Fibromigraine: a cohort study retrospective / Fibroenxaqueca: um estudo de coorte retrospectivo

OBJECTIVE: To diagnose fibromyalgia in patients with migraine and assess the quality of life of these patients. METHODS: A prospective, cross-sectional study was carried out, comparing groups, in a non-randomized sample, consisting of patients diagnosed with migraine. The sample was evaluated using the Widespread Pain Index (WPI) and Symptom Severity Scale (SSS) questionnaires to diagnose fibromyalgia. Quality of life and level of depression were assessed, respectively, using the Headache Impact Test-6 (HIT-6) and Patient Health Questionnaire-9 (PHQ-9). RESULTS: We interviewed 100 patients (5 men and 95 women) diagnosed with migraine, with a mean age of 37.1±11.0 years, ranging from 19 to 64 years. Thirty-four patients (34%) had migraine and fibromyalgia concomitantly. Migraine predominated in females, both in the presence and absence of fibromyalgia. In both groups, there was no difference in headache characteristics. In the group with fibromyalgia, there was a predominance of allodynia and a higher PHQ-9 score (p<0.001). CONCLUSIONS: Patients with migraine are more predisposed to depression when there is an association with fibromyalgia

OBJETIVO: Diagnosticar fibromialgia em pacientes com enxaqueca e avaliar a qualidade de vida desses pacientes. MÉTODOS: Foi realizado um estudo prospectivo, transversal, comparando grupos, em uma amostra não randomizada, composta por pacientes com diagnóstico de enxaqueca. A amostra foi avaliada por meio dos questionários Widespread Pain Index (WPI) e Symptom Severity Scale (SSS) para diagnóstico de fibromialgia. A qualidade de vida e o nível de depressão foram avaliados, respectivamente, por meio do Headache Impact Test-6 (HIT-6) e do Patient Health Questionnaire-9 (PHQ-9). RESULTADOS: Foram entrevistados 100 pacientes (5 homens e 95 mulheres) com diagnóstico de enxaqueca, com idade média de 37,1±11,0 anos, variando de 19 a 64 anos. Trinta e quatro pacientes (34%) apresentavam enxaqueca e fibromialgia concomitantemente. A enxaqueca predominou no sexo feminino, tanto na presença como na ausência de fibromialgia. Em ambos os grupos, não houve diferença nas características da dor de cabeça. No grupo com fibromialgia houve predomínio de alodinia e maior escore no PHQ-9 (p<0,001). CONCLUSÕES: Pacientes com enxaqueca estão mais predispostos à depressão quando há associação com fibromialgia

La relación entre la transición a la menopausia y los trastornos del estado de ánimo / The relationship between menopause transition and mood disorders

Este estudio tuvo como objetivo examinar la relación entre la transición a la menopausia y los trastornos del estado de ánimo, específicamente la ansiedad y la depresión. Se llevó a cabo una revisión narrativa de la literatura relevante sobre la transición a la menopausia y los trastornos del estado de ánimo. Se revisaron estudios que se enfocaron en el impacto de los cambios hormonales durante la menopausia en el bienestar psicológico y se evaluaron diversas opciones de tratamiento para los trastornos del estado de ánimo. La disminución de los niveles hormonales de estrógenos y progesterona durante la menopausia puede llevar a diversos cambios psicológicos, como ansiedad y depresión. La terapia hormonal con estrógenos solo o en combinación con progesterona puede mejorar los síntomas depresivos en mujeres en la menopausia, pero este tratamiento no está exento de riesgos. Otros tratamientos no hormonales, como la terapia cognitivo-conductual, el ejercicio y una buena higiene del sueño, también pueden ser efectivos para manejar los trastornos del estado de ánimo. Se concluyó que existe una compleja interacción entre factores hormonales, biológicos y psicosociales para desarrollar intervenciones efectivas que mejoren el bienestar psicológico de las mujeres en la menopausia.

This study aimed to examine the relationship between menopause transition and mood disorders, specifically anxiety and depression. The authors conducted a narrative review of relevant literature on menopause transition and mood disorders. They reviewed studies that focused on the impact of hormonal changes during menopause on psychological well-being and evaluated various treatment options for mood disorders. The decline in estrogen and progesterone hormone levels during menopause can lead to various psychological changes, such as anxiety and depression. Hormonal therapy with estrogen alone or in combination with progesterone can improve depressive symptoms in menopausal women, but this treatment is not without risks. Other non-hormonal treatments, such as cognitive-behavioral therapy, exercise, and good sleep hygiene, can also be effective in managing mood disorders. The study highlights the need for recognition of the complex interplay between hormonal, biological, and psychosocial factors in developing effective interventions to improve the psychological well-being of menopausal women. Further research is needed to fully understand the potential relationship between menopause transition and mood disorders.

Eficacia de las terapias online de activación conductual y cognitivo conductual para el tratamiento de la depresión en mujeres mexicanas víctimas de violencia / Efficacy of online behavioral activation and cognitive-behavioral therapies for the treatment of depression in Mexican women victims of violence

Antecedentes: La violencia contra la mujer (VCM) y la pandemia por COVID-19 son problemáticas que han afectado la salud mental de las mujeres, con secuelas como la depresión. Objetivo: Comparar la eficacia del tratamiento breve de activación conductual (BATD) y la terapia cognitiva conductual (TCC) con adaptaciones culturales administradas online (telesalud) para la depresión en víctimas de VCM durante la COVID-19 en México. Método: Se realizó un ensayo clínico aleatorizado con 20 mujeres mexicanas de 18-60 años con depresión que experimentaron VCM en los últimos seis meses durante la COVID-19. Las participantes fueron asignadas de manera aleatorizada 1:1 a los grupos BATD y TCC. Para el análisis de datos se aplicaron las pruebas Friedman y U de Mann-Whitney, y se estimó el Índice de Cambio Confiable. Resultados: Se encontró una disminución en síntomas depresivos (p < .001) e incremento en los niveles de activación (p < .001) a favor del grupo BATD, al término de la intervención y en el seguimiento en contraste con la TCC. Conclusiones: La BATD mostró ser eficaz en crisis de emergencia sanitaria en contextos de VCM. Aunar evidencia de intervenciones eficientes para esta población contribuye a mitigar las afecciones de salud mental.

