Baseline Beck Depression Inventory Score Research Articles

Effectiveness of osteopathic manipulative applications on hypothalamic-pituitary-adrenal (HPA) axis in youth with major depressive disorder: a randomized double-blind, placebo-controlled trial.

Osteopathic treatments regulate the neurovegetative system through joint mobilizations and manipulations, and myofascial and craniosacral techniques. Despite the growing body of research, the precise impact of osteopathic medicine on the autonomic nervous system (ANS) is not yet fully elucidated. As to Kuchera's techniques, the stimulation of the sympathetic trunk and prevertebral ganglia contributed to harmonization of the sympathetic activity. However, potential relationships between the harmonization of the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenal (HPA) axis largely remain uncertain and warrant further exploration. This study was designed to evaluate the effectiveness of the osteopathic sympathetic harmonization (OSH) on the SNS and the HPA axis in youth with major depressive disorder (MDD). The study included 39 youths aged 15-21 years and diagnosed with MDD. The participants were randomly assigned into either the OSH or the placebo group. Stimulation was performed on the sympathetic truncus and prevertebral ganglia in the OSH group. The stimulation of the placebo group was performed with a lighter touch and a shorter duration in similar areas. Each participant completed the Beck Depression Inventory (BDI) and the State and Trait Anxiety Inventory (SAI and TAI) before the application. Blood pressure (BP) and pulse measurements were made, and saliva samples were taken before, immediately after, and 20 min after application. The baseline BDI (p=0.617) and TAI (p=0.322) scores were similar in both groups. Although the SAI scores decreased in both groups postintervention, no statistically significant difference was found between the two groups. Subjects who received OSH had a decrease in α-amylase level (p=0.028) and an increase in cortisol level (p=0.009) 20 min after the procedure. Following OSH application in depressed youth, SNS activity may decrease, whereas HPA axis activity may increase. Future studies may examine the therapeutic efficacy of repeated OSH applications in depressed individuals.

The Plasma Neurofilament Light Chain, Brain-Derived Neurotrophic Factor, and Risk of Depression in Chronic Hemodialysis Patients.

Depression is highly prevalent among hemodialysis patients. Understanding the relationship between the plasma neurofilament light chain (NfL) and brain-derived neurotrophic factor (BDNF) may help us to better understand the mechanisms of depression. This study determined their impact, alongside that of other factors, on the risk of depression in hemodialysis patients. The study enrolled 82 patients undergoing chronic hemodialysis. Serum NfL, BDNF, uric acid, urea, potassium, calcium, phosphorus, intact parathyroid hormone, and C-reactive protein (CRP) levels were measured. The patients completed the Beck Depression Inventory (BDI). Blood pressure values, body mass before and after hemodialysis, and weekly duration of hemodialysis in hours were assessed. For 19-month survival analysis, the patients were stratified according to baseline BDI scores. Based on the BDI score, 18.3% of the patients had an increased risk of depression. Lower scores were associated with significantly longer duration of hemodialysis treatment (37.5 (25-57) 24 (14-37) months, p = 0.01). Within the 19-month survival analysis, 31.7% of patients died. The patients with BDI scores above the median had significantly lower survival than those below the median (log-rank test p = 0.02). No significant differences in serum BDNF levels (192.7 [125.2-278.2]; 207.7 [142.8-265.8] pg/mL, p = 0.40), or NfL concentrations (1431.5 [1182.6-1625.7]; 1494.6 [1335.7-1667] kDa, p = 0.52) were found between patients with lower and higher risk of depression. Patients with BDI scores above the median had significantly higher levels of CRP (9.6 [4.4-14]) than those with scores below the median (3.6 [2.2-7.5], p = 0.01). A significant positive correlation was found between the BDI score and serum CRP level (r = 0.38, p = 0.01). A significant negative correlation was observed between the BDI score and URR% value (r = -0.36, p = 0.02). Patients with lower BDI scores had a longer dialysis duration, indicating a potential negative association between depression risk and length of dialysis treatment. Neither serum NfL nor BDNF levels can serve as markers of depression risk in the dialysis population.

