Depression in older adults from the municipality of Mochitlan, Guerrero (Mexico) / Depresión en adultos mayores del municipio de Mochitlán, Guerrero (Mexico) / Depressão em idosos do município de Mochitlán, Guerrero (Mexico)

Introduction: Depression in older adults in an important aspect since it affects significantly their health and quality of life. As people age, they may experience physical, emotional, and social changes that make them more susceptible to depression. Based on estimations from the World Health Organization, the global population over 60 years of age with some depressive symptoms will increase from 12% to 22% between 2015 and 2050. Objective: To identify the prevalence and factors associated with depression in older adults from the municipality of Mochitlan, Guerrero. Materials and methods: Mixt quantitative research with an analytical cross-sectional design and a simple random sampling of 26 older adults. Information was collected through a multiple choice survey administered by the researchers using an instrument with four sections. The ethnographic method was used for the qualitative approach, through a semi-structured interview to a focus group of seven older adults, with 3 open questions. Results: Mild (38.46%), moderate (7.69%), and serious (3.85) was found. The associated factors were: female gender; type of work; and monthly income. The qualitative analysis showed positive and negative emotions. Conclusions: 50% of the population had some type of depression.

Introducción: La depresión en adultos mayores es un tema importante debido a que afecta de manera significativa la salud y calidad de vida. A medida que las personas envejecen, pueden experimentar cambios físicos, emocionales y sociales que los hacen más susceptibles a tener depresión. La Organización Mundial de la Salud (OMS) estima que entre 2015 y 2050 la población mundial mayor de 60 años pasará del 12% al 22% de padecer algún síntoma depresivo. Objetivo: Identificar la prevalencia y factores asociados a la depresión en adultos mayores del Municipio de Mochitlán, Guerrero. Materiales y métodos: Investigación mixta, cuantitativa con diseño transversal analítico, muestreo aleatorio simple en una población de 26 adultos mayores, se recabo información mediante una encuesta aplicada por los investigadores con opción múltiple utilizando un instrumento de cuatro apartados. Para el enfoque cualitativo se utilizó el método etnográfico, mediante una entrevista semiestructurada con 3 preguntas abiertas a un grupo focal de siete adultos mayores. Resultados: Se encontró depresión leve (38,46%), moderada (7,69%) y grave (3,85%). Los factores asociados fueron género femenino, tipo de trabajo; ingreso mensual. El análisis cualitativo mostro emociones positivas y negativas. Conclusiones: 50% de la población presento algún tipo de depresión.

Introdução: A depressão em idosos é um tema importante porque afeta significativamente a saúde e a qualidade de vida. À medida que as pessoas envelhecem, elas podem passar por mudanças físicas, emocionais e sociais que as tornam mais suscetíveis à depressão. A Organização Mundial da Saúde (OMS) estima que entre 2015 e 2050, a população mundial com mais de 60 anos passará de 12% a 22% sofrendo de alguns sintomas depressivos. Objetivo: Identificar a prevalência e os fatores associados à depressão em idosos do município de Mochitlán, Guerrero. Materiais e métodos: Pesquisa mista, quantitativa, com desenho analítico transversal, amostragem aleatória simples em população de 26 idosos, as informações foram coletadas por meio de questionário aplicado pelos pesquisadores com múltipla escolha por meio de instrumento de quatro seções. Para a abordagem qualitativa utilizou-se o método etnográfico, por meio de entrevista semiestruturada com 3 questões abertas a um grupo focal de sete idosos. Resultados: Foi encontrada depressão leve (38,46%), moderada (7,69%) e grave (3,85%). Os fatores associados foram sexo feminino, tipo de trabalho; ingresso mensal. A análise qualitativa evidenciou emoções positivas e negativas. Conclusões: 50% da população apresentou algum tipo de depressão.