Background: Violence against women (VAW) and the COVID-19 pandemic are issues that have affected women's mental health, with sequela such as depression. Objective: To compare the efficacy of brief behavioral activation therapy (BATD) and cognitive behavioral therapy (CBT) with cultural adaptations administered online by telehealth for depression in victims of VAW during COVID-19 in Mexico. Method: A randomized clinical trial was conducted with 20 Mexican women aged 18-60 years with depression who experienced VAW in the last six months during COVID-19. Participants were randomized 1:1 to the BATD and CBT groups. For data analysis, Friedman and Mann-Whitney U tests were applied, and the Reliable Change Index was estimated. Results: A decrease in depressive symptoms (p < .001) and an increase in activation levels (p < .001) were found in favor of the BATD group at the end of the intervention and at follow-up, in contrast to CBT. Conclusions: BATD was shown to be effective in health emergency crises in VAW contexts. Gathering evidence of efficient interventions for this population contributes to mitigating mental health conditions.

Intervenciones en Psicología Positiva para la disminución de la depresión y el fomento del bienestar en personas mayores de 60 años: Una revisión sistemática de la última década (2012-2022) / Interventions in Positive Psychology to reduce depression and promote well-being in the elderly: A systematic review of the last decade (2012-2022)

En los últimos años distintos estudios muestran la eficacia de las intervenciones en Psicología Positiva para mejorar la sintomatología depresiva y el bienestar en población adulta; sin embargo, hay pocos estudios que revisen la eficacia de estas intervenciones en personas de 60 años o más. Objetivo: recoger y sintetizar la evidencia existente en la última década con respecto a las intervenciones en Psicología Positiva en estas personas. Método: se ha realizado una revisión sistemática (RS) que recoge las publicaciones, realizadas entre enero de 2012 y julio de 2022, procedentes de las bases de datos SCOPUS, WOS/Medline y PROQUEST/PsycInfo. Se seleccionaron 944 estudios empíricos, de los cuales 18 cumplieron los criterios de inclusión. Resultados: se presenta evidencia sobre la eficacia de las intervenciones en Psicología Positiva para reducir la sintomatología depresiva e incrementar el bienestar subjetivo y psicológico en personas de estas edades, con efectos superiores a los de otros grupos de control. Esto sucede con programas de intervención en bienestar, al entrenar varias fortalezas- gratitud o perdón junto con otras- o entrenando en mindfulness. Conclusión: estos resultados subrayan la importancia de considerar las intervenciones en Psicología Positiva como terapias complementarias para mejorar la salud mental y la calidad de vida en personas mayores de 60 años.

Recently, different studies have shown the efficacy of interventions in Positive Psychology to improve both depressive symptoms and well-being in adults. However, there are only a few studies that review the efficacy of these interventions in people aged 60 years and older. Objective: synthesize the evidence from the last decade about these interventions in these people. Method: A systematic review was conducted. Publications between 2012 and 2022 -from SCOPUS, WOS/Medline and PROQUEST/PsycInfo- were included. After analyzing 944 empirical works, 18 studies have met the inclusion criteria. Results: the results show the efficacy of interventions in Positive Psychology, both to reduce depressive symptoms, and to increase subjective and psychological well-being in people of these ages, compared to other control groups. These effects are found with interventions on well-being, with interventions on personal strengths -gratitude or forgiveness in combination with sense of humor, empathy, meaning of life or emotional regulation- or through training on mindfulness. Conclusions: The preliminary results point out the importance of interventions in Positive Psychology as complementary therapies to improve the metal health and quality of life in people over 60 years.

Effects of electroacupuncture at "Siguan" points on the expression of colonic 5-hydroxytryptamine and fecal short-chain fatty acids in rats with post-stroke depression / 中国针灸

OBJECTIVE@#To observe the effects of electroacupuncture at "Siguan" points on behavior, colonic 5-hydroxytryptamine (5-HT) and fecal short-chain fatty acids (SCFAs) in rats with post-stroke depression (PSD), and explore the effect mechanism of electroacupuncture at Siguan points on PSD.@*METHODS@#Fifty SD rats were randomly divided into a sham-operation group, a stroke group, a PSD group, a drug group and an electroacupuncture group, with 10 rats in each one. The stroke model was established by middle cerebral artery occlusion (MCAO) method in the stroke group; except for the sham-operation group, the rats in the other groups were intervened with MCAO combined with solitary and chronic unpredictable mild stress (CUMS) to establish PSD model. In the electroacupuncture group, electroacupuncture was delivered at "Hegu" (LI 4) and "Taichong" (LR 3), with disperse-dense wave, 2 Hz/10 Hz in frequency, for 30 min in each intervention, once daily, for consecutive 21 days. Simultaneously, distilled water (0.01 L•kg-1•d-1) was administrated intragastrically. Fluoxetine solution (2.33 mg•kg-1•d-1) was given by gavage , once a day and for 21 days in the drug group. The same procedure of fixation and gavage with distilled water were adopted in the sham-operation group, the stroke group and the PSD group. Separately, before stroke modeling, after PSD modeling and after 21-day intervention, the consumption of sugar water and the scores of horizontal movement and vertical movement in open-field test were observed. After 21-day intervention, the content of colonic 5-HT was detected by immunohistochemical method, and that of fecal SCFAs was determined by gas chromatography mass spectrometry.@*RESULTS@#After PSD modeling, compared with the stroke group, the sugar water consumption, the horizontal movement scores and vertical movement scores of the open-field test were all reduced in the PSD group, the drug group and the electroacupuncture group (P<0.05). After 21-day intervention, the sugar water consumption and the scores of horizontal movement and vertical movement of the open-field test were increased in the drug group and the electroacupuncture group (P<0.05) when compared with the PSD group; and the horizontal movement score in the electroacupuncture group was lower than that of the drug group (P<0.05). Compared with the sham-operation group, the contents of total fecal SCFAs and acetic acid were lower in the stroke group (P<0.05), and the contents of colonic 5-HT and total fecal SCFAs, acetic acid, propionic acid and butyric acid were reduced in the PSD group (P<0.05). In comparison with the PSD group, the contents of colonic 5-HT and total fecal SCFAs, acetic acid and propionic acid were increased in the drug group and the electroacupuncture group (P<0.05); and the content of colonic 5-HT in the electroacupuncture group was lower than that of the drug group (P<0.05). The level of colonic 5-HT was positively correlated with the contents of total fecal SCFAs and propionic acid (r=0.424, P=0.005; r=0.427, P=0.004).@*CONCLUSION@#Electroacupuncture at "Siguan" points can relieve the depression-like behavior of PSD rats, and its underlying mechanism may be related to the regulation of fecal SCFAs, which affects the release of colonic 5-HT.

