Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 10 de 10
Filter
1.
Pediatrics ; 148(1)2021 07.
Article in English | MEDLINE | ID: covidwho-1533449

ABSTRACT

BACKGROUND AND OBJECTIVES: Depression is common, and suicide rates are increasing. Adolescent depression screening might miss those with unidentified suicide risk. Our primary objective in this study was to compare the magnitude of positive screen results across different approaches. METHODS: From June 2019 to October 2020, 803 mostly Medicaid-enrolled adolescents aged ≥12 years with no recent history of depression or self-harm were screened with the Patient Health Questionnaire-9 Modified for Adolescents (PHQ-9A) and the Ask Suicide-Screening Questions (ASQ) across 12 primary care practices. Two PHQ-9A screening strategies were evaluated: screening for any type of depression or other mental illness (positive on any item) or screening for major depressive disorder (MDD) (total score ≥10). RESULTS: Overall, 56.4% of patients screened positive for any type of depression, 24.7% screened positive for MDD, and 21.1% screened positive for suicide risk. Regardless of PHQ-9A screening strategy, the ASQ identified additional subjects (eg, 2.2% additional cases compared with screening for any type of depression or other mental illness and 8.3% additional cases compared with screening positive for MDD). Of those with ≥6 month follow-up, 22.9% screened positive for any type of depression (n = 205), 35.6% screened positive for MDD (n = 90), and 42.7% with a positive ASQ result (n = 75) had a depression or self-harm diagnosis or an antidepressant prescription. CONCLUSIONS: Suicide risk screening identifies cases not identified by depression screening. In this study, we underscore opportunities and challenges in primary care related to the high prevalence of depression and suicide risk. Research is needed regarding optimal screening strategies and to help clinicians manage the expected number of screening-identified adolescents.


Subject(s)
Depression/epidemiology , Mass Screening/methods , Primary Health Care/methods , Suicide/statistics & numerical data , Adolescent , Antidepressive Agents/therapeutic use , COVID-19/epidemiology , COVID-19/psychology , Child , Depression/diagnosis , Depression/drug therapy , Depressive Disorder, Major/diagnosis , Depressive Disorder, Major/drug therapy , Depressive Disorder, Major/epidemiology , Female , Humans , Loneliness , Male , Mental Disorders/diagnosis , Mental Disorders/epidemiology , Pandemics , Risk Factors , SARS-CoV-2 , Social Isolation , Suicide/prevention & control , Young Adult
2.
Mol Med Rep ; 24(6)2021 Dec.
Article in English | MEDLINE | ID: covidwho-1512771

ABSTRACT

The present study aimed to review major depression, including its types, epidemiology, association with different diseases status and treatments, as well as its correlation with the current COVID-19 pandemic. Mental depression is a common disorder that affects most individuals at one time or another. During depression, there are changes in mood and behavior, accompanied by feelings of defeat, hopelessness, or even suicidal thoughts. Depression has a direct or indirect relation with a number of other diseases including Alzheimer's disease, stroke, epilepsy, diabetes, cardiovascular disease and cancer. In addition, antidepressant drugs have several side effects including sedation, increased weight, indigestion, sexual dysfunction, or a decrease in blood pressure. Stopping medication may cause a relapse of the symptoms of depression and pose a risk of attempted suicide. The pandemic of COVID-19 has affected the mental health of individuals, including patients, individuals contacting patients and medical staff with a number of mental disorders that may adversely affect the immune ability of their bodies. Some of the drugs currently included in the protocols for treating COVID-19 may negatively affect the mental health of patients. Evidence accumulated over the years indicates that serotonin (5HT) deficiencies and norepinephrine (NE) in the brain can lead to mental depression. Drugs that increase levels of NE and 5HT are commonly used in the treatment of depression. The common reason for mood disorders, including mania and bipolar disease are not clearly understood. It is assumed that hyperactivity in specific parts of the brain and excessive activity of neurotransmitters may be involved. Early diagnosis and developing new treatment strategies are essential for the prevention of the severe consequences of depression. In addition, extensive research should be directed towards the investigation of the mental health disturbances occurring during and/or after COVID-19 infection. This may lead to the incorporation of a suitable antidepressant into the current treatment protocols.


