bluuebunny/crossref_metadata_2025 huggingface dataset:
Resilient care in times of covid: The stress buddy
Authors: Rius-Ottenheim N. , Vermetten E. , Giltay E. , Boeschoten M. , De Bles N. , Van Der Wee N. , Hemert A. Van
Published: February 2022

Introduction

The COVID-19 outbreak poses a challenge for health care professionals due to a surge in care demands, overwork, fear of contagion and concerns on the availability of protective equipment, and coping with distress of patients and their families. Although there is emerging evidence on prevalence of stress and its predictors, less is known on the trajectory of stress symptoms and the differences between cohorts of health care professionals.

Objectives

To sustain and restore health care professionals the Leiden University Medical Center has launched the Digital Stress Buddy, a mobile app, to assess psychological stress, depressive symptoms, anxiety and posttraumatic stress symptoms.

Methods

Participants fill in a 14-item questionnaire on stress and resilience resources, followed by a COVID-related questionnaire and finally a set of validated questionnaires on depression and anxiety (DASS-21), posttraumatic stress-symptoms (IES-R), burn-out (CBI) and resilience (RES).

Results

To date, 959 health care workers have completed the stress monitor, of whom 223 (23%) showed relevant stress levels. Within this group, anxiety and posttraumatic symptoms were most prevalent (45%), followed by depressive symptoms (15%). Predictors of stress were being female, coping with distress of patients and their families, teleworking, and overwork.

Conclusions

By identifying vulnerabilities and resilience for psychological distress, we are able to tailor the support interventions for health care workers within our hospital. This is an ongoing study and future follow-up during the second wave of the pandemic will provide more insight on the trajectories of stress-related symptoms.

Conflict of interest

No significant relationships.
Psychosocial effects of COVID-19 pandemic in Bolivia. Preliminary results
Authors: Valdés D. , Molina F. , Barrientos C. , Valenzuela P. , Basaigoitia A. , Burrone M. , Reginatto G. , Leniz I. , Solis-Soto M.
Published: February 2022

Introduction

The global health crisis due to Coronavirus Disease 2019 (COVID-19) and related containment measures have led to changes in daily life and, therefore, social and psychological impacts on the population.

Objectives

To explore the psychological and social impact of COVID-19 in the general population of Bolivia.

Methods

Cross-sectional study was implemented using an anonymous and self-administered online questionnaire. Adult people were invited to participate through social networks between May to June 2020. The questionnaire included sociodemographic information, coping strategies, changes in income and working conditions and psychological distress (K10 Scale).

Results

A total of 878 adults living in Bolivia answered the questionnaire. Most people considered COVID-19 as a quite/very serious health problem that affects the entire population, without distinction. 65% reported to accomplish lock down measure, however, one of the main reasons for non-compliance is the need to go out to work. Half of participants (50%) reduced worked hours and 18% modified their employment contract. However, 70% reduced household income. A considerable percentage (62%) reported psychological distress (46% with moderate or severe). It was higher in women, young people and among those with lower household income. In addition, social networks and watching series and movies were the main coping strategies reported.

Conclusions

The COVID-19 pandemic has a considerable impact on psychological and social level. The negative impact was greater in some population groups such as women, young people, and those with a lower socioeconomic level, which may further increase inequities.
Increase in the percentage of obsessive compulsive disorder (OCD) symptoms during the covid pandemic and quarantine at santiago, chile
Authors: Zarate C. , Binder P. , Valdivia V. , Stappung H. , De Arce J.T. Saavedra Perez
Published: February 2022

Introduction

In pandemic conditions, obsessive rituals such as hygiene can be considered adaptive together with the extreme measures that must be followed to avoid contagion by Covid-19, we suggest that the stress the pandemic has caused may result in an increase in the percentage of OCD symptom and severity in the Chilean population at Santiago.

Objectives

Study OCD symptoms and their severity during a contamination pandemic such as COVID and quarentine, and compare them to national reports of OCD prevalence in Chile. We hypothesize that OCD symptoms would be higher in these stressfull situations.

Methods

An online voluntary and annonymous survey was carried out asking about sociodemographic variables and the Y-BOCKS scale, an OCD symptom severity scale version already validated in Chile.

Results

497 completed the survey and Y-BOCKS scale. 241 people which is equivalent to 48% of the sample presented scores that classified them as having OCD.Off these 30% had mild, 12% moderate and 7% severe symptoms. 85% of them were inquarantine for more than 2 months.

Conclusions

These results are above the 2% of OCD reported at the national level. These percentages may be due to a smaller sample size, but even so, the high percentages of people with symptoms during COVID and those who were in quarentine or lockdown for 2 months or more, stand out. Future analysis and research needs to be made. We ask ourselves wether is Covid, quarentine, or both and of so, how much each pf these contribute to these high percentages of OCD symptoms observed.
Models for successful interactions between psychiatrists and indigenous people
Authors: Mainguy B. , Mehl-Madrona L.
Published: February 2022

Introduction

Conventional psychiatric services are not always acceptable to indigenous communities and people.

Objectives

We used qualitative methodology to explore a successful collaboration of psychiatrists and addiction medicine specialists with indigenous communities in Maine, USA, in North America, comparing these results to previously unsuccessful collaborations. We wanted to delineate what leads to success.

