convenience sample of 60 adults with T1D who completed a survey assessing diabetes distress (Type 1 Diabetes Distress Scale), depressive symptoms (Personal Health Questionnaire-9), and disruptions in lifestyle habits (sleep patterns, dietary patterns, exercise routine) and access to support from family/friends. Linear regression analyses examined COVID-19 disruption variables as predictors of diabetes distress and depressive severity. RESULTS Seventy-three percent and 38% of participants reported elevated diabetes distress and depressive symptoms, respectively. Greater eating disruption predicted higher depressive symptom severity (β=1.33, p=0.045) and eating distress (β=0.28, p=0.045). Greater social support disruption predicted higher eating distress (β=0.36, p=0.019). CONCLUSIONS Findings revealed high rates of diabetes distress and depressive symptoms in this T1D sample during the COVID-19 lockdown. Moreover, disruptions in some lifestyle habits and access to social support were associated with worse mental health outcomes.
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Affiliation(s)
- Tricia S Tang
- Faculty of Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Anthony T Vesco
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, United States; Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
| | - Ellen G Fraser
- The Canadian Centre for Behavioural Neuroscience, Department of Neuroscience, University of Lethbridge, Lethbridge, Alberta, Canada
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Premo EM, Magnuson KA, Lorenzo NE, Fox NA, Noble KG. Mental health and sleep quality of low-income mothers of one-year-olds during the COVID-19 pandemic. Infant Ment Health J 2023; 44:572-586. [PMID: 37439103 PMCID: PMC10403317 DOI: 10.1002/imhj.22074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 03/23/2023] [Accepted: 03/28/2023] [Indexed: 07/14/2023]
Abstract
The COVID-19 pandemic and subsequent social restrictions created an unprecedented context for families raising young children. Although studies have documented detrimental effects of the pandemic on maternal well-being, less is known about how the pandemic specifically impacted low-income mothers. We examined depression, anxiety, and sleep quality among low-income mothers of one-year-olds during the early months of the pandemic using data from the Baby's First Years study. Focusing on the control group (n = 547), we compared mothers interviewed before March 14th, 2020 (n = 342) to mothers interviewed between March 14th and June 30th, 2020 (n = 205) to determine whether the pandemic was associated with differences in mental health and sleep quality. Mothers were recruited from four cities in the United States, and most of the sample identified as Hispanic (42.2%) or Black, non-Hispanic (38.6%). We found that mothers interviewed during the pandemic reported better mental health and sleep quality. While we cannot speak to longer-term impacts of the pandemic, it is possible low-income mothers experienced relief from daily stressors during the initial shelter-in-place orders, which may have led to improvements in well-being. These results have implications for understanding how complex life stressors influence mental health and sleep quality among low-income mothers raising young children.
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Affiliation(s)
- Elizabeth M. Premo
- Sandra Rosenbaum School of Social Work, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Katherine A. Magnuson
- Sandra Rosenbaum School of Social Work, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Nicole E. Lorenzo
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland, USA
| | - Nathan A. Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland, USA
| | - Kimberly G. Noble
- Department of Biobehavioral Sciences and Human Development, Teachers College, Columbia University, New York City, New York, USA
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Abstract
Although several strategies have been developed to support medical students during their studies in order to prevent burnout, depression and suicide, not all of them are equally effective. Simulation is an interesting strategy: it gives students the tools to detect and intervene in signs of distress in their colleagues, and helps them break the barrier of silence in the face of psychological distress.
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Affiliation(s)
- Nathalie Nadon
- Centre hospitalier de l'université de Montréal, 1000 rue Saint-Denis, Montréal, QC H2X 0A9, Canada.
| | - Pierre Laramée
- Centre hospitalier de l'université de Montréal, 1000 rue Saint-Denis, Montréal, QC H2X 0A9, Canada
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Ahmadizadeh Z, Shanbehzadeh S, Kessler D, Taghavi S, Khaleghparast S, Akbarfahimi M. Occupational Performance Coaching for Adults with Heart Failure: Randomized Controlled Trial Protocol. Can J Occup Ther 2023; 90:15-24. [PMID: 36266930 DOI: 10.1177/00084174221130167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background: Patients with heart failure (HF) usually experience functional disabilities and face participation challenges. Self-care behavior is an essential component of long-term management of HF. Purpose: This study aims to investigate the effect of occupational performance coaching (OPC) on self-care behaviors and participation in people with HF. Method: This study is a parallel group, single-blind, randomized controlled trial of 44 adults with HF, to evaluate the efficacy of OPC. Patients will be randomly allocated (1:1) into two groups. Both groups will receive usual self-care education and the intervention group will receive eight weekly sessions of OPC as well. We will measure the primary and secondary outcomes at baseline, 8, and 12 weeks after the intervention initiation. Implications: If OPC is superior to usual self-care education on improving self-care behavior and participation, the finding will support the integration of OPC into practice to improve participation and self-care behaviors of HF patients.
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Melamed OC, Kalia S, Moineddin R, Greiver M, Kloiber S, Mulsant BH, Selby P, O'Neill BG. Factors Associated With Initiation of Antidepressant Medication in Adults With Type 1 and Type 2 Diabetes: A Primary Care Retrospective Cohort Study in Ontario, Canada. Can J Diabetes 2023; 47:11-18. [PMID: 35933314 DOI: 10.1016/j.jcjd.2022.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/08/2022] [Accepted: 05/23/2022] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Depression in patients with diabetes mellitus is common and associated with poorer outcomes. This study aims to identify demographic, socioeconomic and medical factors associated with the initiation of antidepressant medication after a diagnosis of diabetes in adult patients without a previous prescription for antidepressants. We also examined frequency of primary care visits in the year after antidepressant initiation compared with the year before treatment began. METHODS This was a retrospective cohort study using routinely collected electronic medical record data spanning January 2011 to December 2019 from the University of Toronto Practice-based Research Network (UTOPIAN) Data Safe Haven. Our primary outcome was a first prescription for an antidepressant in patients with diabetes. We used a mixed-effects logistic regression model to identify sociodemographic and medical factors associated with this event. RESULTS Among 22,750 patients with diabetes mellitus, 3,055 patients (13.4%) began taking an antidepressant medication. Increased odds of antidepressant initiation were observed in younger patients (odds ratio [OR], 1.77; 95% confidence interval [CI], 1.39 to 2.26), females (OR, 1.60; 95% CI, 1.46 to 1.7), those receiving insulin treatment (OR, 1.59; 95% CI, 1.43 to 1.78) and cases of polypharmacy (OR, 3.67; 95% CI, 3.29 to 4.11). There was an increase in the mean number of primary care visits from 4.6 to 5.9 per year after antidepressant initiation. CONCLUSIONS In patients with diabetes, age, sex and medical characteristics were associated with the initiation of antidepressants. These patients accessed primary care more frequently. Screening and prevention of depression, particularly in these subgroups, could reduce its personal and systemic burdens.
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Affiliation(s)
- Osnat C Melamed
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
| | - Sumeet Kalia
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Rahim Moineddin
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Michelle Greiver
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada; North York General Hospital, Toronto, Ontario, Canada
| | - Stefan Kloiber
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Benoit H Mulsant
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Peter Selby
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Braden G O'Neill
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Ontario, Canada
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Subota A, Spotswood N, Roach M, Goodarzi Z, Holroyd-Leduc J. Is Living with Persons with Dementia and Depression Correlated to Impacts on Caregivers? A Scoping Review. Can J Aging 2022; 41:540-9. [PMID: 35314007 DOI: 10.1017/S071498082100060X] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Caregivers of persons with dementia and depression experience adverse effects associated with their role. The aim of this scoping review was to identify the challenges faced by caregivers of people with dementia and depression, along with interventions to support them. The MEDLINE®, Embase and PsycINFO databases were searched using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method. Grey literature was assessed using the Canadian Agency for Drugs and Technologies in Health's Gray Matter tool.The population consisted of caregivers of people with dementia and depression; the concept was to identify the negative impacts that caregivers experience and whether there are interventions to reduce them; the context was any study design targeting family or friends who were caregivers. A total of 12,835 citations were identified; 139 studies were included. Dementia and depression have variable impacts on outcomes experienced by caregivers, including burden/strain (n = 52), depression (n = 27), distress (n = 53), quality of life (n = 5) and health/well-being (n = 9). Pharmacological and non-pharmacological interventions have mixed effects. This study is important considering that depression in people with dementia is associated with caregiver distress. The use of a variety of non-pharmacological interventions could be beneficial to the latter.
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Lindenbaum H. [Depression in the elderly and the care pathway]. Soins Gerontol 2022; 27:15-21. [PMID: 36503659 DOI: 10.1016/j.sger.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
The French population is aging and forecasts for 2040 indicate that seniors could represent a quarter of the population. Depressive illness affects elderly subjects just as much, if not more. There is a clinical specificity of depression in this age group which explains why it is currently under-diagnosed and therefore under-treated. Taking into consideration the care pathway of the depressed elderly subject is a lever to increase the efficiency of access to care and to professionalize the coordinated approach to treatment.
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Affiliation(s)
- Hugo Lindenbaum
- Centre hospitalier Bohars, centre hospitalier régional universitaire de Brest, route de Ploudalmézeau, 29200 Brest, France.
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13
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Thomas P. [Depression in the elderly and the environment]. Soins Gerontol 2022; 27:27-29. [PMID: 36503661 DOI: 10.1016/j.sger.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Depression in the elderly is difficult to identify because it is often masked by other pathological features. It is therefore important for everyone involved to be vigilant and to be able to ask for help from a qualified professional. The individual interacts with his or her human and material environment. The environment can be depressogenic. The quality of life of the person intervenes in the course of the depression.
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Affiliation(s)
- Philippe Thomas
- Centre de recherches sémiotiques, EA 3648, université de Limoges, 39 rue Camille-Guérin, 87000 Limoges, France.
