Prevalence of Anxiety, Depression and Self-Care Behaviour during the Covid-19 Pandemic in the General Population

Introduction: SARS-CoV-2 has affected not only physical health but also devastated mental wellbeing. The government of India ordered a nationwide lockdown limiting movement of the entire 1.3 billion populations. The impact of the pandemic on depression, anxiety and self-care behaviour among the general population was investigated. Methods: An online cross-sectional survey was carried out with an anonymous questionnaire using validated instruments. Multivariable linear regression analysis was carried out to find the role of each variable in determining the relevant scores. Result: The mean age of the 1052 participants was 30.52 (SD � 13.42) years. The mean score of depression and anxiety was 5.96 and 5.27 respectively. Moderate to severe depression was noted among 18.68% and moderate to severe anxiety was noted among 16.1% of the respondents. Gender was a significant predictor of all three (depression, anxiety, and coping) scores, while the civil status predicted both depression and anxiety scores and age predicted only the depression score. Conclusion: A considerable proportion of the surveyed population in our setting has manifested symptoms of anxiety and depression. Gender, civil status and age predicted various scores.

Depression as the first manifestation of primary hyperparathyroidism: A case report and literature review / 中华内分泌代谢杂志

We report a case of primary hyperparathyroidism(PHPT) with depressive symptoms as initial manifestation. Literature review was conduct to further analyze the etiology, clinical manifestations, diagnosis, treatment and prognosis of the disease. The initial symptoms of the patients was the mental system depression and kidney stones was found by physical examination. She first visited a doctor in the urology department after a kidney stones was found. Blood calcium 2.86 mmol/L was found. At second visit, a doctor from endocrinology department conducted a comprehensive examination on the patient′s coexisting mental and renal system symptoms, clearly identified, her as PHPT. The clinical manifestations of PHPT are diverse. Symptoms such as depression, anxiety, mood swings, etc. are rarely evaluated. PHPT patients with onset or accompanied by psychiatric symptoms should be paid attention to by doctors, Measures should be taken to improve the quality of life and prognosis of patients through early screening of blood calcium and parathyroid hormone for timely diagnosis.

Impacto psicosocial de la pandemia por COVID-19 en cirujanos de columna argentinos / Psychosocial impact of the COVID-19 pandemic on Argentine spinal surgeons

Objetivo: Evaluar el impacto psicosocial de la pandemia por COVID-19 en los cirujanos de columna de Argentina. Material y métodos: Se envió un cuestionario diseñado específicamente a los cirujanos de columna de Argentina entre el 4-6 de abril del 2020. Las preguntas incluyeron variables demográficas, económicas, laborales y la escala de depresión PHQ-9. Las variables fueron comparadas y analizadas y las diferencias estadísticamente significativas remarcadas. Resultados: Respondieron en forma completa la encuesta 122 cirujanos de columna de Argentina, la mayoría hombres (97%), la edad promedio fue de 44 años; la mitad (n: 61) eran traumatólogos y la otra mitad neurocirujanos. La mayoría respondieron estar solo haciendo cirugías de emergencia (84%, n: 102). La preocupación promedio respecto a la situación financiera fue de 7.8 en una escala de 1 al 10. El 20% (n: 24) tenía un score superior a 10 en la escala de PHQ-9. Los cirujanos más jóvenes y los neurocirujanos tenían estadísticamente scores de PHQ-9 más altos. Conclusión: Se evaluó el impacto durante la pandemia por COVID-19 en la situación laboral y financiera de los cirujanos de columna encuestados. El impacto psicológico en el largo plazo debe ser considerado, para evitar secuelas en este grupo de profesionales de la salud.

Objective: The aim of this study is to evaluate the psycho-social impact of the COVID-19 outbreak in spine surgeons in Argentina. Methods: A questionnaire was sent to Argentina spine surgeons from April 4-6th, 2020. Questions regarding demographics, economic, working status and the PHQ-9 score were included. All variables were compared, analyzed and statistically significant differences were recorded. Results: 122 surgeons from Argentina answered the complete survey, most of them were male (97 %), the average age was 44 years; half (n: 61) of them were orthopedic surgeons and half neurosurgeons. Most of the surgeons reported performing emergency procedures only during the pandemic (84 %, n: 102). The average concern about the financial situation due to the pandemic was 7.8 in a scale of 1 to 10. Twenty percent (n: 24) of the surgeons had a score over 10 in the PHQ-9. Young age and neurosurgery as a specialty were statistically related with higher PHQ-9 scores. Conclusions: COVID-19 impact ́s in working practice and financial situation of Argentina ́s spine surgeons that answered this survey was evaluated. The long-term psychological impact should be taken into consideration to avoid a heavier burden for health care providers.