Tiaoqi Jieyu acupuncture for treatment-resistant depression: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effect of Tiaoqi Jieyu (regulating qi and relieving depression) acupuncture on the clinical symptoms of treatment-resistant depression (TRD), and to explore the relationship between the acupuncture pain sensitivity and symptom's improvement.@*METHODS@#A total of 78 patients with TRD were randomly divided into an observation group (39 cases, 3 cases dropped off) and a control group (39 cases, 4 cases dropped off). The patients in the control group were treated with medications according to the treatment plan of psychiatrists (at least one medication was 5-hydroxytryptamine reuptake inhibitor). On the basis of the control group, the patients in the observation group were treated with Tiaoqi Jieyu acupuncture, and Baihui (GV 20), Yintang (GV 24+), Yanglingquan (GB 34), Taichong (LR 3), Hegu (LI 4), Neiguan (PC 6), Yinlingquan (SP 9) and Zusanli (ST 36), etc. were selected. The acupuncture was given three times a week. Both groups were treated for 8 weeks. After 8-week treatment, the response rate of Hamilton depression scale-24 (HAMD-24) score after was evaluated in the two groups. The scores of HAMD-24 and Hamilton anxiety scale (HAMA) were compared between the two groups before treatment, after 4, 8-week treatment and 12 weeks after treatment (follow-up). After the first treatment and 8-week treatment, the visual analogue scale (VAS) score in the observation group was evaluated, and the correlation between VAS score after the first treatment and HAMD-24 score before treatment, between VAS score after the first treatment and the course of disease in the observation group was analyzed, and the correlation between difference of VAS after 8-week treatment and after the first treatment and difference of HAMD-24 score before treatment and after 8-week treatment was analyzed.@*RESULTS@#After 8-week treatment, the response rate of HAMD-24 score in the observation group was 52.8% (19/36), higher than 17.1% (6/35) in the control group (P<0.001). Compared before treatment, the scores of HAMD-24 and HAMA in the two groups were decreased after 4-week treatment, 8-week treatment and in follow-up (P<0.05), and those in the observation group were superior to the control group (P<0.05). After 8-week treatment, the acupuncture pain VAS score in the observation group was (5.28±2.13) points, which was higher than (3.33±1.62) points after the first treatment (P<0.001). There was a negative correlation between VAS score after the first treatment and HAMD-24 score before treatment in the observation group (r =-0.486, P=0.003); there was no correlation between acupuncture pain VAS score after the first treatment and the course of disease in the observation group (P>0.05). After 8-week treatment, there was a positive correlation between the difference of VAS score and the difference of HAMD-24 score in the observation group (r =0.514, P=0.001).@*CONCLUSION@#Tiaoqi Jieyu acupuncture could improve the depression and anxiety in patients with TRD, and the symptom's improvement is related to the recovery of acupuncture pain sensitivity.

Professor SUN Shen-tian's experience in acupuncture treatment of depression based on "psychosomatic medicine" / 中国针灸

This paper introduces professor SUN Shen-tian's clinical thoughts and his characteristics of acupuncture techniques for the treatment of depression based on "psychosomatic medicine". Professor SUN, the master of traditional Chinese medicine, believes that depression refers to comorbidity of "heart mind" and "body", resulting from the "body-mind" disharmony, specially dominated by the emotional disorder. This disease is located in the brain, with the injury of mind and closely related to the heart and liver dysfunction. In pathogenesis, the dysfunction of brain mind and the unhealthy conditions of body and mind are involved. The treatment should focus on "regulating the mind, improving the intelligence, co-modulating the abdominal and brain functions and treating the physical and mental disorders". Baihui (GV 20), Ningshen (Extra) and emotional area on the head are selected as the main points to benefit the intelligence and calming down the mind; the abdominal region 1 and region 8 of "Sun's abdominal acupuncture" are used as the main points of the abdomen to regulate the brain functions. The point prescription is modified according to the symptoms and etiologies. The repeated transcranial acupuncture stimulation and electroacupuncture at low frequency (2 Hz) are crucial to the therapeutic effect. Reliving anxious emotions is specially considered before acupuncture, and the mind is protected and deqi is consolidated during acupuncture.