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Al Rjoob M, Hassan NFHN, Azmarul A Aziz M, Normani Zakaria M, Bin Mohamed Mustafar MF. Quality of life in stroke patients with dysphagia: a systematic review. Tunis Med 2022; 100:664-669. [PMID: 36571750 PMCID: PMC9940652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Dysphagia is a common disorder among stroke patients. Dysphagia can lead to consequences that can negatively impact the quality of life (QoL) in stroke patients. AIM To investigate the impact of dysphagia on the QoL in stroke patients. METHODS Relevant types of literature were searched from PubMed, Scopus, ProQuest, and Google Scholar databases from inception to July 2022. Peerreviewed studies that aimed to determine the impact of dysphagia on the QoL in stroke patients were included regardless of the year of publication. The National Institutes of Health tool for observational cohort and cross-sectional studies was used to assess the methodological quality of the selected studies. In addition, data analysis was conducted using qualitative methodology with narrative synthesis. RESULTS A total of 6 studies met the inclusion criteria with a total number of 381 participants. Only one study has good methodological quality while other studies have fair methodological quality. Dysphagia negatively impacts the QoL in stroke patients, especially those with severe dysphagia. However, after treatment, changes were evident through improved QoL and decreased severity of dysphagia. Moreover, the research found that patients with a higher educational level have a better QoL. CONCLUSION Dysphagia has a negative impact on the QoL in stroke patients, so dysphagia in stroke patients should be diagnosed and treated as soon as possible to avoid poor QoL.
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Affiliation(s)
- Mohammad Al Rjoob
- 1. Speech pathology programme / Faculty of Health Sciences / Universiti Sains Malaysia
| | | | - Mohd Azmarul A Aziz
- 1. Speech pathology programme / Faculty of Health Sciences / Universiti Sains Malaysia
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15
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Mazet-Carpentier A, Maoz Z, Sudres JL, Bouchard JP. [Chronic obstructive pulmonary disease: somato-psychological dimensions]. Rev Infirm 2022; 71:46-48. [PMID: 36509483 DOI: 10.1016/j.revinf.2022.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide and is a poorly understood lung disease. It is accompanied by significant psychological co-morbidities (anxiety, depression, identity and body image disorders) which are under-diagnosed and have an impact on quality of life and the frequency of re-hospitalization. The management of COPD is multidisciplinary and its role is to prevent complications, relieve symptoms and slow the progression of the disease. Therapeutic education of the patient brings a real added value in this multidisciplinary management.
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Affiliation(s)
| | - Zeev Maoz
- Clinique cardio-vasculaire et pulmonaire de Saint-Orens, 12 avenue de Revel, 31650 Saint-Orens-de-Gameville, France; Centre d'étude et de recherche en psychopathologie et psychologie de la santé (CERPPS, EA 7411), Maison de la recherche, Université Toulouse Jean-Jaurès, 5 allée Antonio-Machado, 31058 Toulouse cedex 9, France
| | - Jean-Luc Sudres
- Clinique cardio-vasculaire et pulmonaire de Saint-Orens, 12 avenue de Revel, 31650 Saint-Orens-de-Gameville, France
| | - Jean-Pierre Bouchard
- Department of Statistics and Population Studies, Faculty of Natural Sciences, University of the Western Cape, Robert-Sobukwe Road, Bellville, 7535 Cape-Town, South Africa; Institut psycho-judiciaire et de psychopathologie (IPJP), Institute of Forensic Psychology and Psychopathology, Centre hospitalier de Cadillac, 33410 Cadillac, France; Unité pour malades difficiles (UMD), Pôle de psychiatrie médico-légale (PPML), Centre hospitalier de Cadillac, 33410 Cadillac, France; Psychologie, Criminologie, Victimologie (PCV), Bordeaux, France.
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16
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Nasehi L, Morassaei B, Ghaffari M, Sharafi A, Dehpour AR, Hosseini MJ. The impacts of vorinostat on NADPH oxidase and mitochondrial biogenesis gene expression in the heart of mice model of depression. Can J Physiol Pharmacol 2022; 100:1077-1085. [PMID: 36166834 DOI: 10.1139/cjpp-2022-0098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The comorbidity of depression and high risk of cardiovascular diseases (CVD) have been reported as major health problems. Our previous study confirmed that fluoxetine (FLX) therapy had a significant influence on brain function but not on the heart in depression. In the present study, suberoyanilide hydroxamic acid (SAHA) was proposed as another therapeutic candidate for treatment of depression comorbid CVD in maternal separation model, following behavioral analyses and gene expression level in the heart. Our data demonstrated that SAHA significantly attenuates the NOX-4 gene expression level in treated mice with SAHA and FLX without significant change in NOX-2 expression level. SAHA decreased the gene expression level of peroxisome proliferator-activated receptor-gamma coactivator (PGC-1α) and nuclear respiratory factors (Nrf2) in heart tissues of maternally separated mice. It supposed that non-effectiveness of FLX on mitochondrial biogenesis and NOX gene expression level in the heart of depressed patient can be related to recurrence of depression. It revealed that SAHA not only reversed the depressive-like behavior similar to our previous data but also recovered the heart mitochondrial function via effect on NOX-2, NOX-4, and mitochondrial biogenesis genes' (PGC-1α, Nrf-2, and peroxisome proliferator-activated receptor-α (PPAR-α)) expression levels. We suggest performing more studies to confirm SAHA as a therapeutic candidate in depression comorbid CVD.
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Affiliation(s)
- Leila Nasehi
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Zanjan University of Medical sciences, Zanjan, Iran
- Cancer Gene Therapy Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Bahareh Morassaei
- Zanjan Applied Pharmacology Research Center, Zanjan University of Medical sciences, Zanjan, Iran
| | - Maryam Ghaffari
- Zanjan Applied Pharmacology Research Center, Zanjan University of Medical sciences, Zanjan, Iran
| | - Ali Sharafi
- Zanjan Pharmaceutical Biotechnology Research Center, Zanjan University of Medical sciences, Zanjan, Iran
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Zanjan University of Medical sciences, Zanjan, Iran
| | - Ahmad Reza Dehpour
- Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mir-Jamal Hosseini
- Zanjan Applied Pharmacology Research Center, Zanjan University of Medical sciences, Zanjan, Iran
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Mansouri F, Lahlou L, Camara M, Seck S, Hadji Makhtar Ba E, Thiam MH. [Assessing psychological, anxiety, depression and stress levels of Senegalese general population during COVID-19 pandemic]. Ann Med Psychol (Paris) 2022:S0003-4487(22)00279-7. [PMID: 36091092 PMCID: PMC9444494 DOI: 10.1016/j.amp.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 09/01/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES - Assessing of Impact of Event, depression, anxiety and stress levels in the Senegalese general population during the COVID19 pandemic and identifying associated factors. METHODS - Socio-demographic data, psychological impact of the pandemic, and mental health status of participants were collected using an online questionnaire administered to the general population of Senegal between April 1st and April 30th 2021. Psychological impact and mental health status were assessed, respectively, by the Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety, and Stress Scale 21 (DASS21). The data were analyzed by Jamovi software, version 1.6.23. Logistic regression in univariate and multivariate analyses were used to determine statistically significant associations with a significance level of p<0.05. RESULTS - We enrolled 447 respondents with 19% reporting a moderate to severe psychological impact of the outbreak. Respectively 13.4%, 5.1% and 15.2% had moderate to extremely severe symptoms of depression, anxiety and stress. Statistically significant associations with higher odds of severe levels of psychological impact of the event, depression, anxiety, and stress were represented by five characteristics: Living in Dakar, no formal education, a personal medical chronic disease, a close family member with a chronic medical disease and poor to very poor self-reported health status. CONCLUSION - This study determined the prevalence of post-traumatic stress disorder, depression, anxiety, and stress in the Senegalese general population during the COVID19 pandemic. Our study assessed the prevalence of post-traumatic stress disorder, depression, anxiety, and stress in the general population of Senegal during the COVID pandemic19. It confirms that the pandemic has truly an impact on the mental health of the Senegalese population. This impact is strongly influenced by geographic area and level of education.
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Affiliation(s)
- Faouz Mansouri
- Interne de psychiatrie, Service de psychiatrie, Centre Hospitalier National de Fann, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Laila Lahlou
- Professeur de médecine communautaire, épidémiologie et santé publique, Faculté de Médecine et de pharmacie d'Agadir, Université Ibn Zohr, Agadir, Maroc
| | - Momar Camara
- Professeur Assimilé de psychiatrie, service de psychiatrie, Centre Hospitalier National de Fann, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Sokhna Seck
- Professeur Assimilé de psychiatrie, service de psychiatrie, Centre Hospitalier National de Fann, Université Cheikh Anta Diop, Dakar, Sénégal
| | - El Hadji Makhtar Ba
- Professeur Assimilé de psychiatrie, service de psychiatrie, Centre Hospitalier National de Fann, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Mamadou Habib Thiam
- Professeur Titulaire de psychiatrie et chef de service de psychiatrie, Centre Hospitalier Universitaire National de Fann, Université Cheikh Anta Diop, Dakar, Sénégal
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Bovensiepen G. Destructiveness: a 'neglected child' in the theory of analytical psychology. J Anal Psychol 2022; 67:999-1019. [PMID: 36165304 DOI: 10.1111/1468-5922.12831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
C.G. Jung postulates the child motif as the central symbol of the unfolding self towards wholeness. From the 'abandoned child' and the 'invincibility of the child', Jung derives the 'divine child' as hero. It is about the victory of consciousness over the unconscious, about the 'overcoming of the darkness monster'. But in this ego-psychological approach, there is no 'evil', no destructive child. The author is surprised that there is no concept of destructiveness per se, in the Kantian sense, in either psychoanalysis or analytical psychology. In Jung, 'evil' exists as a shadow dynamic that needs to be integrated. This paper is about destructiveness that cannot be integrated. The author's hypothesis is that some patients have the unconscious belief that they are a discarded child and were born as a 'bad' destructive child or have acquired this unconscious belief in the course of their development. Both possibilities are explored with regard to their treatability using clinical vignettes from the therapy of a child, an adolescent and an adult patient. With regard to collective destructiveness, an attempt is also made to highlight some characteristic beliefs of increasingly radicalized political and social groups.
