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Advances in stress and depression research | Janvier 2023 H

Article (Psychiatrie)

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Purpose of review: Stress plays a central role in the onset and course of depression. However, only a subset of people who encounter stressful life events go on to experience a depressive episode. The current review highlights recent advances in understanding when, why, and for whom the stress-depression link occurs, and we identify avenues for future research.

Recent findings: In the last 18 months, researchers have taken a more nuanced perspective on the biopsychosocial mechanisms critical to the stress-depression link. For example, examination of specific facets of emotion regulation, including emotion regulation flexibility and interpersonal emotion regulation, has been critical to understanding its role in depression. Similarly, refined investigations of social support allowed researchers to identify distinct - and occasionally opposite - outcomes depending on the context or manner in which the support was provided. Researchers also documented that the stress-depression link was enhanced by dysregulation of several stress-sensitive biological systems, such as the immune system, microbiome, endocrine system, and neuroanatomical substrates.

Summary: Recent studies highlight the importance of adopting a nuanced understanding of mechanisms and moderators that explain the stress-depression link. We also encourage continued engagement in collaborative, open science that uses multiple methods to study the full breadth of human diversity.
Purpose of review: Stress plays a central role in the onset and course of depression. However, only a subset of people who encounter stressful life events go on to experience a depressive episode. The current review highlights recent advances in understanding when, why, and for whom the stress-depression link occurs, and we identify avenues for future research.

Recent findings: In the last 18 months, researchers have taken a more nuanced ...

Cognition ; Dépression ; Stress ; Angoisse

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Purpose of review: The use of neurostimulation to treat mood disorders dates back to the 1930s. Recent studies have explored various neurostimulation methods aimed at both restoring a healthy brain and reducing adverse effects in patients. The purpose of this review is to explore the most recent hypotheses and clinical studies investigating the effects of stimulating the brain on mood disorders.

Recent findings: Recent work on brain stimulation and mood disorders has focused mainly on three aspects: enhancing efficacy and safety by developing new approaches and protocols, reducing treatment duration and chances of relapse, and investigating the physiological and pathological mechanisms behind treatment outcomes and possible adverse effects.

This review includes some of the latest studies on both noninvasive techniques, such as transcranial magnetic stimulation, magnetic seizure therapy, transcranial direct current stimulation, transcranial alternating current stimulation, electroconvulsive treatment, and invasive techniques, such as deep brain stimulation and vagus nerve stimulation.

Summary: Brain stimulation is widely used in clinical settings; however, there is a lack of understanding about its neurobiological mechanism. Further studies are needed to understand the neurobiology of brain stimulation and how it can be used to treat mood disorders in their diversity, including comorbidities with other illnesses.
Purpose of review: The use of neurostimulation to treat mood disorders dates back to the 1930s. Recent studies have explored various neurostimulation methods aimed at both restoring a healthy brain and reducing adverse effects in patients. The purpose of this review is to explore the most recent hypotheses and clinical studies investigating the effects of stimulating the brain on mood disorders.

Recent findings: Recent work on brain stimulation ...

Troubles bipolaires ; Cerveau - Stimulation - Emploi et thérapeutique ; Dépression

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Anxiety, Depression, and Social Skills in Girls with Fragile X Syndrome: Understanding the Cycle to Improve Outcomes | Décembre 2022 H

Article (Pédiatrie, néonatologie et périnatalité)

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Objective: Female patients with fragile X syndrome (FXS), a genetic condition associated with a mutation in the FMR1 gene, are at significantly elevated risk for developing anxiety and depression. This study is designed to better understand these symptoms in school-age girls, particularly as they relate to age, social skills, and functional outcomes.

Methods: We compared 58 girls aged 6 to 16 years with FXS with 46 age-matched, sex-matched, and developmentally matched peers without FXS on measures of anxiety, depression, social skills, adaptive behavior, and quality of life.

Results: Girls with FXS 10.5 years and older demonstrated significantly higher levels of depression, withdrawal, and social avoidance than girls younger than 10.5 years with FXS (p-values < 0.01). Girls in the comparison group did not show any age-related differences on these measures. The older FXS cohort also showed associations between social communication and interaction skills, adaptive behavior, and measures of anxiety and depression (p-values < 0.05) not seen in the comparison group, regardless of age.

