Ansiedad y depresión en pacientes post-COVID-19 en primer nivel de atención / Anxiety and depression in post-COVID-19 patients at the primary level of health care

Introducción: durante diciembre de 2019 se identificó en Wuhan, China, un nuevo coronavirus, denominado SARS-CoV-2 por el Comité Internacional de Taxonomía de Virus. Después de haber presentado esta enfermedad se han encontrado secuelas como ansiedad y depresión. Objetivo: determinar el nivel de ansiedad y depresión en los pacientes post-COVID-19 en primer nivel de atención. Material y métodos: estudio observacional, descriptivo, transversal, unicéntrico, homodémico, prospectivo, prolectivo. Se realizó en una Unidad de Primer Nivel de Atención del Instituto Mexicano del Seguro Social, en el periodo de enero de 2021 a enero de 2022. Se aplicó la Escala de Hamilton para la Ansiedad y el Inventario de Beck para Depresión. Se realizó un análisis estadístico en el programa SPSS 25, los datos se expresaron como media ± desviación estándar o mediana, según la distribución. Las variables cualitativas se expresaron en frecuencias y porcentajes. Resultados: el promedio de edad fue de 27 años; con predominio del sexo femenino (62.4%), presentaron depresión moderada 6%, depresión grave 1.5%, ansiedad leve 20.9% y ansiedad moderada o grave 9.8%. Conclusión: existe una asociación entre el nivel de depresión y ansiedad en los pacientes post-COVID-19, con una p significativa (AU)

Introduction: during December 2019, a new coronavirus, named SARSCoV-2, by the International Committee on Taxonomy of Viruses, was identified in Wuhan, China. After presenting with this disease, sequelae such as anxiety and depression have been found. Objective: determine the level of anxiety and depression in post-COVID-19 patients of the Family Medicine Unit No. 34. Material and methods: observational, descriptive, cross-sectional, unicentric, homodemic, prospective, prolective study. It was conducted in a first level unit of the Mexican Institute of Social Security, in the period from January 2021 to January 2022. The Hamilton Anxiety Scale and the Beck Depression Inventory were applied. Statistical analysis was performed in the SPSS 25 program, data were expressed as mean ± standard deviation or median, according to the distribution. Qualitative variables were expressed as frequencies and percentages. Results: the mean age was 27 years; with a predominance of females (62.4%), 6% presented moderate depression, 1.5% severe depression, 20.9% mild anxiety and 9.8% moderate or severe anxiety. Conclusions: there is an association between the level of depression and anxiety in post-COVID-19 patients, with a significant p (AU)

COPD and Depression Analysis in Regard to Obstructive Pulmonary Levels.

Depression symptoms take place recurrently in patients suffering from COPD. This study aims to assess the effects of antidepressant therapy in patients with COPD and a depressive disorder in relation to COPD levels. The study population consisted of N = 87 patients diagnosed with COPD, according to the GOLD criteria, and a depressive disorder. All of the patients were subjected to clinical and psychiatric exploration according to psychiatric assessment instruments, which was followed by SSRI therapy for the duration of 8 weeks. The main methods used were descriptive statistics and analysis of variance. The results showed a different distribution of depressive symptoms at a different stage of COPD by FEV1 (χ2 = 30.47, df = 6, p < 0.01) and by mMRC (χ2 = 34.6, df = 6, p < 0.01). After the application of SSRIs, there was a significant improvement in HDRS scores in all stages of COPD by FEV1 (χ2 = 251.62, df = 9, p < 0.01) and by mMRC (χ2 = 919.17, df = 9, p < 0.01). This study contributes to the improvement in the quality of life of patients by the targeted application of SSRI therapy and, therefore, more precise and better overall treatment results.

Higher Depression Scores in Patients with Drug-Resistant Schizophrenia.