Methods

We used constant comparative, iterative methodology within a constructivist, grounded theory approach to generate differences to discuss.

Results

Successful strategies address the highly relational approach to defining the self of the indigenous communities, a collectivist mindset in which the needs of the group can supersede the needs of the individual, a reliance upon stories for transmission of knowledge and culture, and a commitment to a biopsychosocial and spiritual approach, which, in North America, is often symbolized by the metaphor of the Four Cardinal Directions. Successful psychiatrists working in these communities needed to share more personal details than what they are usually accustomed to provide. They acknowledged local culture and spirituality and worked with traditional knowledge holders to create collaborative approaches. As part of this, the use of a narrative approach worked best in which the psychiatrist worked within the stories and beliefs of the community which required taking the time in dialogue to learn those stories and beliefs.

Conclusions

We addressed the challenges of consulting to tribal-based treatment programs, of modifying usual counseling techniques such as motivational interviewing to an indigenous population. We propose that these sorts of participatory-action-based approaches go far to improve service delivery to indigenous people and reduce health disparities.
Who benefits most?
Authors: Van Diermen L.
Published: February 2022

We know from past meta-analyses that several clinical variables are associated with electroconvulsive therapy (ECT) outcome in major depression. In this lecture we give an update of clinical variables associated with ECT outcome and dig deeper into the fact that these variables also seem to be somehow associated with each other. We attempt to disentangle the interdependence between the clinical variables and try to distil the most important predictors of treatment success to help improve patient-treatment matching. Therefore we created a conceptual framework of interdependence between predictors capturing age, episode duration, and treatment resistance, all variables associated with ECT outcome, and the clinical symptoms of what we have called ‘core depression’, i.e., depression with psychomotor agitation, retardation, or psychotic features, or a combination of the three. We validated this model in a sample 73 patients using path analyses, with the size and direction of all direct and indirect paths being estimated using structural equation modelling. Results of these analyses were recently published and will also be disscussed at this symposium. The conceptual model could eb largely validated, the most important finding being that age was only indirectly associated with ECT outcome, meaning that age seems to be associated with ECT outcome only because more psychomotor and psychotic symptoms occur in elderly patients with a depressive disorder.

Disclosure

No significant relationships.
Successful treatment of primary delusional parasitosis with paroxetine: A case report and narrative review
Authors: Delgado L. , González-Rodríguez A. , Pedrero A. Alvarez , Guàrdia A. , Fucho G.F. , Seeman M.V. , Acebillo S. , Monreal J.A. , Labad J. , Vidal D. Palao
Published: February 2022

Introduction

Antipsychotics have been classically considered the treatment of choice for delusional disorder (DD) and antidepressant medications have been restricted to patients with comorbid depression.

Objectives

Our aim is to describe the case of a patient with DD with delusions of parasitosis, who responded to paroxetine as monotherapy. We also aimed to review the recent literature on the potential use of antidepressants as the main treatment for somatic type DD.

Methods

After the case report, we present a narrative review on the use of antidepressants in DD, somatic type (DSM-criteria) by using PubMed database from inception until 2020.

Results

Case: 74 year-old woman without previous psychiatric diagnosis who suffered from long-term cutaneous and vulvar pruritus. She was referred to psychiatry from dermatology to assess thought content and sensoperceptive disturbances. In the past, she had received unsuccessful treatment with antihistamines. The patient brought a collection of “the identified parasite” (matchbox sign) to our first appointment. On assessment, she was diagnosed with DD with delusions of parasitosis. Risperidone 1mg/day was poorly tolerated (excessive sedation). She refused further antipsychotic treatment, so we started paroxetine up to 20mg/day. The patient went into total remission of her pruritus and delusions of parasitosis. Review. In line with our case, 6 studies reported on the successful use of antidepressants as monotherapy for DD, somatic type. Most of studies report the successful use of an antipsychotic/antidepressant combination (case-series, case reports).

Conclusions

Although antipsychotics are the treatment of choice, antidepressant medications may be an effective alternative in somatic type DD when patients refuse antipsychotics.
Indigenous mental health therapies
Authors: Mehl-Madrona L. , Mainguy B.
Published: February 2022

Introduction

Cultural differences exist among indigenous and mainstream peoples about the nature of mind and how one achieves mental health.

Objectives

We aimed to determine what is important and different for indigenous communities from non-indigenous communities.

Methods

We assembled a focus group of 109 indigenous and non-indigenous mental health counselors who worked in indigenous communities to meet weekly for 90 minutes via an internet platform (Zoom) for 810weeks with asynchronous communication between meetings.

Results

The metaphor of the Four Directions, represented with different colors, attributes, and animals, was important in indigenous communities. Participants emphasized the idea of relational, non-local mind which places identity in the relationships between people rather than an individual body. Illnesses were seen as conscious beings who visit people and bring teachings. The healing, participants said, comes from reaching within the suffering and the pain to find the answer from within which makes meaning from an illness. People are expected to make offerings and sacrifices to the spirit of the illness to move toward wellness. These sacrifices can include lifestyle changes that the person might otherwise not make. Using substances without the proper protocols and prayers was likened to sorcery or witchcraft which can become a powerful incentive to stop disrespecting these substances and to find meaning in setting them aside with the help of a supportive community.

