Effects of perioperative intravenous lidocaine and esketamine on the quality of recovery and emotional state of patients after thyroidectomy: A randomised, double-blind, controlled trial.

Background and Aims: Perioperative intravenous (IV) infusions of lidocaine and esketamine reduce postoperative pain, but there are few studies on the quality of recovery and patients' emotional states postoperatively. We aimed to explore the effects of perioperative IV lidocaine and esketamine on the quality of recovery and emotional state after thyroidectomy. Methods: In this randomised trial, 137 patients undergoing thyroidectomy were randomly assigned to three groups: a lidocaine group (Group L), an esketamine group (Group E) and a normal saline placebo group (Group C). The primary outcome was the Quality of Recovery 40 (QoR-40) on postoperative days (PODs) 1 and 2. The secondary outcomes included Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores on days 1 and 2 after surgery, pain scores, opioid consumption and incidence of postoperative nausea and vomiting (PONV). Statistical analysis was performed using the one-way analysis of variance (ANOVA), the Kruskal-Wallis and Chi-square tests. Results: The global QoR-40 scores in groups L and E on POD 1 and POD 2 were significantly higher than in group C (P < 0.001). The SAS and SDS scores on POD 1 and POD 2 in groups L and E were significantly lower than in group C (P < 0.05). There were statistically significant differences in Numerical Rating Scale (NRS) scores among the three groups at 1 h, 2 h, 6 h and 12 h (P < 0.05). Conclusion: Perioperative IV lidocaine and esketamine improve the quality of postoperative recovery and the emotional state of patients undergoing thyroidectomy.

Characteristics of higher depressive tendency in the patients with olfactory disorder.

OBJECTIVE: Most patients with olfactory dysfunction experience stress and anxiety because of the inconvenience and changes caused by the loss of olfaction. However, psychological assessment is not performed routinely in patients with olfactory dysfunction, and the characteristics of these patients with psychological depression are unclear. METHODS: In this study, we used the Self-rating Depression Scale to evaluate the degree of depression in patients who visited our clinic with olfactory dysfunction and examine the characteristics of these patients with strong depressive tendencies. Patients who visited our clinic between April 2019 and March 2020 with complaints of olfactory dysfunction were included in the study. RESULTS: A total of 180 patients (79 male and 101 female) underwent olfactory examination and completed the Self-rating Depression Scale. Eighty-six and 94 patients were included in the low depression and high depression groups, respectively. Binomial logistic regression analysis showed significant positive associations of Self-rating Depression Scale scores with female sex and the presence of parosmia/phantosmia (p < 0.05). CONCLUSION: In our study, approximately half of the patients with olfactory dysfunction had depressive tendencies especially in female and parosmia/phantosmia patients. We believe that psychological assessments, such as that with the SDS, can help identify patients with olfactory dysfunction who may be at a greater risk of developing depression.

Effect of multidisciplinary cooperative continuous nursing and psychological nursing on multiple myeloma with a peripherally inserted central catheter.

Objective: This study was conducted to analyze the effectiveness of multidisciplinary cooperative continuous nursing combined with psychological nursing intervention in multiple myeloma (MM) patients undergoing peripherally inserted central catheter (PICC). Methods: The Numerical Pain Rating Scale (NPRS), Anxiety Self-Assessment Scale (SAS), Depression Self-Assessment Scale (SDS) and Revised Piper Fatigue Scale (PFS-R), Self-Care Ability Scale (ESCA), Quality of Life Core Questionnaire (QLQ-C30), incidence of unplanned extubation of PICC, total incidence of catheter-related complications and satisfaction with nursing were compared between the two groups of patients in a prospective study. Results: Patients in the observation group had reduced NPRS, SAS, SDS and PFS-R scores, total incidence of unplanned extubation of PICC and the total incidence of catheter-related complications, and a higher nursing satisfaction rate in comparison to those in the control group. Conclusion: Multidisciplinary cooperative continuous nursing combined with psychological nursing interventions can relieve pain in MM patients.

The Effects of Implantable Collamer Lens ICL Implantation in High Myopia Patients' Mental Health.

