Independent risk factors for depression in older adult patients receiving peritoneal dialysis for chronic kidney disease

BACKGROUND According to the trend of global population aging,the proportion of elderly patients with chronic kidney disease(CKD)is expected to increase.However,there are more than 20 million people in China with decompensated kidney function,of which 19.25%are elderly people.Therefore,special attention should be paid to the education years,sleep quality,anxiety status,comorbidities with diabetes,cardiovascular disease(CVD),and anemia as independent risk factors for depression in elderly CKD patients.This study explores the clinical management of elderly CKD patients that should address these risk factors to prevent depression and improve their prognosis.AIM To investigate depression risk factors in older patients receiving peritoneal dialysis,aiding future prevention of depression in these patients.METHODS This retrospective study included a primary study population of 170 patients with CKD who received peritoneal dialysis from January 2020 to December 2022.We assessed the patients’mental status using the Beck Depression Inventory Score-II(BDI-II),Self-Rating Anxiety Scale(SAS),Anxiety Inventory Score,and the Pittsburgh Sleep Quality Index(PSQI).Logistic regression was employed to identify depression independent risk factors among these patients.RESULTS The non-depressed group had a significantly longer education period than the depressed group(P<0.05).The depressed group exhibited significantly higher mental status scores than the non-depressed group(P<0.001).Patients with diabetes mellitus(DM)or CVD had a higher probability of developing depression.Patients with depression had significantly lower hemoglobin and albumin levels than patients without depression(P<0.05).Spearman correlation analysis of BDI-II scale scores,measuring depression,indicated positive correlations with BDI-II and SAS scores as risk factors for depression in patients with CKD.In contrast,years of education,hemoglobin levels,and peritoneal Kt/V were negatively correlated,serving as protective factors against depression.An analysis of variance for influences with significant differences in the univariate analysis revealed that years of schooling,BDI-II,SAS,PSQI,DM,CVD,and hemoglobin levels independently influenced depression in older patients with CKD.CONCLUSION Education,BDI-II,SAS,PSQI,DM,and CVD are independent risk factors for depression in older patients with CKD;therefore,post-treatment psychological monitoring of high-risk patients is crucial to prevent depression.

Depression among medical students in Tunisia:Prevalence and associated factors

BACKGROUND Medical school is known for its lengthy process,which is both physically and emotionally draining.Students’mental balance would shrink as they progress in their medical training.A systematic review and meta-analysis reported that the prevalence of depressive symptoms among medical students remained relatively constant at 27.2%.AIM To assess the prevalence of depressive symptoms among Tunisian medical students and evaluate its associated factors.METHODS This is a descriptive cross-sectional study that was carried out in the second semester of the academic year 2017/2018,between April 2018 and July 2018 among 1138 medical students.Data were collected using a socio-demographic questionnaire and the Beck Depression Inventory-II(BDI-II).RESULTS Sixty-four percent(n=728)of the participants had depressive symptoms,of which 266(23.4%)met the criteria for mild,271(23.8%)for moderate,and 191(16.8%)for severe depressive symptoms.Female gender,low socio-economic level,smoking habits and history of mental disorder,performing leisure and physical activities,satisfaction toward a career choice,and happiness perception were the main prognostic factors for depression among medical students.Although academic grades may not be considered a prognostic factor,final-year students appeared to be less depressive than their colleagues.CONCLUSION These findings give insight into mental health issues and comorbidities among Tunisian medical students.It is a hopeful request for decision-makers and academic authorities to set serious measures and draw effective interventions to minimize the currency of psychological distress among this subpopulation.