Effect of transcutaneous auricular vagus nerve stimulation on functional connectivity in the related brain regions of patients with depression based on the resting-state fMRI / 中国针灸

OBJECTIVE@#To explore the brain effect mechanism and the correlation between brain functional imaging and cognitive function in treatment of depressive disorder (DD) with transcutaneous auricular vagus nerve stimulation (taVNS) based on the resting-state functional magenetic reasonance imaging (rs-fMRI).@*METHODS@#Thirty-two DD patients were included in a depression group and 32 subjects of healthy condition were enrolled in a normal group. In the depression group, the taVNS was applied to bilateral Xin (CO15) and Shen (CO10), at disperse-dense wave, 4 Hz/20 Hz in frequency and current intensity ≤20 mA depending on patient's tolerance, 30 min each time, twice daily. The duration of treatment consisted of 8 weeks. The patients of two groups were undertaken rs-fMRI scanning. The scores of Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA) and Wisconsin card sorting test (WCST) were observed in the normal group at baseline and the depression group before and after treatment separately. The differential brain regions were observed before and after treatment in the two groups and the value of degree centrality (DC) of fMRI was obtained. Their correlation was analyzed in terms of HAMD, HAMA and WCST scores.@*RESULTS@#The scores of HAMD and HAMA in the depression group were all higher than those in the normal group (P<0.05). After treatment, the scores of HAMD and HAMA were lower than those before treatment in the depression group; the scores of total responses, response errors and perseverative errors of WCST were all lower than those before treatment (P<0.05). The brain regions with significant differences included the left inferior temporal gyrus, the left cerebellar peduncles region 1, the left insula, the right putamen, the bilateral supplementary motor area and the right middle frontal gyrus. After treatment, the value of DC in left supplementary motor area was negatively correlated to HAMD and HAMA scores respectively (r=-0.324, P=0.012; r=-0.310, P=0.015); the value of DC in left cerebellar peduncles region 1 was negatively correlated to the total responses of WCST (r=-0.322, P=0.013), and the left insula was positively correlated to the total responses of WCST (r=0.271, P=0.036).@*CONCLUSION@#The taVNS can modulate the intensity of the functional activities of some brain regions so as to relieve depressive symptoms and improve cognitive function.

Applications and challenges of wearable electroencephalogram signals in depression recognition and personalized music intervention / 生物医学工程学杂志

Rapid and accurate identification and effective non-drug intervention are the worldwide challenges in the field of depression. Electroencephalogram (EEG) signals contain rich quantitative markers of depression, but whole-brain EEG signals acquisition process is too complicated to be applied on a large-scale population. Based on the wearable frontal lobe EEG monitoring device developed by the authors' laboratory, this study discussed the application of wearable EEG signal in depression recognition and intervention. The technical principle of wearable EEG signals monitoring device and the commonly used wearable EEG devices were introduced. Key technologies for wearable EEG signals-based depression recognition and the existing technical limitations were reviewed and discussed. Finally, a closed-loop brain-computer music interface system for personalized depression intervention was proposed, and the technical challenges were further discussed. This review paper may contribute to the transformation of relevant theories and technologies from basic research to application, and further advance the process of depression screening and personalized intervention.

Depression and Anxiety During the COVID-19 Pandemic: Epidemiology, Mechanism, and Treatment / 神经科学通报·英文版

The Coronavirus Disease 2019 (COVID-19) pandemic has had an adverse impact on the physical and mental health of the public worldwide. In addition to illness in patients with COVID-19, isolated people and the general population have experienced mental health problems due to social distancing policies, mandatory lockdown, and other psychosocial factors, and the prevalence of depression and anxiety significantly increased during the pandemic. The purpose of this review is to elucidate the epidemiology, contributing factors, and pathogenesis of depression and anxiety. during the pandemic. These findings indicate that physicians and psychiatrists should pay more attention to and identify those with a high risk for mental problems, such as females, younger people, unmarried people, and those with a low educational level. In addition, researchers should focus on identifying the neural and neuroimmune mechanisms involved in depression and anxiety, and assess the intestinal microbiome to identify effective biomarkers. We also provide an overview of various intervention methods, including pharmacological treatment, psychological therapy, and physiotherapy, to provide a reference for different populations to guide the development of optimized intervention methods.

Relationships between worry and depressive symptoms during two group therapies for generalized anxiety disorder / A inter-relação entre preocupações e sintomas depressivos em adultos com ansiedade generalizada

OBJECTIVE: Generalized anxiety disorder (GAD) is a chronic and disabling disorder associated with various impairments and shows a significant prevalence in the worldwide and Brazilian populations. This study aimed to investigate the longitudinal relationship of two symptoms relevant to the disorder (worry and depressive symptoms) in the context of a randomized clinical trial (RCT) by using a cross-lagged panel model (CLPM) analysis. METHODS: A total of 92 adult patients with GAD were randomized to receive ten sessions of either acceptance­based group behavioral therapy (ABBT) or nondirective supportive group therapy (NDST). Treatment had four time-point measures. Worries were measured using the Penn State Worry Questionnaire (PSWQ), and depression was measured using the Depression Anxiety Stress Scales (DASS-D). RESULTS: The NDST model revealed significant paths from worry to depression (first wave) and from depression to worry (second wave). There was no other significant cross-lagged effect. These data show that there was an influence between symptoms only during one of the treatment groups, and without a homogeneous and constant pattern in any of the cross-lagged routes. CONCLUSION: A supportive group psychotherapy potentially interferes with the pattern of the direct relationship between worries and depressive symptoms in adults with GAD.