Purpose: To investigate the psychological changes in patients pre and post implantable collamer lens (ICL, EVO) implantation surgery in the posterior chamber. Patients and methods: Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to assess the mental states of 43 patients who underwent ICL implantation surgery performed by the same surgeon between January 2021 and December 2022. Results: Comparing the results before and one week after the operation, there is a significant difference in both the SAS scale (P<0.05) and the SDS scale (P<0.05). Similarly, when comparing the pre-operation and one-month post-operation results, there is also a significant difference in both the SAS scale (P<0.05) and the SDS scale (P<0.05). However, when comparing the one-week post-operation and one-month post-operation results, there is no significant difference in either the SAS scale (P>0.05) or the SDS scale (P>0.05). Moving on to the comparison between the pre-operation results and the national norm level, there is a significant difference in both the SAS scale (P<0.05) and the SDS scale (P<0.05). When comparing the one-week post-operation results and the national norm level, there is a significant difference in the SAS scale (P<0.05). Similarly, when comparing the one-month post-operation results and the national norm level, there is a significant difference in the SAS scale (P<0.05). Conclusion: After undergoing ICL implantation surgery, patients typically experience a notable decrease in anxiety (SAS) and depression (SDS) scales. These improvements gradually stabilize and enhance during the postoperative recovery period. However, it may require a significant amount of time for patients to fully restore their psychological well-being to levels comparable to the national norm, particularly in terms of anxiety levels.

Analysis of mental health status and related factors in patients with acute cerebral infarction.

BACKGROUND: Acute cerebral infarction (ACI) is characterized by a high incidence of morbidity, disability, recurrence, death and heavy economic burden, and has become a disease of concern in global researchers. As ACI has serious effects on patients' physical status, life and economy, often causing anxiety, depression and other psychological problems, these problems can lead to the aggravation of physical symptoms; thus, it is very important to understand the factors affecting the mental health of these patients. AIM: To understand the elements that affect the mental health of patients who have suffered an ACI. METHODS: A questionnaire survey was conducted among patients with ACI admitted to three tertiary hospitals (Quanzhou First Hospital, Fuqing City Hospital Affiliated to Fujian Medical University, and the 900 Hospital of the Joint Service Support Force of the People's Liberation Army of China) in Fujian Province from January 2022 to December 2022 using the convenience sampling method. ACI inpatients who met the inclusion criteria were selected. Informed consent was obtained from the patients before the investigation, and a face-to-face questionnaire survey was conducted using a unified scale. The questionnaire included a general situation questionnaire, Zung's self-rating depression scale and Zung's self-rating anxiety scale. All questionnaires were checked by two researchers and then the data were input and sorted using Excel software. The general situation of patients with ACI was analyzed by descriptive statistics, the influence of variables on mental health by the independent sample t test and variance analysis, and the influencing factors on psychological distress were analyzed by multiple stepwise regression. RESULTS: The average age of the 220 patients with ACI was 68.64 ± 10.74 years, including 142 males and 78 females. Most of the patients were between 60 and 74 years old, the majority had high school or technical secondary school education, most lived with their spouse, and most lived in cities. The majority of patients had a personal income of 3001 to 5000 RMB yuan per month. The new rural cooperative medical insurance system had the largest number of participants. Most stroke patients were cared for by their spouses and of these patients, 52.3% had previously smoked. Univariate analysis showed that gender, age, residence, course of disease, number of previous chronic diseases and smoking history were the main factors affecting the anxiety scores of patients with ACI. Age, living conditions, monthly income, course of disease and knowledge of disease were the primary variables influencing the depression score in patients with ACI. The findings of multivariate analysis revealed that the course of disease and gender were the most important factors influencing patients' anxiety scores, and the course of disease was also the most important factor influencing patients' depression scores. CONCLUSION: Long disease course and female patients with ACI were more likely to have psychological problems such as a high incidence of emotional disorders. These groups require more attention and counseling.

Correlation between the Degree of Hearing Loss and the Levels of Anxiety and Depression in Patients with Tinnitus.