Subject(s)
COVID-19/epidemiology , COVID-19/psychology , Depressive Disorder, Major/epidemiology , Antidepressive Agents/adverse effects , Antidepressive Agents/therapeutic use , COVID-19/complications , Cytokine Release Syndrome/etiology , Depressive Disorder, Major/drug therapy , Depressive Disorder, Major/etiology , Depressive Disorder, Major/metabolism , Glutamic Acid/metabolism , Humans , Oxidative Stress
3.
Psychiatry Res ; 303: 114086, 2021 09.
Article in English | MEDLINE | ID: covidwho-1303645

ABSTRACT

Herein we evaluate the impact of COVID-19 restrictions on antidepressant effectiveness of intravenous (IV) ketamine in adults with treatment-resistant depression (TRD). We conducted a case series analysis of adults with TRD (n = 267) who received four ketamine infusions at an outpatient clinic in Ontario, Canada, during COVID-19 restrictions (from March 2020 - February 2021; n = 107), compared to patients who received treatment in the previous year (March 2019 - February 2020; n = 160). Both groups experienced significant and comparable improvements in depressive symptoms, suicidal ideation, and anxiety with repeated ketamine infusions. Effectiveness of IV ketamine was not attenuated during the COVID-19 period.


Subject(s)
COVID-19 , Depressive Disorder, Major , Depressive Disorder, Treatment-Resistant , Ketamine , Adult , Depression , Depressive Disorder, Major/drug therapy , Depressive Disorder, Treatment-Resistant/drug therapy , Humans , Infusions, Intravenous , Ketamine/therapeutic use , Ontario , Pandemics , SARS-CoV-2
4.
J Psychiatr Pract ; 27(2): 137-144, 2021 Mar 05.
Article in English | MEDLINE | ID: covidwho-1292182

ABSTRACT

The widespread prevalence of coronavirus disease 2019 (COVID-19) means that inpatient psychiatric units will necessarily manage patients who have COVID-19 that is comorbid with acute psychiatric symptoms. We report a case of recurrence of respiratory symptoms and positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription-polymerase chain reaction (RT-PCR) testing in a patient on an inpatient psychiatric unit occurring 42 days after the initial positive SARS-CoV-2 RT-PCR test, 38 days after initial symptom resolution, and 30 days after the first of 3 negative SARS-CoV-2 RT-PCR tests. Over the course of the admission, the patient was safely initiated on clozapine. Recent literature on COVID-19's potential recurrence and neuropsychiatric effects is reviewed and implications for the management of COVID-19 on inpatient psychiatric units are discussed. In the era of COVID-19 and our still-developing understanding of this illness, psychiatrists' role as advocates and collaborators in our patients' physical health care has become even more critical.


Subject(s)
Antidepressive Agents/therapeutic use , Antipsychotic Agents/therapeutic use , COVID-19/complications , Depressive Disorder, Major/complications , Depressive Disorder, Major/drug therapy , Psychotic Disorders/complications , Psychotic Disorders/drug therapy , Adult , Alcoholism/complications , Alcoholism/diagnosis , COVID-19/diagnosis , COVID-19/psychology , COVID-19 Nucleic Acid Testing , Clozapine , Depressive Disorder, Major/diagnosis , Hospitals, Psychiatric , Humans , Inpatients/psychology , Male , Mirtazapine/therapeutic use , Psychotic Disorders/diagnosis , Recurrence , SARS-CoV-2 , Sertraline/therapeutic use , Suicide, Attempted
7.
Int Clin Psychopharmacol ; 36(4): 221-223, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1240983

ABSTRACT

This article reports on the treatment of a patient with nightmares who was treated with doxazosin of an alpha 1-adrenergic antagonists. A 71-year-old Japanese major depressive disorder (MDD) woman experienced nightmares after the coronavirus disease 2019 pandemic. She had nightmares about being chased by a coronavirus and catching the corona virus. After adding doxazosin 1 mg daily in the morning, her nightmares led to remission without side effects. We also had a rechallenge regimen with doxazosin. The nightmares ceased on the second night of the rechallenge and did not return with continued treatment. This case report suggests that doxazosin may be a useful therapeutic option to target nightmares in individuals with MDD.


Subject(s)
Adrenergic alpha-1 Receptor Antagonists/therapeutic use , COVID-19/psychology , Depressive Disorder, Major/drug therapy , Doxazosin/therapeutic use , Dreams/drug effects , Aged , Female , Humans , SARS-CoV-2
8.
Mol Psychiatry ; 26(9): 5199-5212, 2021 09.
Article in English | MEDLINE | ID: covidwho-1065840