BACKGROUND: Schizophrenia is a mental illness with diverse clinical presentation, in which a significant proportion of patients show resistance to treatment. In patients with schizophrenia, symptoms from all psychotic and affective spectra are observed. On the one hand, affective symptoms determine the clinical course of schizophrenia and on the other hand, depressive symptoms are some of the most common ones in psychiatry in general. These data give us reason to explore the impact of depressive symptoms on the course of schizophrenia and its relationship with resistance to treatment. METHOD: A study of 105 patients with schizophrenia was performed. Of these, 39 were male and 66 were female. The evaluation of the effectiveness of the treatment carried out at 12 weeks of therapy showed that 45 were resistant to schizophrenia and the remaining 60 were in clinical remission. The clinical evaluation of the patients was performed with the PANSS (Positive and Negative Syndrome Scale) and BPRS (Brief Psychiatric Rating Scale) scales. The assessment of depressive complaints was conducted with the Hamilton Depression Scale. RESULTS: Our study showed that in the analysis of depressive complaints with the Hamilton scale females got 12.55 points, and males got 11.44 points. We found a correlation of depressive complaints with the evaluation on the PANSS and BPRS scales, and in the analysis on the individual subscales we found a correlation on the subscale for positive and disorganized symptoms and no correlation on the scale for negative symptoms. We established a difference in the level of depression in patients with resistance in whom the level of depressive complaints was 13.82, while in those in clinical remission it was 10.87 points. CONCLUSIONS: The level of depressive symptoms in patients with resistant schizophrenia is higher than in clinical remission. Depressive symptoms correlate with positive and disorganized symptoms on the PANSS scale, but not with negative symptoms. Gender is not a determining factor in depressive complaints.

Alpha-Synuclein RNA Expression is Increased in Major Depression.

Alpha-synuclein (SNCA) is a small membrane protein that plays an important role in neuro-psychiatric diseases. It is best known for its abnormal subcellular aggregation in Lewy bodies that serves as a hallmark of Parkinson's disease (PD). Due to the high comorbidity of PD with depression, we investigated the role of SNCA in patients suffering from major depressive disorder (MDD). SNCA mRNA expression levels were analyzed in peripheral blood cells of MDD patients and a healthy control group. SNCA mRNA expression was positively correlated with severity of depression as indicated by psychometric assessment. We found a significant increase in SNCA mRNA expression levels in severely depressed patients compared with controls. Thus, SNCA analysis could be a helpful target in the search for biomarkers of MDD.

[Factors associated with depressive symptoms in chronic hemodialysis patients of centre hospitalier universitaire Yalgado Ouédraogo (Burkina Faso)]. / Facteurs associés à la symptomatologie dépressive chez les patients hémodialysés chroniques du centre hospitalier universitaire Yalgado Ouédraogo (Burkina Faso).

OBJECTIVE: To determine the factors associated with depressive symptoms in chronic hemodialysis patients at centre hospitalier universitaire Yalgado Ouédraogo de Ouagadougou (CHU-YO). PATIENTS AND METHODS: The study was cross sectional and descriptive, from June 2nd to July 30th, 2014. We included chronic hemodialysis patients of CHU-YO. The frequency of hemodialysis sessions was of every four to five days. The French version of Hamilton depression psychometric scale was used to assess depressive symptoms. The factors associated with depression were identified after descriptive and explanatory analysis. RESULTS: Depressive symptoms were identified in 140 of the 162 patients included in the study, or a prevalence of 86.4%. The average age of the 140 patients was 38.9±12.9years. In bivariate analysis, the risk of having depressive symptoms was 1.5 times for women, 1.7 times for patients with severe anemia, 1.5 times for hemodialysis catheter holders, 1.8 both in case of duration in hemodialysis less than six months. In multivariate analysis, gender and duration in hemodialysis were factors associated with the occurrence of depressive symptomatology. CONCLUSION: Our study confirms the high frequency of depressive symptoms in patients on hemodialysis. To improve the overall care of hemodialysis patients, we suggest routine screening for depressive symptoms and specific support.

Five-year efficacy of finasteride in 801 Japanese men with androgenetic alopecia.

Finasteride is standard medical treatment for androgenetic alopecia; however, no large studies with 5 years or more of follow up have been performed in Japan. The authors followed Japanese men with androgenetic alopecia treated with finasteride for 5 years to evaluate long-term treatment efficacy. Of 903 men treated with finasteride (1 mg/day), 801 patients were evaluated over 5 years by modified global photographic assessment. Although the proportion of improvement was high (99.4%), modified global photographic assessment scores after 5 years of treatment were lower in patients with more advanced disease as measured by the modified Norwood-Hamilton scale. After separating patients into "sufficient" and "insufficient" efficacy groups according to the modified global photographic assessment score after 5 years (scores ≥6 and <6, respectively), multivariate analysis showed that independent risk factors of insufficient efficacy were age at start of treatment of 40 years or more (P = 0.021) and classification on the modified Norwood-Hamilton scale (P < 0.001), whereas presence of stress at start of treatment was a negative predictor (P = 0.025). In conclusion, continuous finasteride treatment for 5 years improved androgenetic alopecia with sustained effect among Japanese. Younger age and less advanced disease at start of treatment were the key predictors of higher finasteride efficacy.