Objectives: This study aimed to explore the correlation between the degree of hearing loss (HL) and the degrees of anxiety and depression in patients with tinnitus. Materials and Methods: This retrospective study involved the use of basic clinical data from 600 enrolled patients with tinnitus who visited the otolaryngology clinic in Affiliated Jinhua Hospital, Zhejiang University School of Medicine from April 2020 to June 2022. The tinnitus handicap inventory (THI) scale was used to assess the tinnitus status among the participants. The pure tone audiometry (PTA) test was used to conduct audiological assessments for all patients to determine their hearing condition. The self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to assess the levels of anxiety and depression among the participants, respectively. The correlation between the HL and anxiety/depression scores from the questionnaires was tested through Pearson correlation analysis. Results: Among the 600 enrolled patients with tinnitus, most patients had mild-to-moderate degree of tinnitus, accounting for 248 cases (41.3%) and 179 cases (29.8%), respectively. PTA results showed that a large proportion of patients with tinnitus were accompanied with HL (467 cases, 77.8%). Among them, patients with mild HL accounted for the largest proportion with a total of 241 cases (40.2%). Based on the results of SAS and SDS test, almost half of the patients had symptoms of anxiety and depression, accounting for 52.3% (314 cases) and 48.8% (293 cases), respectively. Similarly, patients with mild anxiety and depression occupy the largest proportion, accounting for 35.8% (215 cases) and 23% (138 cases), respectively. Pearson correlation analysis showed that the degree of HL was closely related to THI/SAS/SDS scores (P < 0.001). Conclusion: These findings indicate a strong positive correlation between the degree of HL and anxiety/depression scores in patients with tinnitus.

RETN gene polymorphisms interact with alcohol dependence in association with depression.

BACKGROUND: Previous studies suggest that alcohol dependence is associated with increased risk of depression. The occurrence of depressive symptoms is related to polymorphisms in various genetic regions. This study aimed to investigate the interaction of RETN gene polymorphisms (rs1477341, rs3745368) with alcohol dependence on depressive symptoms in adult male during acute alcohol withdrawal. METHODS: A total of 429 male adults were recruited in this study. Alcohol dependence was assessed using the Michigan alcoholism screening test (MAST). Depression was assessed using the 20-item self-rating depression scale (SDS). Hierarchical regression analysis was used to evaluate the interaction between genes and alcohol dependence on depression. Region of significance (ROS) test was used to explain the interaction effect. The strong and weak forms of the differential susceptibility and diathesis models were used to determine which fits the data better. RESULTS: Our results showed that MAST scores were significantly positively associated with SDS scores (r = 0.23, p < 0.01) in alcohol-dependent patients during alcohol withdrawal. The interaction between genotype and alcohol dependence was significant (ß = -0.14, p < 0.05) in a strong diathesis-stress model. Susceptibility for depression symptoms was associated with alcohol dependence in RETN rs1477341 A carriers. Specifically, those that showed more alcohol dependence and the A allele of RETN rs1477341 exhibited more depression symptoms. However, RETN rs3745368 had no significant interaction with alcohol dependence. CONCLUSIONS: The A allele of RETN rs1477341 may correlate with susceptibility to depression symptoms in alcohol-dependent individuals during acute alcohol withdrawal.

The over-expression of miRNA-206 in peripheral blood of patients with burning mouth syndrome and its relationship with anxiety and depression.

BACKGROUND: Burning mouth syndrome (BMS) is characterised by persisting burning pain of the oral mucosa, and its etiopathogenesis remains poorly understood. OBJECTIVES: Our study aimed to detect the expression of miRNA-206 in the blood and clarify the relationship among miRNA-206, pain, anxiety and depression of BMS patients. METHODS: Thirty patients with BMS and 30 healthy individuals were enrolled in the experimental and control groups, respectively. Data on medical history and clinical oral examination for all participants were collected. Simultaneously, scores of Visual Analogous Scale (VAS), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were administered. The expression level of miRNA-206 in plasma were determined by RT-(q)PCR. Finally, the relationship of miRNA-206 expression with the VAS score, SAS score, and SDS score was analysed. Chi-square test and t-test were used for statistical analysis of the data, and p < .05 was considered statistically significant. RESULTS: The majority of the patients with BMS identified the tongue as the main pain area, and showed dry mouth and poor sleep quality. The SAS and SDS scores of patients with BMS were higher than those of healthy controls (p < .05) and were positively correlated with VAS pain score. In addition, miRNA-206 expression was higher in patients with BMS than in healthy individuals (p < .05), and was positively correlated with the VAS and SDS scores (p < .05). CONCLUSIONS: Patients with BMS suffer from pain and tend to be more anxious and depressed than healthy controls. miRNA-206 expression in the peripheral blood of patients with BMS is positively correlated with pain and depression, which may be involved in the pathogenesis of BMS.