Conclusions

What participants saw as important for indigenous populations was different from what is usual for non-indigenous mental health services. Participants stressed the importance of non-indigenous providers understanding this and not dismissing these ideas.
Transcultural psychiatry: Comparison of eastern and western culture and their influence on mental health and its treatment
Authors: Tiong S.P. , Rajkumari S. , Rasidi N.F.B. , Poplavskaya O.V.
Published: February 2022

Introduction

In a globalizing world, the need for humans to understand one another is fundamental. Transcultural Psychiatry aims to bridge the differences due to culture, norms and values between doctors and patients.

Objectives

To study the beliefs of Eastern and Western populations on the subject of religion, the paranormal and its relation to mental health.

Methods

The study was conducted targeting citizens of Eastern and Western countries (target sample size 200). A survey and 2 case studies were distributed, aimed to determine respondent’s level of belief in cultural superstitions and practices, views on mental disorders and opinions on treatment. A chi-square statistical test (significance set at ≤0.05) was performed to test validity.

Results

are tabulated in Table 1. In the case studies, P-value =4.68x10-6 proves a strong relationship between East/West populations and their viewpoints on mental illness vs. possession. There is a strong relationship (p=3.37x10-5) between respondents’ beliefs in spiritual healing and its effectiveness in treating mental illness.Table 1EastWestTotal respondents (226)58%42%Identified as religious74%26%Strong belief in paranormal85%15%Effectiveness of spiritual healing55%45%Preferred methods of treatmentMental health professionals54%46%Religious healer/psychic90%10%

Conclusions

The study revealed that Eastern populations are far more superstitious and religious than their Western counterparts, and also have higher belief in the effectiveness of spiritual healing to treat mental disorders. This difference demonstrates the importance of integrating culture into diagnosis and treatment of mental illnesses, and further explore methods for more inclusive treatment plans.
Association of perceived stress and coping strategies with depressive symptoms in students at a private medical college in islamabad
Authors: Zubair U. , Mansoor S. , Mansoor T.
Published: February 2022

Introduction

The environment at medical colleges is competitive and typically generates higher stress levels. Both academic and psychosocial stresses appear to play a role, and the resourceful students who are able to employ effective coping strategies to deal with their stress are shown to outperform their peers in the academic settings.

Objectives

Objective: To determine the Association of Perceived Stress and Coping Strategies with Depressive symptoms in students at a private medical college in Islamabad

Methods

Fourth and Final year medical students of Foundation university medical college were enrolled in the study. Beck’s Depression Inventory was used to assess the depressive symptoms, Perceived Stress Scale (PSS) was the tool used to look for the perceived stress and the coping strategies were assessed using the Brief COPE Inventory. Association of Perceived Stress and Coping Strategies with Depressive symptoms and other sociodemographic factors was established.

Results

Out of 262 medical students studied, 211 (80.5%) had no or mild depressive symptoms while 51 (19.5%) had moderate to severe depressive symptoms. 66 (25.2%) had low stress, 127 (48.4%) had moderate stress while 69 (26.3%) had high stress. Chi-square test revealed that perceived stress, self-distraction, active coping, denial, substance use, behavioral disengagement, positive reframing, acceptance, religion/ spirituality and self-blaming had statistically significant relationship with presence of depressive symptoms among the target population.

Conclusions

Considerable number of medical students had presence of moderate to severe depressive symptoms in our study. Perceived stress and some specific kinds of coping strategies had significant association with presence of depressive symptoms among target population
Differences in the preferred food tastes characteristics in patients with depressive disorder and healthy subjects
Authors: Pluciute A. , Adomaitienė V. , Steibliene V. , Jarutiene L. , Bartkiene E. , Lele V. , Cernauskas D. , Klupsaite D. , Žadeikė D. , Juodeikiene G.
Published: February 2022

Introduction

There is no doubt that the symptoms of depression is the loss of appetite and loss the ability to taste food. However there is unanswered question how depression disorder impact different preferences of food tastes, which was sought to be explored in this study.

Objectives

were to evaluate changes in characteristics of food tastes in patients with depressive disorder and healthy controls; and to find the association with clinical expression of depressive severity.

Methods

74 patients with depressive disorder (according DSM-V, MINI 6.0.0) and 38 healthy controls, 18 to 55 age old, were included into this study. The subjects were interviewed using the sociodemographic and the food sensory questionnaires. The severity of depression was rated using Montgomery-Asberg Depression Rating Scale (MADRS).

