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.

Study on the impact of comprehensive geriatric assessment on anxiety and depression in chronic obstructive pulmonary disease patients

BACKGROUND Psychological factors such as anxiety and depression will not only aggravate the symptoms of chronic obstructive pulmonary disease(COPD)patients and reduce the quality of life of patients,but also affect the treatment effect and long-term prognosis.Therefore,it is of great significance to explore the clinical application of senile comprehensive assessment in the treatment of COPD and its influence on psychological factors such as anxiety and depression.AIM To explore the clinical application of comprehensive geriatric assessment in COPD care and its impact on anxiety and depression in elderly patents.METHODS In this retrospective study,60 patients with COPD who were hospitalized in our hospital from 2019 to 2020 were randomly divided into two groups with 30 patients in each group.The control group was given routine nursing,and the observation group was given comprehensive assessment.Clinical symptoms,quality of life[COPD assessment test(CAT)score],anxiety and depression Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD)were compared between the two groups.RESULTS CAT scores in the observation group decreased from an average of 24.5 points at admission to an average of 18.3 points at discharge,and in the control group from an average of 24.7 points at admission to an average of 18.3 points at discharge.The average score was 22.1(P<0.05).In the observation group,HAMA scores decreased from 14.2 points at admission to 8.6 points at discharge,and HAMD scores decreased from 13.8 points at admission to 7.4 points at discharge.The mean HAMD scores in the control group decreased from an average of 14.5 at admission to an average of 12.3 at discharge,and from an average of 14.1 at admission to an average of 11.8 at discharge.CONCLUSION The application of comprehensive geriatric assessment in COPD care has a significant effect on improving patients'clinical symptoms and quality of life,and can effectively reduce patients'anxiety and depression.

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.

Functional magnetic resonance imaging study of group independent components underpinning item responses to paranoid-depressive scale

BACKGROUND Our study expand upon a large body of evidence in the field of neuropsychiatric imaging with cognitive,affective and behavioral tasks,adapted for the functional magnetic resonance imaging(MRI)(fMRI)experimental environment.There is sufficient evidence that common networks underpin activations in task-based fMRI across different mental disorders.AIM To investigate whether there exist specific neural circuits which underpin differ-ential item responses to depressive,paranoid and neutral items(DN)in patients respectively with schizophrenia(SCZ)and major depressive disorder(MDD).METHODS 60 patients were recruited with SCZ and MDD.All patients have been scanned on 3T magnetic resonance tomography platform with functional MRI paradigm,comprised of block design,including blocks with items from diagnostic paranoid(DP),depression specific(DS)and DN from general interest scale.We performed a two-sample t-test between the two groups-SCZ patients and depressive patients.Our purpose was to observe different brain networks which were activated during a specific condition of the task,respectively DS,DP,DN.RESULTS Several significant results are demonstrated in the comparison between SCZ and depressive groups while performing this task.We identified one component that is task-related and independent of condition(shared between all three conditions),composed by regions within the temporal(right superior and middle temporal gyri),frontal(left middle and inferior frontal gyri)and limbic/salience system(right anterior insula).Another com-ponent is related to both diagnostic specific conditions(DS and DP)e.g.It is shared between DEP and SCZ,and includes frontal motor/language and parietal areas.One specific component is modulated preferentially by to the DP condition,and is related mainly to prefrontal regions,whereas other two components are significantly modulated with the DS condition and include clusters within the default mode network such as posterior cingulate and precuneus,several occipital areas,including lingual and fusiform gyrus,as well as parahippocampal gyrus.Finally,component 12 appeared to be unique for the neutral condition.In addition,there have been determined circuits across components,which are either common,or distinct in the preferential processing of the sub-scales of the task.CONCLUSION This study has delivers further evidence in support of the model of trans-disciplinary cross-validation in psychiatry.

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.