Pregnant women: psychology, cognitive and behavioral responses, and solutions towards COVID-19.

COVID-19 (Corona Virus Disease 2019) has spread globally and is highly infectious, causing psychological disturbances such as anxiety, depression, or both. Pregnant women, as a vulnerable population, need further attention. This study aims to evaluate the psychological impact of pregnant women during COVID-19 to constitute base data for solution guidance. Using a self-designed questionnaire, self-rated anxiety scale (SAS), and self-rated depression scale (SDS), we conducted a web-based survey on 1160 pregnant women from February 20 to April 30, 2020. The prevalence of anxiety and depression during pregnancy was shown to be 12.93% and 31.21%, respectively. Besides, younger age, housewives, lower education level, and early pregnancy all contributed to psychological disturbance during the COVID-19 pandemic. The results revealed significant variations in cognitive and behavioral responses based on the levels of the COVID-19 pandemic concerns, perceptions of life impacts and family concerns, preparation of personal protection equipment and motherhood, and the need for psychological counseling (P < 0.05). Regarding their primary concerns, 73.2% of the participants worried about the health and safety of childbirth. And 90.6% of respondents anticipated scheduling prenatal appointments to avoid crowds. Pregnant women are susceptible to anxiety/depression during the COVID-19 outbreak, necessitating immediate psychological care and intervention.

Impact of weight loss for depressive symptom in mid-stage patients with Parkinson's disease: a 4-year follow-up study.

Introduction: Weight loss is one of the non-motor symptoms frequently seen in patients with Parkinson's disease (PwPD). Weight loss in PwPD is known to be negatively associated with motor and other non-motor symptoms and has been shown to influence the prognosis of PD. In this study, we followed weight change over a 4-year period in PwPD at a single institution and investigated the relationship between weight change and patients' motor and non-motor symptoms. Methods: PwPD who visited our hospital from January 2018 to December 2022 were enrolled. Body weights were measured at two points in 2018 (at the start of observation, 'baseline') and 2022 (at the end of observation, 'end date'). In addition, motor symptoms, disease severity, cognitive function, and psychiatric symptoms were evaluated during the same period, and the relationship with weight loss was examined. Results: Data of 96 PwPD were available for a 4-year follow-up. At baseline, the mean age was 65.7 ± 10.0 years, the mean disease duration was 6.8 ± 4.0 years, and the mean Hoehn and Yahr stage was 2.4 ± 0.7. Among them, 48 patients (50.0%) had a weight loss of ≥5% from baseline (weight loss group; mean loss was 6.6 ± 2.9 kg). The weight loss group was older (p = 0.031), had a lower Mini-Mental State Examination (MMSE) at baseline (p = 0.019), a significantly lower body mass index (p < 0.001), and a higher Zung Self-Rating Depression Scale (SDS) (p = 0.017) at the end date. There was a negative correlation (γ = -0.349, p < 0.001) between weight change and age, a positive correlation (γ = 0.308, p = 0.002) between weight change and MMSE at baseline, and a negative correlation (γ = -0.353, p < 0.001) between weight change and SDS at the end date. Age-adjusted correlations showed a final negative correlation (γ = -0.331, p = 0.001) between weight change and SDS. MMSE and age-adjusted correlations showed a low negative correlation (γ = -0.333, p = 0.001) between weight change and SDS at the end date. Conclusion: Weight loss in PwPD in mid-stage was more likely with increasing age, and ≥ 5% weight loss was associated with worsening depression. Further research is needed regarding the significance of weight loss in PwPD.

Randomized double-blind placebo-controlled multicenter trial for the effects of a polyherbal remedy, Yokukansan (YiganSan), in smokers with depressive tendencies.