Results

There were significantly more patients with depressive disorder in comparison to healthy controls preferred non-spicy taste of food (66.2 % vs. 47.4 % respectively, p=0.025) and non-sour taste of food (66.2% vs 50.0 %, respectively, p=0.015), without significant differences in preference of salty and sweet food tastes. Among study patients with depressive disorder, the majority (71.6%) suffered from moderate severe depression, 23 % - severe depression and 5.4 % had mild severity depression. The preferences of tastes of the food (sour, sweet, salty, spicy) were independent of the severity of the depressive disorder (p>0.05)

Conclusions

Patients with depressive disorder prefer non-spicy and non-sour food tastes, without differences in salty and sweet foods; it have found independent of the severity of the depressive disorder.
Study of cognitive impairment in depression
Authors: Sharma R. , Khattri J. , Thapa P.
Published: February 2022

Introduction

Cognitive impairment is frequently observed in patients suffering from depression. Cognitive dysfunction play a critical role in increasing the individual’s vulnerability for the first onset, maintenance and future recurrence of depressive episodes.

Objectives

The objectiv was to assess the cognitive impairment in patient with depressive episode.

Methods

A cross sectional, hospital based study was conducted among 100 patients with depressive episodes diagnosed by International Classification of Diseases - 10 visiting outpatient and inpatient in Department of Psychiatry of Manipal Teaching Hospital, Pokhara, Nepal. The subjects were interviewed with Beck’s depression inventory, Perceived deficient questionnaire, Frontal assessment battery, Trail making test A and B and Forward and Backward Digit Span test. For the assessment of correlates, regression analyses were done using SPSS v 20.0.

Results

The mean age of the participants was 32.47 years (SD±12.25), majority were female, married, Hindu and from urban population. Higher number of respondent were student. Most of them were educated till intermediate level and belonged to middle socioeconomic class family. Different domain of cognitive function according to severity of depression was found to be statistically significant (p<0.05). This study also found that age, sex, education, medication use and Becks depression inventory score predicted the cognitive function.

Conclusions

Cognitive impairment is not ucommon among patient with depressive episodes. The impairment is not only seen in severe cases but also in mild to moderate cases. The assessment of cognitive deficits should be the regular part of the assessment in depressive patients.
Peripheral tryptophan and serotonin and kynurenine pathways in major depression: A case-control study
Authors: Colle R. , Verstuyft C. , David D. , Chanson P. , Corruble E.
Published: February 2022

Introduction

The tryptophan pathway along with its two branches of metabolism to serotonin and kynurenine seems to be affected in major depression. In depressed patients, peripheral levels of tryptophan, serotonin, kynurenine and their metabolite remain unclear.

Objectives

Therefore, peripheral tryptophan and metabolites of serotonin and kynurenine were investigated extensively in 173 patients suffering from a current major depressive episode (MDE) and compared to 214 healthy controls (HC).

Methods

Fasting plasma levels of 11 peripheral metabolites were quantified: tryptophan, serotonin pathway (serotonin, its precursor 5-hydroxy-tryptophan and its metabolite the 5-hydroxy-indole acetic acid), and kynurenine pathway (kynurenine and six of its metabolites including anthranilic acid, kynurenic acid, nicotinamide, picolinic acid, xanthurenic acid and 3-hydroxy-anthranilic acid).

Results

60 (34.7%) patients were antidepressant drug free. Tryptophan levels did not differ between MDE patients and HC. Serotonin and its precursor (5-hydroxy-tryptophan) levels were lower in MDE patients than HC. Whereas, its metabolite (5-hydroxy-indole acetic acid) levels were within the standard range. Kynurenine and four of its metabolites (kynurenic acid, nicotinamide, picolinic acid and xanthurenic acid) were lower in MDE patients.

Conclusions

This study uses the largest ever sample of MDE patients, with an extensive assessment of peripheral tryptophan metabolism in plasma. These findings provide new insights into the peripheral signature of MDE. The reasons for these changes should be further investigated. These results might suggest a better stratification of patients and different therapeutic strategies therapeutic strategies.
Depression and hypothyroidism: Literature review and case report
Authors: Limeres P. Coucheiro , De La Torre Cruz B. , Del Campo A. Cerame , Soler A. Franco
Published: February 2022

Introduction

Multiple neuroendocrine disorders can present themselves through diverse psychiatric symptoms. In the case of hypothyroidism it can manifest itself through mood disorders that will require a comprehensive differential diagnosis.

Objectives

We present a case report and a review of the relevant literature about the relation between mood disorders and hypothyroidism.

Methods

We present the case of a 56-year-old man with no prior psychiatric record who concurring with a grieving process, developed a depressed mood, fatigue, decreased daily activity, and home isolation for months of evolution. He was diagnosed of hypothyroidism and treated with levotiroxine. It was necessary to boost hormonal treatment with antidepressant drugs due to the persistence of the symptoms after the resolution of the hormonal deficit.

Results

The relationship of depression in patients with overt hypothyroidism is widely recognized. Common alterations to both disorders that could make their diagnosis difficult have been observed: existence of psychomotor slowing, attentional and executive disturbance, anxiety, asthenia, weight gain, depressed mood or bradypsychia among others. In the case of subclinical hypothyroidism, certain neuropsychiatric disorders have been linked without having conclusive evidence.

