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Documents  Dépression | enregistrements trouvés : 84

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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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Learning objectives: After participating in this activity, learners should be better able to:

* Discuss whether prepubertal depression shows longitudinal continuity with depression in adulthood.

* Summarize existing literature on adult emotional and functional outcomes of prepubertal depression and internalizing problems.

Background: Adolescent- and young adult-onset depression are common, recurrent, and can cause significant distress and psychosocial impairment across the life span, but recognition of prepubertal internalizing problems and depression, along with their prevalence, clinical course, and long-term outcomes, remains elusive.

Objective: To examine whether prepubertal depression, which can manifest differently from adult depression, shows longitudinal continuity with depression in adulthood, and to summarize existing literature on adult emotional and functional outcomes of prepubertal depression and internalizing problems.

Methods: A scoping review was conducted for peer-reviewed cohort articles published between 2000 and 2020 using PubMed and PsycINFO. From 4309 identified references, 17 articles were included.

Results: Prepubertal depression confers increased risk of recurrence of depression in adulthood, with similar findings for prepubertal internalizing problems. No studies found prepubertal depression or internalizing problems predicting adult substance abuse, and no studies asked about adult bipolar diagnoses. More research is needed to draw clear conclusions regarding their implications for other psychiatric, medical, or psychosocial outcomes.

Conclusion: The reviewed studies provide limited evidence that prepubertal depression onset predicts adult depression. The small evidence base and heterogeneous methodological assessments may limit, however, the ability to draw meaningful conclusions about the long-term course of prepubertal-onset depression. Well-designed studies with longer follow-up and multiple assessments in adulthood are needed to clarify and assess the potential effects of prepubertal depression on adult health and functioning. This information will eventually become available as the samples in recently initiated longitudinal cohort studies of children mature further.
Learning objectives: After participating in this activity, learners should be better able to:

* Discuss whether prepubertal depression shows longitudinal continuity with depression in adulthood.

* Summarize existing literature on adult emotional and functional outcomes of prepubertal depression and internalizing problems.

Background: Adolescent- and young adult-onset depression are common, recurrent, and can cause significant distress and ...

Dépression

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Background: Patients with gastrointestinal cancers experience moderate to high levels of sleep disturbance during chemotherapy that decreases their functional status and quality of life (QOL).

Objective: The objectives of this study were to identify subgroups of patients with gastrointestinal cancers with distinct sleep disturbance profiles and evaluate for differences among these subgroups in demographic, clinical, and sleep characteristics, as well as co-occurring symptoms and QOL outcomes.

Methods: Patients (n = 405) completed questionnaires 6 times over 2 cycles of chemotherapy. Latent profile analysis was used to identify subgroups of patients with distinct sleep disturbance profiles.

Results: Three distinct sleep disturbance profiles (ie, low, high, very high) were identified. Compared with the low class, patients in the other 2 classes were significantly younger and less likely to be married and to exercise on a regular basis and received a higher number of previous treatments. Compared with the low class, patients in the other 2 classes reported higher levels of anxiety, depressive symptoms, morning and evening fatigue, and pain and lower levels of attentional function and QOL scores at enrollment.

Conclusions: This study is the first to use latent profile analysis to identify subgroups of patients with gastrointestinal cancers with distinct sleep disturbance profiles. Findings provide new insights on the associations between sleep disturbance and multiple co-occurring symptoms in these patients.

Implications for Practice: Clinicians can identify patients who are at the highest risk for sleep disturbance and recommend a variety of sleep hygiene interventions (eg, establishment of a bedtime routine), as well as initiate interventions for other co-occurring symptoms.
Background: Patients with gastrointestinal cancers experience moderate to high levels of sleep disturbance during chemotherapy that decreases their functional status and quality of life (QOL).

Objective: The objectives of this study were to identify subgroups of patients with gastrointestinal cancers with distinct sleep disturbance profiles and evaluate for differences among these subgroups in demographic, clinical, and sleep characteristics, ...

