Cerebral arterial blood flow,attention,and executive and cognitive functions in depressed patients after acute hypertensive cerebral hemorrhage

BACKGROUND Intracerebral hemorrhage mainly occurs in middle-aged and elderly patients with hypertension,and surgery is currently the main treatment for hypertensive cerebral hemorrhage,but the bleeding caused by surgery will cause damage to the patient's nerve cells,resulting in cognitive and motor dysfunction,resulting in a decline in the patient's quality of life.AIM To investigate associations between cerebral arterial blood flow and executive and cognitive functions in depressed patients after acute hypertensive cerebral hemorrhage.METHODS Eighty-nine patients with depression after acute hypertensive cerebral hemorrhage who were admitted to our hospital between January 2019 and July 2021 were selected as the observation group,while 100 patients without depression who had acute hypertensive cerebral hemorrhage were selected as the control group.The attention span of the patients was assessed using the Paddle Pin Test while executive function was assessed using the Wisconsin Card Sorting Test(WCST)and cognitive function was assessed using the Montreal Cognitive Assessment Scale(MoCA).The Hamilton Depression Rating Scale(HAMD-24)was used to evaluate the severity of depression of involved patients.Cerebral arterial blood flow was measured in both groups.RESULTS The MoCA score,net scores I,II,III,IV,and the total net score of the scratch test in the observation group were significantly lower than those in the control group(P<0.05).Concurrently,the total number of responses,number of incorrect responses,number of persistent errors,and number of completed responses of the first classification in the WCST test were significantly higher in the observation group than those in the control group(P<0.05).Blood flow in the basilar artery,left middle cerebral artery,right middle cerebral artery,left anterior cerebral artery,and right anterior cerebral artery was significantly lower in the observation group than in the control group(P<0.05).The basilar artery,left middle cerebral artery,right middle cerebral artery,left anterior cerebral artery,and right anterior cerebral artery were positively correlated with the net and total net scores of each part of the Paddle Pin test and the MoCA score(P<0.05),and negatively correlated with each part of the WCST test(P<0.05).In the observation group,the post-treatment improvement was more prominent in the Paddle Pin test,WCST test,HAMD-24 score,and MoCA score compared with those in the pre-treatment period(P<0.05).Blood flow in the basilar artery,left middle cerebral artery,right middle cerebral artery,left anterior cerebral artery,and right anterior cerebral artery significantly improved in the observation group after treatment(P<0.05).CONCLUSION Impaired attention,and executive and cognitive functions are correlated with cerebral artery blood flow in patients with depression after acute hypertensive cerebral hemorrhage and warrant further study.

Problem-solving model guided by stimulus-organism-response theory:State of mind and coping styles of depressed mothers after cesarean delivery

BACKGROUND The use of a problem-solving model guided by stimulus-organism-response(SOR)theory for women with postpartum depression after cesarean delivery may inform nursing interventions for women with postpartum depression.AIM To explore the state of mind and coping style of women with depression after cesarean delivery guided by SOR theory.METHODS Eighty postpartum depressed women with cesarean delivery admitted to the hospital between January 2022 and October 2023 were selected and divided into two groups of 40 cases each,according to the random number table method.In the control group,the observation group adopted the problem-solving nursing model under SOR theory.The two groups were consecutively intervened for 12 weeks,and the state of mind,coping styles,and degree of post-partum depression were analyzed at the end of the intervention.RESULTS The Edinburgh Postnatal Depression Scale and Hamilton Depression Scale-24-item scores of the observation group were lower than in the control group after care,and the level of improvement in the state of mind was higher than that of the control group(P<0.05).The level of coping with illness in the observation group after care(26.48±3.35)was higher than that in the control group(21.73±3.20),and the level of avoidance(12.04±2.68)and submission(8.14±1.15)was lower than that in the control group(15.75±2.69 and 9.95±1.20),with significant differences(P<0.05).CONCLUSION Adopting the problem-solving nursing model using SOR theory for postpartum depressed mothers after cesarean delivery reduced maternal depression,improved their state of mind,and coping level with illness.