OBJETIVO: O transtorno de ansiedade generalizada (TAG) é um diagnóstico crônico e incapacitante, associado a diversos prejuízos e com relevante prevalência na população mundial e na brasileira. Este estudo tem por objetivo investigar a relação longitudinal de duas manifestações relevantes para o transtorno (preocupação e sintomas depressivos), utilizando uma análise cross-lagged panel model (CLPM) por meio de dados de um ensaio clínico randomizado (ECR). MÉTODOS: Um total de 92 pacientes adultos com TAG foi randomizado para duas psicoterapias em grupo: terapia comportamental baseada em aceitação (TCBA) ou terapia de apoio não diretiva (TAND). Cada grupo teve duração de 10 sessões, distribuídas em 14 semanas. O tratamento teve quatro tempos de medida: linha de base, meio do tratamento, pós-tratamento e seguimento de três meses. As variáveis investigadas foram: preocupações, medidas pelo Penn State Worry Questionnaire (PSWQ), e sintomas depressivos, medidos pela Depression Anxiety Stress Scales (DASS-D). Os modelos CLMP foram gerados pelo programa Mplus. RESULTADOS: O modelo do grupo TAND revelou duas rotas significativas: preocupação para sintomas depressivos (primeira onda) e sintomas depressivos para preocupação (segunda onda). Não houve outro efeito cross-lagged que obteve significância estatística. Esses dados mostram que houve influência alternada entre os sintomas somente durante o período de um dos dois tratamentos testados, configurando um padrão heterogêneo das rotas cross-lagged. CONCLUSÃO: A psicoterapia suportiva em grupo potencialmente interfere no padrão da relação direta entre preocupação e sintomas depressivos em adultos com TAG.

Effect of Interactive Dynamic Scalp Acupuncture on Post-Stroke Cognitive Function, Depression, and Anxiety: A Multicenter, Randomized, Controlled Trial / 中国结合医学杂志

OBJECTIVE@#To compare the clinical effects of interactive dynamic scalp acupuncture (IDSA), simple combination therapy (SCT), and traditional scalp acupuncture (TSA) on cognitive function, depression and anxiety in patients with post-stroke cognitive impairment.@*METHODS@#A total of 660 patients with post-stroke cognitive impairment who were admitted to 3 hospitals in Shenzhen City between May 2017 and May 2020 were recruited and randomly assigned to the IDSA (218 cases), SCT (222 cases) and TSA groups (220 cases) according to a random number table. All the patients received conventional drug therapy for cerebral stroke and exercise rehabilitation training. Scalp acupuncture and computer-based cognitive training (CBCT) were performed simultaneously in the IDSA group, but separately in the morning and in the afternoon in the SCT group. The patients in the TSA group underwent scalp acupuncture only. The course of treatment was 8 weeks. Before treatment (M0), 1 (M1) and 2 months (M2) after treatment, as well as follow-up at 1 (M3) and 2 months (M4), the cognitive function of patients was assessed using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment Scale (MoCA) Scales; depression, anxiety, sleep quality, and self-care ability of patients were assessed using Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA), Pittsburgh Sleep Quality Index (PSQI), and Modified Barthel Index (MBI), respectively. During this trial, all adverse events (AEs) were accurately recorded.@*RESULTS@#There were no significant differences in the MMSE, MoCA, HAMD, HAMA, PSQI, and MBI scores among the 3 groups at M0 (all P>0.05). In the IDSA group, the MMSE, MoCA and MBI scores from M2 to M4 were significantly higher than those in the SCT and TSA groups, while the HAMD, HAMA and PSQI scores were significantly reduced (all P<0.01). The changes of all above scores (M2-M0, M4-M0) were significantly superior to those in the SCT and TSA groups (all P<0.01, except M4-M0 of HAMD). At M2, the severity of MMSE, HAMD, HAMA, PSQI and MBI in the IDSA group was significantly lower than that in the SCT and TSA groups (all P<0.01). There was no serious AE during this trial.@*CONCLUSIONS@#IDSA can not only significantly improve cognitive function, but also reduce depression, anxiety, which finally improves the patient's self-care ability. The effect of IDSA was significantly better than SCT and TSA. (Trial registration No. ChiCTR1900027206).

Tratamiento del trastorno depresivo en adolescentes: revisión bibliográfica / Treatment of depressive disorder in adolescents: literature review

El trastorno depresivo en adolescentes es un diagnóstico en aumento que se ha asociado con una alta incidencia de patologías psiquiátricas en la adultez, con repercusiones en los resultados educativos, vocacionales, relaciones interpersonales, salud y bienestar físico y mental. Por lo tanto, es crucial el diagnóstico temprano y el tratamiento adecuado. El objetivo de la presente revisión bibliográfica fue analizar las alternativas terapéuticas tanto farmacológicas como no farmacológicas disponibles. Se llevó a cabo una búsqueda en PubMed de artículos publicados en los últimos 5 años y en Google Scholar desde el 2018. Los resultados sugieren que la terapia cognitivo conductual sigue siendo la intervención de primera línea con mayor respaldo de evidencia. Sin embargo, se observa que actividades como la actividad física, intervenciones psicoeducativas, estimulación magnética transcraneal, musicoterapia, yoga, biorretroalimentación, terapia del bosque, terapia basada en el arte e intervenciones digitales también han demostrado alivio de los síntomas en medida heterogénea. En cuanto al tratamiento farmacológico, los antidepresivos son la terapia de primera línea, siendo la fluoxetina y el escitalopram los más respaldados por la evidencia. Esta revisión destaca el interés en investigar el uso de otros fármacos como la lamotrigina y la ketamina, aunque la evidencia es incipiente y se requieren más ensayos controlados aleatorizados para determinar su efectividad.

Depressive disorder in adolescents is a diagnosis that has been increasing and is associated with a high incidence of psychiatric pathologies in adulthood, impacting educational and vocational outcomes, interpersonal relationships, as well as physical and mental well-being. Early diagnosis and proper treatment are crucial in addressing these issues. The objective of this bibliographic review was to examine available pharmacological and non-pharmacological therapeutic alternatives. The review involved a search on PubMed for articles published in the last 5 years and on Google Scholar since 2018. The available evidence suggests that cognitive-behavioral therapy remains the first-line intervention with the most support. However, physical activity, psychoeducational interventions, transcranial magnetic stimulation, music therapy, yoga, biofeedback, forest therapy, art-based therapy, and digital interventions have shown varying degrees of symptom relief. In terms of pharmacological treatment, antidepressants, particularly fluoxetine and escitalopram, are considered the first-line therapy based on the strongest evidence. The review also highlights the interest in exploring the use of other drugs such as lamotrigine and ketamine. However, more randomized controlled trials are needed to establish their effectiveness conclusively.

