Effects of the Treatment of Carpal Tunnel Syndrome with Surgery and Injections on the Hospital Anxiety and Depression Scale (HADS)

Background: The prevalence of carpal tunnel syndrome (CTS) and of anxiety and depression in primary care practice are high. Different studies had shown an increased prevalence of anxiety and depression in CTS patients. Nevertheless, few papers had been published studying the anxiety and depression scales in the treatment of CTS, either with corticosteroid injections (I) or with surgical decompression (S). Objective: To assess whether clinical improvement observed after the treatment of CTS either with I or with S correlates with an improvement in the punctuations of the Hospital Anxiety and Depression scales (HADS), at 3, 6 and 12-month follow-up. Methods: Randomized and open-label clinical trial, comparing I and S. Patients with symptoms suggestive of CTS (nocturnal paraesthesias) of at least 3 months duration and neurophysiological confirmation were included. Patients with clinically apparent motor impairment were excluded. The subjective evaluation of symptoms was carried out using the visual-analogue scale of pain (VAS-p). Clinical reviews were performed 3, 6 and 12 months after treatment. Each patient completed the HADS questionnaire and a VAS-p at 0, 3, 6, and 12 months. Statistical significance was established using the Student’s t test and the Mann-Whitney U test when necessary. A linear regression analysis was used to know the effect of the treatment adjusted for the initial score of both scales. Results: 65 patients were included (30 in group I and 35 in group S). There was no statistical difference between both groups in terms of age, gender distribution, disease duration, VAS-p, neurophysiological testing severity of CTS or the 8 subscales of HADS. Both groups improved significantly in relation to the baseline VAS-p values, in the reviews at 3, 6 and 12 months, with no significant differences between I and S. At 6 months, the reduction in the anxiety scale was around 3 points for both treatments (S = 3.6 and I = 3.2), without reaching significant differences. At 12 months, it was somewhat higher for those treated with I, but always around 3 points and without significant differences. The Depression scale score was slightly reduced at 6 months, and in a similar way for both groups (I = 1 and S = 1.19;p = 0.8). After 12 months, group I doubled the previous reduction, with group S experiencing a very slight change (I = 1.96 and S = 1.03;p = 0.3). When analysing the effect of group S on group I, the result was a reduction of 0.25 points for Anxiety (p = 0.7) and of 0.02 points for Depression (p = 0.9). Conclusions: Treatment of CTS with I or S results in a similar and discrete improvement in Anxiety scores on the HADS scale at 6 and 12 months. For both types of treatment, the Depression scores barely changed at 6 months, being somewhat higher in group I after 12-month follow-up. The independent effect of the S on both scales is small and not significant.

Cronbach's a reliability, concurrent validity, and factorial structure of the Death Depression Scale in an Iranian hospital staff sample

Objective: Death depression is an important component in the process of death and dying. Death depression is the second element of death. Depression is one of the important features in death distress. The aim of this study was to explore the performance of the Farsi version of the Death Depression Scale with an Iranian convenience sample of nurses (n =106).Methods: Nurses were selected using a convenience sampling method, and completed the Death Depression Scale (DDS), Death Concern Scale (DCS), Collett-Lester Fear of Death Scale (CLFDS), Reasons for Death Fear Scale (RDFS), Templer's Death Anxiety Scale (DAS), and Death Obsession Scale (DOS). Results: The results of exploratory factor analysis on DDS identified 4 factors (56.16%of variance). Factor 1 labeled"Death sadness", Factor 2 labeled"Death finality/end and Death dread/fear", Factor 3 labeled"Death despair and Death depression", and Factor 4 labeled"Death loneliness". Cronbach's a coefficient was 0.84, Spearman-Brown coefficient 0.85, and Guttman Split-Half coefficient 0.81 The DDS correlated 0.40 with the DCS, 0.39 with the CLFDS, 0.50 with the DAS, 0.35 with the RDFS, and 0.44 with the DOS, indicating good construct and criterion-related validity. Concurrent validity for the DDS with the other scales were significant. Conclusions: The DDS has good validity and reliability, and it can use in clinical and research settings.