Sociopsychological impact factors of depression patients during the COVID-19 epidemic period

Objective:To investigate the impact factors of the COVID-19 epidemic on the mental health of patients with depression.Methods:The relevant data of 242 residents aged 18-50 years in a certain area were collected,118 patients and 124 healthy people were analyzed by general information questionnaire,the PsychoSocial Index(PSI)questionnaire,Social Support Rating Scale(SSRS)and Symptom Checklist 90(SCL-90).Compare the differences in social and psychological factors between the two groups.Then use logistic regression to evaluate the social and psychological influencing factors of depression patients during the epidemic.Results:Two results of logistic regression analysis showed that marital status,occupational status,abnormal pathological behavior,and utilization of support were still significantly associated with depression.Compared to working,unemployed/unemployed/retired,students are closely related to depression,followed by abnormal pathological behavior and utilization of support.Conclusion:Under the epidemic,depression groups lacking social relationships should actively pay attention to their mental health status and comprehensively enhance their social and psychological support.To avoid the exacerbation of psychological and psychological symptoms caused by the epidemic.

Diagnostic accuracy and clinical utility of non-English versions of Edinburgh Post-Natal Depression Scale for screening post-natal depression in India:A meta-analysis

BACKGROUND The prevalence of post-natal depression(PND)is high in India,as it is in many other low to middle income countries.There is an urgent need to identify PND and treat the mother as early as possible.Among the many paper and pencil tests available to identify PND,the Edinburgh Postnatal Depression Scale(EPDS)is a widely used and validated measure in India.However,the summary diagnostic accuracy and clinical utility data are not available for this measure.AIM To establish summary data for the global diagnostic accuracy parameter as well as the clinical utility of the non-English versions of the EPDS in India.METHODS Two researchers independently searched the PubMed,EMBASE,MEDKNOW and IndMED databases for published papers,governmental publications,conference proceedings and grey literature from 2000-2018.Seven studies that evaluated the diagnostic accuracy of EPDS in five Indian languages against DSM/ICD were included in the final analysis.Two other investigators extracted the Participants’details,Index measures,Comparative reference measures,and Outcomes of diagnostic accuracy data,and appraised the study quality using QUADS-2.Deek’s plots were used to evaluate publication bias.We used the area under the curve of the hierarchical summary area under the receiver operating characteristic curve,with the random effect model,to summarize the global diagnostic accuracy of EPDS.Using the 2×2 table,we calculated positive and negative likelihood ratios.From the likelihood ratios,the Fagan’s nomogram was built for evaluating clinical utility using the Bayesian approach.We calculated the 95%confidence interval(95%CI)whenever indicated.STATA(version 15)with MIDAS and METANDI modules were used.RESULTS There was no publication bias.The area under the curve for EPDS was 0.97(95%CI:0.95-0.98).The pre-test probability for the nomogram was 22%.For a positive likelihood ratio of 9,the positive post-test probability was 72%(95%CI:68%,76%)and for a negative LR of 0.08,the negative post-test probability was 2%(95%CI:1%,3%).CONCLUSION In this meta-analysis,we established the summary global diagnostic parameter and clinical utility of the non-English versions of the EPDS in India.This work demonstrates that these non-English versions are accurate in their diagnosis of PND and can help clinicians in their diagnostic reasoning.

Water scaling predication for typical sandstone geothermal reservoirs in the Xi'an Depression

The Xi'an Depression in the Guanzhong Basin of western China has been suggested to contain geothermal resources that could aid China in achieving carbon neutrality and optimizing energy structure.However,the high concentration of total dissolved solids(TDS)and scale-forming ions in geothermal water from the depression causes severe scaling problems in harvesting geothermal energy.To reduce scale-related problems,accurate identification of scale types and prediction of scaling during geothermal energy utilization are crucial.This study starts with identifying the types and trends of scaling in the study area,using index-based discriminant methods and hydrogeochemical simulation to calculate and analyze the mineral saturation index of water samples from some wellheads and of reconstructed fluid samples of geothermal reservoirs.The results indicate that the scales are mostly calcium carbonate scales rather than sulfate scales as a result of temperature changes.Several portions of the geothermal water systems are found to have distinct mineral scaling components.Quartz and chalcedony are formed in low temperature areas,while carbonate minerals are in high temperature areas.Despite the low iron content of geothermal water samples from the study area,scaling is very common due to scaling-prone iron minerals.The findings can be used to evaluate geothermal drainage systems and guide anti-scaling during geothermal energy utilization in similar settings.