A Comparison of Clinical Features of Depressed and Non-Depressed People Living with HIV/AIDS, in Nigeria, West Africa

Objectives: Depressive disorders are a significant public health issue. They are prevalent, disabling, and often chronic, with a high economic burden to the society. Depressive illness is the most common psychiatric disorder in HIV/AIDS with prevalence 2 to 4 times higher than the general population. It’s still questionable whether HIV related depression is clinically different from sero-positive patients without depression. Studies comparing the clinical features of depressed and non-depressed People Living with HIV/AIDs are limited, hence the need for this study. Methods: This was a hospital based, cross sectional, descriptive study of three hundred adult HIV/AIDS patients attending the HIV clinic of Kwara State specialist hospital, Sobi, Ilorin. The PHQ-9 was administered to the respondents to screen for depression. A pre-tested PHQ-9 questionnaire was used to collect data. Subject who scored one and more were assessed clinically for depression. The three keys of social determinants of depression (SDS) were assessed and the association with depression sought. Results: One hundred and seventy (56.7%) satisfied the criteria for a depressive disorder using the PHQ-9 score. Compared to non-depressed sero-positive patients, depressed HIV patients were more likely to be female, single, unemployed, with below average year of schooling, low social economic status, low social cohesion and more stressful life events. They are more prone to hopelessness, thought of taking life and plan to commit suicide. Conclusion: These findings, show that the clinical and associated features of depression differ between depressed and non-depressed sero-positive subjects, thus requiring different management.

More anxious than depressed:prevalence and correlates in a 15-nation study of anxiety disorders in people with type 2 diabetes mellitus

Background Anxiety disorder, one of the highly disabling, prevalent and common mental disorders, is known to be more prevalent in persons with type 2 diabetes mellitus (T2DM) than the general population, and the comorbid presence of anxiety disorders is known to have an impact on the diabetes outcome and the quality of life. However, the information on the type of anxiety disorder and its prevalence in persons with T2DM is limited. Aims To assess the prevalence and correlates of anxiety disorder in people with type 2 diabetes in different countries. Methods People aged 18-65 years with diabetes and treated in outpatient settings were recruited in 15 countries and underwent a psychiatric interview with the Mini-International Neuropsychiatric Interview. Demographic and medical record data were collected. Results A total of 3170 people with type 2 diabetes (56.2% women;with mean (SD) duration of diabetes 10.01 (7.0) years) participated. The overall prevalence of anxiety disorders in type 2 diabetic persons was 18%;however, 2.8% of the study population had more than one type of anxiety disorder. The most prevalent anxiety disorders were generalised anxiety disorder (8.1%) and panic disorder (5.1%). Female gender, presence of diabetic complications, longer duration of diabetes and poorer glycaemic control (HbA1c levels) were significantly associated with comorbid anxiety disorder. A higher prevalence of anxiety disorders was observed in Ukraine, Saudi Arabia and Argentina with a lower prevalence in Bangladesh and India. Conclusions Our international study shows that people with type 2 diabetes have a high prevalence of anxiety disorders, especially women, those with diabetic complications, those with a longer duration of diabetes and poorer glycaemic control. Early identification and appropriate timely care of psychiatric problems of people with type 2 diabetes is warranted.

THE EFFECTS OF ELECTRO-ACUPUNCTURE VS. AMITRIPTYLINE ON PLATELET 3H-PAROXETINE BINDING SITES IN DEPRESSED PATIENTS

In this study platelet 3H-paroxetine binding site was studied in 16 depressed pa-tients and 16 healthy volunteers. We found that the mean Bmax of 3H-paroxetine binding on theplatelets of depressed patients was significantly lower than that of normal controls. After treated withamitriptyline or electro-acupuncture for 6 weeks, the density of paroxetine binding sites increased to-wards normal in well responded patients. But no significant difference was found between electro-acupuncture and amitriptyline as compared in their effects on 3H-paroxetine binding sites.