Is depression a concern among medical students: a cross sectional study in different academic years of a private medical college in Bangladesh

Background: Depression is not uncommon among medical students all over the world. Few studies have been conducted so far in Bangladesh to depict its actual prevalence and severity. So, the aim of this study was to assess the severity of depression and the level of difficulty faced by medical students in different academic years.Methods: This cross-sectional study was conducted in North East medical college of Bangladesh from January 2018 to June 2018 involving 443 students from 1st year to 5th year. Students were instructed to fill up the patient health questionnaire (PHQ-9) which incorporates diagnostic and statistical manual of mental disorders (DSM-IV) depression diagnostic criteria categorized as no, mild, moderate, moderately severe, and severe depression and also evaluates their level of function.Results: The prevalence of depression was quite high (79.68%). 196 (44.24%) and 157 (35.44%) students had mild and major depression respectively, while 90 (20.32%) showed no depression. Students with major depression were scored as moderate depression 24.38%, moderately severe depression 8.35%, and severe depression 2.71%. Moderate depression was significantly higher in year 1 and year 2 students in comparison to year 3, 4 and 5. Students from year 1 to year 5 with mild, moderate, moderately severe and severe depression experienced varying degree of difficulty in their daily activities. Almost all the students in all years with severe depression found themselves very difficult or extremely difficult to cope.Conclusions: High prevalence of depression among medical students is really alarming and underlying factors need to be addressed.

Propiedades psicométricas del Patient Health Questionnaire (PHQ-9) en estudiantes de medicina en Lima, Perú / Psychometric properties of the Patient Health Questionnaire (PHQ-9) in medical students, Lima, Peru

Resumen Introducción: Se ha reportado que el Patient Health Questionnaire (PHQ-9) es una herramienta psicométricamente válida y confiable aun cuando, evaluado mediante análisis factoriales, no queda claro si una estructura de uno o dos factores es la mejor. Objetivo: Evaluar las propiedades psicométricas y la estructura factorial del PHQ-9 en estudiantes de medicina de una universidad del Perú. Material y Métodos: Investigación instrumental en 200 estudiantes de medicina. Un análisis factorial exploratorio (AFE) permitió evaluar la estructura interna del PHQ-9, sometida luego a un análisis factorial confirmatorio (AFC) de tres modelos. Resultados: Se encontró una adecuada consistencia interna (alfa de Cronbach=0,903). Mediante el AFC se encontraron adecuados índices de ajuste en el modelo bifactorial (x2 (17) =26,451, p = 0,067; CFI = 0,991; GFI = 0,969; RMSEA = 0,056) en comparación con los modelos unidimensional y bidimensional. Conclusiones: El PHQ-9 es un instrumento con propiedades psicométricas adecuadas para su aplicación en estudiantes de medicina de una universidad del Perú. El AFC reveló que un modelo bifactorial que toma en cuenta tanto el factor general como factores latentes somáticos y cognitivo/afectivos, muestra un mejor ajuste.

Summary Introduction: The Patient Health Questionnaire (PHQ-9) is recognized as a psychometrically valid and reliable intrument; however, when assessed by means of a factor analysis method, it remains unclear whether a one- or two-factor structure is the best. Objective: To evaluate the psychometric properties and the factor structure of the PHQ-9 in medical students of a university in Peru. Material and Methods: Instrumental study in 200 medical students. An exploratory factor analysis (EFA) was performed to evaluate the internal structure of the PHQ-9, followed by a confirmatory factor analysis (CFA) of three models. Results: An adequate internal consistency was found (Cronbach's alpha = 0,903).Through the CFA, the bifactorial model (x2 (17) = 26,451, p = 0,067; CFI = 0,991; GFI = 0,969; RMSEA = 0,056) had a better adjustment than the unidimensional and bi-dimensional factor models. Conclusions: The PHQ-9 is an instrument with adequate psychometric properties for its application among medical students of a Peruvian university. The CFA revealed that a bifactorial model, in which both the general factor and latent somatic and cognitive/affective factors are taken into account, yields more fitting results.