Association of erectile dysfunction with depression in patients with chronic viral hepatitis

AIM: To investigate the prevalence of erectile dysfunction(ED) and its association with depression in patients with chronic viral hepatitis.METHODS: This single center cross-sectional study was conducted from August 2013 through January 2014. All outpatients with chronic viral hepatitis in our liver clinic between 18 and 80 years of age were considered eligible for this study. The exclusion criteria included well-established causes of ED, such as diabetes, hypertension, hyperlipidemia, alcohol abuse, liver cirrhosis, ischemic heart disease, renal disease, neurologic disease, and malignancy. We also excluded the patients who had incompletely answered the questionnaires. ED was assessed using the validated Korean version of the International Index of Erectile Function(IIEF-5) scale. The Korean version of the self-administered Beck Depression Inventory(BDI) scale was used to assess depression in the patients. Demographic and medical data were obtained from the patients' medical records. Current or past history of psychiatric diagnosis and drug history including the use of an antiviral agent and an antidepressant were also recorded. RESULTS: A total of 727 patients met the initial eligibility criteria. Six hundred seventeen patients were excluded because their medical records contained one or more of the previously determined exclusion criteria. The remaining 110 patients were assessed based on the BDI and IIEF-5 questionnaires. Based on the IIEF-5 scale, the prevalence of ED among patients with chronic viral hepatitis was 40%. Compared with the non-ED group, patients in the ED group were older. The proportion of patients in the ED group who had a job or who were na?ve peg-interferon users was lower than that in patients in the non-ED group. Patients with ED had significantly lower scores on the IIEF-5 scale than patients without ED(11.75 ± 4.88 vs 21.33 ± 1.86, P = 0.000). Patients with ED rated significantly higher scores on the BDI scale compared with patients without ED(12.59 ± 7.08 vs 5.30 ± 4.00, P = 0.000). Also, the IIEF-5 scores were negatively correlated with age, employment, and BDI scores. In the multiple logistic regression analysis, age and depression were independently associated with erectile dysfunction(P =0.019 and 0.000,respectively).CONCLUSION:Patients with chronic viral hepatitis have a high prevalence of ED.Age and depression are independent factors for ED in male patients with chronic viral hepatitis.

Effects of aquatic exercise on depression and anxiety in ischemic stroke subjects

Background: Stroke ranks third and is the leading cause of permanent disability in western countries. Furthermore there are no treatments for the psychosocial effects of this pathology. Purpose: Analyse the effect of an aquatic exercise program in depression and trace and state anxiety in subjects who suffered an ischemic stroke. Methods: Two groups were analyzed: experimental group (EG) n = 15, 50.3 ± 9.1 years;control group (CG) n = 13, 52.5 ± 7.7 years. EG underwent a 12-week aquatic exercise program. Both groups were evaluated in pre and post- treatment using Beck Depression Inventory (BDI) and Trace State Anxiety Inventory (IDATE). Wilcoxon signed-rank and Mann-Whitney tests were used to compare moments and groups, respec- tively. Results: The BDI scores of aquatic activities were: pre-treatment, 17.4 ± 7.7 and 16.9 ± 8.6 for the EG and CG, respectively;post-treat- ment, 13.2 + 7.1 and 16.4 + 7.9 for the EG and CG, respectively. The IDATE scores for anxiety trace in strength training were: pre-treatment, 43.2 + 12.5 and 42.9 + 12.2 for the EG and CG, respec- tively;post-treatment, 39.7 + 7.1 and 42.6 + 12.1 for the EG and CG, respectively. The IDATE scores for anxiety state in strength training were: pre-treatment, 46.9 + 7.6 and 47.4 + 8.1 for the EG and CG, respectively;post-treatment, 44.4 + 7.9 and 47.5 + 8.0 for the EG and CG, respectively. Significant differences were found in pre and post-treatment values in the EG and between groups in the depression and trace and state anxiety levels in post-treatment (p Conclusions: Aquatic physical activity contributes to an improvement of the levels of depression and anxiety in people who suffered a stroke.