Congenital Depressed Skull Fracture Lifting with Suction Cup: A Therapeutic Alternative to Surgery

Congenital skull fractures of newborn are rare and create medico-legal problems. Their management is controversial. Between surgery considered too aggressive and uncertain conservative attitude, reduction by suction cup or breast pump is an alternative. The authors report their experience through a case of successful resolution of a congenital depressed skull fracture using a suction cup in a newborn at 13 day of life followed by a literature review. This technique avoids the usual complications of surgery and reduces the anxiety of parents related to surgery. It also avoids the anxiety of having a newborn with a recessed skull and a conservative attitude with uncertain outcome.

Congenital Depressed Skull Fracture Due to Maternal-Fetal Trauma

The fetal head trauma is rare and seen in pregnant road accidents and during extractive maneuvers during childbirth. We have reported a case of congenital depressed skull fracture due to an innocuous fall from her own height of a pregnant of 35 weeks of amenorrhea. The diagnosis was made at birth, by vaginal delivery, by the discovery of a left frontal depressed skull fracture without neurological disorder. A surgical lifting of the drepressed skull fracture was made at the 2nd day of life. Outcome was good marked by a normal psychomotor development.

The Depressed Image of Winesburg, Ohio

Winesburg Ohio is a famous short story in American literary history, through the study of this short story collection,the main and primary aim is to discuss social background of that certain time. People's social life in this story was in Midwest America, which represented the whole country at that period of time. For Winesburg as a microcosm: The so called grotesque figures of Winesburg were forced to meet and handle issues and events, which people universally undergo. Winesburg then became Any Town, USA and the flaws and struggles represented by these characters were same as be met by the ordinary people with the common human experience. Sherwood Anderson's motivation to write them was to show the typical human community to us.With analysis of three famous figures below to illustrate how depressed they were, and to indicate Anderson's great contribution to the American literature. Also what were readers' reactions to this masterpiece.

How to Help Your Depressed Friend

When your friend is depressed and retreating from life, how do you draw him out of his shell without getting him into an uncomfortable situation? It’s important to recognize that1is extremely common and, like any illness, deserves your compassion. One in six people will 2 depression sometime in his or her life, according to the American Psychiatric Association.

Mechanism of sodium sulfide on flotation of cyanide-depressed pyrite

The mechanism of sodium sulfide(Na2S)on the flotation of cyanide-depressed pyrite using potassium amyl xanthate(PAX)as collector was investigated by flotation test and electrochemical measurements.The flotation results show that both PAX and Na2S can promote the flotation recovery of cyanide-depressed pyrite and their combination can further improve the pyrite flotation recovery.Electrochemical measurements show that PAX and Na2S interacted with cyanide-depressed pyrite through different mechanisms.PAX competed with cyanide and was adsorbed on the pyrite surface in the form of dixanthogen,thus enhancing the hydrophobicity and flotation of cyanide-depressed pyrite.Unlike PAX,Na2S rendered the pyrite surface hydrophobic through the reduction of ferricyanide species and the formation of elemental sulfur S0 and polysulfide Sn2-.The combined application of PAX and Na2S induced superior pyrite flotation recovery because of a synergistic effect between PAX and Na2S.

Improvement in quality of life in depressed patients following verum acupuncture or electroacupuncture plus paroxetine:A randomized controlled study of 157 cases

Depressed patients with scores of 17 or more on the 17 items of the Hamilton Depression Rating Scale were treated with the antidepressant drug paroxetine. They also underwent verum acupuncture or electroacupuncture at Baihui （GV20） and Yintang （GV29）. The World Health Organization Quality of Life Scale Brief Version showed a significant increase in the total scores of patients who underwent verum acupuncture and electroacupuncture for 6 weeks compared with those who were given paroxetine only; significantly increased physical domain and social relationship scores in verum acupuncture patients compared with paroxetine only; and significantly elevated psychological domain scores with electroacupuncture compared with paroxetine only. These results indicate that both verum acupuncture and electroacupuncture can improve quality of life in depressed patients undergoing paroxetine treatment,

