[Acupuncture combined with repeated transcranial magnetic stimulation for mild to moderate post-stroke depression: a randomized controlled trial].

OBJECTIVE: To explore the clinical effect of acupuncture combined with repeated transcranial magnetic stimulation (rTMS) for mild to moderate post-stroke depression. METHODS: Ninety patients with mild to moderate post-stroke depression were randomly divided into a combination group (30 cases, 4 cases dropped out), an acupuncture group (30 cases, 3 cases dropped out) and a rTMS group (30 cases, 5 cases dropped out). All the three groups received basic treatment, the combination group was treated with acupuncture combined with rTMS, the acupuncture group was treated with acupuncture, and the rTMS group was treated with rTMS. The acupuncture was applied at Baihui (GV 20), Yintang (GV 24+) , Danzhong (CV 17) and bilateral Shenmen (HT 7), Taichong (LR 3), Neiguan (PC 6). All the three groups were treated once a day, 5 times a week for 4 weeks. The Hamilton depression scale (HAMD-17) score, Pittsburgh sleep quality index (PSQI) score and event-related potential were compared among the three groups before and after treatment. RESULTS: After treatment, the HAMD-17 scores and PSQI scores in the three groups were reduced compared with those before treatment (P<0.01) , and the HAMD-17 score and PSQI score in the combination group were lower than those in the acupuncture group and the rTMS group (P<0.05). After treatment, the latency of event-related potential (P300, mismatch negativityï¼»MMNï¼½) in the three groups was shortened compared with that before treatment (P<0.05), and the latency of event-related potential in the combination group was shorter than that in the acupuncture group and the rTMS group (P<0.05). CONCLUSION: Acupuncture combined with rTMS can effectively alleviate the depressive state of patients with mild to moderate post-stroke depression, improve the sleep quality and the latency of event-related potential P300 and MMN.

Clinical effects of nonconvulsive electrotherapy combined with mindfulness-based stress reduction and changes of serum inflammatory factors in depression.

BACKGROUND: Depression is a common and serious psychological condition, which seriously affects individual well-being and functional ability. Traditional treatment methods include drug therapy and psychological counseling; however, these methods have different degrees of side effects and limitations. In recent years, nonconvulsive electrotherapy (NET) has attracted increasing attention as a noninvasive treatment method. However, the clinical efficacy and potential mechanism of NET on depression are still unclear. We hypothesized that NET has a positive clinical effect in the treatment of depression, and may have a regulatory effect on serum inflammatory factors during treatment. AIM: To assess the effects of NET on depression and analyze changes in serum inflammatory factors. METHODS: This retrospective study enrolled 140 patients undergoing treatment for depression between May 2017 and June 2022, the observation group that received a combination of mindfulness-based stress reduction (MBSR) and NET treatment (n = 70) and the control group that only received MBSR therapy (n = 70). The clinical effectiveness of the treatment was evaluated by assessing various factors, including the Hamilton Depression Scale (HAMD)-17, self-rating idea of suicide scale (SSIOS), Pittsburgh Sleep Quality Index (PSQI), and levels of serum inflammatory factors before and after 8 wk of treatment. The quality of life scores between the two groups were compared. Comparisons were made using t and χ2 tests. RESULTS: After 8 wk of treatment, the observation group exhibited a 91.43% overall effectiveness rate which was higher than that of the control group which was 74.29% (64 vs 52, χ2 = 7.241; P < 0.05). The HAMD, SSIOS, and PSQI scores showed a significant decrease in both groups. Moreover, the observation group had lower scores than the control group (10.37 ± 2.04 vs 14.02 ± 2.16, t = 10.280; 1.67 ±0.28 vs 0.87 ± 0.12, t = 21.970; 5.29 ± 1.33 vs 7.94 ± 1.35, t = 11.700; P both < 0.001). Additionally, there was a notable decrease in the IL-2, IL-1ß, and IL-6 in both groups after treatment. Furthermore, the observation group exhibited superior serum inflammatory factors compared to the control group (70.12 ± 10.32 vs 102.24 ± 20.21, t = 11.840; 19.35 ± 2.46 vs 22.27 ± 2.13, t = 7.508; 32.25 ± 4.6 vs 39.42 ± 4.23, t = 9.565; P both < 0.001). Moreover, the observation group exhibited significantly improved quality of life scores compared to the control group (Social function: 19.25 ± 2.76 vs 16.23 ± 2.34; Emotions: 18.54 ± 2.83 vs 12.28 ± 2.16; Environment: 18.49 ± 2.48 vs 16.56 ± 3.44; Physical health: 19.53 ± 2.39 vs 16.62 ± 3.46; P both < 0.001) after treatment. CONCLUSION: MBSR combined with NET effectively alleviates depression, lowers inflammation (IL-2, IL-1ß, and IL-6), reduces suicidal thoughts, enhances sleep, and improves the quality of life of individuals with depression.