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Bisagni F. LET ME GO: Depression and suicidal fantasies in children. J Anal Psychol 2022; 67:939-961. [PMID: 36165301 DOI: 10.1111/1468-5922.12855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/02/2022] [Indexed: 12/01/2022]
Abstract
The paper explores the phenomenology of major depression and suicidal ideation in children, offering a brief overview of relevant findings in psychiatry, with particular reference to statistical evidence, and outlining psychoanalytic models, including Jungian as well as the post-Kleinian and Bionian vertices. Bowlby's seminal contribution to the understanding of mourning processes in relation to Freud's theory is also considered. The case of an eight-year-old boy is examined, with particular attention to a series of drawings that the patient produced over the two years of his psychoanalytic psychotherapy. The therapy was interrupted abruptly by his parents.
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Bronsard G, Lavenne-Collot N, Le Reste JY, Favennec M. [Research on adolescent depression associated with parental depression]. Soins Psychiatr 2022; 43:14-17. [PMID: 36522026 DOI: 10.1016/j.spsy.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
At the crossroads of a global pandemic, here and there where public discourse misuses the concepts of depression, research has begun on a public health issue, that of adolescent depression. The Adodesp study (adolescent depression associated with parental depression) aims to study the interest of a preventive identification of adolescent depression, based on that of parental figures, while evaluating the orientation towards a care system articulated between primary care and mental health devices. To date, this study has included 42 adolescents based on the identification of 30 depressed parents. Preliminary results show that 45% of adolescents are depressed and support the need for systematic identification of adolescent depression in children of depressed parents. They also underline the difficulties and pitfalls of this identification by general practitioners and conclude that it would be useful to strengthen the link between primary care and mental health services.
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Affiliation(s)
- Guillaume Bronsard
- Service de psychiatrie de l'enfant et de l'adolescent, Hôpital de Bohars, Centre hospitalier régional universitaire de Brest, route de Ploudalmézeau, 29280 Bohars, France; SPURBO EA 7479, Département de sciences humaines et sociales, Université de Bretagne occidentale, 22 avenue Camille-Desmoulins, CS 93837, 29238 Brest cedex 3, France.
| | - Nathalie Lavenne-Collot
- Service de psychiatrie de l'enfant et de l'adolescent, Hôpital de Bohars, Centre hospitalier régional universitaire de Brest, route de Ploudalmézeau, 29280 Bohars, France; Laboratoire du traitement de l'information médicale, Inserm U1101, 22 avenue Camille-Desmoulins, Bâtiment IBRBS, 29238 Brest, France
| | - Jean-Yves Le Reste
- SPURBO EA 7479, Département de sciences humaines et sociales, Université de Bretagne occidentale, 22 avenue Camille-Desmoulins, CS 93837, 29238 Brest cedex 3, France; UFR de médecine et des sciences de la santé, 22 avenue Camille-Desmoulins, 29238 Brest cedex 3, France; Service de médecine interne, Hôpital de la Cavale blanche, CHRU de Brest, boulevard Tanguy-Prigent, 29200 Brest, France
| | - Mathieu Favennec
- Service de psychiatrie de l'enfant et de l'adolescent, Hôpital de Bohars, Centre hospitalier régional universitaire de Brest, route de Ploudalmézeau, 29280 Bohars, France; SPURBO EA 7479, Département de sciences humaines et sociales, Université de Bretagne occidentale, 22 avenue Camille-Desmoulins, CS 93837, 29238 Brest cedex 3, France
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21
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O’Reilly H, Rogers M, Ogg J, Ritchie T, Whitley J, Santuzzi A, Shelleby EC. Étude de cohorte portant sur le lien entre les symptômes d’inattention et d’hyperactivité chez les enfants, les symptômes d’internalisation et la parentalité attentive durant la pandémie de COVID-19. Paediatr Child Health 2022; 27:S130-S135. [PMID: 36092290 PMCID: PMC9455646 DOI: 10.1093/pch/pxac005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 11/13/2022] Open
Abstract
Objectifs Les rapports de difficultés de santé mentale chez les enfants canadiens se sont multipliés durant la pandémie de COVID-19, et les nouvelles recherches laissent croire que les enfants qui manifestent des symptômes marqués d’inattention et d’hyperactivité ont été disproportionnellement touchés. En conséquence, la pandémie a aussi eu un effet délétère sur les familles. Cette étude visait à : 1) examiner si les symptômes d’inattention et d’hyperactivité chez les enfants au début de l’année scolaire 2020-2021 étaient associés à la parentalité attentive (ou parentalité en pleine conscience) à la fin de l’année scolaire; et 2) examiner si les symptômes de dépression et d’anxiété chez les enfants à la fin de l’année ont tempéré cette association. Méthodes Les parents de 114 jeunes enfants d’une grande ville canadienne ont participé à cette étude durant l’hiver 2020 et le printemps 2021. Les parents ont répondu à plusieurs échelles d’évaluation dans le but de mesurer la symptomatologie de la santé mentale des enfants et l’attention dans les pratiques de parentalité. Résultats Les symptômes d’inattention et d’hyperactivité chez les enfants étaient significativement associés négativement à la parentalité attentive durant l’année scolaire, et les symptômes de dépression chez les enfants ont tempéré ce lien. En particulier, lorsque les symptômes de dépression étaient légers ou moyens chez les enfants, on a observé que des symptômes plus marqués d’inattention et d’hyperactivité étaient liés à un faible niveau de parentalité attentive. Par ailleurs, lorsque les symptômes dépressifs étaient marqués chez les enfants, les symptômes d’inattention et d’hyperactivité n’avaient aucune valeur prédictive sur la parentalité attentive. Conclusions La santé mentale des enfants, à savoir les symptômes d’inattention/hyperactivité et de dépression, est liée aux difficultés de parentalité attentive durant la pandémie de COVID-19. Ces résultats pourraient indiquer aux médecins quelles familles nécessitent plus de soutien durant la pandémie.
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Affiliation(s)
- Hannah O’Reilly
- Faculté d’éducation, Université d’Ottawa, Ottawa, Ontario, Canada
| | - Maria Rogers
- Faculté d’éducation, Université d’Ottawa, Ottawa, Ontario, Canada
- École de psychologie, Faculté des sciences sociales, Université d’Ottawa, Ottawa, Ontario, Canada
- Département de psychologie, Université Carleton, Ottawa, Ontario, Canada
| | - Julia Ogg
- Département de psychologie, Université Northern Illinois, DeKalb, Illinois, États-Unis
| | - Tessa Ritchie
- École de psychologie, Faculté des sciences sociales, Université d’Ottawa, Ottawa, Ontario, Canada
| | - Jessica Whitley
- Faculté d’éducation, Université d’Ottawa, Ottawa, Ontario, Canada
| | - Alecia Santuzzi
- Département de psychologie, Université Northern Illinois, DeKalb, Illinois, États-Unis
| | - Elizabeth C Shelleby
- Département de psychologie, Université Northern Illinois, DeKalb, Illinois, États-Unis
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Jivraj J, Ameis SH. Is Repetitive Transcranial Magnetic Stimulation (rTMS) Ready for Clinical Use as a Treatment Tool for Mental Health Targets in Children and Youth? J Can Acad Child Adolesc Psychiatry 2022; 31:93-99. [PMID: 35614951 PMCID: PMC9084373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 03/10/2022] [Indexed: 06/15/2023]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation tool with potential for broad application in individuals with neuropsychiatric conditions. As in adults, most rTMS research in youth has focused on treatment-resistant depression. A limited number of rTMS studies have also been conducted in children and youth with primary diagnoses of Autism Spectrum Disorder (ASD), Attention-Deficit/Hyperactivity Disorder (ADHD) or Tourette's syndrome. Across the available rTMS literature, rTMS appears to be well tolerated with few adverse effects reported when applied to child and youth research samples. However, the potential efficacy of rTMS treatment for a variety of targets in children and youth remains unclear, due in part to limitations of the current literature, including studies using diverse protocols, potential for bias in existing clinical trial designs, variability in the research samples, and the use of heterogenous outcome measures. While rTMS is unlikely to take the place of more accessible treatments (e.g., psychopharmacological, psychosocial, psychotherapeutic), rTMS may provide a valuable alternative treatment option, particularly for those individuals where conventional treatments are inaccessible, poorly tolerated, or ineffective. A more robust body of well-designed, controlled trials, is needed in order to clarify rTMS treatment efficacy across relevant neuropsychiatric conditions, optimize treatment protocols, and meet the critical need for novel mental health interventions in children and youth.
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Affiliation(s)
- Jamil Jivraj
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - Stephanie H Ameis
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario
- Centre for Brain and Mental Health, Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario
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Niaz D, Necyk C, Simpson SH. Association Between Antidepressant Use and Adherence to Anti-hyperglycemic Medications in Adults With Type 2 Diabetes and Depression: A Retrospective Cohort Study. Can J Diabetes 2022; 46:S1499-2671(22)00065-X. [PMID: 35927170 DOI: 10.1016/j.jcjd.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 02/22/2022] [Accepted: 03/23/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Depression is a known risk factor for poor medication adherence, but it is unclear whether depression treatment affects adherence rates. In this study, we examined the association between pharmacologic treatment of a new depressive episode and subsequent adherence to oral anti-hyperglycemic medications. METHODS In this retrospective cohort study we used administrative health data to follow adult new metformin users in Alberta, Canada, between 2008 and 2018. Depressive episodes starting ≥1 year after metformin initiation were identified and individuals starting antidepressant treatment within the first 90 days were compared with those who did not. The proportion of days covered (PDC) with oral anti-hyperglycemic medications in the subsequent year (days 91 to 455) was used to estimate adherence. The association between antidepressant treatment and poor adherence (PDC<0.8) was examined using multivariate logistic regression models. RESULTS A new depressive episode occurred in 6,201 people, with a mean age of 56.0 (standard deviation [SD], 15.4) years. Of this cohort, 3,303 (53.2%) were women. Mean PDC was 0.55 (SD, 0.41); 924 (57.0%) of 1,621 people who started antidepressant treatment and 2,709 (59.2%) of 4,580 controls had poor adherence (p=0.13). After adjusting for baseline comorbidities and other characteristics, antidepressant treatment was associated with a lower likelihood of poor adherence (adjusted odds ratio, 0.85; 95% confidence interval, 0.75 to 0.96; p=0.007). CONCLUSIONS Although overall adherence to anti-hyperglycemic medications was low after onset of a depressive episode, antidepressant treatment was associated with a lower likelihood of poor adherence.