Efficacy and Safety of Modified Chaihu Jia Longgu Muli Tang in Treating Mild to Moderate Essential Hypertension Complicated with Depression and Liver-Yang Hyperactivity Syndrome / 中国实验方剂学杂志

Objective:To observe the clinical efficacy and safety of modified Chaihu Jia Longgu Muli Tang in treating mild to moderate essential hypertension complicated with depression and liver-Yang hyperactivity syndrome.Method:Totally 121 mild to moderate hypertensive patients complicated with depression in line with the inclusive criteria were randomized into treatment group and control group. All of the enrolled patients in treatment group and control group were treated with conventional therapy. In treatment group, patients were given modified Chaihu Jia Longgu Muli Tang, one dose per day. The treatment course lasted for 4 weeks. Blood pressure, patient health questionnaire-9 (PHQ-9) score, score of traditional Chinese medicine syndrome, C-reactive protein (CRP), endothelial-dependent vasodilation, and adverse effect were observed in this study.Result:Both systolic blood pressure and diastolic blood pressure were significantly lowered when compared to control group (P<0.05). PHQ-9 score was significantly improved in treatment group (P<0.05). The score of traditional Chinese medicine syndrome was significantly improved in treatment group compared to control group (P<0.05). CRP was significantly improved in treatment group compared with control group (P<0.05). Endothelial-dependent vasodilation was significantly improved in treatment group compared with control group (P<0.05). No severe adverse effect was observed in this research.Conclusion:Chaihu Jia Longgu Muli Tang has a creation clinical efficacy in the treatment of mild to moderate essential hypertension with depression. In addition to the effect in reducing both systolic and diastolic blood pressure, modified Chaihu Jia Longgu Muli Tang was also effective in improving depression, traditional Chinese medicine syndrome and endothelial-dependent vasodilation, and reducing the level of CRP with little adverse effect.

Depression in postpartum women residing in urban slums using Patient Health Questionnaire-9

Background: Postpartum period starts about an hour after the delivery of the placenta and followed until 6 weeks. The hormonal changes that take place during this period lead to depression, one of the silent contributors of poor maternal and child health indices in developing countries leading to increased morbidity among women. In India, postpartum depression (PPD) reports approximately 23% of women in hospital-based data and prevalence varies from 11% to 26% in community-based studies. Objective: The objective of this study was to estimate the prevalence and factors leading to PPD among women residing in urban slums. Materials and Methods: A community-based, cross-sectional study was conducted for 1 year consisting of postpartum women (2–6 weeks) of any age group in urban slums, Dharwad. Patient Health Questionnaire-9 (PHQ-9) scale was used to estimate the prevalence of PPD. Results: Of the 284 women, 45.8% were in the age group of 21–25 years, 38.4% had completed secondary education, and most of them 84.9% were housewives. 35% of women were from nuclear family and 53.2% belonged to the upper middle class. Using PHQ-9 scale, it was seen that 7.7% had minor depression and 0.4% had major depression. Increasing age (χ²âˆ’25.97, P = 0.001), unplanned pregnancy (χ²âˆ’13.51, P = 0.009), those who had pre- and post-term delivery (χ²âˆ’13.83, P = 0.008), and those who delivery through cesarean section (χ²âˆ’35.84, P < 0.0001) were found to be associated with PPD and the association was found to be statistically significant. Conclusion: Equal importance should be given for both physical and mental health of postpartum women for a healthy mother and child.