BACKGROUND: Smoking and depression are closely related and form a vicious cycle. Yokukansan (YiganSan) is a polyherbal remedy that has the effect of calming neuropsychiatric symptoms such as anger and irritation. To examine the efficacy of Yokukansan during smoking cessation (SC) therapy in smokers with depressive tendencies but without major depressive disorders requiring pharmacotherapy. METHODS: A multicenter, double-blind, randomized, placebo-controlled, parallel-group comparison trial was conducted between June 2016 and May 2020 at 12 centers of the National Hospital Organization, Japan. This trial targeted smokers who first visited the SC outpatient clinics, did not receive any pharmacological treatment at the psychiatric or psychosomatic department, and scored 39 or more on the self-rating depression scale (SDS). Participants (n = 198) were randomly assigned to either the Yokukansan or placebo groups. The trial drug was initiated with the start of the SC treatment and continued for 12 weeks. The primary outcome was the high success rate of the SC treatment, and the secondary outcomes included changes in scores of the SDS and the Profile of Mood States (POMS) instrument. RESULTS: The success rate of the SC treatment was similar between the placebo (63%) and Yokukansan (67%) groups (P = .649). The SDS scores (placebo: mean difference [MD] = -3.5, 95% confidence interval [CI][-5.8, -1.2], d = 0.42; Yokukansan: MD = -4.6, 95%CI[-6.8, -2.3], d = 0.55), and the "tension-anxiety" POMS-subscale scores (placebo: MD = -1.6, 95%CI[-2.5, -0.7], d = 0.52; Yokukansan: MD = -1.6, 95%CI[-2.9, -0.3], d = 0.36) showed significant improvement in both groups after the SC treatment. However, "depression-dejection" improved in the Yokukansan group (MD = -1.9, 95%CI[-3.1, -0.7], d = 0.44) but not in the placebo group (MD = -0.1, 95%CI[-1.0, 0.7], d = 0.04). Significant improvement in "fatigue" was noted in the Yokukansan group (MD = -2.1, 95%CI[-3.4, -0.9], d = 0.47) but not in the placebo group (MD = -0.5, 95%CI[-1.8, 0.8], d = 0.11). The time × group interaction on the improvement in "depression-dejection" was significant (P = .019). CONCLUSIONS: Yokukansan does not increase the SC treatment's success rate but has additional positive effects on the psychological states due to the SC treatment in smokers with depressive tendencies but without apparent mental disorders. TRIAL REGISTRATION: ID: UMIN000027036. Retrospectively registered at UMIN on April 18, 2017.

Characteristics of tinnitus and factors influencing its severity.

Background and Objectives: There is a wealth of information regarding the treatment methods for tinnitus; however, the treatment available is unsatisfactory because of the following reasons: first, tinnitus has various etiologies and second, it has distinct heterogeneity among different individuals. Numerous studies have focused on understanding the causes of tinnitus severity, but the conclusions have been inconsistent. The purpose of the present study was to define factors that differentially influence subjectively perceived tinnitus severity. Methods: Clinical data of patients with chronic tinnitus who visited our outpatient clinic from April 2020 to April 2021 were collected. Tinnitus Handicap Inventory (THI) and Tinnitus Evaluation Questionnaire (TEQ) were used to evaluate tinnitus severity among patients, and the independent factors influencing the severity of tinnitus were investigated by performing univariate and multivariate stepwise regression analyses. Results: Eleven variables were associated with THI and TEQ scores, of which nine were identical. Multiple regression analyses results revealed that five variables had a significantly unique predictive effect on tinnitus severity based on THI and the TEQ scores. Three factors including Self-Rating Scale of Sleep (SRSS), change in loudness, and Self-Rating Anxiety Scale (SAS) were identical. Conclusion: Sleep status, anxiety level, and change in loudness in patients with chronic tinnitus were significantly correlated with severity of tinnitus. Follow-up studies should investigate the causal relationship between these factors and tinnitus severity.

Golden bifid might improve diarrhea-predominant irritable bowel syndrome via microbiota modulation.