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Affiliation(s)
- Diva Niaz
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Candace Necyk
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada.
| | - Scot H Simpson
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada; Alberta Diabetes Institute, University of Alberta, Li Ka Shing Centre for Health Research Innovation, Edmonton, Alberta, Canada.
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Amamou B, Ben Saida I, Bejar M, Messaoudi D, Gaha L, Boussarsar M. Stress, anxiety, and depression among students at the Faculty of Medicine of Sousse (Tunisia). Tunis Med 2022; 100:346-352. [PMID: 36155907 PMCID: PMC9477150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate the frequency of anxious and depressive symptoms and to determine their associated factors in a population of students enrolled at the Faculty of Medicine of Sousse (Tunisia). METHODS this is a descriptive cross-sectional study that took place at the Faculty of Medicine of Sousse over the period from 09/15/2017 to 03/15/2018. An anonymous questionnaire was administered to the students in the guided teaching rooms. The assessment of anxiety and depressive symptoms was based on the Anxiety and Depression Scale (HADS) and the quality of sleep was assessed by the PSQI questionnaire. RESULTS A total of 202 medical students participated in the study. The average PSQI score was 5.62±2.87 and 47% of students had poor sleep quality (PSQI ≥ 6). Symptoms of anxiety and depression were observed in 73 (36.1%) and 45 (22.3%) students respectively. The mean HADS-A score was 9.21±4.17 and that of the HADS-D score was 7.37±4.06. In univariate analysis, the factors found to predict a high level of perceived stress were the study cycle (p=0.022) and poor quality of sleep (p 11) were the use of sleeping pills (p=0.004), the quality of sleep (p<0.001), and a high level of perceived stress (p<0.001). The high level of perceived stress was found to predict depression (p=0.006).In the multivariate analysis of variables in the present study, poor sleep quality was a factor independently related to high perceived stress in medical students (ORa=9.062 [4.247-19.334]) while being a medical student of the 1st cycle proved to be a protective factor (ORa=0.101 [0.025-0.406]). Use of sleeping pills (ORa=4.481 [1.135-17.682]), poor sleep quality (ORa=2.131 [1.081-4.203]) and high level of perceived stress (ORa=5.790 [2.444-13.716]) were factors independently related to anxiety symptoms. Female sex was a protective factor for depressive symptoms (ORa=0.440 [0.205-0.945]) while a high level of perceived stress was a factor independently related to depressive symptoms (ORa=3.429 [1.469-8.005]). HAD-A and HAD-D scores were correlated (r=0.631 ; p<0.001). CONCLUSION sleep disturbances, perceived stress, anxious and depressive symptoms are common among Tunisian medical students. Prevention strategies targeting the improvement of sleep quality and student stress management should be developed at the faculty and ministerial level.
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Affiliation(s)
- Badii Amamou
- 1. Service de psychiatrie de Monastir / faculté de médecine de Monastir,
| | - Imen Ben Saida
- 2. Service de réanimation médicale Farhat Hached Sousse / faculté de médecine de Sousse
| | - Maha Bejar
- 3. Service de psychiatrie de Monastir / faculté de médecine de Sfax
| | - Dorsaf Messaoudi
- 2. Service de réanimation médicale Farhat Hached Sousse / faculté de médecine de Sousse
| | - Lotfi Gaha
- 1. Service de psychiatrie de Monastir / faculté de médecine de Monastir,
| | - Mohamed Boussarsar
- 2. Service de réanimation médicale Farhat Hached Sousse / faculté de médecine de Sousse
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Snène H, Rafrafi R, Salah N, Blibech H, Mehiri N, Louzir B. Anxiety and depression in Tunisian patients with COPD. Tunis Med 2022; 99:623-631. [PMID: 35244914 PMCID: PMC8795995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a chronic lung disease with a multi-systemic impact that can be complicated by psycho-affective disorders. AIM To determinethe frequency of anxiety and depression in patients followed for stable COPD in a university hospital-center in Tunisand to determine the predictors of their onset. METHODS This was an analytical cross-sectional studyof patients followed for stable COPD at the pulmonology department of the Mongi Slim La Marsa Hospital. The symptoms of COPD were assessed by the Chronic obstructive pulmonary disease Assessment Test (CAT), its severity by the GOLD 2020 classification and the screening of psycho-affective disorders by the HAD scale. RESULTS One hundred and three patients were enrolled, with an average age of 64 years. The prevalence of anxiety was 44.7% and that of depression was 33.9%with 26.2% of patients with a major depressive episode. In multivariate analysis by binary logistic regression, the highest values of CAT score were associated with anxiety, depression, and the onset of a major depressive episode. Other factors associated with anxiety and the onset of a major depressive episode were associated heart rhythm disorders and the lowest BMI values. In addition, the female gender was associated with the onset of a major depressive episode. CONCLUSION Anxiety and depression are common in Tunisian patients with COPD, hence the interest of their systematic screening.
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Abstract
Burn out is defined as a state of psychological exhaustion in the face of an unfavourable work environment. In the health sector, this includes, among other things, an excessive care burden, the lack of autonomy or control over work, the vicious circle of absenteeism, the lack of support, moral and sexual harassment, discrimination or the Covid-19 health crisis. Burn-out also increases the risk of depression among care workers.
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Affiliation(s)
- Guillaume Lucas
- École des sciences infirmières, faculté des sciences médicales et paramédicales, Aix-Marseille université, 27 boulevard Jean-Moulin, 13385 Marseille cedex 5, France.
| | - Sébastien Colson
- École des sciences infirmières, faculté des sciences médicales et paramédicales, Aix-Marseille université, 27 boulevard Jean-Moulin, 13385 Marseille cedex 5, France
| | - Laurent Boyer
- Centre de recherche sur les services de santé et la qualité de vie, faculté des sciences médicales et paramédicales, Aix-Marseille université, 27 boulevard Jean-Moulin, 13005 Marseille, France; Fondation FondaMental, pôle de psychiatrie, hôpital Albert-Chenevier, 40 rue de Mesly, 94000 Créteil, France
| | - Stéphanie Gentile
- Centre de recherche sur les services de santé et la qualité de vie, faculté des sciences médicales et paramédicales, Aix-Marseille université, 27 boulevard Jean-Moulin, 13005 Marseille, France
| | - Guillaume Fond
- Centre de recherche sur les services de santé et la qualité de vie, faculté des sciences médicales et paramédicales, Aix-Marseille université, 27 boulevard Jean-Moulin, 13005 Marseille, France; Fondation FondaMental, pôle de psychiatrie, hôpital Albert-Chenevier, 40 rue de Mesly, 94000 Créteil, France
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Podlipski PL, Tran E, Chrusciel J, Kaladjian A, Sanchez S. [Management of suicidal crisis in general practice: evaluation of care practices according to patient age]. Soins Psychiatr 2022; 43:42-48. [PMID: 35598914 DOI: 10.1016/j.spsy.2022.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Nearly 800,000 people die by suicide each year worldwide. Up to 75% of suicidal patients consulted their general practitioner in the months preceding their attempt. A study, conducted among 167 practitioners in Champagne-Ardenne in 2016-2017, aims to evaluate the practices of general practitioners in the management of suicidal crisis, particularly according to the age of the patient. It provides elements for reflection on their role in suicide prevention.
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Affiliation(s)
- Pierre-Luc Podlipski
- Pôle de psychiatrie des adultes, centre hospitalier universitaire de Reims, faculté de médecine de Reims, rue du Général-Koenig, 51100 Reims, France
| | - Eric Tran
- Pôle territorial santé publique et performance, unité de recherche clinique et de recherche en soins, Hôpitaux Champagne Sud, 101 avenue Anatole-France, 10000 Troyes, France
| | - Jan Chrusciel
- Pôle territorial santé publique et performance, unité de recherche clinique et de recherche en soins, Hôpitaux Champagne Sud, 101 avenue Anatole-France, 10000 Troyes, France
| | - Arthur Kaladjian
- Pôle de psychiatrie des adultes, centre hospitalier universitaire de Reims, faculté de médecine de Reims, rue du Général-Koenig, 51100 Reims, France
| | - Stéphane Sanchez
- Pôle territorial santé publique et performance, unité de recherche clinique et de recherche en soins, Hôpitaux Champagne Sud, 101 avenue Anatole-France, 10000 Troyes, France.
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Scola C, Le Vigouroux S. [Differences between parental burnout and postpartum depression]. Soins Pediatr Pueric 2021; 42:22-24. [PMID: 34763838 DOI: 10.1016/j.spp.2021.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Parental burnout, postpartum depression and major depression are conditions that share common symptomologies, but are not to be confused with each other. It is therefore important to define each of these disorders before documenting the similarities, differences and the issue of differential diagnosis in each of these conditions.
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Affiliation(s)
- Céline Scola
- Aix Marseille Univ, PsyClé, 29 avenue Robert-Schuman, 13621 Aix-en-Provence cedex 1, France.
| | - Sarah Le Vigouroux
- APSY-v, Université de Nîmes, 5 rue du Docteur- Georges-Salan, CS 13019, 30021 Nîmes cedex 1, France
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Kandouci C, Meçabih F, Meçabih I, Kadari C, Megherbi N, Achouri MY, Kandouci A, Ben Abdelaziz A. Psychosocial impact of COVID-19 among health workers in Algeria. Tunis Med 2021; 99:1015-1029. [PMID: 35288905 PMCID: PMC9390127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND The current COVID-19 pandemic has put health care professionals in the face of increasing psychological distress, with a high risk of infection. PURPOSE To estimate the prevalence of anxiety-depressive disorders among health professionals in Algeria and determine their associated risk factors. METHOD A cross-sectional descriptive study was conducted from January 11 to March 09, 2021 and concerned healthcare professionals in Algeria, through an online self-assessment. The mental health rating scales used were GAD-7 (7 items) for Anxiety, and CES-D (20 items) for Depression. Resilience was estimated by the RISC-CD (10 items). An original questionnaire was used to assess three factors: fear of infection and death, isolation and stigmatization, as well as motivation and escape behaviour at work. RESULTS A total of 1005 health professionals were included in the study, of which 51.5% were doctors, 75.6% were women and 41.1% were at the first front of the fight against COVID-19. The prevalence of Anxiety and Depression was 23.8% and 44.6% respectively. Health professionals with a high resilience score were those who were in direct contact with COVID-19 3.75 [1.11-12.7] and those who feared contracting the disease 1.22 [1.14-1.31]. Among the study population, 508 employees (50.5%) were free from anxiety-depressive disorder: Good mental health of health personnel, has been determined by the male sex 1,55 [1,07, 2,24], without co-morbidity 0,57 [0,39, 0,83], without direct intervention in the fight against COVID-19 0.63 [0.45, 0.89], having a low score of Depression and Anxiety with respectively 0.43 [0.36- 0.50], 0.50 [0.41- 0.58] while denouncing a high Resilience score 1.03 [1.01- 1.05]. CONCLUSION In Algeria, the fight against the COVID-19 pandemic has had an impact on the mental health of health professionals, hence the urgent need for intervention programs, for strengthening their mental health in a more sustainable and effective struggle.