Association of albumin and neutrophil-to-lymphocyte ratio with hormone-mediated depression in prostate cancer.

e24214 Background: Androgen deprivation therapy (ADT) increases the risk of developing depression which can affect quality of life and adherence to treatment. Depression has been associated to inflammation in patients with cancer. Albumin and neutrophil-to-lymphocyte ratio (NLR) are inflammatory biomarkers that to our knowledge have not been evaluated in hormone mediated depression in prostate cancer (PC). The aim of this study is to evaluate the severity of hormone related depression and its association with inflammatory biomarkers, demographics, and cancer treatment variables and to determine antidepressant treatment response. Methods: A retrospective chart review of consecutive referrals to psycho-oncology of PC patients on ADT with new onset depression was conducted. Demographics, cancer and psychiatric history, and laboratories within 1 week of initial visit were collected. Assessments for depression included clinical interview and patient-rated scale [Beck Depression Inventory (BDI)]. These measures were done at baseline (before starting an antidepressant) and follow-up to determine treatment response. Successful antidepressant treatment response is defined as ≥50% reduction in baseline BDI score. Statistical analysis comparing the association of clinical variables between depression, inflammatory biomarkers, and demographics included Pearson’s correlation, chi-square, ANOVA, t-test, and binary logistic regression was used to determine associations with depression. Data was dichotomized using median split for inflammatory biomarkers due to skewness. Results: A sample of 26 PC patients on leuprolide (mean age 70 years; 13 Hispanic, 13 non-Hispanic) included 13 with mild depression (BDI£20) and 13 with moderate- to-severe depression (BDI>20). Moderate-to-severe depression was associated with higher NLR (≥3, p= .041), stage IV PC (n=15, p= .001), and Hispanics ( p= .033). Lower albumin (£3.9) was associated with higher age ( p= .007), higher NLR ( p= .006), and non-Hispanics ( p= .049) but not depression. Over 54% (13/24) of patients did not respond to antidepressant treatment. In logistic regression only NLR and Stage IV PC remained significantly associated with depression after adjusting for confounding variables. Conclusions: NLR and stage IV PC were both associated with moderate-to-severe depression. These results are likely due to increased level of inflammation in advanced cancer. Inflammation has been associated with treatment resistant depression which could explain why 54% of patients did not respond to antidepressant treatment. NLR is an inexpensive routinely used test in cancer centers that has the potential to be used as a biomarker of severity of depression in PC patients.

Differential efficacy of antidepressants in the treatment of hormone mediated depression in patients with ER+ breast cancer.

e24181 Background: Tamoxifen (TAM) and aromatase inhibitors (AI) are associated with a high side-effect burden including depression and cognitive deficits which compromise quality of life and adherence to treatment. The aims of the study were to determine the efficacy of antidepressants (AD) with hormone mediated depression in ER+ breast cancer patients and to determine if any clinical variables predicted successful AD treatment response. Methods: A retrospective chart review of consecutive referrals to psycho-oncology of breast cancer patients on TAM or AI with new onset depression was conducted. Demographic variables, cancer stage and treatment, hormonal treatment, psychiatric history and AD treatment were collected. Assessments for depression, anxiety and cognitive disorders included clinical interviews, patient-rated scales [Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI)] and a clinician-rated scale [Montreal Cognitive Assessment (MoCA)]. These measures were done at baseline (before starting an AD) and follow-up to determine AD treatment response. Successful AD treatment is defined as ≥50% reduction in baseline BDI score, while remission of depression is defined as a BDI score < 8. Statistical analysis comparing clinical variables between AD responders and non-responders included Fischer’s exact test or chi-square, one-way ANOVA, t-test, and binary logistic regression to determine which variables predicted successful AD treatment response. Results: A sample of 40 ER+ breast cancer patients (mean age 55 years; 39 females, 1 male; 26 Hispanic, 14 non-Hispanic) included 18 on TAM and 22 on AI. AD included venlafaxine (N = 18), escitalopram (N = 9), bupropion (N = 4), mirtazapine (N = 4), sertraline (N = 3) and duloxetine (N = 2). Over 72% (29/40) of patients successfully responded to AD with a complete depression remission rate of 50% (20/40). Venlafaxine at a mean dose of 150 mg was significantly more effective (p = .013) in treating hormone-mediated depression when compared to selective serotonin reuptake inhibitors (SSRIs) and other AD (bupropion, mirtazapine). Specifically, 94% (17/18) of patients on venlafaxine successfully responded. Other variables such as cancer stage and treatment, demographics, psychiatric history, and specific hormonal therapy did not predict AD treatment response. Conclusions: Venlafaxine 150 mg daily yielded significantly higher rates of AD response and complete remission of depression in ER+ breast cancer patients with TAM-induced and AI-induced major depression. Venlafaxine was significantly more effective than SSRIs and atypical AD. This high rate of response is likely due to dual serotonin and norepinephrine reuptake inhibition achieved at 150 mg dosing. Venlafaxine can be safely administered with TAM.