Diminished representational momentum for physical states in patients with depressive disorder.

The representational momentum for physical state changes refers to the fact that we remember objects as more changed in physical state than they actually were. It has been well documented that depressive disorder is associated with impairment of time perception. Thus, the present work was conducted with the aim to investigate the representational momentum for physical state changes in patients with depressive disorder, firstly. Forty patients with depressive disorder and forty-two healthy controls were administrated with the task of representational momentum for physical state changes and task of time perception. The stimulus comprises 10 videos showing object state changes (e.g., ice melting). During playing, the video would stop and immediately be obscured by mosaics at a specific point. Participants select from three detection images (the exact frame of the video just be masked, the frame after that, and the frame before that) to test representational momentum and estimate the duration of the video in seconds to test time perception. The depressive group showed diminished representational momentum (i.e., lower scores on the task of representational momentum) than normal controls (U = 215.00, Z = -5.83, p < 0.001). In addition, the scores on the task of representational momentum were significantly positively related with the scores on the task of time perception among depressive group (r = 0.446, p = 0.004). The findings indicate that patients with depressive disorder may exhibit diminished representational momentum for physical states, which may be correlated with their impairment of time perception.

Caregiver Burnout in Pediatric Laryngomalacia: The Role of Clinical and Psychological Factors.

INTRODUCTION: This study aims to assess caregiver burnout in relation to children diagnosed with laryngomalacia and identify factors influencing burnout levels. MATERIALS AND METHODS: A cohort of 101 caregivers of children with laryngomalacia was studied. Burnout was assessed using the Zarit burden interview (ZBI), while the Hamilton anxiety and Hamilton depression scales were employed to gauge psychological distress. The relationship between burnout and variables like the severity of laryngomalacia, the presence of comorbidities, the child's age, and caregiver demographics was examined using statistical tools in SPSS Statistics version 28.0 (IBM Corp., Armonk, NY, USA). RESULTS: Caregiver burnout decreased as the child's age increased. A direct correlation was observed between the severity of laryngomalacia and caregiver burnout. The presence of comorbidities in children increased caregiver burnout. Moreover, caregivers with increased levels of depression and anxiety exhibited higher burnout levels. No significant correlation was found between caregiver burnout and socioeconomic status or educational level. CONCLUSION: The severity of laryngomalacia, the child's age, the presence of comorbidities, and caregivers' psychological health are significant influencers of caregiver burnout. Healthcare professionals should offer targeted support to caregivers, addressing both their physical and psychological needs.

Evaluation of a Possible Association Between Severity of Allergic Rhinitis and the Level of Depression in Patients in a Tertiary Care Hospital in South India: A Cross-Sectional Study.

Introduction Allergic rhinitis is one of the most common diseases in the world. It affects all people irrespective of age, sex and race. Allergic rhinitis leads to the development of social and interpersonal problems and loss of productivity which in turn causes depression. The depression was an underestimated iceberg phenomenon in allergic rhinitis patients. Objective The study evaluates the association between the severity of allergic rhinitis and the level of depression in patients attending tertiary care hospitals in south India. Methodology This cross-sectional study was conducted among 250 patients with allergic rhinitis. All the patients were subjected to the semi-structured questionnaire. And the severity of allergic rhinitis has been made based on the allergic rhinitis, and its impact on asthma classification and depression has been diagnosed and classified based on the Hamilton depression rating scale. And the association between allergic rhinitis and depression has been evaluated with the chi-square test. Results Two hundred fifty patients participated in the study, with a mean age of 33+/-2. Surprisingly the prevalence of depression among the allergic rhinitis patient was 88%. Most of them suffered from mild depression based on the Hamilton depression rating scale. A significant association was seen among allergic patients with age, gender, smoking status, locality, socioeconomic status, and co-morbidities. And the study shows the severity of allergic rhinitis is directly related to the severity of depression with a significant association. Conclusion Depression is one of the underestimated and under-treated problems in today's world. This study concludes that the severity of allergic rhinitis directly and significantly correlates with the severity of depression. The prevalence and intensity of depression should be evaluated and appropriately treated in patients with allergic rhinitis to improve the quality of life.