Anxiété ; Dépression ; Chimiothérapie ; Sommeil ; Fatigue ; Tractus gastro-intestinal - Cancer - Traitement ; Douleur ; Qualité de la vie ; Troubles du sommeil

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Unsatisfactory responses to bipolar disorder treatments have necessitated novel therapeutic approaches. Evidence of levetiracetam's effectiveness in mania was reported in previous studies. This study evaluated its efficacy, safety and tolerability as an adjunct to quetiapine in mania. Forty-four patients with Young Mania Rating Scale (YMRS) score >=20 entered and were randomized to receive levetiracetam plus quetiapine or placebo plus quetiapine for 6 weeks. Patients were assessed using the YMRS and Beck Scale for Suicidal Ideations (BSSI) at baseline and weeks 2, 4 and 6. Changes in the scores, remission rates and response to treatment were compared between the groups. Forty patients completed the trial. The general linear model (GLM) repeated measures demonstrated a significant effect for time x treatment interaction on the YMRS score during the trial (P = 0.04). A greater reduction in YMRS scores was seen in the levetiracetam group compared with the placebo group from baseline to week 4 (P = 0.045). Response to treatment was significantly better in the levetiracetam group (P = 0.046). No significant effect for time x treatment interaction on BSSI score was seen in GLM repeated measures. Finally, there was no significant difference in the frequency of adverse events. Adjunctive levetiracetam is effective, safe and well-tolerated in patients with mania. Further high-quality, large-scale trials are recommended.
Unsatisfactory responses to bipolar disorder treatments have necessitated novel therapeutic approaches. Evidence of levetiracetam's effectiveness in mania was reported in previous studies. This study evaluated its efficacy, safety and tolerability as an adjunct to quetiapine in mania. Forty-four patients with Young Mania Rating Scale (YMRS) score >=20 entered and were randomized to receive levetiracetam plus quetiapine or placebo plus quetiapine ...

Médicaments - Usage ; Suicide - Prévention ; Troubles bipolaires - Traitement ; Psychoses ; Dépression

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The debate around optimal target dose for first-line antidepressants (ADs) is still ongoing. Along this line, therapeutic drug monitoring (TDM) represents one of the most promising tools to improve clinical outcome. Nevertheless, a few data exist regarding the concentration-effect relationship of first-line ADs which limits TDM implementation in routine clinical practice. We conducted the first patient-level concentration-response mega-analysis including data acquired by us previously and explored the concentration dependency of first-line AD (206 subjects). Further, new data on mirtazapine are reported (18 subjects). Hamilton Depression Rating Scale-21 administered at baseline, at month 1 and month 3 was used as the measure of efficacy to assess antidepressant response (AR). When pooling all four first-line ADs together, normalized plasma levels and AR significantly fit a bell-shaped quadratic function with a progressive increase of AR up to around the upper normalized limit of the therapeutic reference range with a decrease of AR at higher serum levels. Our results complement the available evidence on the issue and the recent insights gained from dose-response studies. A concentration-dependent clinical efficacy, such as previously demonstrated for tricyclic compounds, also emerge for first-line ADs. Our study supports a role for TDM as a tool to optimize AD treatment to obtain maximum benefit.
The debate around optimal target dose for first-line antidepressants (ADs) is still ongoing. Along this line, therapeutic drug monitoring (TDM) represents one of the most promising tools to improve clinical outcome. Nevertheless, a few data exist regarding the concentration-effect relationship of first-line ADs which limits TDM implementation in routine clinical practice. We conducted the first patient-level concentration-response mega-analysis ...

Antidépresseurs ; Dépression ; Médicaments - Usage ; Médicaments - Usage - Prévention

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LGBTQ+ individuals are at increased risk of experiencing mental health concerns including depression and substance use. Understanding these mental health disparities has been an increasing focus for researchers, but there is still limited research on the relationship between religion and depression and substance use among LGBTQ+ individuals. In the current study, it was theorized that higher perceived parental religiosity influences current experiences of depression and alcohol and substance use/abuse through the mediator of the perceived familial stigma of sexuality (stigmatizing behaviors experienced in the home). Individuals (N = 427) who identified as gay/lesbian, queer, bisexual, pansexual, asexual, and/or demisexual were recruited for the study. Results showed that perceived parental religiosity was positively linked to both current reports of depression, alcohol use, and cannabis use. In line with predictions, perceived familial stigma of sexuality was found to fully mediate the relationships between perceived parental religiosity and depression and cannabis use and to partially mediate the relationship between perceived parental religiosity and alcohol use. Furthermore, there was a moderating effect of gender, showing that gay men experienced the strongest links between perceived parental religiosity and perceived familial stigma and between perceived familial stigma and depression, alcohol use, and cannabis use. The findings of this study implicate perceived familial stigma of sexuality as an important factor that could explain how perceived parental religiosity increases LGBTQ+ individuals' experiences of mental health concerns.
LGBTQ+ individuals are at increased risk of experiencing mental health concerns including depression and substance use. Understanding these mental health disparities has been an increasing focus for researchers, but there is still limited research on the relationship between religion and depression and substance use among LGBTQ+ individuals. In the current study, it was theorized that higher perceived parental religiosity influences current ...