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 χ^(2) 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,χ^(2)=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-1β,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-1β,and IL-6),reduces suicidal thoughts,enhances sleep,and improves the quality of life of individuals with depression.

Risk of Adverse Perinatal Outcomes and Antenatal Depression Based on the Zung Self-Rating Depression Scale

Objective:The aim of the study is to investigate the relationship between antenatal depression and adverse perinatal outcomes.Methods:This prospective cohort study enrolled pregnant women between gestational ages of 12-20 weeks to complete the Chinese version of the Zung Self-Rating Depression Scale(SDS)and followed them for delivery from September 2015 to September 2016.Participants were classified into mild,moderate,and severe depression groups according to the SDS scores.Logistic regression was performed to assess the association between antenatal depression and perinatal outcomes including preterm birth(PTB),cesarean section use,hypertension disorders,gestational diabetes,and thyroid diseases during pregnancy.An age-stratified analysis was performed.Results:A total of 4,663 pregnant women were analyzed.As a result,13.8%,1.7%,and 0.2%of women were classified as mild,moderate,and severe depression,respectively.Severely depressed mothers were at higher risk for PTB(adjusted odds ratio[OR]=11.31,95%confidence interval[CI]2.13-60.03),especially spontaneous PTB.Moderate-depressed women were at higher risk for hyperthyroidism during pregnancy(adjusted OR=3.67,95%CI 1.10-12.27),while women with mild depression tended to choose cesarean sections(OR=1.24,95%CI=1.04-1.49).Age-stratified analysis indicated an elevated risk of adverse outcomes associated with depression in women aged<25 years,but the association was not significant.Conclusions:Antenatal depression was associated with PTB,hyperthyroidism,and cesarean use.Studies with large sample sizes should verify the relationship between PTB and antenatal depression to avoid casual events.

Narrative nursing for negative emotions in patients with acute pancreatitis:Based on model construction and application

BACKGROUND Acute pancreatitis(AP),as a common acute abdomen disease,has a high incidence rate worldwide and is often accompanied by severe complications.Negative emotions lead to increased secretion of stress hormones,elevated blood sugar levels,and enhanced insulin resistance,which in turn increases the risk of AP and significantly affects the patient's quality of life.Therefore,exploring the intervention effects of narrative nursing programs on the negative emotions of patients with AP is not only helpful in alleviating psychological stress and improving quality of life but also has significant implications for improving disease outcomes and prognosis.AIM To construct a narrative nursing model for negative emotions in patients with AP and verify its efficacy in application.METHODS Through Delphi expert consultation,a narrative nursing model for negative emotions in patients with AP was constructed.A non-randomized quasi-experimental study design was used in this study.A total of 92 patients with AP with negative emotions admitted to a tertiary hospital in Nantong City of Jiangsu Province,China from September 2022 to August 2023 were recruited by convenience sampling,among whom 46 patients admitted from September 2022 to February 2023 were included in the observation group,and 46 patients from March to August 2023 were selected as control group.The observation group received narrative nursing plan,while the control group was given with routine nursing.Self-rating anxiety scale(SAS),self-rating depression scale(SDS),positive and negative affect scale(PANAS),caring behavior scale,patient satisfaction scale and 36-item short form health survey questionnaire(SF-36)were used to evaluate their emotions,satisfaction and caring behaviors in the two groups on the day of discharge,1-and 3-month following discharge.RESULTS According to the inclusion and exclusion criteria,a total of 45 cases in the intervention group and 44 cases in the control group eventually recruited and completed in the study.On the day of discharge,the intervention group showed significantly lower scores of SAS,SDS and negative emotion(28.57±4.52 vs 17.4±4.44,P<0.001),whereas evidently higher outcomes in the positive emotion score,Caring behavior scale score and satisfaction score compared to the control group(P<0.05).Repeated measurement analysis of variance showed that significant between-group differences were found in time effect,inter-group effect and interaction effect of SAS and PANAS scores as well as in time effect and inter-group effect of SF-36 scores(P<0.05);the SF-36 scores of two groups at 3 months after discharge were higher than those at 1 month after discharge(P<0.05).CONCLUSION The application of narrative nursing protocols has demonstrated significant effectiveness in alleviating anxiety,ameliorating negative emotions,and enhancing satisfaction among patients with AP.