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.

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.

Early prediction of major depression in chronic hepatitis C patients during peg-interferon α-2b treatment by assessment of vegetative-depressive symptoms after four weeks

AIM: To study the predictive value of the vegetative- depressive symptoms of the Zung Depression Rating Scale for the occurrence of depression during treatment with peg-interferon α-2b of chronic hepatitis C (CHC) patients. METHODS: The predictive value of vegetative- depressive symptoms at 4 wk of treatment for the occurrence of a subsequent diagnosis of major depressive disorder (MDD) was studied in CHC patients infected after substance use in a prospective, multi- center treatment trial in Belgium. The presence of vegetative-depressive symptoms was assessed using the Zung Scale before and 4 wk after the start of antiviral treatment. RESULTS: Out of 49 eligible patients, 19 (39%) developed MDD. The area under the ROC curve of the vegetative Zung subscale was 0.73, P = 0.004. The sensitivity at a cut-point of > 15/35 was 95% (95% CI: 74-100). The positive predictive value equalled 44% (95% CI: 29-60). CONCLUSION: In this group of Belgian CHC patients infected after substance use, antiviral treatment caused a considerable risk of depression. Seven vegetativedepressive symptoms of the Zung scale at wk 4 of treatment predicted 95% of all emerging depressions, at a price of 56% false positive test results.

Role of irrational beliefs in depression and anxiety: a review

Irrational beliefs play a central role in cognitive theory and therapy;they have been shown to be related to a variety of disorders such as depression and anxiety. Irrational beliefs, which can be assessed via clinical interviewing techniques, are frequently assessed by self-report measures, both clinically and for research purposes. Much of the research demonstrating the effect of irrational beliefs has utilized such measures. The present article reviews the empirical work on irrational beliefs assessment and identifies 25 scales and techniques. The measures are organized according to their theoretical affiliation (i.e., either the Ellis or Beck model), with the goal of providing investigators a source to identify the available tests, their shortcomings, and potential applications. The authors conclude with recommendations which would strengthen empirical cohesion and precision in the measurement of irrational beliefs.

Influence of smoking on postpartum depression in Japan

Aim: To investigate the influence of smoking on postpartum depression. Methods: One thousand fifty-one women, in a rural city in Aomori Prefecture, Japan, prospectively fulfilled the selection criteria and completed self-reporting questionnaires on postnatal depression at 5-6 days, 1 month, 4 months, 7 months and 12 months after childbirth, using the Edinburgh Postnatal Depression Scale (EPDS) and a life and social events scales including smoking habits. Results: Seven hundred seventy-seven women were non-smokers. Among two hundred seventy-four women who were smokers before becoming pregnant (26% of pregnant women), 241 women quit smoking during pregnancy and 33 women continued smoking. Smoking habits were significantly associated with sociopsychological states and we found that EPDS scores of smokers were significantly higher than EPDS of non-smokers. The EPDS scores of both non-smokers and smokers were higher at 5-6 days, but were stable from 1 month to 12 months, after childbirth. Fifty-one women who quit smoking after childbirth resumed smoking during he 1-12 month periods after childbirth. The EPDS scores of 51 women who resumed smoking were significantly reduced after they resumed smoking. Conclusion: The EPDS scores of smokers were higher than those of non-smokers and a smoking habit may help to alleviate postpartum depression.