MP45-13 CAN DELAYED EJACULATION HAVE AN IMPACT ON PSYCHOLOGICAL HEALTH? FINDINGS FROM A CROSS SECTIONAL STUDY

You have accessJournal of UrologyCME1 Apr 2023MP45-13 CAN DELAYED EJACULATION HAVE AN IMPACT ON PSYCHOLOGICAL HEALTH? FINDINGS FROM A CROSS SECTIONAL STUDY Christian Corsini, Federico Belladelli, Edoardo Pozzi, Giuseppe Fallara, Simone Cilio, Massimiliano Raffo, Alessandro Bertini, Francesco Lanzaro, Donato Cannoletta, Fausto Negri, Ludovica Cella, Margherita Fantin, Luigi Candela, Paolo Capogrosso, Luca Boeri, Alessia D'Arma, Francesco Montorsi, and Andrea Salonia Christian CorsiniChristian Corsini More articles by this author , Federico BelladelliFederico Belladelli More articles by this author , Edoardo PozziEdoardo Pozzi More articles by this author , Giuseppe FallaraGiuseppe Fallara More articles by this author , Simone CilioSimone Cilio More articles by this author , Massimiliano RaffoMassimiliano Raffo More articles by this author , Alessandro BertiniAlessandro Bertini More articles by this author , Francesco LanzaroFrancesco Lanzaro More articles by this author , Donato CannolettaDonato Cannoletta More articles by this author , Fausto NegriFausto Negri More articles by this author , Ludovica CellaLudovica Cella More articles by this author , Margherita FantinMargherita Fantin More articles by this author , Luigi CandelaLuigi Candela More articles by this author , Paolo CapogrossoPaolo Capogrosso More articles by this author , Luca BoeriLuca Boeri More articles by this author , Alessia D'ArmaAlessia D'Arma More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Andrea SaloniaAndrea Salonia More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003291.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Delayed Ejaculation (DE) is among the most challenging male sexual dysfunctions. We aimed to explore and compare the sociodemographic and clinical characteristics of men with DE with those complaining of primary premature ejaculation (PE) METHODS: Data from 555 consecutive men seeking first medical help for DE and/or primary PE between 2005 and 2022 at a single tertiary-referral center were retrospectively analyzed. Complete socio-demographic, clinical and laboratory data were collected for all patients. All patients completed the International Index of Erectile Function (IIEF) and the Beck Depression Inventory (BDI) at baseline. We excluded men with known or potential causes responsible for ejaculatory disorders (n= 52). Descriptive statistics was used to detail and compare clinical and sociodemographic characteristics between the two groups (DE vs. PE). Linear regression models tested the association between depressive symptoms (BDI) and baseline IIEF domains scores among men with DE. RESULTS: Of 555 patients, 479 (86.3%) and 76 (13.7%) primary PE and DE, respectively. Men with DE were significantly older (44 vs. 47, p=0.01) than patients with PE. Conversely, the two groups did not differ in terms of educational/relational status, BMI, comorbidities, and hormonal milieu. At psychosexual interview, men with DE report more frequently symptoms referable to anxiety and depression (9.4% and 12,7%) along with higher median baseline BDI scores (8 vs. 6), all p<0.01. DE patients reported lower median IIEF-OF, -SD domains (6 vs. 9) and (7 vs. 8) than patients with PE only, all p<0.05. At linear regression analysis, among DE patients, a higher BDI score was associated with lower IIEF-OS (coeff. -1.57 p=0.004), and IIEF-IS (coeff. -0.72 p=0.01) domains (Figure 1). No association between BDI and IIEF-OF, -EF, -SD domains was found. CONCLUSIONS: Among men complaining of ejaculatory disorders, one out of ten reports DE. These patients have higher chances to report clinically significant depression significantly impacting on their overall satisfactory sexual life. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e626 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Christian Corsini More articles by this author Federico Belladelli More articles by this author Edoardo Pozzi More articles by this author Giuseppe Fallara More articles by this author Simone Cilio More articles by this author Massimiliano Raffo More articles by this author Alessandro Bertini More articles by this author Francesco Lanzaro More articles by this author Donato Cannoletta More articles by this author Fausto Negri More articles by this author Ludovica Cella More articles by this author Margherita Fantin More articles by this author Luigi Candela More articles by this author Paolo Capogrosso More articles by this author Luca Boeri More articles by this author Alessia D'Arma More articles by this author Francesco Montorsi More articles by this author Andrea Salonia More articles by this author Expand All Advertisement PDF downloadLoading ...