Depresión y ansiedad en embarazadas / Depression and anxiety in pregnant women

La pesquisa de depresión y ansiedad en las gestantes permite evitar el deterioro de la salud mental materna y las graves consecuencias sobre sus hijos. Se planteó analizar los niveles de depresión y ansiedad en embarazadas que acudieron a la consulta de perinatología y medicina materno-fetal de un Hospital Materno Infantil entre junio-agosto 2012. Se llevó a cabo un estudio correlacional, transversal y no experimental, con una muestra de 236 embarazadas excluyendo aquellas con diagnóstico anterior de depresión o ansiedad, enfermedad psiquiátrica previamente diagnosticada, patologías de base: Diabetes mellitus tipo 1 y 2, diabetes gestacional, hipertensión arterial sistémica, hipertensión arterial inducida por el embarazo, enfermedades inmunológicas, cáncer, síndrome de Down e infecciones de transmisión sexual y pacientes con discapacidad, a quienes se aplicó los Test de Hamilton para la depresión y ansiedad. El 56,4% pertenecen al estrato socioeconómico IV. 81% tenía una relación de pareja estable y 54,2% tenía un embarazo deseado, de las cuales 67,3% tuvo algún nivel de ansiedad y el 66,1% algún nivel de depresión. Las embarazadas con pareja inestable tienen un riesgo 8,5 veces mayor de presentar ansiedad y 6,5 veces mayor de presentar depresión, con respecto a las que tienen pareja estable. En mujeres con embarazo no deseado, el riesgo de presentar ansiedad fue 1,63 veces mayor que las que querían su gravidez y para la depresión el riesgo fue 1,66 veces mayor, sin embargo este hallazgo no fue estadísticamente significativo. Se concluye que hay elevados niveles de depresión y ansiedad en las embarazadas que tienen relación con tener una pareja inestable.

Early detection of depression and anxiety in the pregnant population avoids mental maternal health deterioration and serious consequences for their children. To analyze the levels of depression and anxiety in pregnant women who attended to the perinatology consultation and maternal-fetal medicine at a Maternal and Child Hospital between June-August 2012. A correlational, non experimental and cross-sectional study was done with a sample of 236 pregnant patients with exclusion of those with prior diagnosis of depression or anxiety, suffering previously diagnosed psychiatric illness, underlying diseases: Diabetes mellitus type 1 and 2, gestational diabetes, hypertension, hypertensive disorders induced by pregnancy, immune disorders, cancer, Down syndrome and sexually transmitted infections and disabled patients, who completed the Hamilton test for depression and anxiety. 56.4% belonged to socioeconomic level IV, 81% had a stable relationship and 54.2% had an unwanted pregnancy, of which 67.3% had some level of anxiety and 66.1% some level of depression. Pregnant women with unstable couples have a 8.5 times higher risk of presenting anxiety and 6.5 times more likely to develop depression, relative to those with stable partner. In women with unwanted pregnancy, the risk of anxiety was 1.63 times higher than those whom wanted their pregnancy and the risk for depression was 1.66 times higher, however this finding was not statistically significant. It was concluded that there are high levels of depression and anxiety in pregnant women who have an unstable relationship.

The Efficacy of Intermittent Walking in Water on the Rate of MHPG Sulfate and the Severity of Depression.

OBJECTIVE: Many studies evaluated the efficacy of exercise on some depression indices, but the effect of physical exercise in exhilarating milieu on urine 3-Methoxy-4-Hydroxyphenylglycol (MHPG) sulfate-the main metabolite of norepinephrine is not clear. The purpose of this research was to study the effect of a six-week intermittent walking in the water on 24-hour urine MHPG sulfate in depressed female teenagers. METHODS: Twenty-four high school female students with depression were divided randomly into case and control group. Pool walking exercise program was implemented 3 sessions weekly for 6 weeks and with a rate of 60-70% of the maximum heart rate. The control group didn't enter any exercise protocol and did not receive any other anti-depressant therapy. HPLC-fluorometric detection assay was used to measure 24-hour urine MHPG sulfate values. The data was analyzed with t-test and Pierson's correlation tests. RESULTS: Twenty hour urine MHPG sulfate increased from 1.93 (±0.59) to 4.66 (±0.85) micromole in case group (P ≤ 0.001), and in control group from 1.67 (±0.58) to 1.80 (±0.58) micromole. Increase of 24-hour urine MHPG sulfate and increasing of maximum oxygen consumption showed significant positive correlation (r = 0.65), and a significant negative correlation (r = 0.65) was observed between urine MHPG sulfate and Hamilton Rating Scale for Depression (Ham-D) score. CONCLUSION: Aerobics training in exhilarating environments shows desirable influence over reduction of depression. This reduction of depression is correlated with MHPG sulfate elevation.