Prevalence of Depression and its Associated Factors among Jordanian Diabetic Foot Patients

Background: Diabetes mellitus is widespread metabolic disorders with long-term complications, which include significant psychosocial dysfunctions such as depression and physiological dysfunctions such as diabetic foot (DF). Related to diabetic studies in general, the prevalence of depression is high and causes deterioration in health related outcomes and quality of life, whereas the studies about depression and diabetic foot in specific are meager and insufficient. Purposes: The purposes of this study were to assess the prevalence of depression, to identify factors associated with depression, and to identify the rate of unscreened depression among diabetic foot patients. Methods: The design of this study is cross-sectional. A convenience sampling of 216 diabetic foot patients was recruited from diabetic clinics of government hospitals in Jordan during the period from January 2016 to March 2016. Data was collected using a structured self-report questionnaire which consisted of 2 sections including socio-demographic questions with one self-reported question, and Patient Health Questionnaire-9 (PHQ-9) scale to assess depression. Results: The current study showed that 179 diabetic foot patients (82.9%) had depression according to PHQ-9 scale with different levels of depression, namely, mild, moderate, moderately severe, and severe that consist 25%, 25.5%, 18.5%, and 13.9% of the total sample respectively. Multiple linear regression showed that the availability of social support by the family and being a nurse as main healthcare provider were associated with low depression scores among DF patients, also high glycated hemoglobin was associated with high depression scores (F=8.923, p=0.001). Conclusion: Prevalence of depression among Jordanian diabetic foot patients and the rate of unscreened depression were high, which indicates an urgent need for thorough assessment of depression level that may help in early detection, treatment, and prevention of depression among diabetic foot patients. Several factors viewed to be associated with depression level that should take into consideration in the diabetic foot care plans.

Depression among tuberculosis patients attending a DOTS centre in a rural area of Delhi: A cross-sectional study

Background: Studies have shown that the prevalence of psychiatric disorders, particularly depression, is high among tuberculosis (TB) patients, and may adversely affect treatment compliance. A person suffering from TB can develop depression in due course of time owing to a number of factors, namely the long duration of treatment for TB, stigmatization faced by the patient due to the disease and lack of family support to name a few. Objectives: The present study aimed to determine the prevalence of depression and its correlates among TB patients enrolled at a Directly Observed Treatment Short-course (DOTS) center in a rural area of Delhi. Methods: The study was a DOTS center-based, cross-sectional study, among 106 patients of pulmonary and extrapulmonary TB, above 18 years of age. An interviewer-administered questionnaire in Hindi was used to collect basic sociodemographic data and the Patient Health Questionnaire (PHQ)-9 was used for detecting depression. Those with a score of 10 or more were considered to be suffering from depression. Data analysis was done using SPSS licensed version 20. Chi-square was used to test for association between qualitative variables, and a P < 0.05 was considered statistically significant. Results: A total of 106 patients participated in the study, of which 61 (57.5%) were males. The median age was 30 years (inter-quartile range 24� years). Depression was found to be present in 25 (23.6%) participants. A higher proportion of patients with depression were unemployed currently, and also belonged to middle or lower class (P < 0.05). Depression was not found to be associated with religion, gender, marital status, HIV status, presence of diabetes, DOTS category nor with the phase of treatment. Conclusion: Depression among TB patients is common, affecting almost one in four TB patients. Physicians and DOTS providers should have a high index of suspicion for depression when assessing TB patients.

Examining the impacts of 12 weeks of low to moderate-intensity aerobic exercise on depression status in patients with systolic congestive heart failure - A randomized controlled study

OBJECTIVES: Psychiatric depression disorder is common in patients with systolic congestive heart failure (HF), and both conditions share underlying pathophysiological mechanisms. The incidence rate of depression disorder has clearly increased with the increase in HF manifestations in recent decades. Depression disorder is considered an independent predisposing factor for hospitalization, disturbed functional performance, and high rates of morbidity and mortality in HF patients. This randomized controlled study was designed to examine the impacts of low- to moderate-intensity aerobic exercise training on depression status in patients with systolic congestive HF. METHODS: A total of 46 systolic congestive HF patients with depression (40-60 years of age) were randomized to receive twelve weeks of mild- to moderate-intensity aerobic exercise plus standard medical treatment (exercise group) or standard medical treatment without any exercise intervention (control group). Depression status was examined using the validated Patient Health Questionnaire-9 (PHQ9) pre- and post-intervention at the end of the study program. RESULTS: No significant differences were observed between the exercise and control groups in demographic data or clinical characteristics (p>0.05). Both study groups showed a significant reduction in depression status at the end of the 12-week intervention (p<0.05). The comparison between the mean values of the depression scores showed significant differences between the two groups after 6 and 12 weeks of the intervention, indicating a greater reduction in depression scores in the exercise group than in the control group (p<0.05). CONCLUSIONS: Twelve weeks of a low- to moderate-intensity aerobic exercise program was safe and effective for reducing depression severity in patients with systolic congestive HF. Low- to moderate-intensity aerobic training should be recommended for cardiac patients, particularly those with HF-related depression.