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Affiliation(s)
- Chahrazed Kandouci
- 1: Faculté de médecine. Laboratoire de recherche en environnement et santé.Université DjillaliLiabes. Sidi Bel Abbès Algérie
| | - Fethi Meçabih
- 2: Département de pharmacie, faculté de médecine d’Alger Algérie
| | - Imene Meçabih
- 3: Département de pharmacie, faculté de médecine, université DjillaliLiabes. Sidi Bel Abbès Algérie
| | - Chifaa Kadari
- 3: Département de pharmacie, faculté de médecine, université DjillaliLiabes. Sidi Bel Abbès Algérie
| | - Nihed Megherbi
- 3: Département de pharmacie, faculté de médecine, université DjillaliLiabes. Sidi Bel Abbès Algérie
| | - Mohamed Yacine Achouri
- 3: Département de pharmacie, faculté de médecine, université DjillaliLiabes. Sidi Bel Abbès Algérie
| | - Abdelkarimn Kandouci
- 1: Faculté de médecine. Laboratoire de recherche en environnement et santé.Université DjillaliLiabes. Sidi Bel Abbès Algérie
| | - Ahmed Ben Abdelaziz
- 4: Faculté de médecine de Sousse.Université de Sousse. Laboratoire de Recherche LR19SP01 (Tunisie)
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Shea AK, Wolfman W, Fortier M, Soares CN. Directive clinique n° 422c : Ménopause : Humeur, sommeil et cognition. J Obstet Gynaecol Can 2021; 43:1324-1333.e1. [PMID: 34555544 DOI: 10.1016/j.jogc.2021.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIF Proposer des stratégies fondées sur les plus récentes données publiées pour améliorer les soins aux femmes ménopausées ou en périménopause. POPULATION CIBLE Les femmes ménopausées ou en périménopause. BéNéFICES, RISQUES ET COûTS: La population cible bénéficiera des plus récentes données scientifiques publiées communiquées par leurs fournisseurs de soins de santé. Aucun coût ni préjudice ne sont associés à cette information, car les femmes seront libres de choisir parmi les différentes options thérapeutiques, y compris le statu quo, pour la prise en charge des symptômes et morbidités associés à la ménopause. DONNéES PROBANTES: Les auteurs ont interrogé les bases de données PubMed, MEDLINE et Cochrane Library pour extraire des articles publiés entre 2002 et 2020 en utilisant des termes MeSH spécifiques à chacun des sujets abordés dans les 7 chapitres. MéTHODES DE VALIDATION: Les auteurs ont évalué la qualité des données probantes et la force des recommandations en utilisant l'approche d'évaluation, de développement et d'évaluation (GRADE). Voir l'annexe A en ligne (tableau A1 pour les définitions et tableau A2 pour l'interprétation des recommandations fortes et conditionnelles [faibles]). PROFESSIONNELS CONCERNéS: gynécologues, obstétriciens, médecins de famille, internistes, urgentologues, infirmières (autorisées et praticiennes), pharmaciens, stagiaires (étudiants en médecine, résidents, moniteurs cliniques) et autres fournisseurs de soins de santé pour la population cible. DÉCLARATIONS SOMMAIRES: RECOMMANDATIONS.
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Hamdi W, Souissi MA, Lassoued Ferjani H, Maatallah K, Cherif I, Kaffel D. Sleep disturbances in chronic rheumatic diseases: Is disease activity the major determinant factor? Tunis Med 2021; 99:890-7. [PMID: 35261017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Sleep disturbances are closely related to chronic pain processes, especially in patients with inflammatory and mechanical joint diseases. OBJECTIVES This study aims to report sleep characteristics in patients with rheumatoid arthritis (RA) and knee osteoarthritis also to determine the responsibility of disease activity in the occurrence of sleep disturbances during chronic rheumatic diseases. METHODS We conducted a comparative study between two groups of patients: the first with RA, the second with primary knee osteoarthritis. We reported sociodemographic and medical data (clinical and biological inflammatory syndrome data). Then, we assessed depression, anxiety, and sleep disturbances with respectively Beck Depression Inventory, Beck Anxiety Inventory and Medical Outcome Study Sleep Scale (MOS-SS). RESULTS Seventy RA patients aged 51.9 years, with an average of 77.1% female were studied. The mean disease duration was 6.9 years. All sleep domains were altered in these patients. Forty patients with knee osteoarthritis aged 57.5 years with an average of 70% female were included. The mean disease duration was 4 years. The most impaired domains in this group were somnolence and sleep disturbance. Multivariate analysis concluded that risk factors independently related to RA were: disease activity score, functional disability, depression, anxiety, and body mass index. Disease activity score were the only parameter to influence all domains of sleep. CONCLUSION So we result that disease activity is a risk factor independently related to sleep disturbances in rheumatoid arthritis. Furthermore, mood disorders and obesity also deteriorate several sleep domains. These factors must be considered in the management of chronic rheumatic disorders.
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Ait Idar A, Madani M, Berghalout M, Adali I, Manoudi F. [Stigma in psychiatry]. Encephale 2021; 48:288-293. [PMID: 34148648 DOI: 10.1016/j.encep.2021.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/23/2021] [Accepted: 03/12/2021] [Indexed: 11/25/2022]
Abstract
Mental illness affects 48.9 % of the Moroccan population. Despite this significant figure, mental illness remains unrecognized. The patients suffering from mental disorders are therefore subject to stigma and social rejection. A descriptive study was conducted at the consultation service of the psychiatric Ibn Nafiss hospital of the CHU of Marrakech. We chose as a sample 100 stabilized patients, followed on an outpatient basis. The study included the three mental disorders: depressive disorder, bipolar disorder, and schizophrenia. The number of patients in each group had been fixed beforehand; and we tried to get a fairly even distribution between the two genders. The questionnaire had three main axes: (1) Sociodemographic data of the patient. (2) Knowledge of the disease. (3) Evaluation of the experience of stigma. The results of our sample were as follows: For both sexes the age extremes were 19 to 68 years with an average of 38.5 with a clear predominance of women. For the entire population, most patients were single with a percentage of 60 %. Two thirds of the patients, i.e. 59 %, did not exceed primary school. For personal medical history, endocrine pathologies were the most prevalent, at 18 % of cases, while depression was the most common family psychiatric history in our study. We noticed that our population suffered more discrimination and disclosure from those around them regardless of family, social and professional with less appreciation of the positive aspects.
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Affiliation(s)
- A Ait Idar
- CHU Mohammed VI BP2360 Principal, avenue Ibn Sina, Marrakech, Maroc.
| | - M Madani
- CHU Mohammed VI BP2360 Principal, avenue Ibn Sina, Marrakech, Maroc
| | - M Berghalout
- CHU Mohammed VI BP2360 Principal, avenue Ibn Sina, Marrakech, Maroc
| | - I Adali
- CHU Mohammed VI BP2360 Principal, avenue Ibn Sina, Marrakech, Maroc
| | - F Manoudi
- CHU Mohammed VI BP2360 Principal, avenue Ibn Sina, Marrakech, Maroc
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33
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Abstract
Depression is a frequent mood disorder that requires a consensual therapeutic arsenal combining psychotropic drugs and psychotherapies. When depression requires hospitalization, particularly in the context of a major depressive disorder, having an integrative tool that induces a state of relaxation, positive mood and anticipation within twenty minutes is useful for patients and care teams. The Receptive Projective Composite Montage is a standardized music therapy device with evaluated effectiveness that can fulfill this role.
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Affiliation(s)
- Lionel Delpech
- Université de Toulouse Jean-Jaurès, centre d'études et de recherches en psychopathologie et psychologie de la santé, UFR de psychologie, 5 allées Antonio-Machado, 31058 Toulouse cedex 9, France
| | - Jean-Luc Sudres
- Université de Toulouse Jean-Jaurès, centre d'études et de recherches en psychopathologie et psychologie de la santé, UFR de psychologie, 5 allées Antonio-Machado, 31058 Toulouse cedex 9, France
| | - Jean-Pierre Bouchard
- Institut psycho-judiciaire et de psychopathologie (IPJP), Institute of Forensic Psychology and Psychopathology, centre hospitalier de Cadillac, 10 avenue Joseph-Caussil, 33410 Cadillac, France; Unité pour malades difficiles, pôle de psychiatrie médico-légale, centre hospitalier de Cadillac, 10 avenue Joseph-Caussil, 33410 Cadillac, France.