Depressão em mulheres climatéricas: análise de mulheres atendidas ambulatorialmente em um hospital universitário no Maranhão / Depression in climacteric women: analysis of a sample receiving care at a university hospital in Maranhão, Brazil

Introdução: O climatério, período de transição entre a fase reprodutiva e não-reprodutiva, ocasiona mudanças biopsicossociais nas mulheres que o vivenciam. A associação entre a maior prevalência de depressão nesse período é, no entanto, ainda controversa. O objetivo deste estudo foi avaliar a prevalência de depressão em mulheres climatéricas atendidas em um hospital universitário numa cidade da Região Nordeste do Brasil e identificar fatores associados. Método: Foi realizado um estudo prospectivo e analítico de 70 mulheres climatéricas. O diagnóstico de depressão foi dado segundo critérios diagnósticos da Classificação Internacional de Doenças em um período de seguimento mínimo de 3 meses. Foram investigadas as seguintes variáveis: escolaridade, situação conjugal, renda pessoal, gravidade da depressão segundo escala de Hamilton, presença e intensidade de sintomas climatéricos, menopausa (natural ou cirúrgica), dependência econômica do parceiro, antecedentes familiares de depressão, história prévia de depressão pós-parto, episódios depressivos e transtorno disfórico pré-menstrual, alterações da função sexual e visão positiva ou negativa da menopausa. Resultados: Um percentual de 34,3 por cento das pacientes apresentou depressão, sendo 70,8 por cento destas na categoria leve da escala de Hamilton. Não houve associação estatisticamente significante entre variáveis socioeconômicas, diminuição da libido e antecedentes familiares de depressão com a presença de depressão. Houve associação entre a presença de depressão e pacientes com sintomas vasomotores (p = 0,03), insônia (p < 0,001), menopausa (p = 0,05), com histórico de depressão pós-parto (p = 0,04) e transtorno disfórico pré-menstrual (p = 0,05) e visão negativa da menopausa (p = 0,001). Conclusões: Foi encontrada uma alta prevalência de depressão nas pacientes estudadas. Múltiplos fatores (impacto da menopausa, antecedentes psiquiátricos e visão pessoal sobre a menopausa) foram associados ...

Introduction: The climacteric is a transition period between reproductive and non-reproductive ages that leads to biopsychossocial changes in women who experience it. However, association between a larger prevalence of depression in this period is still controversial. The objective of this study was to assess the prevalence of depression in climacteric women receiving care at a university hospital in a Northeastern Brazilian municipality and to identify associated factors. Method: A prospective, analytic study of 70 climacteric women was performed. Diagnosis of depression was performed according to the International Classification of Diseases diagnostic criteria through a minimal 3-month follow-up period. The following variables were investigated: educational level, marital status, personal income, Hamilton Depression Rating Scale, presence and intensity of climacteric symptoms, menopause (natural or surgical), financial dependence on the partner, family history of depression, previous history of postpartum depression, depressive episodes, premenstrual dysphoric disorder, sexual function disorders, and positive or negative attitudes toward menopause. Results: A percentage of 34.3 percent of the patients had depression, and 70.8 percent were classified as mild intensity according to Hamilton scale. There was no statistically significant association between socioeconomic variables, reduced sex drive and family history of depression and presence of depression. Conversely, presence of vasomotor symptoms (p = 0.03), insomnia (p < 0.001), menopause (p = 0.05), history of postpartum depression (p = 0.04), premenstrual dysphoric disorder (p = 0.05), and negative attitude toward menopause (p = 0.001) were statistically associated with depression. Conclusions: There was a high prevalence of depression in assessed women. Multiple factors (impact of menopause, psychiatric history and personal impressions of menopause) are responsible for its occurrence.