Conclusions

An early screening of thyroid function at the onset of psychiatric symptoms in individuals without prior psychiatric record is essential in the provision of adequate treatment. Clinical improvement has been seen with hormone replacement therapy alone. However, in up to 10% of patients it becomes insufficient, being necessary to complete it with antidepressant drugs for the complete resolution of the condition.
How effective are ketamine or esketamine in treatment-resistant depression?
Authors: Veluri N. , Mansuri Z.
Published: February 2022

Introduction

Globally, depression affects millions of individuals. A third of depression patients meet the criteria for treatment-resistant depression (TRD). The N-methyl-D-aspartate receptor antagonist, ketamine, improved depressive symptoms in a span of 24-hours. Recently, the FDA approved esketamine, an enantiomer of ketamine for TRD.

Objectives

To determine the effectiveness of ketamine and esketamine in TRD, and observe their role in suicidality.

Methods

Individual systematic searches were conducted on the PubMed database following the PRISMA protocol (Figure 1). Inclusion criteria included randomized clinical trials (RCT). Search strings were (i) “ketamine” OR “esketamine” AND “treatment-resistant depression” (ii) “ketamine” OR “esketamine” AND “suicide.” Eleven studies were included for depression and five studies for suicidality (Table 1). Comparison analysis for suicide appeared trivial because of only one inclusion eligible esketamine RCT. This review was submitted for registration at PROSPERO. Randomized odds ratios, 95% confidence interval (CI), and heterogeneity were obtained.

Results

The comprehensive meta-analysis, version 3.0, was used for analysis. Ketamine improved TRD symptoms and reduced suicidality by a nine-fold and three-fold odds, respectively (OR 9.01, CI 4.89–16.6, p<0.001 and OR 2.9, CI 1.67–5.06, p<0.001). Esketamine also improved TRS symptoms (OR= 2.61, 95% CI= 1.56–4.37, p<0.001). The heterogeneity ranged from 11% to 60% between the three groups. Sensitivity analysis did not alter the results.

Conclusions

Findings must be cautiously interpreted as the primary endpoint differed. The primary endpoint was set at 24-hours and 28-days for ketamine and esketamine, respectively. Esketamine’s effectiveness over 28 days appears promising for TRD. Current aim should consist of structured guidance for clinicians in esketamine administration.
Features of the influence of hereditary factors on the clinical manifestations of depressive disorders
Authors: Maruta N. , Kolyadko S. , Fedchenko V. , Yavdak I.
Published: February 2022

Introduction

The urgency of the problem of depression is due to their high prevalence and severity of consequences. At present, the pathogenetic role of heredity in the course of depressive disorders remains unclear. Therefore, studies related to this problem are designed to identify the relationship between hereditary factors and the characteristics of the clinic of depression.

Objectives

The aim was to study the features of the influence of hereditary factors on the clinic of depressive disorders.

Methods

clinical-psychopathological, psychometric, genealogical, statistical.

Results

Based on the study of clinical, psychometric (Hamilton scale (HDRS)), genealogical data of 87 patients with depression, a high level of family burden of depression at all levels of kinship in the pedigree of patients (73.56%), alcohol abuse (39.08%), the presence of hypertension (54.02%), heart disease (42.53%) and endocrine pathology (14.94%) were identified. Moreover, in the pedigree of the examined most often this pathology was found in relatives of I and II degree of kinship. When comparing the factors of heredity with the clinical structure and features of depression revealed the proportion of correlations of such factors as: observation by a psychiatrist of I and II degree of relatedness (p ≤ 0.01), depressive disorders mainly by II degree of relatedness (p ≤ 0.05), suicidal behavior according to I and II degree of kinship (p ≤ 0.005), alcohol dependence mainly on I degree of kinship (p ≤ 0.03). Selected leading symptom complexes: depressive, asthenic, apathetic, anxiety-phobic, somato-vegetative, hypochondriac.

Conclusions

The data obtained should be taken into account in diagnostic and preventive measures.
Depressive disorder in childhood: The importance of an early diagnosis for a functional recovery. Specific symptoms and treatment in an 8-years old patient with depression
Authors: Rus S.S. Sánchez , Solis M.O. , Rodriguez L. Soldado , Suárez-Gómez M.
Published: February 2022

Introduction

Depressive disorders (Dd) in childhood have a prevalence about 1-2%. Sometimes depression may be underdiagnosed with the risk of complications: comorbidity, chronicity or development of psychiatric diseases in adulthood. Although children often do not show a clear sad mood, they usually presents irritability as a cardinal symptom. Other common symptoms in children´s depression are lack of attention, difficult of concentration and impulsivity. These symptoms actually could define as well an Attention Deficit and Hyperactivity Disorder (ADHD), highly prevalent in school-aged children (5-7%).

Objectives

-To deep into diagnosis and evolution of depressive disorder in primary school-aged children (7-12 years-old). -To contrast clinical evidence about specific aged-symptoms observed in the boy and follow-up until remission.

Methods

-Case study. Graphic description of diagnosis path and treatment in a 8-years-old boy suffers from depression. -Clinical case attended in Mental Health Unit, ambulatory consultation (outpatient). -Diagnosis tools: Clinical examination, family interview, evaluation tests and school psychopedagogical assessment.

Results

-Treatment methods: psychotherapy, psychopharmacology and theater. -Specific depressive symptoms depends on childhood stages (*chart by ages). -Pharmacological treatment used: psychostimulants, benzodiazepines and antidepressants. -Efficacy of monotherapy with Fluoxetine 20mg/day 6-months. -Importance of individual psychotherapy and group activities 12-months. -Episode resolution and functional recovery 15-months.