[Governor vessel moxibustion combined with western medication for mild to moderate depression with kidney-yang deficiency: a randomized controlled trial].

OBJECTIVE: To compare the therapeutic efficacy of governor vessel moxibustion combined with fluoxetine hydrochloride capsule, simple fluoxetine hydrochloride capsule and placebo moxibustion combined with fluoxetine hydrochloride capsule for mild to moderate depression with kidney-yang deficiency. METHODS: A total of 126 patients with mild to moderate depression with kidney-yang deficiency were randomized into a governor vessel moxibustion group (42 cases, 2 cases dropped off), a western medication group (42 cases, 1 case dropped off) and a placebo moxibustion group (42 cases, 1 case dropped off). The western medication group was given fluoxetine hydrochloride capsule orally, 20 mg a time, once a day. On the basis of the treatment in the western medication group, governor vessel moxibustion was applied from Dazhui (GV 14) to Yaoshu (GV 2) in the governor vessel moxibustion group, once a week; placebo moxibustion was applied in the placebo moxibustion group, once a week. Treatment of 8 weeks was required in the 3 groups. Before and after treatment, the scores of Hamilton depression scale-17 (HAMD-17), Asberg's rating scale for side effects (SERS) and TCM clinical symptom were compared, and the clinical efficacy was evaluated. RESULTS: After treatment, the scores of HAMD-17, SERS and TCM clinical symptom were decreased compared before treatment in the 3 groups (P<0.05), the decrease ranges of above scores in the governor vessel moxibustion group were larger than those in the western medication group and the placebo moxibustion group (P<0.05). The total effective rate was 92.5% (37/40) in the governor vessel moxibustion group, which was higher than 75.6% (31/41) in the western medication group and 80.5% (33/41) in the placebo moxibustion group (P<0.05). CONCLUSION: Governor vessel moxibustion combined with fluoxetine hydrochloride capsule can improve the degree of depression and relieve the clinical symptoms in mild to moderate depression patients with kidney-yang deficiency, the efficacy is superior to simple fluoxetine hydrochloride capsule, and can reduce the fluoxetine hydrochloride capsule-induced adverse effect to a certain extent.

Therapeutic effects of Tongdu Qishen acupuncture combined with traditional Chinese medicine decoction on post-stroke depression in 31 patients / 中国基层医药

Objective:To investigate the clinical effects of Tongdu Qishen acupuncture combined with traditional Chinese medicine decoction on post-stroke depression in patients. Methods:Sixty-two patients with post-stroke depression who received treatment in Zhongda Hospital of Southeast University from October 2020 to April 2022 were included in this study. They were randomly treated either with traditional Chinese medicine decoction (control group, n = 31) or Tongdu Qishen acupuncture combined with traditional Chinese medicine decoction (combined group, n = 31) based on routine medication. All patients were treated for 4 weeks. Depressive state, neurological function, and activities of daily living were compared between the two groups. Results:Before treatment, there were no significant differences in the Hamilton Depression Scale (HAMD) score, National Institutes of Health Stroke Scale (NIHSS) score, and Barthel index between the two groups (all P > 0.05). After 4 weeks of treatment, the HAMD and NIHSS scores in the control group were (13.88 ± 3.92) points and (8.56 ± 1.82) points, respectively, and they were (8.72 ± 2.48) points and (6.67 ± 1.14) points in the combined group. There were significant differences in HAMD and NIHSS scores between the two groups ( t = 2.14, 2.43, both P < 0.05). The Barthel index in the combined group was (69.53 ± 13.29) points, which was significantly higher than (62.34 ± 15.67) points in the control group ( t = 2.23, P < 0.05). Conclusion:Tongdu Qishen acupuncture combined with traditional Chinese medicine decoction can reduce depressive symptoms and improve neurological function and activities of daily living in patients with post-stroke depression. The combined therapy has obvious efficacy in the treatment of post-stroke depression.