Effect of Depression on Hypertension among Turkish Individuals Aged 30 and over Years

Background: It is well known that depression is effective upon the occurrence of hypertension. The aim was to determine the prevalence of depression in the population aged 30 years old and over, and its impact on hypertension. Methods: This study is a cross-sectional study conducted on people aged 30 years and over between Sep., 1st and Oct., 30th 2009 in a region of western Turkey, Eskisehir. The questionnaire included the information about the subjects’ sociodemographic characteristics and the Beck Depression Inventory (BDI) used to determine those who were at the risk of depression. The data were analyzed using Student’s t test, Chi-square test and Logistic regression analysis. A value of p < 0.05 was considered statistically significant. Results: According to the Logistic analysis, older age (OR = 16.050), adding extra salt to meals (OR = 2.079), obesity (OR = 2.170) and family history of hypertension (OR = 2.139) were the important risk factors for hypertension (p < 0.05 for each one). It was determined that there was a positive connection between the scores received from the BDI and systolic and diastolic BP values [(rs = 0.151;p < 0.001) and (rs = 0.146;p < 0.001)], respectively. Conclusion: According to the above results, we may conclude that depression is effective upon the occurrence of hypertension.

The Relationship between Depression and Severe Obesity: A Case-Control Study

Objectives: This study investigated the relationship between depression and obesity in severely obese retired individuals using the case-control method. Methods: The subject group consisted of 112 individuals receiving a permanent disability pension primarily due to obesity. The prevalence of depression was measured with a personal psychiatric interview and the Beck Depression Inventory (21). Male and female controls were selected separately, with five controls for male subjects and three controls for female subjects. The controls were matched with the subjects according to place of residence, age, time that pension was granted, and occupation. The statistical analyses included χ2 tests, means, t-tests for paired variables, a conditional logistic linear model, correlation coefficients and the percent distributions. Results: Depression was diagnosed more often in the subject group than in the control group according to the psychiatric interview. Based on the conditional logistic linear model, individuals with severe obesity had a higher risk of depression than those in the control group. The most common disturbance was chronic depression in both groups. Additionally, there were significant findings regarding the outcome of depression for every classification in the psychiatric interview. According to the Beck Depression Inventory, depression was more common in subjects than in controls. However, slight depression was most common in the study group. Seven percent of the subjects had masked depression. The questions on the Beck Depression Inventory that measure irritability, indecisiveness, body image and ability to work were nearly significant. Regarding weight changes, the Beck Depression Inventory questions on both weight loss (p = 0.014) and weight gain (p = 0.017) were statistically significant. In the study group, individuals with BMI over 40 kg/m2 gained the most weight;however, weight loss was very low overall. Regarding changes in appetite, the majority of the study group responded that they had a poorer appetite than previously. Conclusion: This research is essential and provides information on groups that have not been previously examined. The findings from this study can be utilized to improve the care and understanding of individuals with severe obesity.

Beck 抑郁量表的信度和效度

本实验以335名被试检查了 Beck 抑郁量表的信度和效度。被试分为三组:正常组(268人),抑郁症及抑郁性神经症组(38人),其他神经症组(29人)。结果显示:该量表的分半信度为0.879,Cronbach 的 α系数为0.890;量表总体和量表的各个条目组都有较好的效度。实验还为中国被试在 Beck 抑郁量表上的得分的标准化解释提供了参照数据。

Beck抑郁问卷的评价及抑郁与学习成绩的关系

目的 评价Beck抑郁问卷 (BDI)的心理测量特性。方法 使用BDI测定了 1 2 77例医学生和 3 2 0例教育学院学生 ,分析BDI的信度和效度。结果 量表的Cronbach’sα系数 ,医学院样本为 0 .82 0 ,教育学院样本为 0 .82 4。 1 41例医学生重复测试 ,BDI总分重测相关系数为 0 .775。 3 1 8例课程相同的医学生在校学习成绩与BDI总分呈负相关。因子分析显示医学院样本与教育学院样本因子结构明显不同。结论 BDI中译本总体稳定 ,但结构效度欠理想 ,在使用中应引起注意。

Beck抑郁问卷在灾区教师中的试用及评价

为评价Beck抑郁问卷(BDI)的心理测量特性.使用BDI测定了750名灾区教师,分析BDI的信度和效度.结果表明所有题项对被试的抑郁程度均有良好的鉴别力,量表的Cronbach’sα系数为0.915,Spearman-Brown分半信度系数为0.864.因子分析后共得到躯体障碍和抑郁情绪两大因子,与心理学中对抑郁的定义较为一致.但罪感(E)、自责(H)、痛哭(J)、体重减轻(S)等4个条目在两个因子上的载荷差值均小于0.2,表明量表的结构效度欠佳.抑郁总分与总体幸福感各个维度及总分均存在显著的负相关(r=-0.416～-0.577,P<0.001),表明BDI量表具有较好的校标效度;BDI中译本总体稳定,但结构效度欠理想,在使用中应引起注意.