OBJECTIVE: Gut microbiota might play a crucial role in the pathogenesis of irritable bowel syndrome (IBS), and probiotics supplement may be an effective treatment option. This study aims to explore the therapeutic effects of Golden bifid on the diarrhea-predominant IBS (IBS-D). METHODS: Twenty-one consecutive IBS-D patients were recruited based on Rome IV criteria. All patients took 2000 mg Golden bifid triple daily for 4 weeks. Gastrointestinal (GI) symptoms, psychological symptoms, small intestine bacterial overgrowth (SIBO) and fecal microbiota characteristics were evaluated in IBS-D patients before and after treatment. RESULTS: After 4-week treatment of Golden bifid, the GI symptoms such as abdominal pain (2.90 ± 1.04 vs. 1.90 ± 1.26, P = 0.002), abdominal distension (2.00 ± 1.34 vs. 1.29 ± 1.31, P = 0.007), diarrhea (3.24 ± 1.37 vs. 1.81 ± 1.21, P = 0.001), defecatory urgency (3.48 ± 1.03 vs. 2.33 ± 1.35, P = 0.000) and incomplete evacuation (2.71 ± 1.15 vs. 1.76 ± 1.26, P = 0.003) were significantly alleviated in IBS-D patients. The Self-Rating Depression Scale (SDS) decreased significantly (46.19 ± 11.36 vs. 43.33 ± 9.65, P = 0.041), and SIBO could be eradicated in 25% (4/16) of IBS-D patients with SIBO. Meanwhile, the abundance of Unclassified Lachnospiraceae and Dorea in genus level and Unclassified Lachnospiraceae, Bacterium Dorea, Bacterium Butyricicoccus and Dorea formicigenerans ATCC 27755 in species level were increased in fecal microbiota (P < 0.05). CONCLUSIONS: Golden bifid could improve most of GI symptoms and depressive symptoms in IBS-D patients and eradicate a small proportion of SIBO in those IBS-D patients with SIBO. What's more, Golden bifid could also modulate the fecal microbiota in IBS-D patients, which implied that the Golden bifid might improve IBS-D via microbiota modulation.

Prevalence of COVID-19 Pandemic, Self-Esteem and Its Effect on Depression Among University Students in Saudi Arabia.

Background and Aims: University students are commonly identified as susceptible, suffering from higher anxiety, stress, and depression than the overall population. During the Corona Virus Disease pandemic (COVID), education was shifted to the virtual learning environment. Students' ambiguity regarding academic accomplishment, imminent careers, changes in social life, and other concerns all these factors played a role in amplifying their stress levels, anxiety, and depression worldwide. This study investigates university students' self-esteem and depressions after they have been online learning for over 1 year due to the COVID-19 pandemic in Saudi Arabia. Methods: For this research, an adapted questionnaire of Rosenberg (Self-Esteem Scale) and Zung (Self-Rating Depression Scale) was used to get the responses of the participants of public and private universities in Saudi Arabia during March-April 2021. We received a total of 151 valid responses from respondents. For data analysis, we used descriptive statistics, ANOVA, multiple regression and binary logistic regression. Findings: The results showed that 75% of the students experienced different levels of depressions, with half (37.5%) having moderate to extreme levels of depression. A total of 41% of students experienced low self-esteem (38% females and 45% males). The regression results indicated depressive symptoms for low self-esteem. Furthermore, results of logistic regression showed that high self-esteem reduces the chances of getting depressive symptoms by 17%. The depressive symptoms were higher in female students than their male counterparts; furthermore, males experienced depressive symptoms less than females by 38%. Conclusions: Based on the current research results, it is concluded that the presence of the COVID-19 pandemic has dramatically increased the depressive symptoms in students, especially in female students. The findings suggested instant consideration and support for students. It is also suggested to the quest for potential managing policies that have been known and effective during the pandemic. Moreover, training should be provided for students to shift their educational experience mindset to an adaptive mindset, which can help them adapt to the new ways of learning and education.

Impact of physical exercise on depression and anxiety in adolescent inpatients: A randomized controlled trial.

BACKGROUND: Physical exercise therapy is of proven efficacy in the treatment of adults with depression, but corresponding evidence is lacking in depressed adolescent inpatients. The aim of this study was to document the effect of add-on treatment with structured physical exercise in a clinical population of adolescents hospitalized for depression and anxiety in a psychiatric hospital. METHODS: A group of 52 adolescent inpatients was randomly assigned to a physical exercise or control program three to four times per week over a six-week period (20 hours in total). The primary outcome was the Hospital Anxiety Depression Scale (HADS) for evaluation of depression and anxiety symptoms. Secondary outcomes were psychological self-assessments, diagnostic interviews, and physical examinations. RESULTS: Six participants were lost in each group, leaving 20 inpatients each in the intervention and control groups. A linear mixed model with F-test revealed a significant interaction in favor of physical exercise in reducing the mean depression score (HADS-D) by 3.8 points [95% (CI), range 1.8 to 5.7], compared to a mean reduction score of 0.7 [95% (CI), range -0,7 to 2.0] in the control group. No significant interaction was found for anxiety symptoms (HADS-A). LIMITATIONS: The investigation was limited to the six-week hospital window and the small sample size prevented exploring differences in social characteristics. CONCLUSION: Structured physical exercise add-on therapy integrated into the psychiatric hospitalization of adolescents has led to a reduction in their depressive symptoms, demonstrating its effectiveness in the care of adolescent inpatients with depression.