ABSTRACT

A prior meta-analysis showed that antidepressant use in major depressive disorder was associated with reduced plasma levels of several pro-inflammatory mediators, which have been associated with severe COVID-19. Recent studies also suggest that several antidepressants may inhibit acid sphingomyelinase activity, which may prevent the infection of epithelial cells with SARS-CoV-2, and that the SSRI fluoxetine may exert in-vitro antiviral effects on SARS-CoV-2. We examined the potential usefulness of antidepressant use in patients hospitalized for COVID-19 in an observational multicenter retrospective cohort study conducted at AP-HP Greater Paris University hospitals. Of 7230 adults hospitalized for COVID-19, 345 patients (4.8%) received an antidepressant within 48 h of hospital admission. The primary endpoint was a composite of intubation or death. We compared this endpoint between patients who received antidepressants and those who did not in time-to-event analyses adjusted for patient characteristics, clinical and biological markers of disease severity, and other psychotropic medications. The primary analysis was a multivariable Cox model with inverse probability weighting. This analysis showed a significant association between antidepressant use and reduced risk of intubation or death (HR, 0.56; 95% CI, 0.43-0.73, p < 0.001). This association remained significant in multiple sensitivity analyses. Exploratory analyses suggest that this association was also significant for SSRI and non-SSRI antidepressants, and for fluoxetine, paroxetine, escitalopram, venlafaxine, and mirtazapine (all p < 0.05). These results suggest that antidepressant use could be associated with lower risk of death or intubation in patients hospitalized for COVID-19. Double-blind controlled randomized clinical trials of antidepressant medications for COVID-19 are needed.


Subject(s)
COVID-19 , Depressive Disorder, Major , Antidepressive Agents/therapeutic use , Depressive Disorder, Major/drug therapy , Humans , Intubation, Intratracheal , Multicenter Studies as Topic , Observational Studies as Topic , Retrospective Studies , SARS-CoV-2
9.
BMC Psychiatry ; 20(1): 558, 2020 11 25.
Article in English | MEDLINE | ID: covidwho-945198

ABSTRACT

BACKGROUND: The pre-melancholic model described by Tellenbach may provide a common model for understanding the psychological implications of the lockdown. In this case report, we describe a rare catatonic status as a psychological implication linked to the COVID-19 pandemic, a really unique global situation. CASE PRESENTATION: B is a 59 year-old man with mute psychiatric anamnesis whose mother suffered from a major depressive disorder. As the lockdown began, he started to develop concerns about his family's economic condition. According to his wife, he could see no end to the epidemic and no future at all. Moving from this, he started to show a severe and rapidly progressive depression and to develop mood congruent delusions. In addition, he had increasing anhedonia, apathy, starvation and insomnia. This turned in the end into a catatonic-like state, along with a deep desire to die. Admitted to the psychiatry ward in a state of mutism, he was discharged after 15 days with a diagnosis of "Major depressive disorder, single severe episode with no psychotic behavior". He was treated with Sertraline, Olanzapine and Lorazepam. CONCLUSIONS: Our aim is to draw attention to the effect of the lockdown upon a Tellenbach-like personality structure. Identifying this type of pre-morbid personality structure could help clinicians understand and treat some cases of patients with severe major depressive disorders elicited by the COVID-19 pandemic.


Subject(s)
COVID-19/prevention & control , Catatonia/etiology , Depression/etiology , Depressive Disorder, Major/etiology , Physical Distancing , Depressive Disorder, Major/drug therapy , Financial Stress , Humans , Male , Middle Aged
10.
J Clin Pharm Ther ; 45(1): 199-203, 2020 Feb.
Article in English | MEDLINE | ID: covidwho-838508

ABSTRACT

WHAT IS KNOWN AND OBJECTIVE: Some patients with refractory depression who fail to respond to rapid injection of standard-dose ketamine are injected with high doses, but the safety and efficacy of this practice are unclear. CASE DESCRIPTION: A 57-year-old woman with refractory depression whose symptoms did not improve after 20-seconds intravenous injection of 0.5 mg/kg ketamine went into remission following eight, 1-minute intravenous injections of 1 mg/kg ketamine delivered over a 4-week period. By 6-month follow-up, no significant adverse events had occurred and cognitive function had improved. WHAT IS NEW AND CONCLUSION: High-dose intravenous injections of ketamine may stably improve depressive symptoms and cognitive function in patients with refractory depression who do not respond to rapid intravenous injection of standard-dose ketamine. The high-dose treatment appears to be associated with only mild side effects.


Subject(s)
Antidepressive Agents/administration & dosage , Depressive Disorder, Major/drug therapy , Depressive Disorder, Treatment-Resistant/drug therapy , Ketamine/administration & dosage , Antidepressive Agents/adverse effects , COVID-19/drug therapy , Coronavirus Infections/drug therapy , Depressive Disorder, Major/physiopathology , Depressive Disorder, Treatment-Resistant/physiopathology , Drug Synergism , Drug Therapy, Combination , Female , Follow-Up Studies , Humans , Injections, Intravenous , Ketamine/adverse effects , Middle Aged , Remission Induction
SELECTION OF CITATIONS
SEARCH DETAIL
...