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Weiss SJ, Leung C. Maternal depressive symptoms, poverty, and young motherhood increase the odds of early depressive and anxiety disorders for children born prematurely. Infant Ment Health J 2021; 42:586-602. [PMID: 34021614 PMCID: PMC8453766 DOI: 10.1002/imhj.21924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Children born preterm, compared to term, are at risk for behavioral problems. However, the prevalence and predictors of internalizing disorders among children born preterm are unclear. The purpose of this study was to identify the prevalence of depressive and anxiety disorders at 2 years of age among children born preterm and determine the extent to which poverty, maternal depressive symptoms, or young motherhood increase the likelihood of these disorders. Mothers and their infants (N = 105) were recruited from two neonatal intensive care units affiliated with a major U.S. university. A sociodemographic questionnaire, the Patient Health Questionnaire‐9, and the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition scale scores from the Preschool Child Behavior Checklist were used to measure primary variables. We examined mothers’ family satisfaction and quality of caregiving as well as children's degree of prematurity, morbidity, gender, cognitive functioning, and motor function as covariates. Fifteen percent of children met criteria for an anxiety disorder and another 15% for depression. Maternal depressive symptoms increased the odds of children developing both anxiety and depression, whereas young motherhood was associated with child anxiety and poverty with child depression. Results indicate the need for mental health assessment of children born preterm during their first 2 years of life and the importance of early therapeutic and tangible support to vulnerable mothers and children.
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Affiliation(s)
- Sandra J. Weiss
- Department of Community Health SystemsUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Cherry Leung
- Department of Community Health SystemsUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
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35
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Chentouf A. Depression in patients with epilepsy: screening, diagnosis and management. Tunis Med 2021; 99:518-524. [PMID: 35244900 PMCID: PMC8759317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Depression is the most frequent psychiatric comorbidity in epilepsy patients with a considerable impact on quality of life and a poor prognosis for the response to pharmacological and surgical treatments. The relationship between depression and epilepsy is bidirectional, involving common pathophysiogenic mechanisms. Despite its frequency and its negative impact on the natural course of the epileptic disease, depression is still underdiagnosed and insufficiently treated in these patients. This may be due to the lack of specific training of neurologists for the detection and management of psychiatric comorbidities, or even to the atypical clinical presentation of depressive symptoms in these patients. The management of depression in epileptics is both pharmacological and non-pharmacological, the main objective being to achieve complete remission of depressive symptoms without reducing seizure threshold. This article aims to describe the epidemiological, clinical and therapeutic aspects of depression in patients with epilepsy, in the light of the most recent data in the literature.
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Affiliation(s)
- Amina Chentouf
- 1- Faculté de Médecine d'Oran, CHU d'Oran Algérie, Université Oran 1
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36
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Murphy YE, Zhang X, Gatzke-Kopp L. The developmental cascade of early parenting, emergence of executive functioning, and emotional symptoms across childhood. Infant Ment Health J 2021; 42:331-345. [PMID: 33812347 DOI: 10.1002/imhj.21913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Many studies focus on proximal associations between parental sensitivity and emotional well-being in early childhood, with less data examining how parenting in infancy predicts children's emotional trajectories across childhood, in particular negative emotional symptoms of anxiety and depression. Thus, this study utilized data from The Family Life Project (N = 1015), a prospective study of child development in rural poverty, and assessed whether sensitive parenting in the first 4 years of life predicted child internalizing emotional symptoms (i.e., anxiety and depression) from kindergarten to fifth grade and whether early child executive functioning mediated this relationship. Path models indicated that observation of sensitive parenting predicted a decrease in teachers' report of child negative emotional symptoms over time and predicted fewer negative emotional symptoms in fifth grade. Moreover, though executive functioning performance did not mediate change in symptoms over time, executive functioning did mediate the relationship between sensitive parenting and fifth-grade symptoms, suggesting that executive functioning is one mechanism by which early sensitive parenting buffers long-term emotional development. Findings highlight the importance of early parenting and executive functioning in development of anxiety and depression symptoms and suggests potential targets for transdiagnostic intervention.
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Affiliation(s)
- Yolanda E Murphy
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Xutong Zhang
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Lisa Gatzke-Kopp
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania, USA
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Abstract
As the number of older adults is expected to increase exponentially within the next few decades, loneliness, social isolation, and depression among seniors are growing public health concerns. Although formal treatment options, such as therapy and medication, can be helpful for depression, they can also be expensive and sometimes ineffective. It is therefore important to consider other potential treatment options and social interventions. Alternative methods for addressing mental health issues are especially important for older adults, as they may encounter barriers associated with aging such as limited mobility and decreased social networks. In these circumstances, online social networking may offer a potential "social cure" to alleviate loneliness, social isolation, and depression. The purpose of this scoping review was to gather and summarize the current literature on associations between online social networking and mental health outcomes (e.g., depression, life satisfaction, loneliness) among older adults. An initial search of 3,699 articles resulted in 52 articles that met criteria for inclusion. Five common themes were identified: (1) enhanced communication with family and friends, (2) greater independence and self-efficacy, (3) creation of online communities, (4) positive associations with well-being and life satisfaction, and (5) decreased depressive symptoms. Implications for older adults' mental health, social connectedness, programs and policies are discussed.
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Monaghan M, Mara CA, Kichler JC, Westen SC, Rawlinson A, Jacobsen LM, Adams RN, Stone JY, Hood KK, Mulvaney SA. Multisite Examination of Depression Screening Scores and Correlates Among Adolescents and Young Adults With Type 2 Diabetes. Can J Diabetes 2021; 45:411-416. [PMID: 33722492 DOI: 10.1016/j.jcjd.2021.01.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 01/06/2021] [Accepted: 01/16/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Our aim was to evaluate self-reported depressive symptoms and clinical outcomes during routine screening for adolescents and young adults with type 2 diabetes (T2D), and examine associations among depressive symptoms and demographic and clinical characteristics. METHODS The Patient Health Questionnaire (PHQ) was administered to 197 adolescents and young adults with T2D using the PHQ-2 or PHQ-9 in routine pediatric diabetes care at 4 academic medical centres. Data from electronic health records were extracted from the screening date and 12 months earlier. RESULTS Adolescents and young adults with T2D (mean age, 16.85 years; 57% male; 77.2% non-Caucasian) completed the PHQ as part of routine diabetes care. On the PHQ, 19.3% of adolescents and young adults endorsed elevated depressive symptoms (PHQ score ≥10) and, among a subsample with item-level data (n=53), 18.9% endorsed thoughts of self-harm. Subsequently, 50.0% of those with depressive symptoms had a documented referral for mental health treatment in the electronic health record after the positive screening outcome. Older age, shorter diabetes duration, higher glycated hemoglobin level, being non-Hispanic white, more blood glucose checks per day and being prescribed oral medications were significantly associated with more depressive symptoms. CONCLUSIONS Screening for depressive symptoms identifies individuals in need of referral for mental health treatment. A focus on self-harm assessment, standardized methods for documentation of symptoms and mental health referrals and increased referral resources are needed.
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Affiliation(s)
- Maureen Monaghan
- Center for Translational Research, Children's National Hospital, Washington, District of Columbia, United States.
| | - Constance A Mara
- Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
| | - Jessica C Kichler
- Department of Psychology, University of Windsor, Windsor, Ontario, Canada
| | - Sarah C Westen
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, United States
| | - Alana Rawlinson
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, United States
| | - Laura M Jacobsen
- Division of Endocrinology, Department of Pediatrics, University of Florida, Gainesville, Florida, United States
| | - Rebecca N Adams
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, United States
| | - Jenine Y Stone
- School of Nursing, Vanderbilt University and Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Korey K Hood
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, United States
| | - Shelagh A Mulvaney
- School of Nursing, Vanderbilt University and Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
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Abstract
OBJECTIVE Examine the association between news media use frequency during the COVID-19 pandemic and the scale of psychological distress in pregnant women, considering this distress known harmful effects on the fetus development. METHOD Pregnant women living in Quebec province (N = 1014) have been recruited in April 2020 through social media, while a state of health emergency was declared. Participants were divided in 4 groups, according to self-reported frequency of news media consulting (little or none; one time a day; several times a day; constant). They filled measures of depressive symptoms, negative affects, post-traumatic stress symptoms and anxiety specific to COVID-19. Instrument scores were grouped under a unique factor of psychological distress. RESULTS An ANCOVA controlling for age, gestational age, education level, household annual revenue and a diagnosed mental disorder present at the time of participation in study shows that news media exposure frequency is significantly associated with psychological distress severity in pregnant women, during COVID-19 pandemic, F(3,998) = 27.02, p < 0.001, η2 partial = 0.08. Given the mean comparisons a posteriori, higher psychological distress rates are found as soon as news media exposure exceeds once a day (effect sizes between 0.38 and 0.81). CONCLUSIONS The more pregnant women report consulting the news media during the COVID-19 pandemic, the more likely they are to exhibit psychological distress. Results provide one of the first empirical supports to recommendations of World Health Organization, Canada government and psychiatric associations that encourage population to limit their news media consulting during the COVID-19 pandemic.
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Affiliation(s)
- Roxanne Lemieux
- Département des sciences infirmières, 14847Université du Québec à Trois-Rivières, Québec, Canada.,Centre d'études interdisciplinaires sur le développement de l'enfant et la famille (CEIDEF), Québec, Canada.,Groupe de recherche et d'intervention auprès des enfants vulnérables et négligés (GRIN), Québec, Canada
| | - Julia Garon-Bissonnette
- Centre d'études interdisciplinaires sur le développement de l'enfant et la famille (CEIDEF), Québec, Canada.,Groupe de recherche et d'intervention auprès des enfants vulnérables et négligés (GRIN), Québec, Canada.,Département de psychologie, 14847Université du Québec à Trois-Rivières, Québec, Canada.,Centre de recherche interdisciplinaire sur les problèmes conjugaux et les agressions sexuelles (CRIPCAS), Québec, Canada
| | - Mathilde Loiselle
- Centre d'études interdisciplinaires sur le développement de l'enfant et la famille (CEIDEF), Québec, Canada.,Groupe de recherche et d'intervention auprès des enfants vulnérables et négligés (GRIN), Québec, Canada.,Département de psychologie, 14847Université du Québec à Trois-Rivières, Québec, Canada
| | - Élodie Martel
- Centre d'études interdisciplinaires sur le développement de l'enfant et la famille (CEIDEF), Québec, Canada.,Groupe de recherche et d'intervention auprès des enfants vulnérables et négligés (GRIN), Québec, Canada.,Département de psychologie, 14847Université du Québec à Trois-Rivières, Québec, Canada
| | - Christine Drouin-Maziade
- Département des sciences infirmières, 14847Université du Québec à Trois-Rivières, Québec, Canada.,Centre d'études interdisciplinaires sur le développement de l'enfant et la famille (CEIDEF), Québec, Canada
| | - Nicolas Berthelot
- Département des sciences infirmières, 14847Université du Québec à Trois-Rivières, Québec, Canada.,Centre d'études interdisciplinaires sur le développement de l'enfant et la famille (CEIDEF), Québec, Canada.,Groupe de recherche et d'intervention auprès des enfants vulnérables et négligés (GRIN), Québec, Canada.,Centre de recherche interdisciplinaire sur les problèmes conjugaux et les agressions sexuelles (CRIPCAS), Québec, Canada
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40
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Abstract
The recurring failure to accurately account for local realities, by semiology built on the universalist model of evidence-based medicine has made it necessary to theorize culture-bound syndrome. The case of Mrs. S. illustrates how, despite multiple hospitalizations and management, a first symptomatology of psychotic appearance has eclipsed, for years, a recurrent depressive disorder. These diagnostic errors involve people because of their non-Western origins, and lead to an overdiagnostic of schizophrenia. It seems urgent to us to promote awareness of this social inequity of health by sensitizing French psychiatric interns to cross-cultural issues.