Conclusion: We found that age seems to play an important role in the development of mood symptoms and that such symptoms are uniquely correlated with social communication and reciprocal social interaction behaviors and adaptive functioning in girls with FXS after puberty. These data suggest a critical window of intervention for girls with FXS in the improvement of social interaction skills and the prevention of social avoidance and symptoms of anxiety and depression, with the ultimate goal of improving quality of life and promoting greater independence.
Objective: Female patients with fragile X syndrome (FXS), a genetic condition associated with a mutation in the FMR1 gene, are at significantly elevated risk for developing anxiety and depression. This study is designed to better understand these symptoms in school-age girls, particularly as they relate to age, social skills, and functional outcomes.

Methods: We compared 58 girls aged 6 to 16 years with FXS with 46 age-matched, sex-matched, and ...

Anxiété ; Angoisse ; Dépression ; Communication ; Compétence de communication chez l'enfant ; Anxiété chez l'enfant ; Angoisse chez l'enfant ; Dépression chez l'enfant

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Binge-eating (BE) symptoms are relatively common in major depressive disorder (MDD), but their prognostic role is not fully understood. This study compared two groups of patients with MDD experiencing or not BE symptoms to ascertain differences in terms of clinical manifestations, presence of bipolar features, and antidepressant treatment outcomes. The study involved 482 outpatients collected within the Combining Medications to Enhance Depression Outcomes (CO-MED) trial, who were assessed with scales for depressive and hypomanic symptomatology, suicidality, comorbid mental disorders, and childhood traumas. BE symptoms were reported in 95 patients (20%). Patients with MDD experiencing BE symptoms were characterized by higher scores of negative self-outlook (P = 0.0018), negative outlook of future (P = 0.0014), irritability (P = 0.0043), comorbid anxiety disorders (generalized anxiety disorder: P = 0.0006; panic disorder: P < 0.0001; social phobia: P < 0.0001), obsessive-compulsive disorder (P = 0.0053), hypomanic symptoms (increased talkativeness: P = 0.0029; reduced need for sleep: P = 0.0171), and suicidality (suicidal propensity: P = 0.0013; suicidal risk: P = 0.0148; lifetime suicidal behavior: P = 0.0052). BE symptoms (OR = 2.02; 95% CI = 1.06-3.84) and depression severity (OR = 1.04; 95% CI = 1.00-1.08) were independently associated with lifetime attempted suicide. The presence of BE symptoms might indicate higher severity of depressive disorder. Suicidal risk is a major issue in these patients, whereas the association between BE and bipolar features needs further research.
Binge-eating (BE) symptoms are relatively common in major depressive disorder (MDD), but their prognostic role is not fully understood. This study compared two groups of patients with MDD experiencing or not BE symptoms to ascertain differences in terms of clinical manifestations, presence of bipolar features, and antidepressant treatment outcomes. The study involved 482 outpatients collected within the Combining Medications to Enhance ...

Antidépresseurs ; Alimentation - Aspect psychologique ; Dépression ; Troubles bipolaires ; Suicide ; Troubles du comportement alimentaire

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Inflammatory processes are associated with mood disorders, but data on pediatric patients are scarce. The aim of this study was to investigate a possible association between elevated neutrophil/lymphocyte ratio (NLR) - a marker of inflammation and mood polarity (manic/depressed) in adolescents, admitted between 2010 and 2015 due to a mood disorder episode and to an adolescent inpatient ward. Electronic medical records of 305 patients (aged 10-19 years, 60.6% males) admitted during the study period due to a mood disorder episode were reviewed. Of these, 63 were diagnosed with manic episodes and 242 with depressive episodes. Multivariate analyses were used to compare NLR between and within the two groups, covarying for age, sex, and antipsychotic use. NLR was significantly higher in the manic episode group compared with the depression one. Moreover, in inpatients with multiple hospitalizations, the NLR was higher during their manic episodes than that during their nonmanic states. These results suggest that, as has been reported in adults with bipolar disorder, inflammatory mechanisms may be involved in adolescents' mood disorders as well, particularly in the manic episodes. Thus, clinicians may consider adding anti-inflammatories as part of the treatment of these patients.
Inflammatory processes are associated with mood disorders, but data on pediatric patients are scarce. The aim of this study was to investigate a possible association between elevated neutrophil/lymphocyte ratio (NLR) - a marker of inflammation and mood polarity (manic/depressed) in adolescents, admitted between 2010 and 2015 due to a mood disorder episode and to an adolescent inpatient ward. Electronic medical records of 305 patients (aged 10-19 ...