Religions ; PARENTS ; Familles ; Sexualité ; Dépression ; Toxicomanie

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Objective: High negative affect, low positive affect, and low cognitive functioning are depression-related states that may be particularly relevant to females who smoke cigarettes and may be more prominent following overnight tobacco abstinence. This study aimed to assess relations between depression symptom levels and negative affect, positive affect, and subjective cognitive functioning in premenopausal females who smoke. Methods: Premenopausal females who smoke daily with low (n = 66) or elevated (n = 33) baseline depression symptoms completed subjective ratings of negative affect, positive affect, and cognitive functioning pre-first cigarette (i.e., after overnight tobacco abstinence) and at random prompts throughout the day via ecological momentary assessment (EMA) for 35 days. Results: Participants with elevated depression symptoms reported overall higher negative affect (p = .01). Positive affect was significantly lower prior to the first cigarette of the day (p < .001), but did not significantly differ between depression symptom groups. Subjective cognitive functioning was significantly lower pre-first cigarette of the day (p < .001). There was a significant Depression Symptom x Prompt Type interaction for subjective cognitive functioning (p = .01). Subjective cognitive functioning did not significantly differ by depression symptom group pre-first cigarette of the day but was significantly different at random prompts throughout the day. Conclusions: As participants smoked as usual, findings identify naturalistic factors which may influence smoking behavior among premenopausal females who smoke with elevated depression symptoms.
Objective: High negative affect, low positive affect, and low cognitive functioning are depression-related states that may be particularly relevant to females who smoke cigarettes and may be more prominent following overnight tobacco abstinence. This study aimed to assess relations between depression symptom levels and negative affect, positive affect, and subjective cognitive functioning in premenopausal females who smoke. Methods: Pre...

Tabagisme ; Dépression ; Femmes

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Importance Transgender and nonbinary (TNB) youths are disproportionately burdened by poor mental health outcomes owing to decreased social support and increased stigma and discrimination. Although gender-affirming care is associated with decreased long-term adverse mental health outcomes among these youths, less is known about its association with mental health immediately after initiation of care.

Objective To investigate changes in mental health over the first year of receiving gender-affirming care and whether initiation of puberty blockers (PBs) and gender-affirming hormones (GAHs) was associated with changes in depression, anxiety, and suicidality.

Design, Setting, and Participants This prospective observational cohort study was conducted at an urban multidisciplinary gender clinic among TNB adolescents and young adults seeking gender-affirming care from August 2017 to June 2018. Data were analyzed from August 2020 through November 2021.

Exposures Time since enrollment and receipt of PBs or GAHs.

Main Outcomes and Measures Mental health outcomes of interest were assessed via the Patient Health Questionnaire 9-item (PHQ-9) and Generalized Anxiety Disorder 7-item (GAD-7) scales, which were dichotomized into measures of moderate or severe depression and anxiety (ie, scores ≥10), respectively. Any self-report of self-harm or suicidal thoughts over the previous 2 weeks was assessed using PHQ-9 question 9. Generalized estimating equations were used to assess change from baseline in each outcome at 3, 6, and 12 months of follow-up. Bivariate and multivariable logistic models were estimated to examine temporal trends and investigate associations between receipt of PBs or GAHs and each outcome.

Results Among 104 youths aged 13 to 20 years (mean [SD] age, 15.8 [1.6] years) who participated in the study, there were 63 transmasculine individuals (60.6%), 27 transfeminine individuals (26.0%), 10 nonbinary or gender fluid individuals (9.6%), and 4 youths who responded “I don’t know” or did not respond to the gender identity question (3.8%). At baseline, 59 individuals (56.7%) had moderate to severe depression, 52 individuals (50.0%) had moderate to severe anxiety, and 45 individuals (43.3%) reported self-harm or suicidal thoughts. By the end of the study, 69 youths (66.3%) had received PBs, GAHs, or both interventions, while 35 youths had not received either intervention (33.7%). After adjustment for temporal trends and potential confounders, we observed 60% lower odds of depression (adjusted odds ratio [aOR], 0.40; 95% CI, 0.17-0.95) and 73% lower odds of suicidality (aOR, 0.27; 95% CI, 0.11-0.65) among youths who had initiated PBs or GAHs compared with youths who had not. There was no association between PBs or GAHs and anxiety (aOR, 1.01; 95% CI, 0.41, 2.51).