A 6-month longitudinal study on worsening of Parkinson’s disease during the COVID-19 pandemic

Further studies are required to investigate the impact of the COVID-19 pandemic on Parkinson’s disease (PD) progression. This study investigated the motor and non-motor progression of people with PD (PWP) at 6 months during the COVID-19 pandemic compared with that during the pre-pandemic period. Patients were recruited from Ain Shams University Hospitals, Cairo, in the period between April 2019 and December 2020. Fifty patients were included, of whom 17 and 33 patients were followed for 6 months before and during the pandemic, respectively. All patients were assessed at baseline and at 6 months using the MDS-UPDRS, Schwab and England scale (S&E), Hoehn and Yahr scale (H&Y), Berg Balance Scale, Timed Up and Go test (TUG), International Physical Activity Questionnaire, New Freezing of Gait Questionnaire, Non-Motor Symptoms Scale, and Beck Depression Inventory (BDI). Both groups were matched in age, gender, and disease characteristics. Patients followed during the pandemic showed more significant worsening of the total, part I and motor part of MDS-UPDRS, and balance scores (p < 0.001) than those followed during the pre-COVID-19 period. Gait (TUG), balance, and physical activity worsening were significantly correlated with baseline BDI, gait and balance scores, total and part I MDS-UPDRS scores, H&Y, and S&E OFF scores. Gait deterioration (TUG) was correlated with baseline physical activity (r = −0.510, p = 0.002). PWP showed worsening of motor and non-motor symptoms during the COVID-19 pandemic at the 6-month follow-up. Worsening of gait, balance, and physical activity was correlated with baseline motor and physical activity OFF scores.

Prognostic and predictive analysis of effectiveness of pharmacological and non-pharmaceutical treatment approaches for chronic insomnia

Background. Limited access to cognitive behavioral therapy for insomnia (CBT-I) which is the most effective and safe treatment approach for chronic insomnia leads to the elaboration of shortened and interned delivered CBT-I methods. Investigation of effectiveness predictors of the new methods is important for their better result.&#x0D; Aim. Investigation of effectiveness predictors for pharmacotherapy and CBT-I based brief behavioral therapy for insomnia (BBT-I).&#x0D; Materials and methods. The data for the analysis were acquired from a randomized study of 42 participants with chronic insomnia who received either zopiclone 7.5 mg or BBT-I for 2 weeks. The difference of the insomnia severity index from pre- to post-treatment was the main outcome measure. Potential predictors included demographic and medical history data, objective sleep characteristics, baseline scores of Beck depression inventory (BDI), Spielberger anxiety scale, Toronto alexithymia scale, sleep hygiene index, dysfunctional beliefs and attitudes about sleep scale, Epworth sleepiness scale. Univariate linear regression analysis was used for prognostic analysis. To identify predictors of treatment outcome after the treatment course and after the 2 weeks follow-up we used multiple linear regression models with interaction.&#x0D; Results. In the prognostic analysis higher amount of awakenings during the night and a higher proportion of the 1 stage NREM sleep measured objectively correlated with better outcome E=0.2202 (p=0.05) and E=0.55 (p=0.039) respectively. Older age and higher baseline BDI score significantly worsened the outcome: E=0.233 (p=0.047) and E=0.2 (р=1.55e-06) respectively. Clinical predictors of the BBT-I effectiveness were an absence of the sleep onset problems and absence of GABA hypnotics use in medical history and the higher baseline daytime sleepiness.&#x0D; Conclusion. Neurophysiological (frequency of awakenings, percentage of the sleep stage N1) and clinical (severity of depression, age, daytime sleepiness) predictors of the effectiveness of BBT-I were revealed. This findings will help to select the patients who should undergo a shortened course of CBT-I.

High-Energy Flux Density Extracorporeal Shock Wave Therapy Versus Traditional Physical Therapy Modalities in Myofascial Pain Syndrome: A Randomized-controlled, Single-Blind Trial.

This study aims to investigate the effects of extracorporeal shock wave therapy (ESWT) on pain, sleep, fatigue, disability, depression, and quality of life (QoL) in patients with myofascial pain syndrome (MPS). Between March 2018 and September 2018, a total of 94 patients (16 males, 78 females; mean age 44.2±11.94 years; range, 19 to 74 years) with the diagnosis of MPS were included in the study. The patients were divided into two groups. The treatment group consisted of 49 patients and a total of seven sessions of high-energy flux density ESWT (H-ESWT) (0.26 mJ/mm2) were given with three days interval. The control group consisted of 45 patients and the treatment of hot pack, transcutaneous electrical nerve stimulation, and ultrasound was given for five days for two weeks. At baseline and one month after treatment, the visual analog scale (VAS), Short Form-36 (SF-36), Pittsburgh Sleep Quality Index (PSQI), Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue Scale, Neck Disability Index (NDI), and Beck Depression Inventory (BDI) scores were compared between the groups. There were no statistically significant differences in the age, sex, demographic characteristics, and baseline VAS, SF-36, NDI, BDI, FACIT, and PSQI scores between the groups (p>0.05). In the ESWT group, there was a statistically significant decrease in the VAS, SF-36, NDI, BDI, FACIT, and PSQI scores after treatment compared to the baseline scores, while only the SF-36 subscale scores were statistically significantly higher (p<0.05). There was a statistically significant correlation between the VAS and SF-36 scores and the BDI, NDI, FACIT and PSQI scores after the treatment. Our study results suggest that H-ESWT is more effective than traditional physical therapy methods on pain, QoL, sleep, fatigue, depression, and disability in patients with MPS.