Adolescents ; Dépression ; Humeur (Psychologie)

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Risk of conversion to bipolar disorder in patients with late-onset major depression | Novembre 2022 H

Article (Pharmacologie et laboratoires)

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To evaluate the impact of age at onset on late-life depression course and on risk of conversion to bipolar disorder (BD). A retrospective chart review of 100 elderly patients (age >= 65 years) diagnosed with a moderate-to-severe depressive episode and followed up for at least 18 months was conducted. Among patients affected by major depressive disorder (N = 57), follow-up morbidity differences between those with typical onset depression (TOD) (<60 years) and those with late-onset depression (LOD) (>=60 years) were investigated using Wilcoxon rank-sum test and Cox proportional hazard model. Patients belonging to the LOD group had a significantly lower percentage of follow-up time spent with depressive symptoms compared with patients with TOD (r = 0.36; P = 0.006), but significantly more time spent with (hypo)manic episodes (r = -0.31; P = 0.021). Moreover, LOD was significantly associated with a faster conversion to BD (hazard ratio = 3.05; P = 0.037). Depression first emerging in late life may represent an unstable condition with a high risk to convert to BD. Given the potential clinical implications, further studies on the course of LOD are required.
To evaluate the impact of age at onset on late-life depression course and on risk of conversion to bipolar disorder (BD). A retrospective chart review of 100 elderly patients (age >= 65 years) diagnosed with a moderate-to-severe depressive episode and followed up for at least 18 months was conducted. Among patients affected by major depressive disorder (N = 57), follow-up morbidity differences between those with typical onset depression (TOD) ...

Troubles bipolaires ; Dépression ; Personnes âgées

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Abstract: Data are equivocal on the consequences of COVID-19 pandemic on pain and well-being for individuals with chronic pain. Furthermore, little is known regarding its impact on the health of young adults with chronic pain. We conducted a longitudinal study to compare pain, psychological functioning, and substance use before and during the pandemic of 196 young adults with chronic pain. Participants aged 18 to 24 years (M = 21.1 years; 79.6% females) reported on pain, anxiety, depression, and substance use before (October 2018-August 2019) and during the pandemic (October 2020-November 2020), in addition to the assessment of COVID-19 exposure and its impact. Before the pandemic, young adults experienced mild-to-moderate pain intensity (M = 3.75, SD = 2.33) and pain interference (M = 3.44, SD = 2.69). Findings were that pain intensity, pain interference, and depression symptoms remained stable during the pandemic. In contrast, anxiety symptoms increased significantly (M = 8.21, SD = 5.84 vs M = 8.89, SD = 5.95, P = 0.04). Tobacco, alcohol, and cannabis use were unchanged. Mixed linear models revealed that COVID-19 exposure and impact were not associated with changes in pain intensity or interference, with female sex associated with increased pain intensity ([beta] = 0.86, P = 0.02) and pain interference ([beta] = 0.87, P = 0.02). Our findings indicated relative stability of pain symptoms experienced by young adults with chronic pain. However, the increases in anxiety highlight the need to facilitate treatment access for mental health services to mitigate downstream impact.
Abstract: Data are equivocal on the consequences of COVID-19 pandemic on pain and well-being for individuals with chronic pain. Furthermore, little is known regarding its impact on the health of young adults with chronic pain. We conducted a longitudinal study to compare pain, psychological functioning, and substance use before and during the pandemic of 196 young adults with chronic pain. Participants aged 18 to 24 years (M = 21.1 years; 79.6% ...

Douleur chronique ; Jeunes adultes ; COVID-19 ; Anxiété ; Dépression

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Abstract: This study examined the efficacy of internet-delivered cognitive and behavioural interventions for adults with chronic pain AND explored the role of clinical and study characteristics as moderators of treatment effects. PubMed, Embase, PsycINFO, CENTRAL and CINAHL were searched to identify randomized controlled trials published up to October 2021. A meta-analysis of 36 studies (5778 participants) was conducted, which found small effect sizes for interference/disability (Hedges' g = 0.28; 95% confidence interval [CI] 0.21-0.35), depression (g = 0.43; 95% CI 0.33-0.54), anxiety (g = 0.32; 95% CI 0.24-0.40), pain intensity (g = 0.27; 95% CI 0.21-0.33), self-efficacy (g = 0.39; 95% CI 0.27-0.52) and pain catastrophizing (g = 0.31; 95% CI 0.22-0.39). Moderator analyses found that interventions which involved clinician guidance had significantly greater effect sizes for interference/disability (g = 0.38), anxiety (g = 0.39), and pain intensity (g = 0.33) compared with those without (g = 0.16, g = 0.18, and g = 0.20, respectively). Studies using an inactive control had greater effects for depression (g = 0.46) compared with active control trials (g = 0.22). No differences were found between treatments based on traditional cognitive behaviour therapy vs acceptance and commitment therapy. Sample size, study year, and overall risk of bias (Cochrane rating) did not consistently moderate treatment effects. Overall, the results support the use of internet-delivered cognitive and behavioural interventions as efficacious and suggest guided interventions are associated with greater clinical gains for several key pain management outcomes.
Abstract: This study examined the efficacy of internet-delivered cognitive and behavioural interventions for adults with chronic pain AND explored the role of clinical and study characteristics as moderators of treatment effects. PubMed, Embase, PsycINFO, CENTRAL and CINAHL were searched to identify randomized controlled trials published up to October 2021. A meta-analysis of 36 studies (5778 participants) was conducted, which found small effect ...