Effects of repetitive transcranial magnetic stimulation combined with paroxetine hydrochloride on executive function in depressed adolescents with non-suicidal self-injury / 中国基层医药

Objective:To investigate the effects of repetitive transcranial magnetic stimulation combined with paroxetine hydrochloride on executive function in depressed adolescents with non-suicidal self-injury.Methods:The clinical data of 120 depressed adolescents with depressive disorders who were admitted to The Second Hospital of Jinhua from August 2021 to July 2022 were retrospectively analyzed. They were randomly assigned to undergo treatment either with paroxetine hydrochloride (control group, n = 60) or repetitive transcranial magnetic stimulation combined with paroxetine hydrochloride (observation group, n = 60). All patients were treated for 2 months. Hamilton Depression Rating Scale-24 (HAMD-24) score, Non-suicidal Self-injury Behavior and Function Scale for Adolescents (ANSSIQ) score, executive function, brain-derived neurotrophic factor, 5-hydroxytryptamine, and clinical efficacy were determined in each group. Results:After treatment, the Hamilton Depression Rating Scale-24 score in the observation group was significantly lower than that in the control group [(15.85 ± 1.08) points) vs. (18.72±1.21) points, t = 13.71, P < 0.001). After treatment, the number of self-injury attacks, number of self-injury impulsions, and the intensity of self-injury thought within 2 weeks in the observation group were significantly lower than those in the control group ( t = 3.42, 3.03, 1.92, all P < 0.05). The scores of the Trail Making Test, Stroop Word test, Stroop Color test, and Stroop Color-Word Interference Test were significantly higher in the observation group than those in the control group ( t = 2.66, 3.33, 3.97, 4.64, all P < 0.01). Brain-derived neurotrophic factor and 5-hydroxytryptamine levels in the observation group were (11.45 ± 1.79) μg/L and (136.68 ± 11.90) μg/L, respectively, which were significantly higher than (9.06±2.21) μg/L and (124.82 ± 10.34) μg/L in the control group ( t = 6.51, 5.83, both P < 0.001). The total response rate in the observation group was significantly higher than that in the control group (91.7% vs. 78.3%, Z = 2.73, P = 0.006). Conclusion:Repetitive transcranial magnetic stimulation combined with paroxetine hydrochloride is highly effective on depressive disorders in adolescents with non-suicidal self-injury. The combined therapy can reduce symptoms, improve executive function and cognitive function, and optimize serological indicators, and thereby deserves the clinical promotion.

A qualitative study on the influencing factors of parents′ participation in emotional management of adolescents with affective disorder / 中国实用护理杂志

Objective:To understand the barriers and facilitators to parental involvement in emotionally disturbed adolescents′ emotion management and to provide a basis for healthcare professionals to develop interventions for parental involvement in emotionally disturbed adolescents′ emotion management.Methods:Use of purposive sampling method from July to December 2021, 16 face-to-face semi-structured in-depth interviews were conducted with fathers or mothers of adolescents with affective disorders from the Third Hospital of Daqing City, and the data were analyzed using the Colaizzi 7-step analysis method.Results:Refining the theme from two aspects, one was the hindering factors: parents′ own factors including lack of knowledge about the disease, little time for companionship, poor emotional control, inappropriate communication style, and poor couple relationship; the child′s own factors including pathological factors, personality; environmental factors including academic stress, interpersonal relationships; economic factors including high cost of treatment, life stress. The other was the facilitating factors: support from others including family support, professional help; positive coping including finding coping strategies, change of mindset.Conclusions:Healthcare professionals should pay attention to these influencing factors and construct a program for parental involvement in emotionally disturbed adolescents′ emotion management from various aspects, so that parents can actively participate in their children′s emotion management and promote the rehabilitation of emotionally disturbed adolescents.

Caracterización clínica y terapéutica del episodio depresivo en pacientes hospitalizados / Clinical and therapeutic characterization of depressive episodes in hospitalized patients