济宁医学院学生精神抑郁症现状调查

目的 :了解医科类大学生抑郁症状流行情况。方法 :采用现况研究方法 ,对 1 4 1 4名某高等医学院的大学生进行Beck抑郁自评问卷 (BDI- 1 3)调查。结果 :该组医学生BDI- 1 3问卷总计分平均值 (x±s)为 6 .0 0 2 1± 4 .681 6 ,抑郁症状总流行率为 54 .2 4 % ,轻度、中度和严重抑郁症状流行率分别为 2 2 .91 %、2 6 .80 %和 4 .53 %。结论 :应重视大学生精神卫生和心理保健工作。

110例海洛因依赖者抑郁情况分析

目的:了解海洛因依赖者在强制戒毒期间的抑郁情况、抑郁程度并分析出现抑郁的原因。方法:采用Beck抑郁自评问卷,对在本院2 0 0 3年3月期间住院的病人中随机抽取的110例符合DSM -IV阿片类依赖诊断标准的海洛因依赖者进行抑郁症状的调查评定。结果:抑郁症状的出现率为87. 3% ,其中轻度抑郁占被调查者的8 .2 % ,中度抑郁占38 .2 % ,重度抑郁占4 1 .8%。抑郁程度与住院时间及婚姻呈显著正相关,与文化程度呈显著负相关。结论:被强制戒毒的海洛因依赖者中抑郁症状的出现率非常高,抑郁程度与住院时间、婚姻状况、文化程度有显著相关性。

1597名大学生抑郁的流行病学调查

目的 调查大学生中抑郁的流行情况。方法 采用横断面调查方法，使用Ｂｅｃｋ 抑郁问卷（ＢＤＩ）调查了两所大学的１５９７名在校大学生。结果 大学生ＢＤＩ平均总分（均数±标准差）为９．８８±７．３５；年龄、性别、学校对某些抑郁症状有一定影响；轻度抑郁流行率为４２．１％ ，重度抑郁流行率为２．１％ 。结论 大学生中抑郁症状较为普遍存在，多为轻度或中度抑郁，少数症状较为严重；大学生心理保健工作应引起重视。

综合心理健康教育对劳动密集型企业产业工人抑郁早期识别的干预效果

目的:了解综合心理健康教育对劳动密集型企业产业工人抑郁早期识别的干预效果,以便在更多的劳动密集型企业推广,提高工人抑郁早期识别能力及总体心理健康水平。方法:选取深圳有代表性的某劳动密集型企业的A、B两个厂区分别作为综合心理健康教育干预产区和非干预产区,然后利用抽签法从A厂区的9个车间中抽取1个车间作为综合心理健康教育干预组(简称干预组),从B厂区的9个车间中抽取1个车间作为非干预对照组。干预组接受为期6个月,每月至少1项干预措施的综合心理健康教育,对照组按照常规管理。用自编的心理健康教育需求状况调查表、贝克抑郁量表(BDI)和定性访谈评价干预效果。干预前后共脱落653人,故采用符合方案(PP集)和意向性分析(ITT集)比较干预效果。结果:PP集中,干预组干预后的抑郁早期识别关键信息知晓率高于干预前(83.5%vs.50.5%,P<0.01),对照组干预前后差异无统计学意义(32.8%vs.42.6%,P>0.05);两组的自报抑郁情绪阳性率干预前后差异均无统计学意义(干预组21.8%vs.13.8%,P>0.05;对照组31.9%vs.16.7%,P>0.05)。ITT集中,两组的抑郁早期识别关键知识知晓率干预前后差异均无统计学意义(干预组:46.8%vs.50.6%,P>0.05;对照组:49.1%vs.47.1%,P>0.05);两组的自报抑郁情绪阳性率干预前后均无统计学意义(干预组:25.4%vs.22.4%,P>0.05;对照组:33.6%vs.29.8%,P>0.05)。定性访谈显示,综合心理健康教育可能提高工人的总体心理健康水平。结论:本研究表明,综合心理健康教育能有效提高劳动密集型企业产业工人对抑郁早期识别关键信息的知晓率及总体心理健康水平。