Burden, Health and Sense of Coherence among Relatives of Depressed Inpatients

In Europe, there are an increasing number of persons suffering from depression, which also affects many relatives. The burden and health when being the relative of an inpatient suffering from severe depression has been less examined. The aim of the study was to describe burden, health and sense of coherence among relatives of inpatients with severe depression. Furthermore, the aim was to investigate relatives’ burden in relation to their health and sense of coherence. A cross-sectional design was performed, with a questionnaire consisting of background questions and three instruments;Burden Assessment Scale, General Health Questionnaire and Sense of Coherence scale. The participants consisted of 68 relatives recruited from a sample of inpatients diagnosed with depression in the psychiatric specialist health services in one hospital trust in Norway. The Regional Committee for Medical and Health Research Ethics, Norway South East, gave approval to the study. The relatives reported burden to a various degree, with some reporting a significantly greater burden, poorer health and a weaker sense of coherence than others. With regard to subjective burden eight out of ten relatives reported “Worry about future”, and almost six out of ten were “Upset by change in patient”. Regarding objective burden, more than half the relatives reported having “Less time for friends” and “Reduced leisure time”. In conclusion the relatives with a high level of burden reported more mental distress, poorer health and weaker sense of coherence than those with lower level of burden. Further research should focus on identification of factors predicting burden and health of relatives of inpatients with severe depression.

Implementation Strategies for Improving the Care of Depressed Elderly Persons—Summary of an International Workshop

The aim of the study was to identify the most important research priorities as well as future strategies for promoting and implementing evidence-based care of depressed elderly persons. An interdisciplinary workshop was organized using a focus group format and the transcript of the discussion was interpreted by means of the qualitative content analysis. The most important research priorities for improving the care of depressed elderly persons, implementation levels, theoretical approaches as well as possible outcomes were analysed on individual consumer, healthcare system, and policy level. A wide range of theories and methods are necessary to identify and explain implementation processes and results. Qualitative and quantitative methodologies in combination with knowledge synthesis were discussed. In addition, the need to summarize the literature in terms of specific issues was emphasized. In conclusion, the implementation strategies for improving the care of depressed elderly persons should be addressed on three levels: individual consumer, healthcare system and policy. Although some aspects of the implementation model may need to be enhanced, the fact that it includes conditions on individual level, i.e. self-management support, is of importance. The expansion and maintenance of evidence-based care generate potential for change in mental healthcare, thus improving outcomes for individual elderly patients. Areas that require further research are organization, cost and leadership. The use of mixed methods could strengthen future studies. Implementation researchers need a broad repertoire in order to plan and perform evidence-based research. To improve practice, implementation strategies should be developed in clinical and community guidelines.

Contribution of attachment insecurity to health-related quality of life in depressed patients

AIM: To examine the individual contributions of insecure attachment styles and depression symptom severity to health-related quality of life(HRQo L) in patients diagnosed with adjustment disorder(AJD) with depressed mood. METHODS: Participants were 67 patients diagnosed with International Classification of Diseases, Tenth edition AJD with depressed mood, who completed standardised self-report questionnaires measuring study variables. Mean scores and SDs were computed for the outcome and predictor measures. Pearson correlations among the measures were computed. The study hypotheses were tested using analysis of variance(ANOVA) and multiple regression analyses. All analyses were performed using the SPSS-17 software package(SPSS Inc., Chicago, IL, United States).RESULTS: ANOVA showed a significant main effect of the insecure attachment styles on depression symptom severity and life satisfaction scores. The results suggestthat depressive symptoms were more severe(F = 4.13, df = 2.67, P < 0.05) and life satisfaction was poorer(F = 5.69, df = 2.67, P < 0.01) in both anxious-ambivalently and avoidantly attached patients compared with their securely attached counterparts, whereas the two insecure groups did not significantly differ by these variables. The anxious/ambivalent attachment style and depression symptom severity significantly contributed to HRQo L, accounting for 21.4% and 29.7% of the total variance, respectively [R2 = 0.79; Adjusted R2 = 0.77; F(5, 67) = 33.68, P < 0.0001], even after controlling for gender, marital and employment status confounders.CONCLUSION: The results show that the anxious/ambivalent attachment style together with depression symptom severity substantially and independently predict the HRQo L outcome in AJD with depressed mood.