Mirtazapine added to SSRIs or SNRIs for treatment resistant depression in primary care: phase III randomised placebo controlled trial (MIR)

ObjectiveTo investigate the effectiveness of combining mirtazapine with serotonin-noradrenaline reuptake inhibitor (SNRI) or selective serotonin reuptake inhibitor (SSRI) antidepressants for treatment resistant depression in primary care.DesignTwo parallel group multicentre phase...

Vitamin D Decreases Beck Depression Inventory Score in Patients with Mild to Moderate Ulcerative Colitis: A Double-Blind Randomized Placebo-Controlled Trial

ABSTRACTThe prevalence of depression in inflammatory bowel disease (IBD) is significantly more than in controls. Some studies assessed the link between vitamin D and depression. The aim of this study was to assess the effect of vitamin D on Beck Depression Inventory (BDI) score in ulcerative colitis (UC) patients. In this double-blind randomized controlled trial, 90 mild to moderate UC patients were assigned to receive a single injection of 300,000 IU vitamin D3 or 1 ml normal saline as placebo. At baseline and 3 months later, measurements of BDI score and serum 25-OH-vitamin D3 were done. Data were compared by independent sample t test, Mann–Whitney U test, and analysis of covariance (ANCOVA). Baseline BDI scores were not statistically different between the two groups (p = .4); scores decreased in the vitamin D group after the intervention (p = .023). Further subgroup analysis regarding baseline serum vitamin D levels and adjusted for baseline BDIs revealed lowering effect of vitamin D on BDI scores only in subgroup with baseline serum vitamin D levels equal to or higher than 30 ng/ml (p < .001). In this study, there was a statistically significant reduction in BDI score in mild to moderate UC patients 3 months after 300,000 IU vitamin D3 injection. Subgroup analysis showed that patients with sufficient baseline vitamin D may benefit from supplementation more than vitamin D–deficient patients, which indicates that higher serum vitamin D levels may be needed for its antidepressant effect.

Brain-derived neurotrophic factor levels and depression during methamphetamine withdrawal

BackgroundDepression symptoms is highly comorbid with methamphetamine (METH) dependence. Except for the role in the pathophysiology of depression symptoms, brain-derived neurotrophic factor (BDNF) is also involved in the METH dependence. The present study aims to explore whether BDNF plays a role in the development of depression symptoms during METH withdrawal. MethodsWe recruited 179 patients with METH dependence who were followed up for two weeks. Ultimately, 131 (73.2%) patients finished the follow-up. Besides, 90 healthy controls were also recruited. Serum BDNF levels were measured by DuoSet ELISA Development System upon admission. The short form (13 items) of the Beck Depression Inventory (BDI) and Amphetamine Withdrawal Questionnaire (AWQ) were used to measure the depression and withdrawal symptoms. Patients with BDI score ≥ 8 were identified to have depression symptoms. ResultsOf the 131 patients, 64 (48.9%) were identified to have depression symptoms at the two-week endpoint. Patients with depression symptoms showed significantly lower BDNF levels than those with no depression symptoms. Serum BDNF levels (≤ 1251.0pg/ml) were independently associated with the development of depression symptoms during METH withdrawal (OR = 3.50, 95% CI, 1.14–10.73, p = 0.028). LimitationsBDNF levels were tested in serum but not in brain and the baseline BDI and AWQ scores between the depression and non-depression groups were not matched. Besides, the follow-up time was relatively short. ConclusionsOur study demonstrated that patients with serum BDNF levels ≤ 1251.0pg/ml had higher risk of depression symptoms during METH withdrawal.

Health-related quality of life in patients with chronic hepatitis B during antiviral treatment and off-treatment.