Evaluating Pharmacological and Rehabilitation Strategies for Effective Management of Bipolar Disorder: A Comprehensive Clinical Study

Bipolar disorder presents significant challenges in clinical management, characterized by recurrent episodes of depression and mania often accompanied by impairment in functioning. This study investigates the efficacy of pharmacological interventions and rehabilitation strategies to improve patient outcomes and quality of life. Utilizing a randomized controlled trial with multiple treatment arms, participants will receive pharmacotherapy, polypharmacotherapy, rehabilitation interventions, or combination treatments. Outcome measures will be assessed using standardized scales, including the Hamilton Depression Scale, Yale-Brown Obsessive Compulsive Scale (Y-BOCS), and Mania Scale. Preliminary data suggest improvements in symptom severity and functional outcomes with combination treatments. This research aims to inform clinical practice, guide treatment decisions, and ultimately enhance the quality of care for individuals living with bipolar disorder. Findings will be disseminated through peer-reviewed journals and scientific conferences to advance knowledge in this field.

Psychological Intervention for Postpartum Depression

Summary： The postpartum depression outcome and the effect of psychological intervention were studied in order to reduce the occurrence and development of the postpartum depression. A survey of 4000 women within 4-6 weeks postpartum in 80 communities in Shenzhen, China was performed using random cluster sampling method. By employing Edinburgh Postnatal Depression Scale （EPDS） as a screening tool, the positive women （defined as EPDS 〉10） were randomly divided into intervention group and control group at a ratio of 1：2. The women in the intervention group were treated by means of mailing postpartum depression prevention and treatment knowledge manual, face-to-face counseling, and telephone psychological counseling interventions aiming at individual risk factors, while those in the control group were treated with conventional methods. EPDS scores were assessed in these two groups again at 6th month postpartum. Totally, 3907 valid questionnaires were obtained. All the 771 positive women were divided into two groups： 257 in the intervention group, and 514 in the control group. At 6th month postpartum, the EPDS scores in the intervention group were decreased significantly, from baseline stage （12.84±3.02） to end stage （3.05±2.93）, while EPDS scores in the control group were reduced from 12.44±2.78 to 6.94±4.02. There were significant differences in the EPDS scores at end stage between the two groups （t=13.059, P〈0.001）. Psychological intervention can reduce postpartum depression, with better maternal compliance. It is feasible and necessary to establish postpartum depression screening and psychological intervention model in community-hospital and include the postpartum depression screening, intervention, and follow-up into the conventional healthcare.

Peripartum depression and its predictors:A longitudinal observational hospital-based study