Conclusions

Variability of symptoms in children´s depression can be confused with other psychiatric disorders like decreased school performance (ADHD), that may make diagnosis difficult. Sometimes, both disorders coexist, especially when the mood disorder is secondary to academic problems caused by ADHD. Early diagnosis and continued follow-up in specialized units is necessary to avoid progression and complications of Dd.
Prevalence of psychoemotional disorders in patients with pathological kinking of the internal carotid arteries
Authors: Malenkova E. , Zagorulko O.
Published: February 2022

Introduction

Pathological kinking of the internal carotid arteries (PK ICA) is a controversial issue of angioneurology. Patients with PK ICA often present a variety of complaints, such as headache, dizziness, decreased concentration, memory impairment, and general weakness [1].

Objectives

To study the prevalence of anxiety and depression in patients with PK ICA.

Methods

We studied 132 patients who had PK ICA (main group) and 86 patients without brachiocephalic artery pathology (control group). Hospital Anxiety and Depression Scale (HADS) was used to evaluate anxiety and depression, considering depression or anxiety if the score was ≥10. Statistical analysis was performed with SPSS software, p-value<0.05 was considered statistically significant.

Results

The mean age of the patients in the main group was 38.4±5.2 years, in patients of the control group 41.2±4.8 years, respectively. Anxiety disorders were detected significantly more frequently in the main group of patients than in the control group (35.7% and 10.2%, p=0.017 respectively). The frequency of depressive disorders was comparable in both groups – 13.6% and 14.3%, p=0.061, respectively. The level of anxiety was also significantly higher in the group of patients with PK compared to the control group (14.2±4.3 and 9.7±3.1 points, p=0.019). patients with PK ICA with anxiety are more likely suffered from depression (10.2% and 5.8%, p<0.001).

Conclusions

Anxiety disorders were present in one-third of patients with PK ICA, while depressive disorders were not typical for this group. In patients with PK ICA, in addition to collecting complaints, anamnesis, and evaluating the neurological status, it is advisable to conduct neuropsychological testing. References:1.Medvedeva LA, Zagorulko OI.Korsakov Journal 2019
Major depression revealing primary hyperparathyroidism: A case report
Authors: Ouali R. , Turki M. , Ellouze S. , Babah T. , Charf R. , Halouani N. , Aloulou J.
Published: February 2022

Introduction

Psychiatric symptoms associated with Primary hyperparathyroidism (PHPT) involved several presentations; the most characteristic is depression. However, PHPT remains often overlooked by physicians when making differential diagnosis for patients with psychiatric disorders, particularly in the elderly.

Objectives

We proposed to describe the clinical and therapeutic characteristics of major depression secondary to PHPT.

Methods

We report a case of PHPT revealed by depression. Then, we conducted a literature review using “PubMed” database and keywords “primary Hyperparathyroidism”, “depression”.

Results

A 73-year-old man presented with a 3-month history of depressed mood, loss of interest, clinophilia, poor concentration, and weight loss. These symptoms were associated with epigastralgia and constipation not responding to symptomatic treatment. The etiological assessment was normal. The diagnosis of major depression was established, and the patient was treated with Sertraline (25 mg/day). After one month of treatment, somatic and psychiatric symptoms worsened. Physical examination revealed a deteriorated general condition, dehydration, and cardiac arrhythmia. Blood analysis revealed renal failure, hypercalcemia (4.2mmol/L), hypophosphatemia (0.4mmol/L), and increased parathyroid hormone level (180 pg/ml). The patient was hospitalized in intensive care unit. Cervical echography showed 2 hyperparathyroid adenomas, and diagnosis of PHPT was established. Under symptomatic treatment, the patient’s somatic and psychiatric condition improved. An hyperparathyroidectomy is undergone soon.

Conclusions

This case highlighted the importance of considering a primary psychiatric disorder as a diagnosis of exclusion, especially in the elderly. PHPT is one of differential diagnoses for psychiatric symptoms, like depression, whose management is conditioned by that of the somatic disease.
Alcohol use disorder as a warning sign for depressive disorders in acute psychiatric care? hospitalization demographics in arad (ROMANIA)
Authors: László A. , Mariș M.
Published: February 2022

Introduction

Screening for psychiatric disorders is the job of primary care providers. As such, general practice residents spend one month on psychiatry rotation. During which, they need to familiarize with the diagnostic and treatment of mental disorders. Since depressive disorders in early stages can be easily overlooked by the untrained eye, we set out to analyse the demographic particularities of our patients.

Objectives

The objective of our study was to analyze demographic characteristics of patients hospitalised on Acute Inpatient Psychiatry Ward with unipolar depression and to identify the specific warning signs, later to be used for an awareness campaign addressed to family medicine residents.

Methods

Data was collected from Acute Inpatient Psychiatry Ward of Arad County Emergency Clinical Hospital (Romania) between 1th January 2019 and 30th September 2020. We included every patient who was discharged with unipolar depression diagnosis according to ICD-10 criterias(F32-F33). Every patient was included only once. In cases of multiple hospitalisations, we included the most severe episode. If the severity of episodes was similar, the longest hospitalisation from the selected period. The data analysis accomplished in Microsoft Excel2010.