Discrimination and structural validity evaluation of Zung self-rating depression scale for pregnant women in China.

PURPOSE: The applicability of the Zung self-rating depression scale (SDS) in pregnancy is unknown. We aimed to identify redundant items and evaluate the Zung SDS's structural validity. METHOD: Two samples of pregnant women were invited from two districts in Shanghai (Yangpu sample, n = 6468 and Huangpu sample, n = 402). The Yangpu sample was randomly split into YGroup1/2/3. Item's properties were evaluated via the item response theory in YGroup1. Exploratory and confirmatory factor analyses were correspondingly executed in YGroup2 and YGroup3. Those items with discrimination parameter (α) lower than 0.65 or factor loading smaller than 0.4 were deleted from the scale. The final structure was validated in the Huangpu sample. RESULTS: Items 4 (sleep), 7 (weight loss), 8 (constipation) and 9 (tachyarrhythmia) exhibited low discrimination power. Items 2 (diurnal variation), 5 (appetite), 10 (fatigue) and 19 (suicide idea) made a low contribution to all factors. A three-factor model was eventually constructed as cognitive (Items 14, 16, 17, 18 and 20), psychomotor (Items 6, 11 and 12) and affective (Items 1, 3, 13 and 15). CONCLUSION: The Zung SDS needs modification before applied to pregnant women in China. The items describing the overlap symptoms of the physical change in pregnancy and mood disorder should be deleted.

Investigation on anxiety, depression and sleep quality in primary glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the anxiety, depression and sleep status of patients with primary angle-closure glaucoma(PACG)and primary open angle glaucoma(POAG).<p>METHODS: Retrospective clinical study. The Anxiety Self-Rating Scale(SAS), Depression Self-Rating Scale(SDS)and Pittsburgh Sleep Quality Index(PSQI)were used to evaluate 60 patients with primary glaucoma(30 PACG, 30 POAG)diagnosed in the department of ophthalmology in our hospital during the period from June 2019 to December 2020 and 30 healthy adults from the physical examination department of our hospital as a control group. The scores of anxiety, depression and sleep quality in the three groups were compared.<p>RESULTS: The scores of SAS, SDS and PSQI in PACG and POAG groups(48.40±9.302, 53.40±8.625, 9.57±2.861; 42.57±9.684, 48.80±10.320, 7.23±2.223)were significantly higher than those in control group(37.03±6.805, 38.63±7.881, 4.87±2.688)(<i>P</i><0.05). The scores of SAS and PSQI in PACG group were higher than those in POAG group(all <i>P</i><0.05). With SAS≥45, SDS≥50 and PSQI>7, the positive rates of anxiety, depression and insomnia in the PACG group(77%, 73%, 70%)were higher than those in the POAG group(43%, 40%, 37%)and the control group(13%, 10%, 20%)(<i>P</i><0.05).<p>CONCLUSION: Patients with PACG has more severe anxiety, depression and insomnia than POAG, so necessary psychological intervention should be given.

Effects of nursing care in fast-track surgery on postoperative pain, psychological state, and patient satisfaction with nursing for glioma.

BACKGROUND: The brain is the most complex organ in the human body. Treatment for a glioma always involves a multi-disciplinary team. Nursing care in fast-track surgery or enhanced recovery after surgery is such kind of work implemented by an interdisciplinary team to provide services to patients to improve their outcomes. AIM: To explore the effects of nursing care in fast-track surgery on postoperative pain, psychological state, and patient satisfaction with nursing for glioma. METHODS: From June 2018 to June 2020, 138 patients who underwent operation for glioma at Cancer Hospital Affiliated to Chongqing University were selected. They were categorized into groups according to different nursing care that they received. Of them, 69 patients receiving nursing care in fast-track surgery were included in an experimental group, and 69 patients receiving conventional postoperative nursing were included in a control group. Visual analogue scale was used to evaluate postoperative pain in the two groups immediately after the operation and at 3 d after the operation. Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate the psychological status of patients immediately after operation and on the 3rd postoperative day. A self-made satisfaction scale for patient satisfaction with nursing was used to evaluate and compare patient satisfaction with nursing between the two groups. RESULTS: Time to excretion, time to out-of-bed activities, and length of hospital stay were significantly shorter in the observation group than in the control group (P < 0.05). There was no significant difference in duration of operative time or intraoperative bleeding between the two groups (P > 0.05). There was no significant difference in postoperative pain score between the two groups (P > 0.05). The pain score was significantly lower in the observation group than in the control group at 3 d after the operation (P < 0.05). There was no significant difference in postoperative SAS or SDS score between the two groups (P > 0.05). SAS and SDS scores were significantly lower in the observation group than in the control group at 3 d after operation (P < 0.05). The rate of patient satisfaction with nursing was 94.2% in the observation group, which was significantly higher than that (81.2%) of the control group (P < 0.05). CONCLUSION: Nursing care in fast-track surgery can relieve postoperative pain, anxiety, and depression, and improve patient satisfaction with nursing in patients with glioma, which is worthy of clinical application.