BACKGROUND Depression is a common problem in women in childbearing years due to burdens of motherhood and building a family.Few studies estimate the prevalence of antepartum depression compared to those in the postpartum period.AIM To estimate the prevalence and the severities of peripartum depression and major depressive disorder and their predictors.METHODS This is a longitudinal observation study.It included 200 women scoring≥13 with the Edinburgh Postpartum Depression Scale,indicating presence of symptoms of depression.They had a gestational age of≥6 wk and did follow-ups until the 10^(th) week to 12^(th) weeks postpartum.Information of women's reactions to life circumstances and stressors during the current pregnancy were gathered from answers to questions of the designed unstructured clinical questionnaire.Severities of depression,anxiety,and parenting stress were determined by the Beck Depression Inventory,State-Trait Anxiety Inventory for Adults,and Parenting Stress Index-Short Form,respectively.Psychiatric interviewing was done to confirm the diagnosis of major depression.Measuring the levels of triiodothronine(T3),thyroxine(T4),and thyroid stimulating hormone(TSH)was done in both antepartum and postpartum periods.RESULTS Out of 968(mean age=27.35±6.42 years),20.66%(n=200)of the patients had clinically significant symptoms of depression and 7.44%had major depression.Previous premenstrual dysphoria,post-abortive depression,and depression unrelated to pregnancy and were reported in 43%,8%,and 4.5%of the patients,respectively.Psychosocial stressors were reported in 15.5%of the patients.Antepartum anxiety and parenting stress were reported in 90.5%and 65%of the patients,respectively.Postpartum T3,T4,and TSH levels did not significantly differ from reference values.Regression analysis showed that anxiety trait was a predictor for antepartum(standardized regression coefficients=0.514,t=8.507,P=0.001)and postpartum(standardized regression coefficients=0.573,t=0.040,P=0.041)depression.Antepartum depression(standardized regression coefficients=-0.086,t=-2.750,P=0.007),and parenting stress(standardized regression coefficients=0.080,t=14.34,P=0.0001)were also predictors for postpartum depression.CONCLUSION Results showed that 20.66%of the patients had clinically significant symptoms of depression and 7.44%had major depression.Anxiety was a predictor for antepartum and postpartum depression.Antepartum depression and parenting stress were also predictors for postpartum depression.

Prevalence of Depression in Pre-Dialytic Chronic Kidney Disease Patients Attending at a Tertiary Care Hospital in Bangladesh

Background: Depression is a common and serious medical illness around the world. It occurs more frequently in patients with chronic illness than in the general population. It is a common psychiatric problem in patients with chronic kidney disease (CKD). Objective: To assess the level of depression in pre-dialytic CKD patients attending at a tertiary care hospital in Bangladesh. Methodology: This cross sectional study was conducted at Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2020 to June 2020. A total of 100 pre-dialytic CKD patients were selected by convenience sampling technique and their level of depression was assessed by Zung Self-Rating Depression Scale (ZSDS). Data were collected by existing questionnaire with face to face interview and analyzed by statistical test. Results: The mean age of the participants was 49.70 ± 11.80 years. Among them 64% were male, 95% were muslim, 98% were married, 65% were completed secondary/above higher secondary level education, 65% were unemployed and 55% were lived in urban area. It was observed that 65% participants were economically dependent to their family, only 6% were engaged in regular exercise, 14% had family history of depression, 8% were smoker and 12% were alcohol/drug abuser. According to the Zung Self-Rating Depression Scale (ZSDS) we found 29% participants were mildly depressed, 39% participants were moderately depressed and 18% participants were severely depressed. Prevalence of depression was 86% in pre-dialytic CKD patients. Of them, 7% was in CKD stage-I, 17.4% was in CKD stage-II, 19.8% was in CKD stage-III, 22.1% was in CKD stage-IV and 33.7% was in CKD stage-V. Conclusion: Depression is highly prevalent in pre-dialytic CKD patients and more frequent in the advanced stages of CKD.

Predictive power of abnormal electroencephalogram for post-cerebral infarction depression

Electroencephalography is a sensitive indicator for measuring brain condition, and can reflect early changes in brain function and severity of cerebral ischemia. However, it is not yet known whether electroencephalography can predict development of post-cerebral infarc- tion depression. A total of 321 patients with ischemic stroke underwent electroencephalography and Hamilton Depression Rating Scale assessment to analyze the relationship between electroencephalography and post-cerebral infarction depression. Our results show that electroencephalograms of ischemic stroke patients with depression exhibit low-amplitude alpha activity and slow theta activity. In con- trast, electroencephalograms of ischemic stroke patients without depression show fast beta activity and slow delta activity. ＂Ihese findings confirm that low-amplitude alpha activity and slow theta activity can be considered as independent predictors for post-cerebral infarction depression.