Télémédecine ; Psychothérapie ; Douleur chronique ; Dépression ; Anxiété ; Thérapie d'acceptation et d'engagement

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Background: Neuropsychiatric symptoms are common following traumatic brain injury (TBI), but their etiological onset remains unclear. Mental health research implicates neuroinflammation in the development of psychiatric disorders. The presence of neuroinflammatory responses after TBI thus prompts an investigation of their involvement in the emergence of neuropsychiatric disorders postinjury.

Objective: Review the literature surrounding the role of neuroinflammation and immune response post-TBI in the development of neuropsychiatric disorders.

Methods: A search of scientific databases was conducted for original, empirical studies in human subjects. Key words such as "neuroinflammation," "TBI," and "depression" were used to identify psychopathology as an outcome TBI and the relation to neuroinflammatory response.

Results: Study results provide evidence of neuroinflammation mediated post-TBI neuropsychiatric disorders including anxiety, trauma/stress, and depression. Inflammatory processes and stress response dysregulation can lead to secondary cell damage, which promote the development and maintenance of neuropsychiatric disorders postinjury.

Conclusion: This review identifies both theoretical and empirical support for neuroinflammatory response as feasible mechanisms underlying neuropsychiatric disorders after TBI. Further understanding of these processes in this context has significant clinical implications for guiding the development of novel treatments to reduce psychiatric symptoms postinjury. Future directions to address current limitations in the literature are discussed.
Background: Neuropsychiatric symptoms are common following traumatic brain injury (TBI), but their etiological onset remains unclear. Mental health research implicates neuroinflammation in the development of psychiatric disorders. The presence of neuroinflammatory responses after TBI thus prompts an investigation of their involvement in the emergence of neuropsychiatric disorders postinjury.

Objective: Review the literature surrounding the role ...

Anxiété ; Dépression ; Inflammation (Pathologie) ; Neuropsychiatrie ; Cerveau - Lésions et blessures ; Traumatisme cranio-cérébral

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Objective: Parkinson's disease (PD) is a neurodegenerative disorder caused by disruption of dopamine-producing cells. PD is associated with motor symptoms and nonmotor symptoms including depression and cognitive impairment. Past research suggests an association between depression and cognitive impairment in PD. Physical activity may have a therapeutic effect on both depression and cognitive impairment. The present study investigates if physical activity mediates the association between depressive symptoms and cognition in a longitudinal sample of individuals with PD. Method: Participants include individuals newly diagnosed with PD (N = 487) enrolled in the Parkinson's Progression Marker Initiative (PPMI). Participants completed an array of neuropsychological tests over the course of 5 years, as well as questionnaires of depression and physical activity. Between-person and within-person effects of depression and cognition mediated through physical activity were analyzed using structural equation modeling. Results: A significant direct effect demonstrated depression was associated with worse global cognitive functioning. Furthermore, there was a significant indirect within-person effect, indicating that physical activity fully mediated the association between depression and cognition. Individuals who became more depressed over time became less physically active and subsequently experienced cognitive decline over the 5-year period. Conclusions: Findings have implications for prognostic detection and/or the role of physical activity interventions to buffer effects of depression on cognitive impairment among individuals diagnosed with PD. Physical interventions may potentially be implemented among depressed persons to preserve cognitive functioning. Worsened depression early during PD may be a risk factor for inactivity and cognitive diminishment.
Objective: Parkinson's disease (PD) is a neurodegenerative disorder caused by disruption of dopamine-producing cells. PD is associated with motor symptoms and nonmotor symptoms including depression and cognitive impairment. Past research suggests an association between depression and cognitive impairment in PD. Physical activity may have a therapeutic effect on both depression and cognitive impairment. The present study investigates if physical ...