Evaluation of reliability and validity of the patient health questionnaire-9 in patients with acne / 中华皮肤科杂志

Objective To evaluate the reliability and validity of the patient health questionnaire-9 (PHQ-9) in patients with acne.Methods A total of 300 patients with acne were enrolled from the Department of Dermatology,Affiliated Hospital of Southwestern Medical University from January 2017 to June 2018.Questionnaire survey was conducted among these patients to evaluate their depression status with the PHQ-9 and Hamilton depression scale (HAMD),and the questionnaire completion time was recorded.The structured clinical interview (SCID) for American Diagnostic and Statistical Manual of Mental Disorders (4th Version) (DSM-Ⅳ) served as the "gold standard" for diagnosis of depression.Reliability analysis of the PHQ-9 was performed using the Cronbach's α coefficient and one-week testretest reliability.Factor analysis,Spearman correlation analysis and receiver operating characteristic (ROC) curve were used for validity analysis of the PHQ-9,and the screening validity was also analyzed in different subgroups.Results A total of 258 patients with acne completed all the survey,and 47 were diagnosed with depressive disorder according to the diagnostic gold standard SCID.An optimal cutoff score of 9 was determined for the diagnosis of depression using the PHQ-9,with a sensitivity of 95.7％,a specificity of 88.6％,and an area under the ROC curve (AUC) of 0.973 (95％ CI:0.956-0.990).In different groups of people,the AUC ranged from 0.886 to 0.955.Validity analysis showed that the correlation coefficient between the total score of PHQ-9 and HAMD was 0.766,and the kappa value was 0.530.Factor analysis revealed that there were two common factors (cognitive-emotion factor and somatic symptom factor),which explained 65.52％ of the total variances.As reliability analysis showed,the Cronbach's α coefficient of the PHQ-9 was 0.851,the correlation coefficients of the 9 items with the total scale score ranged from 0.550 to 0.709,the inter-item correlation coefficients ranged from 0.224 to 0.654,and the test-retest reliability value of the PHQ-9 was 0.824.The time to complete the PHQ-9 (4.9 ± 1.2minutes) was significantly less than the time to complete HAMD (44.2 ± 5.9 minutes;t =108.787,P ＜0.001).Conclusions The PHQ-9 shows good reliability and validity for the diagnosis of depression in patients with acne,and can be used for preliminary screening of depression in patients with acne.Compared with the HAMD,the PHQ-9 has obvious advantages of being more timesaving and manpower-saving to make it easier to implement in clinic.

Relationship Between Metabolic Syndrome and Depression Using Patient Health Questionnaire-9 : 2016 Korea National Health and Nutrition Examination Survey Result Analysis / 우울ㆍ조울병

BACKGROUND: The purpose of this study was to investigate the relationship between metabolic syndrome and depressive symptoms by administering the nine-item depression module from the Patient Health Questionnaire-9 (PHQ-9) to participants from the general population of Korea.METHODS: In total, 8,150 adults participated in the 1st year of the 7th Korea National Health and Nutrition Examination Survey, which was conducted in 2016. Of them, 5,556 participants underwent tests pertaining to the criteria for metabolic syndrome and responded to PHQ-9; 2,594 respondents were excluded. Analysis of covariance was performed to analyze the relationship between the presence of metabolic syndrome and the PHQ-9 score after adjusting for the effects of demographic and hematologic characteristics and underlying diseases.RESULTS: The total PHQ-9 score (mean=2.98) was significantly higher in participants with metabolic syndrome than in those without it (mean=2.59) (p=0.002). Among the individual PHQ-9 items, changes in sleep, thoughts of suicide or self-harm, and depressive mood showed the greatest differences.CONCLUSION: The PHQ-9 scores in Korea were higher in adults with metabolic syndrome, suggesting an association between metabolic syndrome and depressive symptoms.