Effect of wheat-grain moxibustion on the expression of 5-HT and cortisol in the serum, and MR and GR in the hippocampus in rats with hypothyroidism complicated with depression / 中国针灸

OBJECTIVE@#To observe the effect of wheat-grain moxibustion on behavior, 5-hydroxytryptamine (5-HT) and cortisol in the serum, mineralocorticoid receptor (MR) and glucocorticoid receptor (GR) in the hippocampus in rats with hypothyroidism complicated with depression, and to explore the possible mechanism of wheat-grain moxibustion on improving depression in rats with hypothyroidism.@*METHODS@#A total of 32 SPF SD rats were randomly divided into a blank group, a model group, a medication group and a wheat-grain moxibustion group, 8 rats in each group. Except for the blank group, the rats in the remaining groups were treated with intragastric administration of 0.1% propylthiouracil (PTU) suspension at 1 mL/100 g, once a day for 4 weeks to establish the rat model of hypothyroidism, and whether the rats were accompanied with depression-like behavior determined through behavioristics evaluation. The rats in the medication group were intervened with euthyrox at 0.9 mL/100 g, once a day, for 4 weeks; the rats in the wheat-grain moxibustion group were treated with wheat-grain moxibustion at "Dazhui" (GV 14), "Mingmen" (GV 4), "Shenshu" (BL 23) and "Pishu" (BL 20), 7 cones each acupoint, once a day, six times a week for 4 weeks. After the intervention, the depression status was observed by behavioristics test; the contents of thyroid stimulating hormone (TSH), total thyroxine (TT4), 5-HT and cortisol in the serum were detected by ELISA; the protein expressions of MR and GR in hippocampus were detected by Western blot; the expressions of MR mRNA and GR mRNA in the hippocampus were detected by real-time PCR.@*RESULTS@#Before the intervention, compared with the blank group, the scores of open field test (OFT) were decreased and the immobility time of tail suspension test (TST) was prolonged (P<0.05); the serum TSH contents were increased and TT4 contents were decreased (P<0.01) in the other three groups. After the intervention, compared with the model group, the vertical score of OFT was increased and the immobility time of forced swimming test (FST) was prolonged in the medication group (P<0.05), while the scores of three items of OFT were increased (P<0.05, P<0.01), and the immobility time of FST and TST was shortened in the wheat-grain moxibustion group (P<0.01, P<0.05). Compared with the medication group, the immobility time of TST and FST in the wheat-grain moxibustion group was shorter (P<0.05, P<0.01). Compared with the blank group, in the model group, the contents of serum TSH and cortisol were increased (P<0.01, P<0.001), while the contents of serum TT4 and 5-HT were decreased (P<0.01, P<0.001). Compared with the model group, the contents of serum TT4 and 5-HT were increased, while the contents of serum TSH and cortisol were decreased in the medication group and wheat-grain moxibustion group (P<0.01, P<0.05). Compared with the blank group, the protein and mRNA expression of MR, GR in the hippocampus in the model group was decreased (P<0.01, P<0.05, P<0.001); compared with the model group, the protein and mRNA expression of MR in the hippocampus in the medication group were increased (P<0.05), and the protein expression of MR, GR and mRNA expression of MR in the hippocampus in the wheat-grain moxibustion group were increased (P<0.05, P<0.01). Compared with the medication group, the expression of MR mRNA in the wheat-grain moxibustion group was increased (P<0.05).@*CONCLUSION@#Wheat-grain moxibustion could significantly improve thyroid function and depression in rats with hypothyroidism. Its mechanism may be related to up-regulating the protein and mRNA expression of MR and GR in the hippocampus, and then affecting the expression of serum cortisol and 5-HT.

FU Wen-bin's experience in treatment of depression complicated with obsessive-compulsive disorder from perspective of heart and gallbladder / 中国针灸

Based on the thinking of integrative and holistic acupuncture and moxibustion, FU Wen -bin proposes to treat depression complicated with obsessive-compulsive disorder from perspective of heart and gallbladder. In clinical practice, the treatment pattern of "acupuncture at the top priority, followed by moxibustion, and consolidation at the end" is applied, acupuncture, refined moxibustion, intradermal needle and other therapies are comprehensively adopted, acupoints on the heart meridian, pericardium meridian and gallbladder meridian are selected or back-shu points and front-mu points of the heart, gallbladder and pericardium are matched, and the acupoints on the conception vessel and governor vessel and with the functions of tonifying kidney and regulating qi are added to calm the heart and tranquilize the mind, so as the symptoms of depression and obsessive-compulsive can be effectively relieved.

SUN's abdominal acupuncture for depression after methamphetamine withdrawal: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical effect of SUN 's abdominal acupuncture and conventional acupuncture in the treatment of depression after methamphetamine withdrawal.@*METHODS@#A total of 80 female patients with depression after methamphetamine withdrawal were randomly divided into an observation group (40 cases, 1 case dropped off) and a control group (40 cases, 2 cases dropped off). The control group was treated with conventional acupuncture at Baihui (GV 20), Yintang (GV 29), Taichong (LR 3), Shenmen (HT 7), Neiguan (PC 6), Danzhong (GV 17), and the observation group was treated with SUN 's abdominal acupuncture at area 1 of the abdomen and area 8 of the abdomen. Both groups were treated once a day, 30 min each time, 6 days as a course of treatment, 1 day rest between treatment courses, a total of 4 courses of treatment. The scores of withdrawal symptoms, Hamilton depression scale (HAMD), Pittsburgh sleep quality index (PSQI) scale and serum serotonin (5-HT) level were compared between the two groups before and after treatment.@*RESULTS@#After treatment, the scores of withdrawal symptoms, HAMD and the various scores and total score of PSQI scale in the two groups were all lower than before treatment (P<0.01), and the scores of withdrawal symptoms, HAMD and the sleep quality, time to fall asleep, sleep time scores and total score of PSQI in the observation group were lower than the control group (P<0.05, P<0.01). After treatment, the serum 5-HT level of the two groups was increased (P<0.01), and that in the observation group was higher than the control group (P<0.05).@*CONCLUSION@#SUN 's abdominal acupuncture can improve withdrawal symptom, depression and sleep quality, increase serum 5-HT content in treatment of depression after methamphetamine withdrawal, and has better effect than conventional acupuncture.