RESUMEN Introducción: la depresión es la enfermedad psiquiátrica más frecuente y puede sufrirse a cualquier edad. Cerca del 20 % de las personas padecen durante su vida una depresión, de ellos el 70 % son mujeres. Objetivo: caracterizar los pacientes hospitalizados con diagnóstico de episodio depresivo según síntomas clínicos, terapia utilizada y presencia de complicaciones, en el Hospital Clínico Quirúrgico Docente Dr. León Cuervo Rubio de Pinar del Río durante los años 2017-2018. Métodos: se realizó un estudio observacional, descriptivo y transversal. El universo quedó constituido por 116 pacientes con el diagnóstico clínico de episodio depresivo que necesitaron tratamiento psicológico durante la hospitalización. Los datos fueron obtenidos de las historias clínicas, mediante la entrevista y la observación. Resultados: se evidenció que el sexo femenino fue el mayor afectado, en edades entre 40-59 años. Como factores de riesgo sociales se incluyeron estados familiares de salud; económicos relacionados con la personalidad del paciente, y los factores biológicos. La disminución de la atención y concentración, perdida de la confianza en sí mismo, sentimientos de inferioridad, ideas de culpa e inutilidad, fueron los principales síntomas. Conclusiones: la disminución de la atención y concentración, estuvieron presentes en todos los pacientes con predominio de ideas de culpa y de inutilidad, las complicaciones escasas fueron escasas, siendo la terapia cognitivo conductual el tratamiento de elección utilizado.

ABSTRACT Introduction: depression is the most common psychiatric illness. About 20% of people suffer from depression during their lifetime, of which 70 % are women and can be suffered at any age. Objective: to characterize hospitalized patients with diagnosis of depressive episode based on clinical symptoms, therapy applied and presence of complications at Dr. León Cuervo Rubio Teaching Clinical Surgical Hospital. Pinar del Río during the years 2017-2018. Methods: an observational, descriptive and cross-sectional study was performed. The target group included 116 patients with clinical diagnosis of depressive episode who needed psychological treatment during hospitalization. Data were obtained from clinical histories, and through interview and observation. Results: it was evidenced that female gender was mostly affected, in ages between 40-59 years. The main risk factors identified were social factors, such as health relatives, economic factors related to the patient's personality, and biological factors. The main symptoms were reduced attention and concentration, loss of self-confidence and feelings of inferiority, guilt and uselessness. Conclusions: decreased of attention and concentration were present in all patients with predominance of guiltiness and uselessness ideas, scarce complications, cognitive behavioral therapy was the treatment of choice.

Effect of sodium valproate tablets and venlafaxine hydrochloride sustained-release tablets in the treatment of female schizophrenia with affective disorder / 中国基层医药

Objective To investigate the clinical effect of sodium valproate tablets combined with venlafaxine hydrochloride sustained-release tablets in female patients with schizophrenia complicated with affective disorders and its influence on the recurrence time.Methods From January 2013 to July 2016,98 female patients with schizophrenia complicated by affective disorder in Taiyuan Mental Hospital were selected and randomly divided into single group (n =49) and combination group (n =49) according to the digital table.The single drug group was treated with sodium valproate tablets,and the combination group was treated with venlafaxine hydrochloride sustained-release tablets on the basis of a single drug group.The clinical efficacy and recurrence time of the two groups were compared.Results The scores of withdrawal symptoms [(4.39 ± 0.94) points],positive symptoms [(11.55 ± 4.30) points],negative symptoms [(11.09 ± 1.21) points] and psychiatric symptoms [(12.01 ±2.16) points] in the combination group were all significantly lower than those at 1 month after treatment[(10.98 ±1.43) points,(16.74 ± 3.89) points,(18.43 ± 2.05) points,(19.83 ± 3.44) points] (t =12.957,18.471,all P ＜0.05).The incubation period and amplitude of the P300 potentials in the combination group were (314.55 ± 9.21) s,(4.05 ± 1.76)s,respectively,which were both higher than those of the single drug group [(341.60 ± 25.87)s,(2.58 ± 2.30)s] (t =18.251,15.738,all P ＜ 0.05).The eye movements of the combination group 12 weeks after operaion were (27.30 ± 1.41) s and (6.15 ± 0.98) s,respectively,which were higher than those of the single drug group[(25.10 ± 2.93) s and (5.10 ± 1.20) s] (t =13.992,15.836,all P ＜ 0.05).The recurrence rate of the combined group was 8.16％,which was lower than 18.37％ of the single drug group(x2 =6.893,P ＜ 0.05).The hospitalization duration [(14.83 ± 4.61)d],symptom improvement time [(34.94 ± 7.85)d] of the combined group were shorter than those of the single drug group [(27.91 ± 7.49) d,(59.81 ± 10.94) d] (t =18.946,21.461,all P ＜ 0.05).The recurrence time at 12 weeks after treatment of the combination group was (148.48 ± 33.19)d,which was longer than (109.46 ±28.88)d of the single drug group(t =16.893,P ＜0.05).Conclusion The combination of sodium valproate tablets and venlafaxine hydrochloride sustained-release tablets in.patients with schizophrenia complicated with affective disorders can improve the clinical effect,shorten the recurrence time and improve the cognitive function of patients,which is worth popularizing and applying.