Results

A number of 344 patients were included in our analysis (175 male, 169 female). Their presumptive diagnosis upon hospitalisation: Depressive Episode(F32)-32.3%, Recurring Depression(F33)-32,3%, Alcohol Use Disorder(F10)-23,8%, Suicid Attempt(X61-80)-7,0%, Other Psychiatric Disorders(F06,F20-23), Other Substance Use Disorder(F19)-0,6%. From 82 patients with presumptive diagnosis of Alcohol Use Disorder and definitive diagnosis of Depressive Disorder, 90,2% were male.

Conclusions

In primary practice alcohol misuse can be objectively spotted. Awareness is needed to investigate a possibly underlying depressive disorder.
Depressive and anxiety disorders among women with obesity
Authors: Kornetov N. , Yarosh O. , Sitnikova E.
Published: February 2022

Introduction

Abdominal obesity is currently a growing problem in public health and has a high comorbidity with depressive and anxiety disorders. Obesity significantly decreases life quality, causes disability and decreases life expectancy.

Objectives

The objective of this study was to examine anxiety and depressive symptoms among women, who received individual or group psychotherapy sessions due to obesity control.

Methods

577 women aging from 18 to 65 were examined. Height and weight were measured, Body mass index (BDI) was calculated based on received data. Depressive symptoms were determined with the PHQ-9 questionnaire [Kroenke K, Spitzer RL, Williams JB]. Anxiety symptoms were determined with the GAD-7 questionnaire. The level of social adaptation was examined.

Results

The prevalence of mild depression in our sample of women with obesity was 31.5%, 19.1% - moderate depression, 1% - severe depression, 48.4% had no depression symptoms. Anxiety symptoms were found in 38.2% of examined women, 61.8% showed no anxiety symptoms. Furthermore, when patients were divided into subgroups accordingly to BMI, anxiety was mostly registered among ones with normal BMI. An average correlation between indicators of anxiety and depressive symptoms was identified (r=0,62, p<0,05). Average correlation between indicators of anxiety and depression and the level of social adaptation (r=0,59 and r=0,48 relatively, p<0,05). Anxiety and depressive symptoms’ dependency on BMI was not established.

Conclusions

The received data showed that anxiety and depression have high prevalence among women with obesity. The study will help medical specialists draw attention to high comorbidity between abdominal obesity and anxiety-depressive disorders.
Self-reported validity of self-presentation on social media sites and its association with affective disorder
Authors: Rydahl K. , Speed M. , Østergaard S.
Published: February 2022

Introduction

Individuals with affective disorders, who are prone to negative cognitive bias, may be particular vulnerable to positively biased presentations by other social media users. The degree of positive bias in self-presentations on social media sites is however poorly understood

Objectives

To investigate the validity of self-presentation on social media sites and its association with affective disorder

Methods

Individuals aged 18-75 receiving treatment at the outpatient clinic for affective disorders at Aarhus Hospital or at two general practices were invited to participate in a survey focusing on social media use. Two core questions were: “To what extent do your social media content reflect your real life” and ”To what extent do others’ social media content reflect their real lives”. Response was provided on a likert scale with the following steps: “much more negative” (1), “more negative” (2), “the same as” (3), “more positive” (4) and “much more positive” (5) than real life. Based on these responses on bias, we calculated a bias ratio (validity of own self-presentation/validity of others’ self-presentation). The association between unipolar depression, bipolar disorder and bias ratio>1 was investigated using logistic regression with adjustment for age and sex

Results

A total of 183 individuals with unipolar depression, 119 with bipolar disorder and 186 controls participated in the study. Unipolar depression was associated with a bias ratio >1 (OR: 3.4, 95%CI: 1.2;9.9)

Conclusions

Individuals with unipolar depression are prone to consider their self-presentation as more positively biased compared to others’ self-presentation. This may shape the impact of social media use on these individuals.
Effectiveness of vortioxetine in real-world clinical practice: Interim results from the relieve study
Authors: Mattingly G. , Christensen M. , Simonsen K. , Hammer-Helmich L. , Ren H.
Published: February 2022

Introduction

Vortioxetine has demonstrated sustained efficacy and favorable safety profile in multiple clinical trials.

Objectives

This study aims to describe the effectiveness and safety of vortioxetine in real-world clinical practice.

Methods

RELIEVE is a prospective, multi-national, observational cohort study of outpatients initiating vortioxetine treatment for MDD at physician’s discretion and followed for 6 months. Data were collected at routine clinical visits. The primary outcome was functioning measured by Sheehan Disability Scale (SDS). Depressive symptoms measured by Patient Health Questionnaire 9-item (PHQ-9), cognitive symptoms measured by PDQ-5 and DSST were key secondary outcomes. Safety outcomes including adverse events were reported. This interim analysis presents results of 527 patients who completed the study and were followed for 6 months. Mixed models of repeated measures were used to assess improvements between baseline and month 6, adjusted for relevant confounders.