Development of a Scale to Evaluate the Depressive State among Elderly Patients in General Wards

This study aims to develop a scale to evaluate depressive states among elderly patients in general wards, and verify the reliability and validity of the scale. Based on the results of interviews with nurses, we developed a draft of a scale comprised of 48 questions (NDE48). The Geriatric Depression Scale short version (GDS15), and the Zung Self-rating Depression Scale (SDS) were administered to 54 elderly patients. Two groups of nurses completed the NDE48 on different days. After performing an explanatory factor analysis, the NDE48 was simplified to a 16 question item scale (NDE16), comprising three factors. The correlation coefficient between GDS15 and NDE16 was 0.41 (p = 0.00191), and between SDS and NDE16 was 0.30 (p = 0.02633). Alpha coefficient of the total score of NDE16 was 0.88. For inter-rater reliability, the correlation coefficient was 0.57 (p = 0.00005). The findings suggest that the NDE16 will be highly useful when nurses evaluate depressive states among elderly inpatients.

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.

Increased P wave duration in patients with depression or anxiety disorder

BACKGROUND： Activation of the sympathetic nervous system plays an important role in regulating cardiovascular actions. P wave parameters can provide general information on central cardiovascular autonomic regulatory responses, which are altered in patients with anxiety disorders and depression. In particular, there are no reports addressing changes in P wave duration and dispersion. OBJECTIVE： To compare the differences in P wave duration and P wave dispersion between patients with anxiety disorders and depression, because patients with anxiety disorders and depression develop abnormal electrocardiograms. DESIGN, TIME AND SETTING： A non-randomized concurrent controlled study was performed. Patients with depression and general anxiety disorders were admitted at the psychiatry outpatient clinics of the Medical Faculty of Duezce University of Turkey between May 2005 and October 2006. PARTICIPANTS： A total of 71 consecutive patients with depression and anxiety disorders, as well as 50 physically and mentally healthy age- and gender-matched controls were selected. METHODS： Electrocardiogram records were obtained at the time of admission to the outpatient clinics. MAIN OUTCOME MEASURES： P wave duration and P wave dispersion were measured. RESULTS： Both the maximum （Prnax） and minimum （Pmin） P wave duration were greater in patients with psychiatric disorders than in healthy controls. Pmax was significantly greater in patients with depression or anxiety disorders （Bonferroni test, P 〈 0.017）. The P wave dispersion was similar between patients and controls （P 〉 0.017）. P waves were similar between panic patients and other anxiety patients. Beck depression results were positively correlated with Prawn and Prnax （r= 0.374, 0.302, P = 0.013, 0.049, respectively）, and not associated with P wave dispersion （P 〉 0.05）. CONCLUSION： Psychiatric disorders are associated with increases in Prnax, but not with P wave dispersion. The P wave changes were associated with the degree of depression.

The prevalence of depression amongst outpatients with multimorbidity

Objectives: Depression may be under-diagnosed and under-treated amongst older adults with multiple chronic illnesses. The current study explores the prevalence of depression diagnosis and Geriatric Depression Scale (GDS) symptoms amongst older multimorbid outpatients, and agreement between GDS scores and doctor-diagnosed depression. Method: Deidentified data from the files of 452 patients aged over 64, with chronic conditions present in two or more organ domains, were extracted from the clinical database of a tertiary referral hospital multidisciplinary outpatient clinic in South Australia between 2005 and 2011. Frequency calculations determined the prevalence of depression diagnosis and GDS categories. Logistic regression, cross-tabulation, kappa and ROC graphs explored relationships between variables. Results: A depression diagnosis had been recorded for 71 (15.7%) patients. Using the recommended cut-off scores for the GDS, 225 (49.8%) patients met criteria for mild-severe depressive symptoms, and 96 (21.3%) met criteria for moderate-severe symptoms. Poor agreement was found between doctor diagnosis of depression and a positive screen for depression using a GDS cut-off score of either 5, k = 0.112 (p = 0.001), or 9, k = 0.189 (p < 0.001), although logistic regression found an association between severity of depression and depression diagnosis, OR = 1.15, p < 0.001 (CI = 1.08 - 1.22). Con-clusion: A much higher proportion of patients with multimorbidities reported threshold level depression symptoms than had a recorded diagnosis of depression, suggesting that although likelihood of diagnosis increases with symptom severity, depression often goes undetected in this population. Depressions’ negative impact on prognosis calls for further investigation of the barriers to screening and diagnosis of depression in multimorbid patients.