Depressive Symptoms and Sociodemographic Risk Factors among Chronic Disease Inpatients at University Medical Centers

BACKGROUND: The purpose of this study was to examine the prevalence of and the sociodemographic risk factors for depressive symptoms among inpatients with chronic diseases who completed the Patient Health Questionnaire-9 (PHQ-9) conducted by a social work department at university medical centers. METHODS: In 2015, PHQ-9 data were collected from six medical centers affiliated with Hallym University Medical Center. The sample comprised 517 inpatients aged 18 years or over with chronic diseases. Descriptive statistics, chi-square test, simple logistic regression, and multiple logistic regression were used for data analyses. RESULTS: The prevalence of depressive symptoms among inpatients with chronic diseases was 31.7 percent. The results of the simple and multiple logistic regressions showed that the single/widowed/divorced/separated group was at higher risk for depressive symptoms than married inpatients. Having a religion or being unemployed also increased the risk of depressive symptoms among the respondents. CONCLUSIONS: Findings of this study emphasize the importance of systematic depressive symptom management for inpatients with chronic diseases.

Reliability and validity of the Farsi version of the Patient Health Questionnaire-9 (PHQ-9) with Iranian psychiatric outpatients / Confiabilidade e validade da versão persa do Patient Health Questionnaire-9 (PHQ-9) em pacientes psiquiátricos ambulatoriais iranianos

Abstract Introduction: The Patient Health Questionnaire-9 (PHQ-9) is a brief screening and diagnostic tool for depression. It has been used in research and clinical practice in primary care and other clinical and non-clinical settings. The PHQ-9 has not had its validity examined in psychiatric and psychological settings in Iran. Methods: A cross-sectional study was conducted to investigate the validation of the Farsi version of the PHQ-9. A convenience sample of 130 Iranian volunteer psychiatric outpatients was selected from psychiatric and psychological clinics. They completed the PHQ-9, the Patient Health Questionnaire-15 (PHQ-15), the World Health Organization-five Well-Being Index (WHO-5), and the short form of the Beck Depression Inventory-13 (BDI-13). Data were analyzed by descriptive statistics, Cronbach's α, Pearson correlation coefficient, principal component analysis, exploratory factor analysis, and confirmatory factor analysis. Results: Mean score of the PHQ-9 was 12.83 (standard deviation = 6.25), indicating moderately severe depression in the sample. Cronbach's α coefficient for PHQ-9 was 0.88, and one-week test-retest reliability 0.79. The PHQ-9 correlated 0.64 with PHQ-15, −0.35 with WHO-5, and 0.70 with BDI-13, indicating good construct and criterion-related validity. The results of the factor analysis of PHQ-9 items identified and confirmatory factor analysis confirmed a single factor labeled general depression. Conclusions: The PHQ-9 appears to have a unidimensional structure, adequate validity and reliability, and can be useful in epidemiological/research settings. Based on previous literature and on the present findings, the PHQ-9 may have applicability to other contexts in the studied population, but this needs to be confirmed by other studies.

Resumo Introdução: O Patient Health Questionnaire-9 (PHQ-9) é uma ferramenta breve de triagem e diagnóstico para depressão. Tem sido usado em pesquisa e na prática clínica primária e em outros contextos clínicos e não clínicos. O PHQ-9 não teve sua validade examinada em contextos psiquiátricos e psicológicos no Irã. Métodos: Um estudo transversal foi conduzido para investigar a validação da versão persa do PHQ-9. Uma amostra de conveniência de 130 pacientes psiquiátricos ambulatoriais iranianos foi selecionada em clínicas psiquiátricas e psicológicas. Os pacientes completaram o PHQ-9, Patient Health Questionnaire-15 (PHQ-15), the World Health Organization-five Well-Being Index (WHO-5) e a forma abreviada do Beck Depression Inventory-13 (BDI-13). Os dados foram analisados por estatística descritiva, α de Cronbach, coeficiente de correlação de Pearson, análise de componentes principais e análise fatorial exploratória e confirmatória. Resultados: O escore médio do PHQ-9 foi 12,83 (desvio padrão=6,25), indicando depressão moderadamente severa na amostra. O α de Cronbach para PHQ-9 foi 0,88, e a confiabilidade teste-reteste de uma semana 0,79. O PHQ-9 apresentou correlação de 0,64 com PHQ-15, −0,35 com WHO-5 e 0,70 com BDI-13, indicando boa validade do construto e dos critérios relacionados. Os resultados da análise fatorial dos itens do PHQ-9 identificaram, e a análise fatorial confirmatória confirmou, um único fator, chamado depressão geral. Conclusões: O PHQ-9 parece ter uma estrutura unidimensional, validade e confiabilidade adequadas, e pode ser útil em contextos epidemiológicos e de pesquisa. Com base na literatura prévia e neste estudo, o PHQ-9 pode ter aplicabilidade em outros contextos na população estudada, mas isso precisa ser confirmado.