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

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

One-year outcomes of resveratrol supplement with aflibercept versus aflibercept monotherapy in wet agerelated macular degeneration

AIM:To determine the one-year outcomes of resveratrol oral supplement in patients suffering from wet age-related macular degeneration(AMD).METHODS:Fifty naïve and previously untreated patients suffering from wet AMD,were randomly assigned in two subgroups of 25 patients each.All the participants were treated with 3 monthly intravitreal injections of 2.0 mg aflibercept(IAIs)followed by injections“according to need”,while in one group the patients also received daily two tablets of resveratrol oral supplement.Prior to treatment initiation,a complete ophthalmological examination,including best corrected visual acuity(BCVA)and contrast sensitivity evaluation,optical coherence tomography(OCT)scans,fundus autofluorescence(FAF),fluorescein angiography,indocyanine green angiography,and OCT angiography(OCTA),was performed to every participant,while all of them completed the Hospital Anxiety and Depression Scale(HADS)questionnaire,in order to assess their quality of life(QoL)status.The patients were assessed monthly for 1y with FAF,and OCT or OCTA;the main endpoints were the number IAIs,the changes in BCVA,in contrast sensitivity,and in patients’QoL status.RESULTS:No significant differences were present between the groups regarding the baseline demographic and clinical data.Over the 12-month period,a similar number of IAIs was applied in both groups(4.52±1.00 vs 4.28±0.90,P=0.38),while the rest of the clinical data also did not differ significantly after the completion of the study period.However,for HADS Depression(11.88±2.51 vs 8.28±1.54,P<0.001)and HADS Anxiety(11.92±2.52 vs 7.76±1.51,P<0.001)questionnaires values,the score was significantly better in patients who received resveratrol supplements.Moreover,a statistically significant difference was detected in the mean change from baseline values of contrast sensitivity(0.17±0.19 vs 0.35±0.24,P=0.005),HADS Depression(0.08±1.38 vs-3.88±1.48,P<0.001),and HADS Anxiety(0.36±1.98 vs-5.12±2.70,P<0.001)scores,in favour of the patients treated with resveratrol supplements.CONCLUSION:The resveratrol oral supplement is a complementary treatment in cases of wet AMD,highlighting its effectiveness in improving patients’QoL status.

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

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

Quality of life and emotional change for middle -aged and elderly patients with diabetic retinopathy

AIM:To evaluate the SF-36, Diabetes Specificity Quality of Life Scale (DSQL) and anxiety and depression symptoms and investigate its changes in proliferative diabetic retinopathy (PDR) by vitrectomy interventions. METHODS:The present study included 108 diabetic retinopathy (DR) patients:54 with PDR and 54 with non-proliferative diabetic retinopathy (NPDR). Each healthy control group (n =54) sociodemographically matched to DR groups was established respectively. The quality of life, anxiety and depression symptoms were evaluated and analyzed on preoperative and postoperative month 1 using SF-36, DSQL and Hospital Anxiety and Depression Scale (HADS). · RESULTS:DR patients described impaired HRQL (Health Related Quality of life, SF -36) in 6 out of 8 subscales, including ‘Body Health’, ‘Body RoleFunction’,‘General Health’,‘Society Function’,‘Emotion Role Function’and‘Mental Health’. Compared with controls, DR patients (NPDR and PDR) suffered from statistically significantly impaired HRQL (SF-36 Summary score) (P【 0.05). By surgical intervention, the anxiety and depression score were significantly reduced, while the health and quality of life (SF-36 Summary scores and DSQL scores) was improved in patients with PDR (P 【0.05). CONCLUSION:DR patients were affected in mentation and quality of life. Surgery interventions can improve SF-36, DSQL, anxiety and depression in PDR patients.

Investigation of the effect of military stress on the prevalence of functional bowel disorders