Fluvoxamine in Treatment of Depression in Russian Patients: An Open-Label, Uncontrolled and Non-Randomized Multicenter Observational Study

Background: Fluvoxamine, a selective serotonin reuptake inhibitor is widely used in the treatment of depression, one of the most common disorders prevalent in Russia. However, studies demonstrating its efficacy and safety in routine settings in Russia are scarce. Methods: This prospective, uncontrolled, open-label study was conducted at 11 centers in Russia. Total 293 patients (aged ≥ 18 years), meeting DSM-IV criteria for depression and scoring ≥ 17 on 17-item Hamilton Rating Scale of Depression (HAMD-17) received fluvoxamine 50 - 300 mg for 6 weeks. Primary efficacy measures included change from baseline in the HAMD-17 and Clinical Global Impression (CGI) scores. Secondary efficacy measure was evaluation of sleep quality changes on HAMD-17 subscale. Safety was assessed by monitoring of adverse drug reactions (ADRs). Results: Mean age of patients was 42.7 years and the majority of them were women (72%). At the end of treatment (day 42), clinically significant reduction was observed in mean HAMD-17, CGI-severity of illness and HAMD-17 sleep sub-score from 23.1, 4.5 and 3.9 at baseline to day 42;change from baseline (Δ) was: Δ-17.3 [95% CI: -18.0;-16.7]), Δ-2.1 and Δ-3.4 [95% CI: -3.53;-3.20]), respectively. At day 42, 20.8% patients reported as normal (not at all ill) on the CGI-severity scale and 85% patients reported as “much improved” or “very much improved” on the CGI-change in severity and quality of life scores. Nausea (12.6%) and somnolence (5.1%) were the most frequently reported ADRs. No deaths or serious ADRs were reported but eight patients discontinued treatment due to ADRs. Conclusion: Treatment with fluvoxamine under routine settings showed marked improvement in Russian patients with depression as measured by HAMD-17 and CGI ratings and was thus efficacious as well as safe and well-tolerated.

Factors Associated with Mental Depression among Men Who Have Sex with Men in Southern India

Background: Mental health has been a largely neglected issue among Men Who Have Sex with Men (MSM) across the world. This study examines the prevalence and correlates of depression among MSM. Data and Methods: Data for this study are used from a cross-sectional Behavioral Tracking Survey—2012 conducted among 1176 MSM from Andhra Pradesh (undivided), a southern state of India. Depression of MSM was assessed using Patient Health Questionnaire-2 scale. Descriptive statistics, bivariate and multivariate logistic regression techniques were used for analysis. Results: More than one-third of MSMs (35%) in the survey reported to have depression. The likelihood of experiencing depression was 5 times higher among MSM who were mobile for sex work outside their place of residence (55% vs 17%, AOR: 5.2, 95% CI: 3.7 - 7.3) and had experienced physical or sexual violence (82% vs 33%, AOR: 6.0, 95% CI: 2.1 - 17.4) than their respective counterparts. Rates of depression were significantly higher among MSM who had experienced Sexually Transmitted Infections symptoms;knowledge of their HIV positivity;who didn’t use condoms during anal sex with any clients/partners;those who consumed alcohol and were in financial debt at the time of survey than others. Those who were associated with any community groups have significantly less chances of reporting depression. Discussion: The study certainly highlighted that the HIV prevention efforts with MSM in India require an integrated approach on addressing the mental health issues. To support this, programs and research-based evidence will be highly needed to ensure that mental health issues are properly addressed among MSM and other high risk groups.