Therapeutic Misconception in Psychiatry Research: A Systematic Review

Therapeutic misconception (TM) denotes the phenomenon in which research subjects conflate research purpose, protocols and procedures with clinical treatment. We examined the prevalence, contributory factors, clinical associations, impact, and collated solutions on TM within psychiatric research, and made suggestions going ahead. Literature search for relevant empirical research papers was conducted until February 2015. Eighty-eight reports were extracted, of which 31 were selected, summarised into different headings for discussion of implications and collated solutions of TM. We found variable and high rates of TM (ranging from 12.5% to 86%) in some psychiatry research populations. Contributory factors to TM included perceived medical roles of researchers, media, research setting and subject factors. Greater TM in affective, neurodevelopmental and psychotic spectrum conditions were associated with demographic variables (such as lower education, increased age), clinical factors (such as poor insight, cognitive deficits, increased symptoms, poorer self-rated quality of health), and social functioning (such as decreased independence). Inattention to TM may lead to frustration, negative impression and abandonment of participation in psychiatry research. Strategies such as the employment of a neutral educator during the informed consent process and education modules may be effective in addressing TM. Further research is warranted to examine the different TM facets, specific clinical correlates and more effective management strategies.

Avaliação dos níveis de depressão em idosos praticantes de diferentes exercícios físicos / Evaluation of depression levels in elderly practitioners of different physical exercise

Introdução: A população de idosos vem aumentando em todo o mundo, assim como a preocupação com a qualidade de vida, que abrange aspectos físicos, psicológicos e sociais. Objetivo: Avaliar o nível de depressão em idosos praticantes de diferentes tipos de exercícios físicos. Métodos: A amostra foi composta de 116 idosos, praticantes regulares de exercícios físicos: G1-Musculação (n=23), G2-Hidroginástica (n=22), G3-Ginástica (n=25), G4-Pilates (n=22), além do grupo G5-Controle (n=24), sendo aplicada a escala GDS (Geriatric Depression Scale), em forma de entrevista, para avaliar os níveis de depressão. Foi utilizada estatística descritiva (média±DP) e Anova One Way para comparação da variável dependente entre os grupos, sendo adotado um α =0,05. Resultados: Apenas o G5 obteve pontuação para depressão (n=12, 50%). O G3 apresentou os escores mais baixos para depressão em relação aos demais grupos (p≤0,01). Conclusão: A prática regular de exercícios físicos pode contribuir para redução de sintomas depressivos em idosos, independente da atividade escolhida.

Introduction: The elderly population is increasing worldwide, as the concern for quality of life, which includes physical, psychological and social aspects. Objective: To evaluate the level of depression in elderly practicing different exercise. Methods: The sample consisted of 116 elderly, regular physical exercise practitioners: Strength training-G1 (n=23), G2-Hydrogymnastis (n=22), G3-Gymnastics (n=25), G4-Pilates (n=22) besides G5-Control (n=24) group. GDS (Geriatric Depression Scale) scale was used as an interview to assess depression levels. Descriptive statistics (average±SD) and One Way Anova was used to compare the dependent variable between groups, and adopted a α =0.05. Results: Only the G5 obtained scores for depression (n=12, 50%). The G3 had the lowest scores for depression in relation to the other groups (p≤0.01). Conclusion: Regular physical exercise may contribute to reduction of depressive symptoms in the elderly, regardless of the chosen activity.