IntroductionHealth-related quality of life (HRQoL) has emerged as an important consideration in the care of patients with chronic hepatitis B (CHB). However, whether benefits from the improved HRQoL that occurs after antiviral treatment or drug discontinuation outweigh the risks of viral relapse is an unanswered question. The aim of this study was to evaluate the HRQoL among patients with CHB during antiviral treatment and withdrawal of treatment.Patients and methodsThere were 102 patients who met the enrollment criteria with 54 patients in the treatment group and 48 patients in the discontinuation group. Sociodemographic information was collected. The 36-Item Short-Form Health Survey (SF-36), European Quality of Life-5 Dimensions, and Beck Depression Inventory (BDI) were adopted to evaluate life quality and mental health.ResultsIn the treatment group, SF-36 showed that the physical functions were significantly increased. In the discontination group, the psychological functions showed improvement. A multivariate regression analysis indicated that baseline SF-36 score was a predictor for improvement in HRQoL (odds ratio =1.17, P=0.003) and baseline BDI score was a factor for remission of depression (odds ratio =0.75, P=0.005) after medical intervention. When the cutoff value of SF-36 score was set at 79.5, the sensitivity and specificity to predict improvement in HRQoL were 82.8% and 74.0%, respectively. When the cutoff value of BDI was found as 8.5, the sensitivity and specificity to predict alleviation of depression were 58.6%, and 76.0%, respectively.ConclusionAntiviral treatment benefits the physical health of the patients with CHB, while conferring no obvious improvement in their psychological condition. Improved psychological interventions for patients with CHB, especially for those with lower baseline SF-36 scores and higher BDI scores, may improve their quality of life.

Functional Polymorphism in the Interleukin 6 (IL6) Gene with Respect to Depression Induced in the Course of Interferon-α and Ribavirin Treatment in Chronic Hepatitis Patients.

Interleukin (IL)-6 is a multifactorial cytokine known to be increased in patients with chronic hepatitis C (CHC) and to be predictive of depression incidence. The aim of the study was to explore the association between IL6 gene C-174G polymorphism and depressive symptom severity in the longitudinal study design following the course of pegylated interferon/ribavirin treatment in CHC patients. In our study, we included 62 CHC subjects. They were assessed using present state examination, Beck Depression Inventory (BDI) and Montgomery Åsberg Depression Rating Scale (MADRS) at weeks 0, 3, 5, 9, 13, 24 and 24 weeks after the end of treatment. The risk of depression was associated with higher baseline MADRS score and BDI score. Interestingly, when stratified by IL6 C-174G polymorphism, higher baseline depressive symptom severity measured by MADRS and BDI predicted higher risk of depression in the course of antiviral treatment only in high IL-6 producers—G allele carriers (patients with GG and CG genotypes) (p = 0.004, p = 0.00008, respectively). There is interaction between severity of baseline depressive symptoms at the beginning of antiviral therapy and IL6 gene C-174G polymorphism leading to increased risk for the development of depressive episode in CHC patients in the course of antiviral treatment.

Risk factors and clinical characteristics of the depressive state induced by pegylated interferon therapy in patients with hepatitis C virus infection: A prospective study.

Pegylated interferon (PegIFN) therapies for hepatitis C virus (HCV) infection often induce a depressive state. This study aimed to identify the risk factors for and clinical characteristics of PegIFN-induced depressive state. Sixty-nine subjects with HCV who received PegIFN therapy were enrolled. Before beginning therapy, all subjects were evaluated using the Neuroticism-Extraversion-Openness Five-Factor Inventory and the List of Threatening Events Questionnaire. Beck Depression Inventory (BDI) scores were also evaluated at baseline, 2-4 weeks after initiating therapy, and every 4 weeks thereafter. During the study, 18 subjects (24.3%) developed a depressive state (BDI ≥ 10). A bimodal peak of onset was observed during the early (2-8 weeks) and late (after 20 weeks) therapy phases. Moreover, we observed that baseline BDI scores (odds ratio [OR] = 1.40, P = 0.0104) and neuroticism (OR = 1.14, P = 0.0275) were significant risk factors for developing a depressive state. To determine the specific characteristics of this condition, we compared the BDI subscales between the 'PegIFN-induced' and 'general' depressive state reported previously. We found that the score at 'somatic symptoms' was higher in the 'PegIFN-induced' group. Our results indicate the following: (i) PegIFN-induced depressive state most frequently develops during the first 8 weeks of therapy; (ii) baseline BDI and neuroticism scores are risk factors for PegIFN-induced depressive state; and (iii) the core symptoms of PegIFN-induced depressive state are different from those of 'general' depression.

Associated and predictive factors of depressive symptoms in patients with Parkinson's disease.