Governor vessel moxibustion combined with western medication for mild to moderate depression with kidney-yang deficiency: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the therapeutic efficacy of governor vessel moxibustion combined with fluoxetine hydrochloride capsule, simple fluoxetine hydrochloride capsule and placebo moxibustion combined with fluoxetine hydrochloride capsule for mild to moderate depression with kidney-yang deficiency.@*METHODS@#A total of 126 patients with mild to moderate depression with kidney-yang deficiency were randomized into a governor vessel moxibustion group (42 cases, 2 cases dropped off), a western medication group (42 cases, 1 case dropped off) and a placebo moxibustion group (42 cases, 1 case dropped off). The western medication group was given fluoxetine hydrochloride capsule orally, 20 mg a time, once a day. On the basis of the treatment in the western medication group, governor vessel moxibustion was applied from Dazhui (GV 14) to Yaoshu (GV 2) in the governor vessel moxibustion group, once a week; placebo moxibustion was applied in the placebo moxibustion group, once a week. Treatment of 8 weeks was required in the 3 groups. Before and after treatment, the scores of Hamilton depression scale-17 (HAMD-17), Asberg's rating scale for side effects (SERS) and TCM clinical symptom were compared, and the clinical efficacy was evaluated.@*RESULTS@#After treatment, the scores of HAMD-17, SERS and TCM clinical symptom were decreased compared before treatment in the 3 groups (P<0.05), the decrease ranges of above scores in the governor vessel moxibustion group were larger than those in the western medication group and the placebo moxibustion group (P<0.05). The total effective rate was 92.5% (37/40) in the governor vessel moxibustion group, which was higher than 75.6% (31/41) in the western medication group and 80.5% (33/41) in the placebo moxibustion group (P<0.05).@*CONCLUSION@#Governor vessel moxibustion combined with fluoxetine hydrochloride capsule can improve the degree of depression and relieve the clinical symptoms in mild to moderate depression patients with kidney-yang deficiency, the efficacy is superior to simple fluoxetine hydrochloride capsule, and can reduce the fluoxetine hydrochloride capsule-induced adverse effect to a certain extent.

[Huayu Tongluo moxibustion combined with intradermal needling in patients with mild to moderate depression after cerebral infarction].

OBJECTIVE: To observe the effect of Huayu Tongluo (resolving stasis and promoting collateral circulation) moxibustion combined with intradermal needling on depressive symptoms, quality of life and cognitive impairment in patients with mild to moderate depression after cerebral infarction on the basis of western medicine treatment. METHODS: Fifty patients with mild to moderate depression after cerebral infarction were randomly divided into an acupuncture combined with western medication group (group A, 25 cases) and a western medication group (group B, 25 cases). In the group B, paroxetine hydrochloride tablets were taken orally, 20 mg after breakfast, once a day, and the dose could be adjusted to the maximum 40 mg/d according to the patients' condition, for 4 weeks totally. On the basis of the treatment in the group B, the group A was treated with Huayu Tongluo moxibustion, namely aconite cake-separated moxibustion at Baihui (GV 20) and suspended moxibustion at Dazhui (GV 14) and Shenting (GV 24), combined with intradermal needling at Shenmen (HT 7), Jianshi (PC 5), Zusanli (ST 36), etc. Huayu Tongluo moxibustion was performed 6 times a week, and intradermal needling was performed 3 times a week，for 4 weeks totally. In the two groups, the scores of Hamilton depression scale (HAMD), stroke specific quality of life scale (SS-QOL) and mini mental state examination (MMSE) were observed before and after treatment, and the clinical efficacy and safety were compared. RESULTS: After treatment, the HAMD score in the each group was decreased compared with that before treatment (P<0.05), and that in the group A was lower than the group B (P<0.05); after treatment, the SS-QOL score in the group A and MMSE score in the two groups were increased compared with those before treatment (P<0.05), and the SS-QOL score in the group A was higher than the group B (P<0.05). The total effective rate was 88.0% (22/25) in the group A, which was higher than 60.0% (15/25) in the group B (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (4.0% [1/25] vs 16.0%[4/25], P>0.05). CONCLUSION: On the basis of the treatment of western medication paroxetine hydrochloride tablets, Huayu Tongluo moxibustion combined with intradermal needling therapy can effectively improve the depressive symptoms, quality of life and cognitive impairment of patients with mild to moderate depression after cerebral infarction.

A Chinese adaptation of six items, self-report Hamilton Depression Scale: Factor structure and psychometric properties.