Conclusions and Relevance This study found that gender-affirming medical interventions were associated with lower odds of depression and suicidality over 12 months. These data add to existing evidence suggesting that gender-affirming care may be associated with improved well-being among TNB youths over a short period, which is important given mental health disparities experienced by this population, particularly the high levels of self-harm and suicide.
Importance Transgender and nonbinary (TNB) youths are disproportionately burdened by poor mental health outcomes owing to decreased social support and increased stigma and discrimination. Although gender-affirming care is associated with decreased long-term adverse mental health outcomes among these youths, less is known about its association with mental health immediately after initiation of care.

Objective To investigate changes in mental ...

Transgenres - Psychologie ; Dépression ; Anxiété ; Suicide

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The Role of MicroRNA and Microbiota in Depression and Anxiety | Février 2022 H

Article (Neurologie et neuropsychologie)

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Depression and anxiety are devastating disorders. Understanding the mechanisms that underlie the development of depression and anxiety can provide new hints on novel treatments and preventive strategies. Here, we summarize the latest findings reporting the novel roles of gut microbiota and microRNAs (miRNAs) in the pathophysiology of depression and anxiety. The crosstalk between gut microbiota and the brain has been reported to contribute to these pathologies. It is currently known that some miRNAs can regulate bacterial growth and gene transcription while also modulate the gut microbiota composition, suggesting the importance of miRNAs in gut and brain health. Treatment and prevention strategies for neuropsychiatric diseases, such as physical exercise, diet, and probiotics, can modulate the gut microbiota composition and miRNAs expressions. Nonetheless, there are critical questions to be addressed to understand further the mechanisms involved in the interaction between the gut microbiota and miRNAs in the brain. This review summarizes the recent findings of the potential roles of microbiota and miRNA on the neuropathology of depression and anxiety, and its potential as treatment strategies.
Depression and anxiety are devastating disorders. Understanding the mechanisms that underlie the development of depression and anxiety can provide new hints on novel treatments and preventive strategies. Here, we summarize the latest findings reporting the novel roles of gut microbiota and microRNAs (miRNAs) in the pathophysiology of depression and anxiety. The crosstalk between gut microbiota and the brain has been reported to contribute to ...

Anxiété ; Dépression ; Microbiote

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Dépression [84]

Dépression - Traitement [18]

Angoisse [9]

Anxiété [9]

Santé mentale [6]

Biblio-Santé - Santé mentale [5]

Psychose maniacodépressive [5]

Psychothérapie [5]

Dépressifs [4]

Suicide [4]

Thérapie cognitive [4]

Alcoolisme [3]

Antidépresseurs [3]

Dépressifs - Entretiens [3]

ENFANTS [3]

Personnes âgées [3]

Stress [3]

Thérapie de comportement [3]

Troubles du sommeil [3]

Angoisse - Traitement [2]

Autisme [2]

Cyclothymie [2]

Dépressifs - Relations familiales [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 [2]

Troubles bipolaires - Traitement [2]

Troubles de la personnalité [2]

Vieillissement [2]

Absentéisme (Travail) [1]

Adaptation (Psychologie) [1]

Adaptation sociale [1]

Alimentation - Aspect psychologique [1]

Alimentation - Comportement compulsif [1]

Angoisse - Médecines parallèles [1]

Anorexie mentale [1]

Anxiété - Aspect social [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]

Chimiothérapie [1]

Chirurgie bariatrique [1]

Cognition [1]

Compassion [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 l'enfant [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]

Gériatrie [1]

Habiletés sociales chez l'adolescent [1]

Honte [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]

Maladie d'Alzheimer [1]

Maladie de Parkinson [1]

Maladies mentales [1]

Maladies mentales - Aspect religieux [1]

Maniacodépressifs - Entretiens [1]

Marche (Exercice) [1]

Médiation [1]

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