Stress and cardiovascular disease

As we have summarized, a confluence of pathophysiological and epidemiological studies establish that both acute and chronic forms of psychosocial stress contribute to the pathogenesis of atherosclerosis. Clinical consequences of acute stress include the development of myocardial ischemia, cardiac arrhythmias, and fostering of more vulnerable coronary plaques and hemostatic changes. Chronic stress and affective disorders, such as depression, appear to promote atherosclerosis via hypothalamic-pituitary-adrenal (HPA) axis overstimulation. Chronic stress can contribute to the occurrence of cardiovascular disease (CVD) by direct and indirect pathways. These results establish that, in addition to traditional CVD risk factors, psychosocial factors contribute to CVD. Physicians should never neglect to assess psychosocial risk factors, for example depression, hostility, social isolation, and chronic life stress and job stress, by clinical interview or standardized questionnaires. Management approaches include directly treating patients with mild forms of psychological distress by applying multifactorial lifestyle interventions and treating patients with clinical depression and anxiety. However, patients with severe psychological distress should be referred to specialists. Additional attention and research related to stress and CVD will be needed in the future.

Analysis on literature distribution and research status of depression in the elderly published in journals of Chinese Medical Association from 2003 to 2012 / 中华老年医学杂志

Objective To analyze the literature distribution and research status of depression in the elderly published in Chinese Medical Association journals.Methods The literatures of elderly depression published in 85 kinds of Chinese Medical Association journals from 2003 to 2012 were collected.The publication year,distribution,content,author,institution and region of these literatures were analyzed.Results From 2003 to 2012,there were 85 articles on depression in the elderly published in 15 kinds of journals of the Chinese Medical Association.These literatures were published mostly in 2011 (18 articles,21.2％),secondly in 2010 (13 articles,15.3％) and 2012 (12 articles,14.1％),which were published mostly in Chinese Journal of Geriatrics (29,34.1％).These articles mainly included basic science,inventory survey,diagnostic methods and clinical treatment strategy,and the most published form was treatise (77 articles,90.6％).The author who published the most articles was YUAN Gui yong from Nanjing (3 articles,3.5％),the institution which published the most articles was People's Hospital of Hainan Province (4 articles,4.7％),and the provinces or cities which published the most articles were Beijing (15 articles,17.6％),Shandong (9 articles,10.6％) and Zhejiang (7 articles,8.2％) by turns.Among the 85 articles,31 articles (36.5％) were supported by foundations.The definition,epidemiology,mechanism,influence factors,clinical characteristics,diagnosis and treatment strategy of elderly depression,and especially secondary depression were well discussed in these literatures.Conclusions The literatures of elderly depression published in Chinese Medical Association journals are insufficient in quantity,and more than half of the literatures are published from 2010 to 2012.The distribution of journals is relatively concentrated,but the distribution of author,institution and region in these articles is dispersed.Secondary depression in the elderly is concerned especially.

Analysis of therapeutic effect of hyperbaric oxygen therapy on neuropsychological disorders in senile patients with type 2 diabetes mellitus combined with cerebral infarction / 中华老年医学杂志

Objective To explore the therapeutic effect of hyperbaric oxygen therapy (HBO) in the treatment of neuropsychological disorders in senile patients with type 2 diabetes mellitus combined with cerebral infarction. Methods A total of 70 senile patients with type 2 diabetes mellitus combined with cerebral infarction were randomly divided into two groups: treatment group receiving HBO plus routine medicine treatment and control group receiving routing medicine treatment only. A suit of senile neuropsychological tests was administered pre and post treatment by an experienced psychometrician who was blinded to treatment group assignments. Results Neuropsychological disorders were improved partly in control group while the efficacy in treatment group was markedly improved(P<0.01). Spearman rank correlation analysis revealed that the improvement degree of neuropsychological disorders was positively correlated with hyperbaric oxygen therapy (HBO) (r= 0.502,P<0.05), the time of test before therapy (r=0.260, P<0.05) and the time of test after therapy (r=0.386, P<0.05), and was negatively correlated with hyperlipoidemia (r=-0.261, P< 0.05), glycosylated hemoglobin(GHbAlc) (r=-0.321,P<0.05) and body mass index(BMI) (r= 0.360,P<0.05). Multiple stepwise regression analysis showed that HBO and hyperlipoidemia were the independent predictors for the improvement degree of neuropsychological disorders. Conclusions HBO is an efficacious way to treat neuropsychological disorders in senile patients with type 2 diabetes mellitus combined with cerebral infarction.