自愿和劳教戒毒中海洛因依赖者抑郁发病情况的调查分析

目的:调查自愿和劳教戒毒中海洛因依赖者伴发抑郁症状的情况,并分析两种不同戒毒模式对抑郁症状的影响。方法:采用Beck抑郁自评问卷(BDI-13),对自愿戒毒423例、劳教戒毒108例(共531例)海洛因依赖者进行调查分析,并将自愿戒毒和劳教戒毒者的检测结果进行比较。结果:531例海洛因依赖者中,伴有抑郁症状的488例,占被调查者的91.9%;自愿戒毒机构和劳教戒毒机构中分别有91.25%(386/423)和94.44%(102/108)伴有抑郁症状;轻度抑郁者分别占13.7%(58/423)和5.6%(6/108),中度抑郁分别占35.7%(151/423)和35.2%(38/108),重度抑郁分别占41.8%(177/423)和53.7%(58/108)。自愿与劳教两种戒毒模式中抑郁症状的发病与严重程度的比较差异有统计学意义(χ2=8.57,P<0.05)。婚姻状况与抑郁程度无显著相关性,但离异者中抑郁程度较重。结论:海洛因依赖者中抑郁症状发生率较高,呈中、重度程度,离异者中抑郁程度较重,劳教戒毒者的抑郁症状更明显。

抑郁体验问卷(DEQ)的信度和效度研究

目的:探讨抑郁体验问卷(DEQ)的信度和效度。方法:采用抑郁体验问卷(DEQ)和Beck抑郁问卷(BDI)对356名被试进行测试。结果:内部一致性信度在0.81以上,重测信度在0.79以上,分半信度0.98;因子分析呈现三因子结构:依赖性、自我批评性和有效性因子,有22个条目的因子负荷不理想;依赖性和自我批评得分均与BDI的得分显著正相关;抑郁症患者在DEQ各因子上的得分与其它组相比有极显著的差异。结论:DEQ的信度和效度是满意的,但有必要对条目进一步研究。

急性心肌梗死合并抑郁情绪患者治疗依从性分析

目的：明确合并抑郁状态是否影响心肌梗死患者对改善其预后的医疗干预的顺应性.方法：入选我院2004-03/2007-02因急性心肌梗死住院的病例,在住院期间进行宣教,建议所有患者7~10项医疗干预措施,在心肌梗死后3~5 d使用Beck抑郁自评量表（BDI）的13项版本评估患者是否合并抑郁状态及其程度.对出院后存活的患者在急性心肌梗死后6 mo（n=132,男性78例）进行门诊或电话随访,使用治疗结果特异依从性研究积分（MOSSAS）的评分,让患者对7~10项医疗干预措施的坚持情况进行自我评分.结果：住院期间合并至少轻-中度抑郁状态的心肌梗死患者[BDI≥5,n=27（20.5%）]在随访期间能够坚持低脂饮食、缓减压力、按医嘱服药和获得社会支持的较少.而合并抑郁状态的糖尿病患者在饮食控制方面也较无抑郁状态的糖尿病患者差.结论：AMI后合并抑郁状态的患者对有利于改善预后的医疗干预的依从性较差.此结果可部分解释住院期间合并抑郁状态的心肌梗死患者的远期预后较差.