OBJECTIVES: The objective of this research was to verify the psychometric characteristics of the Chinese Adaptation of self-report HAMD-6. METHODS: Outpatients and inpatients who met the DSM-5 criterion for major depressive disorder (MDD) were evaluated by the Chinese self-report HAMD-6, seventeen items of Hamilton Depression Rating Scale (HAMD-17), Patient Health Questionnaire Depression Scale (PHQ-9) and Improved Clinical Global Impression Scale (iCGI-S). The internal consistency reliability, retest reliability, criterion validity and construct validity of the Chinese self-report HAMD-6 were tested. Pearson correlation coefficient was used to assess the correlativity between the total score and the item scores. By drawing the Receiver Operating Characteristics (ROC) curve, the best cut-off value, sensitivity and specificity of Chinese Adaptation self-report HAMD-6 were obtained. RESULTS: Cronbach's alpha coefficient of the Chinese self-report HAMD-6 was 0.91, and the intra-group correlation coefficient (ICC) of retest reliability was 0.81(P < 0.01). The Spearman correlation coefficients of the Chinese self-report HAMD-6, Chinese clinician version of HAMD-6, PHQ-9 and HAMD-17 were 0.86, 0.81 and 0.86, respectively (all P < 0.01). Results of the confirmatory factor analysis (CFA) supported a unidimensional construct. In addition, HAMD-17 ≤ 7 and iCGI-S= 1 were taken as the remission criteria for depression disorder, and the ROC curves of the Chinese self-report HAMD-6 were plotted with a cut-off value of 3/4, the specificity and sensitivity were 0.85/0.92 and 0.96/0.93 respectively. CONCLUSION: These results suggested that the abbreviated Chinese self-report HAMD-6 has good reliability and validity among the Chinese population. This study suggested that the remission cut-off value of the scale is 3/4.

A Preliminary Study of Different Treatment Strategies for Anxious Depression.

BACKGROUND: Despite the best treatments, about 20% of patients with major depressive disorder (MDD) receiving drugs and psychological intervention show little or no improvement. There is no trial comparing different treatment methods in patients with anxiety/somatic subtype MDD. AIM: To compare the efficacy and safety of various treatments in patients with anxiety/somatic subtype MDD. METHODS: This was a preliminary multicenter randomized controlled trial at eight participating hospitals in China (09/2016-06/2019) (ClinicalTrials.gov #NCT03219008). The patients were randomized to mirtazapine/SNRIs, mirtazapine/SNRIs+cognitive behavioral therapy (CBT), mirtazapine+SNRIs, or mirtazapine+SNRIs+physical therapies (modified electroconvulsive treatment or repetitive transcranial magnetic stimulation). The primary endpoint was the 17-item Hamilton Depression Scale (HAMD-17). The Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR) and Quality of Life (QOL)-6 were the secondary endpoints. The adverse events (AEs) were monitored. The patients were assessed at baseline (0 weeks), and at the end of the 2nd, 4th, 6th, 8th, and 12th week during treatment. RESULTS: Finally, 107 patients were included: mirtazapine/SNRIs (n=36), mirtazapine/SNRIs+CBT (n=28), mirtazapine+SNRIs (n=29), and mirtazapine+SNRIs+physical therapies (n=14). The 17-HDRS and QIDS-SR scores decreased in all four groups, and the QOL-6 scores increased. There were no differences in the 17-HDRS (P=0.099), QIDS-SR (P=0.407), and QOL-6 (P=0.485) scores among the four groups. There were no differences in the occurrence of AEs among the four groups (P=0.942). CONCLUSION: This preliminary trial suggests that all four interventions (mirtazapine/SNRIs, mirtazapine/SNRIs+CBT, mirtazapine+SNRIs, or mirtazapine+SNRIs+physical therapies) achieved similar response and remission rates in patients with anxiety/somatic subtype MDD. The safety profile was manageable.

Influence of preoperative depression on clinical outcomes after cervical laminoplasty: A retrospective study.

Background: Depression is a highly prevalent mental disorder, and we found that patients with preoperative depression had worse postoperative improvement in lumbar fusion. Are mental factors related to the prognosis of laminoplasty? Objective: To analyze the relationship between depression and clinical outcomes after laminoplasty for the treatment of multilevel CSM. Methods: In this retrospective study, 115 patients with multilevel cervical spondylotic myelopathy (CSM), who underwent laminoplasty and were followed up for more than 1 year, were enrolled in this study from October 2018 to October 2021. Patients with the scores of 21-item Beck Depression Inventory (BDI) ≥ 15 or Hamilton Depression Scale-24 (HAMD-24) > 20 were included in the depression group. The clinical outcomes were evaluated by the changes and recovery rate (RR) of Japanese Orthopaedic Association Scores (JOA) and Neck Disability Index (NDI) respectively. Univariate and multiple linear regression analyses were performed to reveal the relationship between preoperative depressive states and clinical outcomes. Results: Fourteen patients were diagnosed with depression by BDI and twenty-nine by HAMD-24. Between the depression group and the non-depression group, the age, gender, smoking history, and duration of symptoms were statistically significant (P < 0.05). Multiple linear regression showed that the BDI scores had a negative relationship with the changes and RR of JOA and NDI, and the HAMD-24 scores had a negative relationship with the changes and RR of JOA. Conclusions: Preoperative depression in patients with multilevel CSM can lead to worse prognosis. In order to improve the curative effect of the operation, we should pay attention to the psychological state monitoring and intervention of patients before they receive laminoplasty.