Results

A total of 527 patients (mean age, 50.2 years, 65% female) were enrolled from US, Canada, France and Italy, and included in the analysis. Mean SDS total score, PHQ-9, PDQ-5 scores decreased by 8.6, 7.4 and 4.7 respectively from baseline to last visit. Mean DSST score improved by 6.5 from baseline to last visit. Patients’ overall functioning and quality of life significantly improved, sick leave days and underproductive days (both absenteeism and presenteeism) decreased over the entire follow up period. The overall incidence of adverse events(AE) was 25%, with the most common AEs being nausea and headache.

Conclusions

The results confirm the effectiveness and good tolerability of vortioxetine in a broad range of patients in routine clinical practice.

Conflict of interest

Dr. Mattingly has served as researcher, consultant or speaker for Akili, Alcobra, Alkermes, Allergan, Axsome, Boehringer, Forum, Genentech, Jansen, Lundbeck, Medgenics, Merck, Neos, NLS Pharma, Otsuka, Reckitt Benckiser, Roche, Sage, Shire, Sunovion, Supe
The role of zinc, albumin, c reactive protein, and interleukin-6 in differentiation of unipolar depression and depression in bipolar disorder
Authors: Bagaric T. , Zivkovic M. , Marinovic P. , Kozmar A. , Jaksic N. , Sagud M. , Mihaljevic-Peles A.
Published: February 2022

Introduction

There is no clinical difference between depressive episodes in bipolar disorder compared to major depressive disorder, which is why bipolar disorder remains unrecognized. Correctly distinguishing these disorders is of great importance because the therapeutic approach differs significantly. According to previous research, zinc, albumin, C reactive protein (CRP), and interleukin-6(IL-6) seem to play a role in differentiating these two types of depressive episodes.

Objectives

To determine zinc, albumin, CRP and IL-6 serum concentrations in patients with major depressive disorder and depressive episode of bipolar disorder.

Methods

Research involved 60 participants. Participants signed informed consent prior to inclusion in the study. Sociodemographic data have been collected using a previously structured questionnaire. The severity of depressive symptoms has been measured by the Montgomery Asberg Depression Rating Scale (MADRS) and the Hamilton Depression Scale (HAM-D-17). Blood samples were obtained from each study participant’s brachial vein, to determine zinc, albumin, C reactive protein and interleukin-6 serum concentrations.

Results

Statistically significant difference was found in zinc serum levels between the two analysed groups. In the overall sample, there is a significant positive correlation between the results on the rating scales and the serum level of CRP.

Conclusions

We confirmed an association between serum levels of CRP and the severity of the illness. Regardless, these are preliminary results of the research. Sufficient final conclusion cannot yet be drawn because it is being limited by the sample size and further investigation is needed.
Challenging stigma attached to mental disorders: A psychosocial perspective
Authors: Fiorillo A.
Published: February 2022

Stigma attached to mental disorders represent one of the main obstacles to patients’ full recovery and empowerment. In the last decades, many anti-stigma programmes have been implemented worldwide, but stigma still represents a major obstacle for people with severe mental disorders, their family members, friends and also healthcare professionals. Stigma is a complex social phenomenon, which entails a lack of knowledge, discriminating attitudes and excluding behaviours in the general population, which deserves a multi-level approach. In particular, anti-stigma strategies combining the three most common approaches, including contact, education, and organization of protest activity, are the most effective. Interventions should contain age-appropriate information and should be provided at an early age (e.g., in schools). Interdisciplinary approaches are recommended. In particular, contact strategies are important to reduce prejudice and change attitudes towards people with mental disorders and may be implemented either by video (interviews/personal testimonies), but ideally in person with affected individuals, reporting their real life experiences. In this workshop, the role of advocacy associations together with all stakeholders of mental health will be discussed in the process of fighting stigma according to a psychosocial perspective.

Disclosure

No significant relationships.
Online psychological intervention with LGBT clients in Portugal
Authors: Pereira H. , Figueira M.
Published: February 2022

Introduction

This is a quasi-experimental and pioneering study in Portugal.

Objectives

(1) to provide assessment materials for symptoms of internalized homophobia, depression, and anxiety targeted at LGBT people; (2) offer support materials for psychotherapeutic work-oriented in the areas of internalized homonegativity, depression, and anxiety; and (3) offer monitoring measures throughout the program to demonstrate changes. It consists of three phases (pre-program evaluation, therapeutic activities and post-program evaluation).

Methods

38 LGBT + individuals participated, average age was 34.15 years, 30 self-identified as male. Measures used for the pre and post-intervention assessment were the sociodemographic questionnaire, the LGBT identity questionnaire, the Rosenberg self-esteem scale, and the BSI-18. Participants were invited to join the program online, through a platform created for this purpose, where ethical aspects were clarified, namely: confidentiality and commitment to adherence. Therapeutic tasks were sent by email or WhatsApp depending on the preference of each participant.

Results

Relevant differences in internalized homophobia, depressive, and anxious symptoms between the pre and post-intervention moments were observed, indicating that the program is effective in changing these symptoms.

Conclusions

The importance of validating this type of program allows reaching “hidden” populations by offering online support that minimizes the effects of sexual stigma on LGBT + populations.