Expert consensus statement on diagnosis and treatment of cancer-related depressed mood state based on Chinese medicine

This consensus statement is organized into six parts:1)Definitions:cancer-related depressed mood state is defined as a group of depressive symptoms,rather than major depressive disorder.Thus,“cancer-related depression”or“depressed mood state”is introduced as standard terminology and associated with the Chinese medicine concept of“yu zheng”(depression syndrome).2)Pathogenesis:factors including psychological stress,cancer pain,cancer fatigue,sleep disorders,surgery trauma,chemotherapy,and radiation therapy are strongly associated with cancer-related depressed mood state.Crucial elements of pathogenesis are cancer caused by depression,depression caused by cancer,and the concurrence of phlegm,dampness,and stasis from constrained liver-qi and spleen deficiency.3)Symptoms:these include core symptoms,psychological symptoms,and somatic symptoms.Depressed mood and loss of interest are the main criteria for diagnosis.4)Clinical evaluation:based on the Mini-International Neuropsychiatric Interview and a numeric rating scale,and taking mood changes during cancer diagnosis and treatment into consideration,a questionnaire can be drafted to distinguish between major depressive disorder and cancer-related depression.The aim is to assist oncology clinicians to identify,treat,and refer patients with cancer-related depression.5)Diagnosis:diagnosis should be based on the Chinese Classification for Mental Disorders(CCMD-3),taking patients’mood changes during diagnosis and treatment into consideration.6)Treatment:treatments for cancer-related depression must be performed concurrently with cancer treatment.For mild depression,non-pharmacologic comprehensive therapies,including psychological intervention,music therapy,patient education,physical activity,and acupuncture,are recommended;for moderate depression,classical Chinese herbal formulas based on syndrome pattern differentiation combined with antidepressants are suggested;for severe depressive symptoms that have progressed to major depressive disorder, patients should be referred to a psychiatric clinician for specialized care.

Comparison of Meta-Cognitive Beliefs with Regard to Depressed, Obsessive-Compulsive and Normal Individuals

The main purpose of the present study was to investigate and compare the meta-cognitive beliefs of three groups consisting of depressed, obsessive-compulsive and normal individuals. This expost facto study was carried out on 174 individuals (58 depressed, 58 obsessive-compulsive, and 58 normal). The depressed and obsessive-compulsive patients were selected from psychological clinics in central and southern Tehran using purposive sampling. The normal group was randomly selected from the staff of the related clinics. Participants completed three questionnaires including the Beck Depression Inventory-II (BDI-II), the Maudsley Obsessive-Compulsive Inventory (MOCI), and the Meta-CognitionsQuestionnaire-30 (MCQ-30). The MANOVA test was used to analyze the statistical data. There were significant differences between the mean scores with regard to the meta-cognitive beliefs in normal individuals and in patients with depression or obsessive-compulsive disorders. Furthermore, with regard to cognitive confidence and cognitive self-consciousness subscales, there were significant differences between depressed and obsessive-compulsive patients. The mean scores of these two subscales were higher in obsessive-compulsive patient, in comparison with depressed individuals. There was no significant difference between the depressed and obsessive-compulsive groups regarding the three subscales of positive beliefs about worry, uncontrollability and need to control thoughts.

Understanding and Improving Quality of Care in the Context of Depressed Elderly Persons Living in Norway

Effective leadership plays an important role in safe patient care. The aim of this paper was to understand and improve the implementation outcomes identified by empirical studies based on Proctors et al.’s key concepts, acceptability appropriateness, feasibility and fidelity, and to propose recommendations for further research. Methods: An interdisciplinary approach using mixed methods. Results: A total of twenty papers based on data from this interdisciplinary study have been published. Overall, our published empirical studies revealed that the CCM intervention had positive results due to staff members’ engagement to improve care, their awareness of the need for collaboration and willingness to assume responsibility for patient care. From the perspective of the depressed elderly persons the results of the research project indicated their need for support to increase self-management. In conclusion, an improved understanding of the implementation outcomes will have an impact on best practice for depressed elderly persons and dissemination purposes. Quality management and highly action-oriented involvement are necessary in implementation research. These will also affect the professional development of interdisciplinary teams as well as constitute a basis for further research on understanding and improving the care of depressed elderly individuals.