Combined use of Shenmen (HT 7) and Sanyinjiao (SP 6) to improve the anxiety and depression in patients with insomnia: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effect of electroacupuncture (EA) at Shenmen (HT 7) and Sanyinjiao (SP 6) on anxiety and depression in patients with insomnia, and to explore the mechanism of its compatibility effect.@*METHODS@#Ninety patients of insomnia were randomly divided into a combination group, a Shenmen group and a Sanyinjiao group, 30 cases in each group. In addition, 37 cases with anxiety (12 cases in the combination group, 13 cases in the Shenmen group and 12 cases in the Sanyinjiao group) and 42 cases with depression (14 cases in the combination group, 14 cases in the Shenmen group and 14 cases in the Sanyinjiao group) were identified. The patients in the combination group, Shenmen group and Sanyinjiao group were treated with EA (dilatational wave, frequency of 5 Hz/25 Hz) at Shenmen (HT 7)-Sanyinjiao (SP 6), Shenmen (HT 7) and Sanyinjiao (SP 6), respectively, 30 min each treatment, once a day. The consecutive 5 days of treatments were taken as a course of treatment, and 2 courses of treatment were given. The insomnia severity index (ISI), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores were evaluated before and after treatment, and the serum contents of dopamine (DA) and norepinephrine (NE) were measured.@*RESULTS@#Compared before treatment, the ISI, SAS and SDS scores in the three groups were all decreased after treatment (P<0.05), and the ISI score in the combination group was lower than that in the Shenmen group (P<0.05). Among the patients with anxiety, compared before treatment, the ISI, SAS scores and serum contents of DA were all decreased after treatment in the three groups (P<0.05), and the serum contents of NE in the combination group and Shenmen group were decreased after treatment (P<0.05); the SAS score and serum contents of NE in the combination group and Shenmen group as well as the ISI score in the combination group were lower than those in the Sanyinjiao group (P<0.05). Among the patients with depression, compared before treatment, the ISI, SDS scores and serum contents of DA were all decreased after treatment in the three groups (P<0.05), and the serum contents of NE in the combination group and Shenmen group were decreased after treatment (P<0.05); the ISI, SDS scores and serum contents of NE in the combination group as well as SDS score in the Shenmen group were lower than those in the Sanyinjiao group (P<0.05).@*CONCLUSION@#EA at Shenmen (HT 7) and Sanyinjiao (SP 6) has advantages over EA at Sanyinjiao (SP 6) on improving insomnia, anxiety and depression. Shenmen (HT 7) plays a major role in improving anxiety and depression. Shenmen (HT 7) and Sanyinjiao (SP 6) may play a compatibility effect of regulating consciousness and sleeping by reducing the level of serum NE.

Effects of Promove - Saúde da Mulher on anxiety, depression, social skills, and satisfaction: A single-subject design

Terapia Analítico-Comportamental (TAC) (in English, behavioral-analytic therapy, behavior therapy, or clinical behavior analysis) is a possible intervention for cases of anxiety and depression, but it still has much to advance in terms of efficacy and clinical utility evidence. This article aims to describe the effects of a semi-structured intervention in the model of TAC regarding anxiety and depression, behavior, complaints, and satisfaction indicators. Participants included three women with children, marital relationships, and work, aged between 34 and 41 with complaints compatible with anxiety and depression disorders. The intervention used Promove - Saúde da Mulher (PSM) (in English, Promote Women's Health), which included 17 topics, most of them related to social skills. Instruments included the GAD-7 for anxiety, PHQ-9 for depression, IHS-2 Del Prette for social skills, a Complaints Checklist for monitoring clinical demands, and an Evaluation of the Therapeutic Process to describe clients' satisfaction rates. The results from the standardized instruments were statistically analyzed via the JT method. All three participants showed reliable improvements in anxiety and/or depression, improvement in most complaints, and satisfaction with the intervention and its outcomes. Acquisition of social skills occurred in two cases. One participant dropped out and another one relapsed at follow-up. The efficacy criteria were used to evaluate the internal validity of the present study. The study collected the first evidences of outcome and satisfaction for PSM, thus enabling future investigations on the efficacy and clinical utility of this intervention program. (AU)

Homebound Elderly People Psychotherapeutic Intervention (HEPPI): study protocol for a randomized controlled trial / Intervenção psicoterapêutica com adultos idosos confinados no domicílio: protocolo para um ensaio clínico randomizado controlado

Objective: To present the study protocol for the Homebound Elderly People Psychotherapeutic Intervention (HEPPI), a home-delivered cognitive-emotional intervention aimed at homebound older adults with mild cognitive impairment and depression and/or anxiety symptoms. Methods: A two-arm, open-label, parallel-group randomized controlled trial will be conducted to compare the effects of HEPPI with treatment as usual. Homebound older adults will be recruited from the community through contact with their health care networks in mainland Portugal. All participants will complete baseline, post-intervention, and 3-month follow-up assessments. Primary outcomes will be changes in episodic memory and depression and anxiety symptoms. Secondary outcomes will include changes in general cognition, attentional control, subjective memory complaints, quality of life, functional status, and loneliness. Relevance: The availability of evidence-based home-delivered non-pharmacological interventions meeting the cognitive and emotional needs of the homebound older population could improve their access to mental health care resources and increase their mental health and quality of life.