AIM: To investigate the morbidity of functional bowel disorders (FBD) under military stress conditions in order to lay foundations for the prevention and treatment of this disease. METHODS: Four hundred and fifty-seven soldiers who were assigned to specified services and 471 soldiers who were assigned to routine services were enrolled using cluster sampling, with the latter as a control group. They were surveyed using the Rome Ⅲ FBD standard questionnaire. The FBD symptom question-naire included FBD-related symptoms, severity, dura- tion or attack time, and accompanying symptoms. RESULTS: The morbidity of the military stress group (14.6%) was significantly higher than in the control group (9.98%) ( 2 = 4.585, P < 0.05). The incidence of smoking, abdominal pain and acid regurgitation ( 2 = 4.761, P < 0.05) as well as the ZUNG anxiety/depression scores ( 2 = 7.982, P < 0.01) were also sig- nificantly higher in the military stress group compared with the control group. ZUNG anxiety ( 2 = 11.523, P < 0.01) and depression ( 2 = 5.149, P < 0.05) scores were higher in the FBD group compared with the non-FBD group. The differences in the ZUNG self-rated anxiety and depression scales between the 2 groups were statistically significant ( 2 = 14.482, P < 0.01 and 2 = 6.176, P < 0.05). CONCLUSION: The morbidity of FBD was higher under military stress conditions.

The norepinephrine transporter gene is associated with the retardation symptoms of major depressive disorder in the Han Chinese population

The norepinephrine transporter plays an important role in the pathophysiology and pharmacological treatment of major depressive disorder. Consequently, the norepinephrine transporter gene is an attractive candidate in major depressive disorder research. In the present study, we evaluated the depression symptoms of subjects with major depressive disorder, who were all from the North of China and of Hart Chinese origin, using the Hamilton Depression Scale. We examined the relationship between two single nucleotide polymorphisms in the norepinephrine transporter, rs2242446 and rs5569, and the retardation symptoms of major depressive disorder using quantitative trait testing with the UNPHASED program, rs5569 was associated with depressed mood, and the GG genotype may be a risk factor for this; rs2242446 was associated with work and interest, and the TT genotype may be a risk factor for loss of interest. Our findings suggest that rs2242446 and rs5569 in the norepinephrine transporter gene are associated with the retardation symptoms of depression in the Hart Chinese population.

Association between gastrointestinal symptoms and affectivity in patients with bipolar disorder

AIM To study if anxiety, depression and experience of stress are associated with gastrointestinal(GI) symptoms in patients with bipolar disorder.METHODS A total of 136 patients with bipolar disorder(mean age 49.9 years; 61% women) and 136 controls from the general population(mean age 51.0 years; 60% women) were included in the study. GI symptoms were assessed with The Gastrointestinal Symptom Rating Scale-irritable bowel syndrome(GSRS-IBS), level of anxiety and depression with The Hospital Anxiety and Depression Scale(HADS) and stress-proneness with Perceived Stress Questionnaire. Over a ten year period, all visits in primary care were retrospectively recorded in order to identify functional GI disorders.RESULTS In subjects with low total HADS-score, there were no significant differences in GI-symptoms between patients and controls(GSRS-IBS 7.0 vs 6.5, P = 0.513). In the patients with bipolar disorder there were significant correlations between all GSRS and HADS subscores for all symptom clusters except for "constipation" and "reflux". Factors associated to GI symptoms in the patient group were female sex(adjusted OR = 2.37, 95%CI: 1.07-5.24) and high HADS-Depression score(adjusted OR = 3.64, 95%CI: 1.07-12.4). These patients had also significantly more visits for IBS than patients with low HADS-Depression scores(29% vs 8%, P = 0.008). However, there was no significant differences in consulting behaviour for functional GI disorders between patients and controls(25% vs 17%, P = 0.108).CONCLUSION Female patients and patients with high HADS depression score reported significantly more GI symptoms, whereas patients with low HADS scores did not differ from control subjects.

Effect of biofeedback combined with high-quality nursing in treatment of functional constipation