Maladie de Parkinson ; Dépression ; Cognition ; Médiation

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Objective: In a large multisite cohort of Veterans who underwent Roux-en-Y gastric bypass (RYGB) or laparoscopic sleeve gastrectomy (LSG), initiation of (ie, incident) and persistence of (ie, continuation of preoperative) depression treatment are compared with matched nonsurgical controls.

Background: Bariatric surgery has been associated with short-term improvements in depression but less is known about longer term outcomes.

Methods: In a retrospective cohort study, we matched 1713 Veterans with depression treatment who underwent bariatric surgery in Veterans Administration bariatric centers from fiscal year 2001 to 2016 to 15,056 nonsurgical controls using sequential stratification and examined the persistence of depression treatment via generalized estimating equations. Incidence of depression treatment was compared using Cox regression models between 2227 surgical patients and 20,939 matched nonsurgical controls without depression treatment at baseline.

Results: In surgical patients with depression treatment at baseline, the use of postsurgical depression treatment declined over time for both surgical procedures, but postsurgical patients had greater use of depression treatment at 5 years [RYGB: odds ratio=1.24, 95% confidence interval (CI): 1.04-1.49; LSG: odds ratio=1.27, 95% CI: 1.04-1.56] compared with controls. Among those without depression treatment at baseline, bariatric surgery was associated with a higher incidence of depression treatment compared with matched controls (RYGB: hazard ratio=1.34, 95% CI: 1.17-1.53; LSG: hazard ratio at 1-5 years=1.27, 95% CI: 1.10-1.47).

Conclusions: Bariatric surgery was associated with a greater risk of postoperative incident depression treatment and greater persistence of postoperative depression treatment. Depression may worsen for some patients after bariatric surgery, so clinicians should carefully monitor their patients for depression postoperatively.
Objective: In a large multisite cohort of Veterans who underwent Roux-en-Y gastric bypass (RYGB) or laparoscopic sleeve gastrectomy (LSG), initiation of (ie, incident) and persistence of (ie, continuation of preoperative) depression treatment are compared with matched nonsurgical controls.

Background: Bariatric surgery has been associated with short-term improvements in depression but less is known about longer term outcomes.

Methods: In a ...

Dépression ; Obésité ; Obésité - Chirurgie ; Chirurgie bariatrique

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Background
Individuals with a family history of alcohol and other substance use disorders (FH+) are several times more likely to develop alcohol problems compared to individuals with no such family histories (FH–). Here we sought to evaluate associations of early life adversity (ELA) with two key risk-related FH+ phenotypic characteristics: increased antisocial and depressive tendencies.

Methods
We examined data from 1187 FH+ and FH– young adults (average age 23.6 years old) with and without personal histories of substance use disorders. Antisocial tendencies were evaluated with the Socialization scale of the California Personality Inventory (CPI-So), while depressive tendencies were evaluated with the Beck Depression Inventory II (BDI).

Results
In general, being FH+, having a personal substance use disorder history, and experiencing greater levels of ELA were associated with lower CPI-So scores (indicating more antisocial tendencies) and higher BDI scores (indicating more depressive tendencies).

Conclusions
These results suggest that ELA is linked to increased antisocial and depressive tendencies observed in FH+ persons. Given that FH+ individuals are disproportionately exposed to ELA, this increased exposure may be a major contributor to these and other risk-related characteristics commonly present in FH+ individuals. Additional studies are needed to evaluate the impact of ELA on risk-related phenotypic characteristics, including prospective studies in early childhood and mechanistic studies evaluating pathways by which ELA exerts its effects on FH phenotypic characteristics.
Background
Individuals with a family history of alcohol and other substance use disorders (FH+) are several times more likely to develop alcohol problems compared to individuals with no such family histories (FH–). Here we sought to evaluate associations of early life adversity (ELA) with two key risk-related FH+ phenotypic characteristics: increased antisocial and depressive tendencies.

Methods
We examined data from 1187 FH+ and FH– young ...