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41
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Portal B, Guiard BP. [Role of astrocytic connexins in the regulation of extracellular glutamate levels: implication for the treatment of major depressive episodes]. Biol Aujourdhui 2020; 214:71-83. [PMID: 33357364 DOI: 10.1051/jbio/2020008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Indexed: 11/14/2022]
Abstract
Major depression is a psychiatric disorder relying on different neurobiological mechanisms. In particular, a hypersensitivity of the hypothalamic-pituitary-adrenal axis leading to an excess of cortisol in blood and a deficit in monoaminergic neurotransmission have been associated with mood disorders. In keeping with these mechanisms, currently available antidepressant drugs act by increasing the extracellular levels of monoamines in the synaptic cleft. Since the discovery of the rapid and long-lasting antidepressant effects of ketamine, an NMDA receptor antagonist, a growing attention in psychiatry is paid to the pharmacological tools able to attenuate glutamatergic neurotransmission. Astrocytes play an important role in the excitatory/inhibitory balance of the central nervous system through the regulation of glutamate reuptake and secretion. Interestingly, the release of this excitatory amino acid is controlled, at least in part, by plasma membrane proteins (i.e. connexins) that cluster together to form gap junctions or hemichannels. Preclinical evidence suggests that these functional entities play a critical role in emotional behaviour. After a brief overview of the literature on mood disorders and related treatments, this review describes the role of astrocytes and connexins in glutamatergic neurotransmission and major depression. Moreover, we highlight the arguments supporting the therapeutic potential of connexins blockers but also the practical difficulties to target the hemichannels while maintaining gap junctions intact.
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Affiliation(s)
- Benjamin Portal
- Centre de Recherches sur la Cognition Animale, Centre de Biologie Intégrative, Université de Toulouse, CNRS, 31000 Toulouse, France
| | - Bruno P Guiard
- Centre de Recherches sur la Cognition Animale, Centre de Biologie Intégrative, Université de Toulouse, CNRS, 31000 Toulouse, France
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42
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Hazif-Thomas C, Thomas P. [Accommodation facility for dependent elderly people, ensuring relational proximity after health emergencies]. Soins Gerontol 2020; 25:28-30. [PMID: 32988484 DOI: 10.1016/j.sger.2020.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The health emergency linked to Covid-19 has been stressful for staff working in nursing home, and doubly painful for residents faced with the risk of infection and the reality of family separation. We explore in this article some psychological consequences resulting from their experience in the waning health crisis, hoping that the experience gained will allow greater efficiency in the event of a resumption of the pandemic.
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Affiliation(s)
- Cyril Hazif-Thomas
- Service de psychiatrie du sujet âgé, EA 7479, centre hospitalier régional universitaire de Brest, route de Ploudalmezeau, 29820 Bohars, France
| | - Philippe Thomas
- Centre de recherches sémiotiques, EA 3648, université de Limoges, 39 rue Camille-Guérin, 87000 Limoges, France.
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43
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Abstract
While many studies have looked into the consequences of climate change on physical health, its impact on mental health is still relatively unknown. Climate-related disasters lead to psychotrauma in populations, as well as sleeping disorders, anxiety and depression. Rising temperatures increase the level of agression and violence. Climate migration also leads to psychological disorders in migrants. Mental health professionals must be trained in these pathologies which are set to become more common over the decades to come.
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Affiliation(s)
- Guillaume Fond
- Assistance publique-Hôpitaux de Marseille (AP-HM) Marseille Université, faculté de médecine - secteur Timone, EA 3279 : CEReSS - Centre d'étude et de recherche sur les services de santé et la qualité de vie, Hôpital La Conception, Marseille, France.
| | - Christophe Lançon
- Assistance publique-Hôpitaux de Marseille (AP-HM) Marseille Université, faculté de médecine - secteur Timone, EA 3279 : CEReSS - Centre d'étude et de recherche sur les services de santé et la qualité de vie, Hôpital La Conception, Marseille, France
| | - Pascal Auquier
- Assistance publique-Hôpitaux de Marseille (AP-HM) Marseille Université, faculté de médecine - secteur Timone, EA 3279 : CEReSS - Centre d'étude et de recherche sur les services de santé et la qualité de vie, Hôpital La Conception, Marseille, France
| | - Laurent Boyer
- Assistance publique-Hôpitaux de Marseille (AP-HM) Marseille Université, faculté de médecine - secteur Timone, EA 3279 : CEReSS - Centre d'étude et de recherche sur les services de santé et la qualité de vie, Hôpital La Conception, Marseille, France
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44
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Bohr Y, Bimm M, Bint Misbah K, Perrier R, Lee Y, Armour L, Sockett-DiMarco N. The Crying Clinic: Increasing accessibility to Infant Mental Health services for immigrant parents at risk for peripartum depression. Infant Ment Health J 2020; 42:140-156. [PMID: 32644229 DOI: 10.1002/imhj.21879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Peripartum depression (PPD) is considered a major public health concern due to its profound impact on families, including infants. In this paper, we report on a pilot initiative designed to reduce barriers and stigma related to the use of traditional infant mental health services for immigrant parents deemed at high risk of PPD. The Crying Clinic (CC) is an innovative walk-in service offered in a culturally diverse Canadian community to support maternal well-being and healthy parent-infant relationships. The CC was designed to be a gateway to existing infant mental health services, through its emphasis on accessibility and cultural sensitivity. Support for concrete concerns, such as anxiety about normative infant behaviors like crying, is underscored in this approach to attract vulnerable families who would otherwise not access mental health support. A review of 44 users, utilization, plans for the use of additional services, and client evaluations suggests that the CC accomplished most of its goals. We conclude that gateway service models such as the CC have the potential to enhance traditional infant mental health programs by creatively addressing the challenge of engaging highly vulnerable parents from culturally diverse backgrounds.
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Affiliation(s)
- Y Bohr
- Department of Psychology, York University, Toronto, Canada
| | - M Bimm
- Department of Psychology, York University, Toronto, Canada
| | - K Bint Misbah
- Department of Psychology, York University, Toronto, Canada
| | - R Perrier
- Department of Psychology, University of Montreal, Montreal, Canada
| | - Y Lee
- Department of Psychology, York University, Toronto, Canada
| | - L Armour
- Aisling Discoveries Child and Family Centre, Scarborough, Canada
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45
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Yared Z, Blunden S, Stotland S. Addressing a Care Gap in Type 1 Diabetes Management: Using the Diabetes Distress Scale in a Community Care Setting to Address Diabetes-Related Treatment Challenges. Can J Diabetes 2020; 44:514-520. [PMID: 32792105 DOI: 10.1016/j.jcjd.2020.06.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 05/25/2020] [Accepted: 06/11/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To bridge the gap between existing clinical evidence and recommendations around screening for diabetes-related distress (DD) and the observation of a low level of adoption of these suggestions in everyday clinical practice. We focused on the use of the Diabetes Distress Scale (DDS) by adult diabetes care specialists. METHODS We conducted a survey of endocrinologists and diabetes educators in our clinics, examining the use of DD screening and assessment tools, including DDS-2, DDS-17 and T1-DDS-28. RESULTS Our results indicated that very few practitioners surveyed are currently using the DD questionnaires, and highlighted their perceptions of the primary barriers to doing so. CONCLUSIONS We discuss the results of our survey of colleagues' use of the DDS and provide suggestions about how to incorporate this tool, and tips about how to address the various facets of DD. We argue that integrating the assessment of DD in clinical practice, with the use of standardized and validated self-report questionnaires, is a necessary and very feasible step towards achieving further improvements in the health and quality of life of people living with type 1 diabetes.
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Affiliation(s)
- Zeina Yared
- LMC Diabetes & Endocrinology, Montreal, Québec, Canada
| | - Sarah Blunden
- LMC Diabetes & Endocrinology, Montreal, Québec, Canada
| | - Stephen Stotland
- Montreal Comprehensive Weight Management Program, and Department of Nutrition, University of Montreal, Montreal, Québec, Canada.
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46
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Montesano M, Reed JL, Tulloch HE, Pipe AL, Terada T. Cardiac rehabilitation is associated with greater improvements in psychological health following coronary artery bypass graft surgery when compared with percutaneous coronary intervention. Appl Physiol Nutr Metab 2020; 45:1339-1344. [PMID: 32544341 DOI: 10.1139/apnm-2020-0213] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Following coronary revascularization, patients treated with coronary artery bypass graft surgery (CABG) have lower risk of major adverse cardiovascular events when compared with those treated with percutaneous coronary intervention (PCI). We compared changes in cardiovascular risk factors, such as psychological and cardiometabolic health indicators, among patients who completed cardiac rehabilitation (CR) following CABG and PCI. Longitudinal records of 278 patients who completed an outpatient CR program following CABG or PCI were analyzed. We compared changes in anxiety and depression assessed by the Hospital Anxiety and Depression Scale (HADS); health-related quality of life (HR-QoL) measured by the Medical Outcomes Study Short Form-36 (SF-36); and indicators of cardiometabolic health (i.e., body mass, blood pressure, glucose, and lipid profiles) between CABG and PCI groups using analysis of covariance (ANCOVA). At baseline, patients treated with PCI (n = 191) had superior physical function (i.e., physical functioning: 62.5 ± 22.1 vs. 54.3 ± 23.0 points, p = 0.006; and role limitations due to physical health: 31.2 ± 36.8 vs. 20.6 ± 31.8 points, p = 0.024) when compared with those treated with CABG (n = 87). Following CR, patients treated with PCI showed significantly smaller improvements in depression (-0.4 ± 3.1 vs. -1.3 ± 2.7 points, p = 0.036) and mental HR-QoL (mental component summary: 2.4 ± 10.8 vs. 5.7 ± 10.7 points, p = 0.020) when compared with those treated with CABG. Novelty Patients with coronary artery disease treated with PCI have smaller functional limitations but similar psychological health when compared with those treated with CABG at CR enrollment. Patients participating in CR following PCI appear to achieve smaller psychological health benefits from CR when compared with those recovering from CABG.