Treatments to post-stroke depression, which is more effective to HAMD improvement? A network meta-analysis.

Introduction: Post-stroke depression (PSD) is a common mental health problem after cerebrovascular accidents. There are several treatments that have been shown to be effective in treating post-stroke depression. However, it is not clear which treatment is more effective. Methods: In this meta-analysis, an appropriate search strategy was used to search eligible randomized controlled trials (RCTs) on different treatments to treat patients with Post-stroke depression published up to December 2021 from the CNKI, PubMed, and Cochrane Library. We assessed the mean difference or odds ratio between each treatment and placebo and summarized them as the average and 95% confidence interval (CI) by conducting Bayesian network meta-analyses. Results: By constructing a Bayesian network meta-analysis, we found that acupuncture combined with fluoxetine (vs placebo MD, -8.9; 95% CI, [-15, -2.9]) or paroxetine (vs placebo MD,-8.5; 95% CI, [-15, -2.5]) was the most effective for change in Hamilton depression scale (HAMD) at the end of the 4th week. For change in Hamilton depression scale at the end of the 8th week, rTMS combined with paroxetine (vs placebo MD, -13; 95% CI, [-17, -7.9]) had the greatest amount of change. The efficacy of medication combined with adjuvant therapy was also superior for the percentage of patients with Hamilton depression scale change over 50%. Discussion: The combination of antidepressants with adjuvant therapy may enhance the efficacy of antidepressants and achieve better results than antidepressant monotherapy in both Hamilton depression scale changes at the end of week 4 or 8 and 50% Hamilton depression scale improvement rate. Acupuncture combined with fluoxetine treatment was more effective in the treatment of post-stroke depression at week 4, while rTMS combined with paroxetine was more effective at week 8. Further research is needed to determine whether acupuncture combined with fluoxetine is better than rTMS combined with paroxetine for post-stroke depression at week 8.

Efficacy of combined fluoxetine and aniracetam tablets in the treatment of senile depression and its effects on serum total bile acid and norepinephrine levels / 中国基层医药

Objective:To investigate the efficacy of combined fluoxetine and aniracetam tablets in the treatment of senile depression and its effects on serum total bile acid (TBA) and norepinephrine (NE) levels.Methods:A total of 100 older adult patients with depression who received treatment in Heze Medical College from January 2019 to December 2019 were included in this study. They were randomly assigned to receive either fluoxetine tablets alone (control group, n = 50) or fluoxetine and aniracetam tablets (study group, n = 50). All patients received two months of treatment. Clinical efficacy, scores of the Hamilton Rating Scale for Anxiety (HAMA) and the Hamilton Rating Scale for Depression (HAMD), adverse reactions, and serum TBA and NE levels were compared between the two groups. Results:Total response rate was significantly higher in the study group than in the control group [96.0% (48/50) vs. 84.0% (42/50), χ2 = 4.00, P = 0.045]. HAMD and HAMA scores post-treatment in the study group were (5.85 ± 1.81) points and (4.81 ± 1.57) points, respectively, which were significantly lower than those in the control group [(11.65 ± 2.65) points, (10.85 ± 2.84) points, t = 10.84, P < 0.001; t = 11.16, P < 0.001). Serum NE level was significantly higher in the study group than in the control group [(138.68 ± 16.35) ng/L vs. (127.17 ± 14.34) ng/L, t = 3.17, P = 0.002]. There were no significant differences in serum TBA level [(5.85 ± 0.63) μmol/L vs. (5.91 ± 0.65) μmol/L] and the incidence of adverse reactions (8.00% vs. 6.00%) between the study and control groups ( t = 0.39, P = 0.692; χ2 = 0.15, P = 0.695). Conclusion:The combined therapy of fluoxetine and aniracetam tablets for the treatment of senile depression is safe and highly effective, does not affect metabolic function and thereby deserves clinical application.