Toxicomanie ; Dépression ; Dépendance (Psychologie) ; Habiletés sociales chez l'adolescent

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Impression management (IM) in the personnel selection context is traditionally seen as a dishonest
response distortion that indicates maladaptive coping. However, it has recently been proposed as a
personality trait that relates to better mental health and work performance. In the current investigation,
we examined the role of IM in buffering depression-related social stress and predicting individual’s
adaptive work behaviors. Through 3 studies in a large sample (N 2,317) in a real postgraduate
enrollment context and 1 follow-up study, we found that IM moderated the associations of depression
with 2 stressors related to lack of tangible and intangible stress-coping resources. The associations of
depression with social support and socioeconomic status were weaker among individuals with higher IM
tendency (Study 1). IM also predicted more perseverance in solving highly difficult problems (Study 2)
and enduring boredom (Study 3), which was thought to be adaptive and crucial in achieving occupational
success. Furthermore, we also showed that IM in the selection context predicted better adjustment and
performance in real academic life after the enrollment (Study 4). These findings demonstrate the positive
role of IM in making inferences about applicants’ mental health and potential work performances, which
is the top issue in personnel selection practices.
Impression management (IM) in the personnel selection context is traditionally seen as a dishonest
response distortion that indicates maladaptive coping. However, it has recently been proposed as a
personality trait that relates to better mental health and work performance. In the current investigation,
we examined the role of IM in buffering depression-related social stress and predicting individual’s
adaptive work behaviors. Through 3 studies ...

Stress ; Dépression ; Adaptation sociale

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Detecting Anxiety in Long-Term Care Residents: A Systematic Review | Juin 2022 H

Article (Gériatrie - gérontologie)

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L’anxiété est fréquemment observée dans les centres de soins de longue durée (CSLD). Cependant, la précision des outils pour sa détection n’a pas encore été comparée à une norme de référence chez les résidents des CSLD. Quatre bases de données et des sources de littérature grise ont été consultées en utilisant les mots-clés “anxiety” (anxiété) et “LTC” (CSLD). Les études incluses ont évalué la précision diagnostique d’outils de détection de l’anxiété par rapport à une norme de référence chez des résidents de CSLD. Les mesures de précision diagnostique pour ces études ont été extraites. Quatre articles parmi les 4,620 recensés répondaient aux critères d’inclusion. Malgré les données limitées et certains manques dans la documentation des méthodes et des caractéristiques d’étude, le Geriatric Anxiety Inventory (sensibilité: 90.0%, spécificité: 86.2%) et le Hospital Anxiety and Depression Scale-Anxiety (sensibilité: 90.0%, spécificité: 80.6%) présentent les meilleurs résultats pour la détection du trouble anxieux généralisé. Cette étude a montré que quatre outils pour la détection de l’anxiété sont appropriés en CSLD, ce qui constitue une première étape essentielle pour assurer le diagnostic et la gestion de l’anxiété chez les résidents des CSLD. Les troubles anxieux non généralisés et la faisabilité des outils nécessitent toutefois de plus amples études.
L’anxiété est fréquemment observée dans les centres de soins de longue durée (CSLD). Cependant, la précision des outils pour sa détection n’a pas encore été comparée à une norme de référence chez les résidents des CSLD. Quatre bases de données et des sources de littérature grise ont été consultées en utilisant les mots-clés “anxiety” (anxiété) et “LTC” (CSLD). Les études incluses ont évalué la précision diagnostique d’outils de détection de ...

Vieillissement ; Dépression ; Soins de longue durée ; Anxiété chez les personnes âgées ; Personnes âgées

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Abstract: The current study hypothesizes a mediating role for shame in the association between vulnerable narcissism (VN) and depressive and social anxiety symptoms. A sample of 600 undergraduates was administered psychometrically sound self-reports to assess the study variables. Structural Equation Modeling supported the mediating effect of shame in the association between VN and depressive symptoms, irrespective of the way VN was assessed (i.e., Hypersensitive Narcissism Scale [HSNS] or Pathological Narcissism Inventory). Conversely, shame did not mediate the association with social anxiety when VN was assessed through the (HSNS). A direct effect of VN on both depressive and social anxiety symptoms was also detected. The results are discussed in the context of their implications, while also focusing on the different findings that emerged via the measures used to assess VN.
Abstract: The current study hypothesizes a mediating role for shame in the association between vulnerable narcissism (VN) and depressive and social anxiety symptoms. A sample of 600 undergraduates was administered psychometrically sound self-reports to assess the study variables. Structural Equation Modeling supported the mediating effect of shame in the association between VN and depressive symptoms, irrespective of the way VN was assessed ...

Dépression ; Détresse ; Anxiété - Aspect social ; Narcissisme ; Honte

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Objectives
To examine the effectiveness of group cognitive behavioural therapy (CBT) for postpartum depression (PPD) delivered by public health nurses with little to no previous psychiatric training at improving depression, worry, social support and the mother-infant relationship.