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Affiliation(s)
- Matthew Montesano
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada.,Department of Surgery, Amsterdam UMC, Location VU University Medical Centre, Amsterdam 1081 HV, the Netherlands
| | - Jennifer L Reed
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada.,School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1Y 4W7, Canada
| | - Heather E Tulloch
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada
| | - Andrew L Pipe
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada
| | - Tasuku Terada
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada
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47
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Kalra G, Gill S, Tang TS. Depression and Diabetes Distress in South Asian Adults Living in Low- and Middle-Income Countries: A Scoping Review. Can J Diabetes 2020; 44:521-529.e1. [PMID: 32792106 DOI: 10.1016/j.jcjd.2020.06.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES In this study, we conducted a scoping review to identify the prevalence of both depression and diabetes distress in patients with type 2 diabetes in low- and middle-income countries in South Asia. METHODS This scoping review was grounded in the methodology of Arksey and O'Malley by searching for relevant studies using Ovid MEDLINE, PsycINFO and Cumulative Index of Nursing and Allied Health Literature databases, as well as grey literature sources and hand searches. Two reviewers independently screened and extracted data from articles that met the inclusion criteria. RESULTS A total of 46 studies were included, with only 1 addressing both depression and diabetes distress. We present 42 total articles on depression and 5 on diabetes distress. The prevalence of type 2 diabetes and elevated depressive symptoms ranged from 11.6% to 67.5%, whereas the prevalence of diabetes distress ranged from 18.0% to 76.2%. CONCLUSIONS The prevalence of elevated depressive symptoms was found to be much higher than that reported in data from high-income countries and in data on South Asians living in high-income countries. Diabetes distress was found to be lower compared with other studies; however, the scarcity of data makes this observation inconclusive. Variations in depression inventories, lack of culturally tailored inventories and the focus on urban clinic-based populations are identified as limitations and areas requiring further research. Our review provides evidence for the need of increased mental health screening and treatment in diabetes care in South Asian countries.
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Affiliation(s)
- Gunisha Kalra
- Faculty of Health Sciences-Global Health, McMaster University, Hamilton, Ontario, Canada
| | - Simran Gill
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tricia S Tang
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
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48
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Lutes LD, Cummings DM, Littlewood K, Le MT, Kirian K, Patil S, Solar C, Carraway M, Hambidge B. A Tailored Cognitive-Behavioural Intervention Produces Comparable Reductions in Regimen-Related Distress in Adults With Type 2 Diabetes Regardless of Insulin Use: 12-Month Outcomes From the COMRADE Trial. Can J Diabetes 2020; 44:530-6. [PMID: 32792107 DOI: 10.1016/j.jcjd.2020.05.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 05/21/2020] [Accepted: 05/28/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Our aim in this study was to determine whether a cognitive-behavioural therapy plus small changes lifestyle intervention can produce comparable improvements in insulin users vs patients not using insulin with uncontrolled type 2 diabetes (T2D) and comorbid depressive or regimen-related distress (RRD) symptoms. METHODS This study is a secondary analysis of Collaborative Care Management for Distress and Depression in Rural Diabetes Study, a randomized, controlled trial of a 16-session, severity-tailored cognitive-behavioural therapy plus small changes lifestyle intervention compared with usual care. Outcomes included glycated hemoglobin (A1C), regimen-related distress, depression, medication adherence and diabetes self-care. Our investigation provides 2 sets of contrasts: 1) insulin users in the intervention group compared with insulin users in the usual-care group and 2) insulin users compared with noninsulin users in the intervention group only. RESULTS Of the 139 participants, 72 (52%) were using insulin at baseline and had significantly higher levels of A1C (10.2±2.1% vs 8.9±1.6%) and RRD (3.3±1.4 vs 2.8±1.1), and significantly poorer medication adherence (5.2±2.1 days/wk vs 5.5±1.7 days/wk). Intervention patients using insulin exhibited significantly greater reductions in RRD and marginally significant improvements in medication adherence and A1C compared with insulin users in usual care. Within the intervention group, changes in RRD, medication adherence and A1C did not differ significantly by insulin use. CONCLUSIONS Tailored cognitive-behavioural therapy with a small-changes lifestyle intervention improved elevated RRD and A1C outcomes at least as effectively in insulin users as non‒insulin users. Future powered studies need to address the role of insulin use in uptake and treatment outcomes.
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49
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Benson J, Severn C, Hudnut-Beumler J, Simon SL, Abramson N, Shomaker LB, Gulley LD, Taylor A, Kelsey MM, Nadeau KJ, Zeitler PS, Pyle L, Cree-Green M. Depression in Girls With Obesity and Polycystic Ovary Syndrome and/or Type 2 Diabetes. Can J Diabetes 2020; 44:507-513. [PMID: 32792104 DOI: 10.1016/j.jcjd.2020.05.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 05/26/2020] [Accepted: 05/26/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Polycystic ovary syndrome (PCOS) is a common reproductive/metabolic condition associated with obesity, type 2 diabetes (T2D) and depression in adult women. Depression in adults is related to PCOS dermatologic manifestations. Adolescents with obesity with or without T2D have elevated depression symptoms, but data from youth with PCOS and obesity with/without T2D are limited. METHODS Our study included girls, aged 11 to 17 years, with obesity and PCOS, PCOS+T2D or T2D, who were newly seen in an obesity complications clinic after March 2016. All participants had Center for Epidemiologic Studies-Depression (CES-D, 20 items) scores obtained within 6 months of PCOS or T2D diagnosis. Data on history of psychiatric diagnosis and treatment, metabolic syndrome and severity of acne and hirsutism were collected through chart review. RESULTS One hundred five girls (47 with PCOS, 14 with PCOS+T2D, 44 with T2D) had similar age (15±1.8 years) and body mass index z scores (2.2±0.4). CES-D scores ≥16, indicating elevated depression symptoms, and CES-D scores ≥24, indicating severe depression symptoms, were observed in 60% and 30% of girls with PCOS, 78% and 71% of those with PCOS+T2D and 39% and 21% of those with T2D, respectively (p<0.0001 for both cutpoints). A higher CES-D score was not associated with severity of hirsutism or acne (p>0.05 for both). CONCLUSIONS Adolescents with PCOS and obesity have higher rates of elevated depression symptoms compared with girls with T2D, which is not related to worse dermatologic symptoms. Because depression may impact both PCOS and T2D management and adherence to therapy, greater efforts should be made to screen for and address mental health in adolescents with PCOS and obesity, especially if T2D is present.
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Affiliation(s)
- Jessie Benson
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Cameron Severn
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado, United States
| | - Julia Hudnut-Beumler
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Stacey L Simon
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States; Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Natalie Abramson
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Lauren B Shomaker
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States; Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, United States
| | - Lauren D Gulley
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States; Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, United States
| | - Anya Taylor
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Megan M Kelsey
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States; Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Kristen J Nadeau
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States; Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Philip S Zeitler
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Laura Pyle
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado, United States; Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Melanie Cree-Green
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States; Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States.
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50
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Wong J, Mehta G. Efficacy of Depression Management in an Integrated Psychiatric-Diabetes Education Clinic for Comorbid Depression and Diabetes Mellitus Types 1 and 2. Can J Diabetes 2020; 44:455-460. [PMID: 32653155 DOI: 10.1016/j.jcjd.2020.03.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 03/25/2020] [Accepted: 03/27/2020] [Indexed: 01/28/2023]
Abstract
OBJECTIVES Patients with type 1 and type 2 diabetes mellitus (DM) are 2 times as predisposed to developing mood disorders, such as major depressive disorder (MDD), compared with patients without diabetes. Management of comorbid MDD and DM remains a challenge because patients often suffer from poor medication compliance, lifestyle factors and refractory depression. Integration of psychiatric care into diabetes education clinics (DECs) has been suggested as an effective method of managing the comorbid conditions. As this strategy is being implemented into clinical care, its effectiveness in practice warrants further research. METHODS A retrospective chart review of 24 patients (10 men and 14 women) followed by an integrated psychiatry-DEC in Newmarket, Ontario, Canada, between April 2016 and July 2019 was performed. Depressive symptom severity at each appointment was assessed with the Patient Health Questionnaire-9 (PHQ-9) depression rating scale. RESULTS There was no significant change in PHQ-9 depression rating scale scoring between the first and most recent appointments (paired t test, p=0.356); however, patients who had improved PHQ-9 scoring were more likely to have more clinic visits (analysis of variance, p=0.0271). A significant negative correlation was found between both number of visits (Pearson coefficient, -0.56; p=0.005) and overall time the patients were followed by DEC (Pearson coefficient, -0.42; p=0.040) and PHQ-9 score changes between the first and most recent appointments. PHQ-9 change between individual appointments also displayed a positive correlation with time between appointments (Pearson coefficient, 0.26; p=0.027). CONCLUSIONS Regular follow up in a psychiatry-DEC service might be beneficial in managing MDD symptom severity for comorbid MDD and DM.
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Affiliation(s)
- Jackson Wong
- University College Cork, School of Medicine, Cork, Ireland
| | - Gaurav Mehta
- Southlake Regional Health Centre, Newmarket, Ontario, Canada; University of Toronto, Faculty of Medicine, Toronto, Ontario, Canada.
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