Suicidal Ideation among Depressed People Living with HIV/AIDS in Nigeria, West Africa

Objective: Transient suicide thoughts are common to some people throughout the course of HIV disease and often do not indicate significant risk of suicide. However, persistent suicidal thoughts with associated feelings of hopelessness and intent to die are very serious and must be assessed promptly and carefully. The aim of this study, therefore, was to examine the relationship between depression, hopelessness, psychosocial stressors and suicidal ideation in PLWHAs. Methods: This was a hospital based, cross sectional, descriptive study, of one hundred and seventy depressed adult HIV/AIDS patients of Kwara State Specialist Hospital, Ilorin. Depression and suicidal assessment were evaluated using the PHQ-9 scale. A score of >9 or any affirmative response to question 9 of the PHQ-9 scale necessitated suicidal risk assessment. The social determinant questionnaire was used to evaluate social cohesion and negative life events. Results: The prevalence of depression among the HIV/AID patient was 56.7%. Twenty nine (17.1%) were hopeless, twenty eight (16.5%) had at one time or the other thought of taking their lives, six (3.5%) had plan to take their lives. There was strong statistical association between depression, hopelessness (p-value = 0.000) thought of taking life (p-value = 0.000) and plan to take their lives (p-value = 0.030). Conclusion: The significant correlations between hopelessness, depression and suicidal ideation are important markers that should alert clinicians to underlying suicide risk in HIV-positive patients. In addition, low social cohesion and stressful life events were found to be risk factors for depression and suicide. Clinicians should routinely enquire about suicidality in PLWHAs to assist early diagnosis and intervention.

Depressed female cynomolgus monkeys(Macaca fascicularis) display a higher second-to-fourth(2D:4D)digit ratio

This research aimed to provide evidenee of a relationship between digit ratio and depression status in the cynomolgus monkey(Macaca fascicularis).In stable cyno molgus mon key social groups,we selected 15 depressed monkeys based on depressive-like behavioral criteria and 16 normal control mon keys.All animals were video recorded for two weeks,with the duration and frequency of the core depressive behaviors and 58 other behaviors in 12 behavioral categories then evaluated via behavioral analysis.Fin ger len gths from the right and left forelimb hands of both groups were measured by X-ray imagi ng.Fin ger length and digit ratio comparisons between the two groups were con ducted using Stude nt's Mest.In terms of the durati on of each behavior,signifies nt differences emerged in“Huddling”and five other behavioral categories,including Ingestive,Amicable,Parental,Locomotive,and Resting.In addition to the above five behavioral categories,we found that depressed mon keys spent less time in parental and rubbing back and forth behaviors than the control group.Furthermore,the 4th fin gers were significantly Ion ger in the left and right hands in the control group relative to the depressed mon keys.The sec ond?to?fourth(2D:4D)digit ratio in the left and right forelimb hands was significantly lower in the control group tha n that in the depressed group.Our fin dings revealed significant differences in finger lengths and digit ratios between depressed mon keys and healthy controls,which concords with our view that relatively high fetal testosterone exposure may be a protective factor against developing depressive symptoms(or that low fetal testosterone exposure is a risk factor).

The way early-onset chronically depressed patients are treated today makes me sad

The author has treated almost 400 chronically depressed outpatients during his career. He has also participated as a Field Trial Coordinator in the Unipolar Field Trials of DSM-IV and consulted with the DSM-V Mood Disorders Workgroup concerning his research for the new diagnostic nomenclature for the chronic depressions, Chronic Depression Disorder. In addition, he has served as Principal Investigator in several large clinical trials involving 2200 chronically depressed outpatients. The current paper is a Brief Report describing his negative reactions to the way 40 of his chronically depressed patients have been treated today by both Psychologists and Psychiatrists. All the patients are his patients and have been seen by him in psychotherapy over the past decade. Several reasons are proposed for the inadequate treatment and specific proposals are made for the improvement of treatment for the early-onset chronically depressed patient.