Methods
Mothers (n = 141) living in Ontario, Canada with Edinburgh Postnatal Depression Scale Scores ≥10 and an infant <12 months of age were randomized to receive nine weekly 2-h sessions of in-person group CBT for PPD delivered by two public health nurses plus treatment as usual (TAU; experimental group) or TAU alone (control group). Primary outcomes were change in EPDS score and current major depressive disorder (Mini International Neuropsychiatric Interview) assessed immediately post-treatment (T2). Secondary outcomes included maternal worry, social support, and quality of the mother-infant relationship. All outcomes were assessed again six months post-treatment (T3).

Results
Participants in the experimental group had statistically significantly greater reductions in PPD symptoms immediately post-treatment (T2) (B = -5.35, p < 0.01), were more likely to manifest a clinically significant improvement in EPDS scores (≥4 points; OR = 3.44, 95%CI: 1.49–7.94), and no longer have symptoms consistent with current MDD (OR = 5.31, 95% CI: 1.78–15.83). Six months post-treatment (T3), experimental group participants had higher odds of clinically significant PPD improvement (OR = 5.10, 95%CI: 1.89–13.78), while 25% of the experimental group and 70% of remaining control group participants reported current MDD (p < 0.01). Statistically significant improvements in worry and the mother-infant relationship were also observed, decreases maintained at six months post-treatment.

Conclusions
Public health nurses with little to no previous psychiatric training can be trained to deliver effective group CBT for PPD to improve depression, worry, and the mother-infant relationship. Task shifting PPD treatment with group CBT to public health nurses could improve treatment uptake and lead to better outcomes for mothers, families, and the healthcare system.

(Trial Registration NCT03039530)
Objectives
To examine the effectiveness of group cognitive behavioural therapy (CBT) for postpartum depression (PPD) delivered by public health nurses with little to no previous psychiatric training at improving depression, worry, social support and the mother-infant relationship.

Methods
Mothers (n = 141) living in Ontario, Canada with Edinburgh Postnatal Depression Scale Scores ≥10 and an infant <12 months of age were randomized to receive ...

Dépression ; Anxiété ; Santé publique ; SOINS INFIRMIERS ; Dépression du post-partum

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Spirituality, Quality of Life and Frailty in Community-Dwelling Adults >= 50 Years | Mai 2022 H

Article (Soins palliatifs et soins spirituels)

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Frailty is a known risk factor for morbidity and death among older adults. Frailty is also known to be directly related to levels of depression and stress. While the beneficial effects of religion and spirituality on depression and stress have been well documented, it is unknown if they can mitigate the effects of depression and stress on physical frailty. This cross-sectional analysis of 110 community-dwelling adults 50 years of age and older, characterized by a range of frailty levels, examined whether spirituality reduced the effect of less-than-optimal quality of life (QoL) as measured by depression and stress on risk for frailty. Results of multivariable logistic regression analyses showed that the interaction of spirituality and QoL was significantly related to the likelihood of frailty. At the lowest tertile of spirituality, poor and mid QoL (those with depression +/- stress) increased the odds of frailty (Odds Ratio [OR] = 8.23 and 95% Confidence Interval [CI] = 1.34-50.74 for depression and stress and OR = 8.75, 95% CI = 1.20-64.09 for depression only). With increased medical utilization and costs due to aging it is important to address psychosocial aspects associated with frailty to mitigate their effects. Spirituality appears to have a beneficial effect in lessening the negative impact of depression and stress upon physical frailty, which may help older adults maintain a more robust state of health. These findings are worth further examination.
Frailty is a known risk factor for morbidity and death among older adults. Frailty is also known to be directly related to levels of depression and stress. While the beneficial effects of religion and spirituality on depression and stress have been well documented, it is unknown if they can mitigate the effects of depression and stress on physical frailty. This cross-sectional analysis of 110 community-dwelling adults 50 years of age and older, ...