Depression is one of the most common non-motor symptoms in Parkinson’s disease (PD). A thorough understanding of factors associated with depressive symptomatology may facilitate early detection and guide future intervention strategies. The objective of the study was to determine associated and predictive factors of depression in patients with PD. Analyses were performed in data of the SCOPA-PROPARK cohort, a 5-year hospital-based longitudinal cohort of over 400 PD patients who have been examined annually. Linear mixed models using data of all patients were used to identify factors associated with longitudinal changes in Beck Depression Inventory (BDI) scores. A survival analysis using data of patients without depression at baseline was performed to identify risk factors for future depression (i.e. BDI ≥ 15). The proportion of patients with depression was approximately 20 % and remained stable during follow-up, with approximately half of cases showing a persistent course. Female gender, more severe disability, more severe motor fluctuations, autonomic and cognitive dysfunction, poorer nighttime sleep and daytime sleepiness were independently associated with higher BDI scores over time. Higher baseline BDI score, daytime sleepiness and a higher levodopa dosage were risk factors for future depression. Depression is common in PD, where it may follow a persistent or non-persistent course. Apart from motor fluctuations and levodopa dose, depressive symptoms in PD are mainly associated with factors of non-dopaminergic origin. This suggests that depression in PD is an inherent consequence of the progressive pathobiology of the disease, which may render its treatment with currently available treatment options difficult.Electronic supplementary materialThe online version of this article (doi:10.1007/s00415-016-8130-3) contains supplementary material, which is available to authorized users.

Impact of Depression on Progression of Impairment and Disability in Early Parkinson's Disease.

Depression is one of the most common nonmotor symptoms associated with Parkinson's disease (PD), yet the impact of depression on progression of disease is unclear. The aim of this study was to prospectively characterize the relationship between depressive symptoms and measures of disease progression in a large sample of patients with early, medically treated PD. Baseline and longitudinal Beck Depression Inventory (BDI) scores from participants in the NINDS Exploratory Trials in PD Long Term Study 1 were correlated with changes in multiple measures of disease severity over 5 years. Multivariate analysis of predictors of change in BDI was performed. Of 1,741 participants, 746 completed 5-year assessments and were included. Mean age was 62.00 years (standard deviation [SD]: 9.22) and mean disease duration was 1.69 years (SD, 1.16). Mean BDI score was 6.24 (SD, 5.02) at baseline and 8.57 (SD, 6.60) at 5 years. Baseline BDI score was strongly associated with rate of change in all examined measures of disease severity. In multivariate analysis, BDI 5-year change was associated with change in UPDRS Part I (excluding depression item; P < 0.01), 33-item Parkinson's Disease Questionnaire (P < 0.01), EuroQOL Five Dimensional Questionnaire (P = 0.02), and Total Functional Capacity (P < 0.01), but was not associated with motor or cognitive measures. This model explained 68.8% of the variance 5-year change of the BDI score. Worse baseline BDI scores are associated with a decline in multiple measures of disease severity in PD. Worsening of BDI at 5 years was associated with worsening in UPDRS Part I and quality-of-life measures, but not with motor or cognitive measures.

PP-099 Effects of Supraventricular Tachycardia Ablation on Anxiety and Depression

Effects of Supraventricular Tachycardia Ablation on Anxiety and Depression. Fatma Yigit, Ebru Altintas. Department of Cardiology, Baskent University Medical Faculty Adana Teaching and Reseach Center, Adana, Turkey; Department of Psychiatry, Baskent University Medical Faculty Adana Teaching and Reseach Center, Adana, Turkey. Backgrounds: Supraventricular tachycardia is a common rhythm disturbance. Radiofrequency catheter ablation is an effective and safety treatment choice in this arrhythmia. Depression and anxiety are often today. Palpitations may be symptom of the many mental and the phsycal disorders. The aim of this study is investigate to effects of radiofrequency catheter ablation on anxiety and depression in supraventricular tachycardia patients. Methods: Twenty-eight patients with palpitation that cardiac electrophysiology (EPS) was that planned were included to the study. Patients were evaluated by the same psychiatrist both just before EPS and after 1 month. Groups were compared with regard to socio-demographic characteristics, co morbid disorders, Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI). Results: There were no statistically significant differences between the groups in terms of age, gender, marital status, occupation, family history for psychiatric and cardiac diseases, and concomitant physical diseases. After EPS, in 60.7% of patients was detected typical atrioventricular nodal reentrant tachycardia. Ablation success was in 91% of the patients. The most common mental disorder was anxiety disorder (41%, 14 patients). In 3 patients (10.7%) had depressive disorder. After EPS -1 month laterBAI score was significantly lower as compared with baseline BAI score. Whilst there was no significant difference in BDI score after EPS compared with baseline BDI score (table). Conclusions: The present study revealed that the anxiety level is decreasing in patients with palpitation after EPS with RF ablation, but not depression. Table. The Anxiety and Depression Scores Before and After Electrophysiology Study Score median (minimum-maximum) p BAI-1 20 (0-42) BAI-2 13.5 (1-36) 0.049 BDI-1 14 (1-25) BDI-2 12 (0-25) 0.23 BDI-1: Baseline Beck Depression Scale score; BDI-2: post-EPS Beck Depression Inventory score; BAI-1: Baseline Beck Anxiety Inventory score; BAI-2: post-EPS Beck Anxiety Inventory score. p1⁄4 Wilcoxson test (group comparison results of repeated measurements). Bold indicates statistically significant p-values.