BACKGROUND Functional constipation(FC)is a common functional gastrointestinal disease with various clinical manifestations.It is a physical and mental disease,which seriously affects patient physical and mental health and quality of life.Biofeedback therapy is the treatment of choice for FC,especially outlet obstructive constipation caused by pelvic floor dysfunction.High-quality nursing is a new nursing model in modern clinical work and a new concept of modern nursing service.AIM To explore the effect of biofeedback combined with high-quality nursing in the treatment of FC.METHODS A total of 100 patients with FC admitted to our hospital from March 2015 to July 2019 were selected for clinical observation.These patients were randomly divided into two groups of 50:Experimental group(biofeedback combined with highquality nursing treatment group)and control group(biofeedback group).RESULTS The constipation symptom score of the experimental group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).The anal canal resting pressure and initial defecation threshold of the experimental group were significantly lower than those of the control group,and the maximum squeeze systolic pressure of the anal canal of the experimental group was significantly higher than that of the control group(P<0.05).The Self-Rating Anxiety Scale and Zung’s Self-Rating Depression Scale scores of the two groups were significantly lower than before treatment.The Self-Rating Anxiety Scale and Self-Rating Depression Scale scores of the experimental group were significantly lower than those of the control group(P<0.05).The patient satisfaction score of the experimental group was significantly higher than that of the control group(P<0.05).CONCLUSION The application of biofeedback combined with high-quality nursing in the treatment of FC has significant advantages over pure biofeedback treatment,and it is worthy of promotion in clinical work.

Identifying the factors associated with depressive symptoms among postpartum mothers in Kathmandu, Nepal

Purpose:This study aimed to identify the factors associated with depressive symptoms among postpartum mothers in Kathmandu,Nepal.Method:A hospital-based cross-sectional study that included 346 postpartum mothers at 4-14 weeks after delivery was carried out.Validated Nepalese version of Edinburgh Postnatal Depression Scale with cut-off value of≥12 was used to screen depressive symptoms and structured questionnaires were used to identify the associated factors.Possible factors associated with depressive symptoms were identified by logistic regression analysis.Result:The mean age of the mothers was 22.75(SD=4.51).The prevalence of depressive symptoms among postpartum mothers was 17.1%(95%CI=15.07-19.12).No significant association existed between postpartum depressive symptoms and socio demographic and economic characteristics.In multivariate analysis,risk factors for postpartum depressive symptoms were identified as follows:women without adequate rest during pregnancy(aOR=4.023,95%CI=1.294-12.501),abortion history(aOR=3.25,95%CI=1.208-9.065),poor relationship with husband(aOR=1.67,95%CI=1.073-8.384),marital dissatisfaction(aOR=4.053,95%CI=2.281-12.819)and stressful life events(aOR=3.89,95%CI=1.504-9.810).Conclusions:This study aids to draw attention on the incorporation of routine screening for basic support and intervention for identified risk factors in postpartum period.Policies can be formulated to encourage postpartum women to obtain adequate rest during pregnancy,support women with poor partner relationship,reduce marital dissatisfaction,help women adjust with stressful life events,and prevent and manage abortion appropriately.These policies may reduce harmful consequences of postpartum depressive symptoms for women,newborn and their family.

Depression among elderly Chinese-Canadian immigrants from China's Mainland

Background This study examined the prevalence of depressive symptoms among elderly immigrants from China's Mainland to Canada and the impact of various psychosocial factors as predictors of the number of depressive symptoms reported by the elderly Chinese immigrants Methods The participants were 444 elderly immigrants who migrated from China's Mainland to Canada They were a part of a random sample of 2272 elderly Chinese living in the communities and took part in a face-to-face interview to answer questions in an orally administrated questionnaire The depressive symptoms of the participants were measured by a Chinese version of the Geriatric Depression Scale Data obtained from the 444 elderly Chinese immigrants was analyzed to assess the impact of various psychosocial factors on the number of depressive symptoms that they reported Results The findings indicated that 23 2% of the elderly immigrants were assessed to have some depressive symptoms When other predicting variables were adjusted, elderly immigrants with more chronic illnesses, less positive attitude towards ageing, poorer physical health, less adequate financial situation, lower level of ethnic identification as Chinese, more service barriers, lower level of life satisfaction, shorter length of residency in Canada and those who lived alone tended to have more depressive symptoms Conclusions The findings indicate that the prevalence rate of depressive symptoms among our elderly immigrant sample is higher than the one reported in a general elderly population While further research is recommended to examine the reasons for such a difference, culturally appropriate health services, including health promotion programs, should be promoted to reduce mental health disparities