Spiritualité ; Qualité de vie chez la personne âgée ; Dépression ; Stress

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Les enfants vivant avec un parent atteint d’un trouble dépressif majeur sont à plus haut risque de vivre des difficultés sociales, scolaires et émotionnelles (Reupert et al., 2012). Ils se retrouvent également très souvent à avoir un rôle de proche aidant auprès de leur parent (Cooklin, 2010). À l’étranger, entre autres aux États-Unis, en Europe et en Australie, plusieurs interventions ont été développées pour ces enfants et leurs familles dans le but de favoriser leur résilience. Au Québec, le programme FAMILLE+, une intervention préventive ciblée pour les enfants et les familles vivant avec un parent ayant un trouble dépressif, a été développé en 2018. Le contenu du programme, notamment les objectifs, la structure générale, les activités d’apprentissage et les outils novateurs proposés seront détaillés. Puis, les auteurs présenteront les résultats d’une étude pilote de la fidélité de la mise en oeuvre du programme, les principaux facteurs facilitant et entravant l’implantation, ainsi que les retombées perçues par les participants (enfants, parents) et les animateurs. Finalement, les implications pour la pratique seront abordées.
Les enfants vivant avec un parent atteint d’un trouble dépressif majeur sont à plus haut risque de vivre des difficultés sociales, scolaires et émotionnelles (Reupert et al., 2012). Ils se retrouvent également très souvent à avoir un rôle de proche aidant auprès de leur parent (Cooklin, 2010). À l’étranger, entre autres aux États-Unis, en Europe et en Australie, plusieurs interventions ont été développées pour ces enfants et leurs familles dans ...

Santé mentale ; ENFANTS ; Dépression ; Familles

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Dépression [91]

Dépression - Traitement [18]

Angoisse [11]

Anxiété [10]

Santé mentale [6]

Suicide [6]

Biblio-Santé - Santé mentale [5]

Psychose maniacodépressive [5]

Psychothérapie [5]

Troubles bipolaires [5]

Antidépresseurs [4]

Dépressifs [4]

Stress [4]

Thérapie cognitive [4]

Alcoolisme [3]

Dépressifs - Entretiens [3]

ENFANTS [3]

Personnes âgées [3]

Thérapie de comportement [3]

Troubles du sommeil [3]

Alimentation - Aspect psychologique [2]

Angoisse - Traitement [2]

Autisme [2]

Cognition [2]

Cyclothymie [2]

Dépressifs - Relations familiales [2]

Dépression chez l'enfant [2]

Dépression du post-partum [2]

Douleur chronique [2]

Familles [2]

Gestion du stress [2]

Intervention préventive ciblée [2]

Médicaments - Usage [2]

Narcissisme [2]

Névroses obsessionnelles [2]

Obésité [2]

Psychopathologie [2]

Qualité de la vie [2]

Schizophrénie [2]

Tabagisme [2]

Toxicomanie [2]

Troubles bipolaires - Traitement [2]

Troubles de la personnalité [2]

Troubles du comportement alimentaire [2]

Absentéisme (Travail) [1]

Adaptation (Psychologie) [1]

Adaptation sociale [1]

Adolescents [1]

Alimentation - Comportement compulsif [1]

Angoisse - Médecines parallèles [1]

Angoisse chez l'enfant [1]

Anorexie mentale [1]

Anxiété - Aspect social [1]

Anxiété chez l'enfant [1]

Anxiété chez les personnes âgées [1]

Art-thérapie [1]

Arts - Emploi en thérapeutique [1]

Bouddhisme [1]

Boulimie [1]

Cerveau - Lésions et blessures [1]

Cerveau - Maladies - Aspect nutritionnel [1]

Cerveau - Maladies - Prévention [1]

Cerveau - Stimulation - Emploi et thérapeutique [1]

Chimiothérapie [1]

Chirurgie bariatrique [1]

Communication [1]

Compassion [1]

Compétence de communication chez l'enfant [1]

Complexes (Psychologie) [1]

Confiance en soi [1]

Counseling [1]

COVID-19 [1]

Dépendance (Psychologie) [1]

Dépressifs - Travail [1]

Dépression - Médecines parallèles [1]

Dépression chez l'adolescent [1]

Dépression chez la personne âgée [1]

Détresse [1]

Douleur [1]

Éducation des enfants - Ouvrages pour la jeunesse [1]

Émotions [1]

Enfants de malades mentaux [1]

Estime de soi [1]

État de stress post-traumatique [1]

Événements stressants de la vie [1]

Fatigue [1]

Femmes [1]

Femmes - Santé et hygiène [1]

Femmes - Santé mentale [1]

Habiletés sociales chez l'adolescent [1]

Hommes - Santé mentale [1]

Honte [1]

Humeur (Psychologie) [1]

Hypocondrie [1]

Identité (Psychologie) [1]

Inflammation (Pathologie) [1]

INFORMATION [1]

Interaction sociale chez l'enfant [1]

Jeunes adultes [1]

Jeunesse - Protection, assistance, etc. [1]

Lithium - Emploi en thérapeutique [1]

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