Objetivo: Apresentar o protocolo do estudo da Homebound Elderly People Psychotherapeutic Intervention (HEPPI), uma intervenção cognitivo-emocional, realizada no domicílio, dirigida a adultos idosos confinados no domicílio com declínio cognitivo leve e sintomatologia depressiva e/ou ansiógena. Métodos: Será realizado um ensaio clínico randomizado, controlado e aberto, com o objetivo de comparar os efeitos da intervenção HEPPI com um grupo de tratamento usual. Os idosos confinados no domicílio serão recrutados na comunidade, em Portugal continental, por meio de contato com sua rede de prestação de cuidados de saúde. Todos os participantes serão avaliados em três momentos: pré-intervenção, pós-intervenção e três meses depois da intervenção. As alterações na memória episódica e na sintomatologia depressiva e ansiógena serão os desfechos primários, já os secundários serão constituídos pelas alterações no funcionamento cognitivo geral, controle atencional, queixas subjetivas de memória, qualidade de vida, capacidade funcional e solidão. Relevância: A disponibilidade de intervenções não farmacológicas em domicílio com evidência empírica, que atendam às necessidades cognitivas e emocionais dos adultos idosos confinados no domicílio, poderá facilitar o seu acesso a recursos de saúde mental, bem como melhorar sua saúde mental e qualidade de vida.

Efeitos da musicoterapia sobre os sintomas de ansiedade e depressão em adultos com diagnóstico de transtornos mentais: revisão sistemática / Efectos de la musicoterapia sobre los síntomas de ansiedad y depresión en adultos con diagnóstico de trastornos mentales: revisión sistemática / Effects of music therapy on anxiety and depression symptoms in adults diagnosed with mental disorders: a systematic review

Resumo Objetivo Identificar e sintetizar as evidências oriundas de ensaios clínicos randomizados que avaliaram os efeitos da musicoterapia sobre os sintomas de ansiedade e de depressão em adultos com transtornos mentais. Métodos Revisão sistemática guiada pelo protocolo Preferred Reporting Items for Systematic Reviews and Meta-Analysis. A busca dos artigos nas bases de dados MEDLINE, Embase, CENTRAL Cohcrane, CINAHL, PsycINFO e LILACS, bem como a busca manual, seleção dos estudos, extração dos dados e avaliação metodológica pela Escala de Jadad e pela ferramenta do Risco de Viés da Cochrane foram realizadas por dois revisores de forma independente. Resultados Foram identificados 1649 estudos, sendo oito selecionados e analisados. Os achados mostraram um efeito positivo da musicoterapia nos sintomas de ansiedade e depressão na população adulta em diferentes contextos. De acordo com a Risco de Viés da Cochrane, quatro estudos foram classificados como baixo risco de viés, e os outros quatro como alto risco de viés. Os adultos que receberam musicoterapia apresentaram relaxamento físico e mental, redução dos sintomas ansiosos e depressivos, promovendo o bem-estar de forma consciente e saudável. Conclusão A musicoterapia se apresenta como uma potencial estratégia para reduzir a ansiedade e a depressão bem como para auxiliar na manutenção e recuperação da saúde das pessoas adultas com transtornos mentais.

Resumen Objetivo Identificar y sintetizar las evidencias oriundas de ensayos clínicos aleatorizados que evaluaron los efectos de la musicoterapia sobre los síntomas de ansiedad y depresión en adultos con trastornos mentales. Métodos Revisión sistemática orientada por el protocolo Preferred Reporting Items for Systematic Reviews and Meta-Analysis. La búsqueda de los artículos en las bases de datos MEDLINE, Embase, CENTRAL Cohcrane, CINAHL, PsycINFO y LILACS fue realizada por dos revisores de forma independiente, así como también la búsqueda manual, selección de los estudios, extracción de datos y evaluación metodológica a través de la Escala de Jadad y la herramienta de riesgo de sesgo de Cochrane. Resultados Se identificaron 1649 estudios, de los cuales ocho fueron seleccionados y analizados. Los resultados mostraron un efecto positivo de la musicoterapia en los síntomas de ansiedad y depresión en la población adulta en diferentes contextos. De acuerdo con el riesgo de sesgo de Cochrane, cuatro estudios fueron clasificados con bajo riesgo de sesgo y otros cuatro con alto riesgo de sesgo. Los adultos que recibieron musicoterapia presentaron relajamiento físico y mental, reducción de los síntomas ansiosos y depresivos, lo que promueve el bienestar de forma consciente y saludable. Conclusión La musicoterapia se presenta como una estrategia potencial para reducir la ansiedad y la depresión, así como para ayudar a mantener y recuperar la salud de las personas adultas con trastornos mentales.

Abstract Objective To identify and synthesize evidence from randomized clinical trials that assessed the effects of music therapy on anxiety and depression symptoms in adults with mental disorders. Methods This is a systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocol. The search for articles in the MEDLINE, Embase, CENTRAL Cohcrane, CINAHL, PsycINFO and LILACS databases, as well as manual search, selection of studies, data extraction and methodological assessment using the Jadad Scale and the Cochrane risk-of-bias, was performed by two reviewers independently. Results 1,649 studies were identified, eight of which were selected and analyzed. The findings showed a positive effect of music therapy on anxiety and depression symptoms in the adult population in different contexts. According to the Cochrane risk-of-bias, four studies were classified as low risk of bias, and the other four as high risk of bias. Adults who received music therapy showed physical and mental relaxation, reduced anxiety and depressive symptoms, promoting well-being in a conscious and healthy way. Conclusion Music therapy presents itself as a potential strategy to reduce anxiety and depression as well as to help maintain and recover the health of adults with mental disorders.