2型糖尿病患者认知功能障碍与贝克认知疗法的应用

目的了解2型糖尿病患者的认知功能障碍,探索在2型糖尿病患者中运用贝克认知疗法的可行性.方法应用SCL—90、BDI和BAI对32例符合条件并自愿入组的2型糖尿病患者进行心理评估,运用贝克认知方法对患者进行言语盘诘,揭示其潜在的功能失调性认知结构,并在抗糖尿病常规药物治疗基础上应用贝克认知疗法.结果2型糖尿病患者存在认知功能障碍,表现为以对疾病的认识为基础的消极的负性的自动思维,经过8次贝克认知治疗,患者的认知曲解得到纠正,情绪明显改善.结论2型糖尿病患者存在认知功能障碍,是贝克认知疗法的适应症.

健身气功.五禽戏干预大学生轻度抑郁症的效果评价

目的探讨健身气功.五禽戏干预大学生轻度抑郁症的效果,为抑郁症的防治提供参考。方法选择符合轻度抑郁诊断标准的大学生60例为研究对象,按照配对原则分为健身气功.五禽戏干预组（E）和对照组（C）,每组30人。其中E组进行健身气功.五禽戏每周3次,每次3-4遍,时间40-60 min,连续训练12周,对照组不进行训练。观察健身气功.五禽戏干预前后两组的BECK抑郁自评量问卷（BDI）和汉密尔顿量抑郁表（HRSD）得分变化。结果健身气功.五禽戏干预12周后,E组BDI、HRSD得分均显著低于干预前,差异有统计学意义（P〈0.01）,与对照组12周后相比,T组BDI、HRSD得分均显著降低,差异有统计学意义（P〈0.01）。结论健身气功.五禽戏对大学生轻度抑郁症的改善有一定效果,值得研究。

悲伤情绪人群立冬节气表现特点分析

目的探索非疾病悲伤情绪大学生立冬节气的躯体、情绪和人格表现特点及其相互的关联性,从中医角度讨论悲伤情绪的内在病机。方法运用自拟躯体健康状况调查问卷、贝克焦虑量表(Beck Anxiety Inventory,BAI)、贝克抑郁量表(Beck Depression Inventory,BDI)及艾森克人格问卷简式量表(Eysenck Personality Questionnaire-Revise Short Scale for Chinese,EPQ-RSC)作为测评工具,在立冬节气对中医院校大学生的悲伤情绪进行问卷调查。结果 308例被试者中,共有169例存在悲伤情绪。在躯体健康状况调查问卷的躯体总分、精神情绪总分,BAI评分,BDI评分,以及EPQ-RSC的多个因子方面,男性和女性悲伤被试者与不悲伤者比较,差异均具有统计学意义(P<0.05,或P<0.01)。169例悲伤被试者中,出现频率大于50%的躯体不适条目有口干、头部不适、疲乏无力、怕冷、咽部不适和善太息;有3%的被试者存在焦虑情绪,21.3%的被试者存在抑郁情绪,悲伤者合并有注意力下降、郁闷和烦躁等精神情绪失调。女性悲伤被试者EPQ-RSC量表的P、N因子评分显著高于不悲伤者,L因子评分显著低于不悲伤者;男性悲伤被试者EPQRSC量表的E因子评分显著低于不悲伤者(P<0.01)。经Pearson相关分析发现,悲伤情绪评分与BAI、BDI及躯体健康亚量表的一些条目评分存在显著相关性。结论悲伤情绪者具有一定程度的躯体不适,合并有较多的情绪失调,人格特质具有性别差异性。悲伤情绪者的病机为肝郁脾虚、胃脘气滞、气机失调。

“积极心理学”对高职在校生心理干预的意义与实践

积极心理学作为心理学领域中新近发展的一门学科,其实质是研究那些发生在正常生活轨道上的事件。将积极心理学引入高职院校心理健康教育,其意义在于高校心理健康教育工作不再仅仅针对"问题学生",而是通过挖掘与引导学生群体与个体潜在的正面的能量来达到解决心理问题的目的。而且通过中长期危机检验验证,其干预效果与传统心理学干预相比较有着较为明显的效果,为高职心理健康教育提供了新的工作思路。