Effects of repetitive transcranial magnetic stimulation combined with oral paroxetine on cognitive status and activities of daily living in older adult patients with severe depression / 中国基层医药

Objective:To investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with oral paroxetine in the treatment of older adult patients with severe depression and its effects on the scores of the Hamilton Rating Scale for Depression (HAMD), the Mini-Mental State Examination (MMSE), and Activities of Daily Living (ADL).Methods:A total of 192 older adult patients with severe depression who received treatment in Shaoxing 7 th People's Hospital from January 2018 to December 2019 were included in this study. They were randomly assigned to receive either oral paroxetine (control group, n = 96) or rTMS + oral paroxetine (observation group, n = 96). All patients received 1 month of treatment. Clinical efficacy was compared between the two groups. HAMD, MMSE, and ADL scores pre- and post-treatment and the incidence of adverse events during the treatment were compared between the two groups. Results:Total response rate was significantly higher in the observation group than in the control group [96.88% (93/96) vs. 89.58% (86/96), χ2 = 4.04, P < 0.05]. HAMD scores post-treatment were significantly lower in the observation group than in the control group [(6.43 ± 2.33) points vs. (11.32 ± 2.02) points, t = 15.53, P < 0.05]. MMSE and ADL scores post-treatment in the observation group were (29.13 ± 3.01) points and (71.52 ± 5.32) points, respectively, which were significantly higher than those in the control group [(24.65 ± 2.79) points, (69.65 ± 5.17) points, t = 10.69, 2.47, P < 0.05]. There was no significant difference in the incidence of adverse events between the two groups ( P > 0.05). Conclusion:The combined therapy of rTMS and oral paroxetine is highly effective on severe depression in older adult patients. It can improve cognitive function and the activities of life living.

[Mild and moderate postpartum depression treated with acupuncture of Tiaoren Tongdu: a real world study].

OBJECTIVE: To observe the clinical therapeutic effect on mild and moderate postpartum depression treated with acupuncture of Tiaoren Tongdu (regulating the conception vessel and unblocking the governor vessel) on the base of real world. METHODS: A total of 116 patients with mild and moderate postpartum depression were divided into an acupuncture group (103 cases) and a non-acupuncture group (13 cases) according to treatment regimen provided. In the acupuncture group, acupuncture of Tiaoren Tongdu was applied to Baihui (GV 20), Yintang (GV 29), Zhongwan (CV 12), Qihai (CV 6), Guanyuan (CV 4), Neiguan (PC 6), Shenmen (HT 7), Hegu (LI 4), Zusanli (ST 36), Sanyinjiao (SP 6) and Taichong (LR 3). Needles were retained for 30 min each time, the treatment was given once every other day, 3 times a week. In the non-acupuncture group, psychotherapy was provided, once daily. The duration of treatment in the two groups was 8 weeks. According to the treatment times of acupuncture, the acupuncture group was subdivided into an acupuncture A group (60 cases with total treatments ≥ 6 times) and an acupuncture B group (43 cases with total treatments<6 times). Using propensity score matching method, the patients of the acupuncture A and B groups were matched each other. Finally, 31 pairs of cases were matched successfully. Before treatment, at 1st, 2nd, 4th and 8th weeks of treatment, as well as at 3-month follow-up, the scores of Hamilton depression scale (HAMD) were compared in patients among the three groups. Using Logistic regression, the impact of acupuncture frequencies on the therapeutic effect was analyzed and the clinical therapeutic effect was assessed. RESULTS: The total effective rate of the acupuncture A group was 100.0% (31/31), better than 76.9% (10/13) in the non-acupuncture group and 58.1% in the acupuncture B group (18/31) (P<0.05). HAMD score at each time point after treatment was lower than that before treatment in the patients of each group (P<0.05). But HAMD score at each time point after treatment in either the acupuncture A group or the acupuncture B group was lower than that in the non-acupuncture group separately (P<0.05), HAMD scores in the acupuncture A group at the 4th and 8th weeks of treatment and at follow-up were lower than those in the acupuncture B group (P<0.05). Logistic regression analysis showed that the total times of acupuncture treatment and the persistent days of treatment had a certain relation to therapeutic effect (P<0.05). CONCLUSION: Acupuncture of Tiaoren Tongdu effectively improves in mild and moderate postpartum depression and its therapeutic effect is closely related to treatment course.

[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.

[Effect of Tiaodu Jieyu acupuncture on cancer-related depression: a randomized controlled trial].

