Development of a Scale to Evaluate Depressive States among Elderly Patients in General Wards —Verification of the Contents to Improve the Accuracy of the Scale

Purpose: This study aims to verify the validity of the contents of the Nurse Administered Depression Scale for Elderly Inpatients16 (NDE16) using the Delphi approach in order to further improve the accuracy of the NDE16, a scale for rating potential depressive states in elderly inpatients through the observations reported by nurses. Methods: Participants were nurses working in general wards for longer than 3 years and who expressed consent to the study participation. Data were collected using the Delphi method (3 times). Responses are scored from 1 to 5 (3 - 5 points as positive) using the Likert method. The standard criteria for inclusion in the further evaluation are “mean ≥ 3.0”, “standard deviation < 1.0”, “median ≥ 3.0”, and “IQR ≤ 1.0”. Items that meet all the criteria at the third survey are employed as question items in the final questionnaire. Results: The respondents were 139 females, 10 males, and 1 unknown, aged 25 to 65. The collection rates of the three surveys were 75% to 82%. Based on the results of the first survey, wordings of 9 questions were modified. Since Question 13 “Queries are not really responded to.” did not meet the criteria (IQR = 2) at the third survey, we excluded this question and named the revised scale NDE15. Discussion: The reason why Question 13 did not meet the criteria could be due to the difficulty in distinguishing “Expressing thought suppression” from the state of cognitive decline in dementia. Further studies are needed to determine cutoff points.

Effectiveness of Bushen Huoxue Granule (补肾活血颗粒) on 5-Serotonin and Norepinephrine in the Brain of Parkinson's Disease Patients with Depressive State

Objective：To observe the clinical curative effect of Chinese medicine Bushen Huoxue Granule（补肾活血颗粒,BHG） on Parkinson＇s disease（PD） patients with depressive state.Methods：Sixty-two PD patients with depressive state were randomly assigned to two groups by using a random number table,31 in each group.Madopar was given to all as the conventional treatment.The fluoxetine hydrochloride dispersible tablet was given to the patients in the control group and BHG was given to those in the treatment group.The therapeutic course for all was 12 weeks.Before and after treatment,Hamilton depression rating scale（HAMD） was applied to judge the curative effect,and the changes of cerebral neurotransmitters levels in the brain of patients were detected by encephalofluctuograph technique.Results：The scores of HAMD in the two groups were decreased markedly after 12-week treatment.It was lower in the treatment group than that in the control group with significant difference（P〈0.01）.The contents of norepinephrine（NE） and 5-serotonin（5-HT） in the PD patients were obviously lower than normal value.There was no significant difference between the two groups before treatment（P〉0.05）.The contents of NE and 5-HT were all increased in the two groups after treatment（P〈0.05）,with significant differences between the two groups（P〈0.01）.Conclusion：BHG could increase the contents of NE and 5-HT in PD patients＇ brain to improve the depressive state of PD patients.

Guanxin Danshen Dripping Pills Improve Quality of Life and Cardiovascular Prognoses of CHD Patients after PCI with Anxiety or Depression(GLAD Study):A Randomized Double-Blind Placebo-Controlled Study

Objective:To assess the efficacy and safety of Guanxin Danshen Dripping Pills(GXDS)in the treatment of depression or anxiety in patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI).Methods:From September 2017 to June 2019,200 CHD patients after PCI with depression and anxiety were included and randomly divided into GXDS(100 cases)and placebo control groups(100 cases)by block randomization and a random number table.Patients in the GXDS and control groups were given GXDS and placebo,respectively,0.4 g each time,3 times daily for 12 weeks.The primary outcomes were scores of Patient Health Questionnaire-9(PHQ-9),Generalized Anxiety Scale(GAD-7)and the Seattle Angina Pectoris Scale(SAQ).The secondary outcomes included 12 Health Survey Summary Form(SF-12)scores and the first onset time and incidence of major adverse cardiovascular events(MACEs).Other indices including blood pressure,blood lipids,microcirculation and inflammatory-related indices,etc.were monitored at baseline,week 4,and week 12.Results:In the full analysis set(200 cases),after treatment,the PHQ-9 and GAD-7 scores in the GXDS group were considerably lower than those in the control group(P<0.05).Compared with the baseline,the total PHQ-9 scores of the experimental and control groups decreased by 3.97 and 1.18,respectively.The corrected mean difference between the two groups was–2.78(95%CI:–3.47,–2.10;P<0.001).The total GAD-7 score in the GXDS group decreased by 3.48%compared with the baseline level,while that of the placebo group decreased by 1.13%.The corrected mean difference between the two groups was–2.35(95%CI:–2.95,–1.76;P<0.001).The degree of improvement in SAQ score,SF-12 score,endothelin and high-sensitive C-reactive protein levels in the GXDS group were substantially superior than those in the placebo group,and the differences between the two groups were statistically significant(P<0.05).Similar results were obtained in the per protocol population analysis of 177 patients.Three cases of MACES were reported in this study(1 in the GXDS group and 2 in the placebo group),and no serious adverse events occurred.Conclusions:GXDS can significantly alleviate depression and anxiety,relieve symptoms of angina,and improve quality of life in patients with CHD after PCI.(Registration No.ChiCTR1800014291)