Patients With Epilepsy Who Underwent Epilepsy Surgery During the COVID-19 Pandemic Showed Less Depressive Tendencies.

Introduction: Our hypothesis in this study was that differences might exist between patients with epilepsy (PWE) who underwent epilepsy surgery before and within the period of the coronavirus disease 2019 (COVID-19) pandemic. The purpose of this study was to compare results of the Zung Self-Rating Depression Scale (SDS) between PWE who underwent epilepsy surgery before and during the pandemic period. Methods: Participants were PWE who underwent open cranial epilepsy surgery between February 2019 and February 2021 in our hospital. Patients who underwent surgery in the first half of this period, between February 2019 and January 2020, were defined as the pre-pandemic period group (pre-Group) and those treated in the second half, between February 2020 and February 2021, were categorized as the pandemic period group (within-Group). All patients completed the SDS before surgery, and scores were compared between groups. Results: SDS score was significantly higher in the pre-Group than in the within-Group (p = 0.037). Other factors, including age (p = 0.51), sex (p = 0.558), epilepsy duration from onset to SDS score evaluation (p = 0.190), seizure frequency (p = 0.794), number of anti-seizure medications (p = 0.787), and intelligence quotient (p = 0.871) did not differ significantly between groups. Conclusion: SDS score was higher in the pre-pandemic group than in the within-pandemic group, which may indicate that PWE with less-positive outlooks may be less likely to seek medical attention during stressful periods.

[Clinical observation of acupuncture combined with moxibustion on college students with depression].

OBJECTIVE: To observe the clinical efficacy of acupuncture combined with moxibustion with seed-sized moxa cone in the treatment of depression in college students, and explore its effect on serum 5-hydroxytryptamine (5-HT). METHODS: Sixty undergraduates with depression were divided into acupuncture-moxibustion group and medication group according to the random number table, with 30 patients in each group. The patients in acupuncture-moxibustion group received acupuncture and moxibustion with seed-sized moxa cone at acupoints on Shaoyang meridian according to the method of "rotating the pivot and regulating the qi", one time every other day. The patients in medication group received oral administration of fluoxetine hydrochloride capsule 20 mg once a day, and both groups were treated continuously for 8 weeks. The scores of Hamilton depression (HAMD-17) scale, self-rating depression scale (SDS) and serum 5-HT content before and after treatment were compared between the two groups. RESULTS: Compared with before treatment, the HAMD-17 and SDS scores of the acupuncture-moxibustion group began to decrease after 2 weeks of treatment (P<0.05); while the HAMD-17 and SDS scores of the the medication group began to decrease after 4 weeks of treatment (P<0.05). After 2, 4 and 8 weeks of treatment, the HAMD-17 and SDS scores of the acupuncture-moxibustion group decreased more significantly than the medication group (P<0.05). The 5-HT contents of the two groups were significantly higher than those before treatment (P<0.05)，and there was no significant difference in serum 5-HT content between the two groups (P>0.05). The adverse reaction score of the acupuncture-moxibustion group was lower than that of the medication group (P<0.05). The total effective rate of the acupuncture-moxibustion group was 92.86%（26/28）, better than the medication group 81.48% (22/27,P<0.05). CONCLUSION: Acupuncture combined with seed-sized moxa cone moxibustion is more effective than oral administration of fluoxetine hydrochloride in treating college students' depression, and acupuncture combined with moxibustion has a faster onset and fewer adverse reactions in the treatment of college students' depression.