OBJECTIVE: To observe the effect of Tiaodu Jieyu acupuncture combined with sertraline hydrochloride and sertraline hydrochloride alone on cancer-related depression (CRD), and to explore its action mechanism. METHODS: A total of 120 patients with CRD were randomly divided into an observation group and a control group, 60 cases in each group. Based on the routine treatment of oncology, the patients in the control group were treated with sertraline hydrochloride tablets, 50 mg per time, once a day, and the patients in the observation group were additionally treated with Tiaodu Jieyu acupuncture at Zhongwan (CV 12), Baihui (GV 20), Shenting (GV 24), Xinshu (BL 15), Ganshu (BL 18), Pishu (BL 20), Shenmen (HT 7), Taichong (LR 3), Taixi (KI 3), 20 to 40 min per time, once a day, 5 times a week. Both the treatments were given for 6 weeks. The self-rating depression scale (SDS) score, Hamilton depression scale (HAMD) score before treatment and after 2-week, 4-week and 6-week treatment as well as the levels of serum interleukin (IL)-2, IL-4, IL-10, interferon gamma (IFN-γ) and transforming growth factor ß (TGF-ß) before and after treatment were observed in the two groups. RESULTS: Compared before treatment, the SDS scores and HAMD scores in the two groups were reduced after 2-week, 4-week and 6-week treatment (P<0.05), and SDS scores and HAMD scores in the observation group were lower than those in the control group (P<0.05). Compared before treatment, the serum levels of IL-4, IL-10 and TGF-ß in the two groups after treatment were reduced (P<0.05), and those in the observation group were lower than the control group (P<0.05). Compared before treatment, the serum levels of IL-2 and IFN-γ in the two groups after treatment were increased (P<0.05), and those in the observation group were higher than the control group (P<0.05). CONCLUSION: Tiaodu Jieyu acupuncture combined with sertraline hydrochloride tablets could effectively relieve the depression state in patients with CRD, and the curative effect is better than sertraline hydrochloride tablets alone. The mechanism may be related to regulating the expression of immune-related cytokines.

Effects of structured group psychotherapy on symptoms and social function of patients with mild to moderate depression / 中国基层医药

Objective:To investigate the effects of structured group psychotherapy on symptoms and social function of patients with mild to moderate depression.Methods:Sixty patients with mild to moderate depression who received treatment in Department of Psychiatry of the Third People's Hospital of Yongkang from June 2019 to May 2020 were included in this study. They were randomly assigned to receive either conventional antidepressants ( n = 30, control group) or conventional antidepressants combined with structured group psychotherapy ( n = 30, observation group). The Self-rating Anxiety Scale, Self-rating Depression Scale Hamilton Anxiety Scale, Hamilton Depression Scale and the Simplified Coping Style Questionnaire were used to compare the anxiety state, depression state and coping style between the two groups. Results:Self-rating Anxiety Scale, Self-rating Depression Scale, Hamilton Anxiety Scale, Hamilton Depression Scale and Simplified Coping Style Questionnaire scores in the observation group were (44.21 ± 4.15) points, (45.28 ± 5.16) points, (12.41 ± 2.16) points, (9.75 ± 2.83) points, and (10.35 ± 2.23) points, respectively, which were significantly lower than those in the control group [(51.14 ± 4.39) points, (53.64 ± 5.31) points, (16.73 ± 2.54) points, (14.18 ± 2.72) points, (14.73 ± 2.54) points, t = 6.283, 6.184, 7.097, 6.182, 7.375, all P < 0.001]. Simplified Coping Style Questionnaire score in the observation group was significantly higher than that in the control group [(31.42 ± 4.43) points vs. (24.16 ± 4.27) points, t = 7.432, P < 0.001]. Conclusion:Structured group psychotherapy combined with conventional antidepressant therapy for treatment of mild to moderate depression can greatly reduce the symptoms of anxiety and depression and improve the coping style.

Mild and moderate postpartum depression treated with acupuncture of / 中国针灸

OBJECTIVE@#To observe the clinical therapeutic effect on mild and moderate postpartum depression treated with acupuncture of @*METHODS@#A total of 116 patients with mild and moderate postpartum depression were divided into an acupuncture group (103 cases) and a non-acupuncture group (13 cases) according to treatment regimen provided. In the acupuncture group, acupuncture of @*RESULTS@#The total effective rate of the acupuncture A group was 100.0% (31/31), better than 76.9% (10/13) in the non-acupuncture group and 58.1% in the acupuncture B group (18/31) (@*CONCLUSION@#Acupuncture of