Depresión en artritis reumatóide / Depression in Rheumatoid Arthritis

Resumen Introducción: La depresión es una importante comorbilidad en pacientes con artritis reumatoide; diversos factores como la actividad de la enfermedad, el dolor y la discapacidad contribuyen a su desarrollo. Materiales y métodos: Se realizó un estudio transversal en pacientes con artritis reumatoide para determinar la prevalencia de depresión, utilizando el cuestionario Patient health questionnaire (PHQ-9) y su relación con la actividad de la enfermedad mediante DAS-28 y la discapacidad funcional mediante HAQ-DI. Resultados: El 42,9% de los pacientes presentaron depresión. Se encontró una asociación entre depresión con DAS-28 y HAQ-DI, ya que el 70% de los pacientes con alta actividad de la enfermedad y el 38% de los pacientes con discapacidad funcional presentaron depresión de moderada a grave. El número de articulaciones dolorosas y tumefactas fue mayor en los pacientes con depresión grave que en aquellos con depresión leve. Los pacientes con mayor depresión referían un dolor más intenso según la escala visual del dolor.

Abstract Introduction: Depression is significant comorbidity in patients with rheumatoid arthritis (RA), with many factors, such as disease activity, pain, and disability determining its development. Materials and method: A cross-sectional study including patients with rheumatoid arthritis was conducted to determine prevalence of depression using the Patient Health Questionnaire (PHQ-9), and its relationship with disease activity using DAS-28. The HAQ-DI was used to determine functional disability and the number of painful and swollen joints. Results: Depression was observed in 42.9% of the patients. An association was found between depression, DAS-28 and HAQ-DI. It was also found that 70% of the patients with high activity disease and 38% of the patients with functional disability had moderate-severe depression. The number of painful and swollen joints was greater in patients with severe depression than in patients with mild depression. Patients with greater depression referred to more intense pain according to the visual analogue pain scale.

No Association between the Polymorphism rs6943555 in the AUTS2 Gene and Personality Traits in Japanese University Students

OBJECTIVE: The autism susceptibility candidate 2 (AUTS2) gene has been implicated in multiple neurological disorders. Several recent studies have revealed that the polymorphism rs6943555 in the AUTS2 gene is broadly associated with human mental function and behavior. Therefore, in the present study we investigated whether the polymorphism rs6943555 is associated with human personality traits in Japanese university students. In addition, our previous study reported that the AUTS2 rs6943555-rs9886351 haplotype is associated with alcohol dependence. As a preliminary analysis, we also examined whether the AUTS2 haplotypes are related to personality traits. METHODS: After written informed consent had been obtained from the participants, two AUTS2 polymorphisms were analyzed, and personality was assessed using the Temperament and Character Inventory (TCI) in 190 university students. In addition, in order to exclude the influence of the results for students with mental health problems, we gave the Patient Health Questionnaire-9 (PHQ-9) to all subjects. RESULTS: In all the subjects, there was a main effect of the polymorphism rs6943555 genotype on reward dependence (p=0.038) and cooperativeness (p=0.031), although the significance was lost on Bonferroni correction. Similarly, on analysis that excluded the subjects with PHQ-9 scores≥10, no significant association with any TCI dimension score among the rs6943555 genotypes was seen. There was no effect of the rs6943555-rs9886351 haplotypes on the TCI dimension scores. CONCLUSION: This study suggests that the polymorphism AUTS2 rs6943555 is not associated with personality traits. Further large-scale studies with more subjects using other self-report questionnaires are needed.

Screening for Depressive Disorder in Elderly Patients with Chronic Physical Diseases Using the Patient Health Questionnaire-9

OBJECTIVE: We aimed to identify depressive symptom profiles that indicated the presence of depressive disorder and present optimal cut-off sub-scores for depressive symptom profiles for detecting depressive disorder in elderly subjects with chronic physical diseases including diabetes, chronic obstructive pulmonary disease/asthma, and coronary artery disease, using the Patient Health Questionnaire-9 (PHQ-9). METHODS: Two hundred and thirty-one elderly patients with chronic physical diseases were recruited consecutively from a university-affiliated general hospital in South Korea. RESULTS: Greater severities of all 9 depressive symptoms in the PHQ-9 were presented in those with depressive disorder rather than those without depressive disorder. A binary logistic regression modeling presented that little interest [adjusted odds ratio (aOR)=4.648, p<0.001], reduced/increased sleep (aOR=3.269, p<0.001), psychomotor retardation/agitation (aOR=2.243, p=0.004), and concentration problem (aOR=16.116, p<0.001) were independently associated with increased likelihood of having depressive disorder. Receiver operating characteristics (ROC) curve analysis presented that the optimal cut-off value of score on the items for little interest, reduced/increased sleep, psychomotor retardation/agitation and concentration problem (PHQ-9) for detecting depressive disorder was 4 with 61.9% of sensitivity and 91.5% of specificity [area under curve (AUC)=0.937, p<0.001]. CONCLUSION: Our findings suggested that the diagnostic weighting of little interest, reduced/increased sleep, psychomotor retardation/agitation, and concentration problem is needed to detect depressive disorder among the elderly patients with chronic physical diseases.

Association between Depression and Sociodemographic Factors of Elderly Welfare Facility Users in a City / 정신신체의학

OBJECTIVES: As the prevalence of elderly depression increases, it becomes urgent problem to provide preventive and management measures. But in practice, it is difficult to detect depression in early stage. The purpose of this study is to evaluate the association between sociodemographic factors and depression in elderly welfare facility users in a city. METHODS: In this research, the severity of depression and sociodemographic factors(gender, age, education, comorbid disease, housing type, number of children, number of family members living with the subjects) was evaluated through PHQ-9 and interview. Using the data, the associations of depression and sociodemographic factors were analyzed. Based on PHQ-9 depression cut-off value(10 points), the subjects were divided into two groups, and the difference of the variables between groups were analyzed statistically. RESULTS: ‘Own house’(YES/NO), education(less than elementary school graduation/more than elementary school graduation) were sociodemographic factors which showed significance difference in mean PHQ-9 scores. Group with Over PHQ-9 10 points showed less ‘having their own house’ and less education level than group with less PHQ-9 10 points. CONCLUSIONS: With this research, it is expected that the risk factors for the elderly depression can be understood and the measures for early detection and invention of elderly depression would be provided.

Application of patient health questionnaire-9 in psychosomatic disease outpatients in a general hospital / 中华行为医学与脑科学杂志

Objective To explore the feasibility of patient health questionnaire-9 (PHQ-9) in a general hospital outpatients and analyze the risk factors of depressive syndromes.Methods Two hundred fifty-eight outpatients filled out PHQ-9 and the World Health Questionnaire Quality of Life Brief Questionnaire(WHOQOL-BREF) by themselves.Then they were evaluated by professionals with Hamilton Depression Rating Scale (HAMD-17).Ninety-seven of them were further interviewed with the Structured Clinical Interview for DSM-Ⅳ Disorders(SCID) for the diagnosis of major depression which in order to analyze the validity of the PHQ-9.All patients were divided into the depressive group and non-depressive group according the score of PHQ-9,and then analyzed the risk factors of depression.Results ①The sensitivity of PHQ-9 was 98％,the specificity was 67％ and Kappa was 0.664.The total score of PHQ-9 was high correlated with the total score of HAMD,the coefficient was 0.75(P＜0.01).②The Univariate analysis showed that the depressive symptom was associated with age,monthly income,health status,the quality of life.Logistic regression analysis showed that age,health status,the quality of life were the main factors of depression.Conclusion PHQ-9 may svere as a screening tool to increase the recognition of depression and age,health status,the quality of life were the main factors of depression.