Psychiatric Outcome Over a Decade After Electrical Injury: Depression as a Predictor of Long-Term Adjustment.

Electrical injury (EI) produces a variety of physical, cognitive, and emotional consequences. Psychiatric and neurocognitive symptoms may complicate survivors' psychosocial adjustment and ability to return to work. However, due to a paucity of longitudinal research, the long-term course of EI remains poorly understood. The purpose of this study was to investigate psychiatric and functional status in EI patients over a decade after injury. Fourteen EI patients who originally underwent baseline neuropsychological evaluation participated in this long-term follow-up. Participants completed a telephone survey of functional status, neuropsychological symptom checklist, and the Psychosocial Adjustment to Illness Scale Self-Report. Participants were grouped according to baseline Beck Depression Inventory (BDI) scores. After an average of 12.36 years postinjury, participants with elevated baseline BDI scores experienced difficulty across multiple domains of psychosocial adjustment at follow-up. This group was also less likely to return to work and exhibited a significant increase in psychological distress. EI results in significant chronic psychiatric complaints for many survivors. In the current sample, psychiatric sequelae of EI continue to persist over a decade after injury. Moreover, elevated baseline BDI scores predicted worse outcomes for vocational and psychosocial adjustment. Findings underscore the impact of emotional symptoms on recovery and need for specialized psychiatric intervention immediately following injury.

Effects of omega-3 fatty acids on depression and quality of life in maintenance hemodialysis patients.

Depression and health-related quality of life (HRQoL) are closely interrelated among hemodialysis (HD) patients and associated with negative impacts on patients' clinical outcomes. Considering previous reports on clinical benefits of omega-3 fatty acids in major depression and HRQoL in other patient populations, this study examined effects of omega-3 fatty acids on depression and HRQoL in chronic HD patients. In this randomized placebo-controlled trial, 40 adult patients with a Beck Depression Inventory (BDI) score of ≥16 and HD vintage of at least 3 months were randomized to ingest 6 soft-gel capsules of either omega-3 fatty acids (180 mg eicosapentaenoic acid and 120 mg docosahexaenoic acid in each capsule) or corresponding placebo, daily for 4 months. At baseline and after 4 months, 2 questionnaires of BDI and the Medical Outcome Study 36-Item Short-Form Health Survey were completed by each patient. Although baseline BDI score was comparable between the 2 groups, it was significantly lower in the omega-3 group compared with the placebo group at the end of the study (P = 0.008). Except for mental health, social functioning, and general health, other domains of HRQoL showed significant improvement in the omega-3 group compared with the placebo group at month 4 of the study (P < 0.05 for all). Regression analysis revealed that ameliorated BDI score by omega-3 treatment had considerable role in the improvement of overall HRQoL score, physical and mental component dimensions, and score of physical functioning, role-physical, and bodily pain. Supplemental use of omega-3 fatty acids in HD patients with depressive symptoms seems to be efficacious in improving depressive symptoms and HRQoL.

The impact of supportive counselling on women's psychological wellbeing after miscarriage--a randomised controlled trial.

To assess the effectiveness of supportive counselling after miscarriage. Randomised controlled trial. University hospital. Two hundred and eighty women with miscarriage. Women were randomised to receive supportive counselling from a nurse (at diagnosis and 2 weeks later) or routine care. Psychological wellbeing was measured with the General Health Questionnaire (GHQ-12) and Beck Depression Inventory (BDI). Primary outcome measured the proportion of women suffering psychological distress (GHQ-12 score ≥4) at 3 months after miscarriage. Secondary outcomes were GHQ-12 and BDI scores at 6 weeks, 3 and 6 months. There was no difference in the proportion of women suffering psychological distress at 3 months after miscarriage (17.1% in counselling group versus 24.4% in control group; 95% CI -0.034 to 0.177; P = 0.19). However, for the subgroup of women (n = 152) with high baseline GHQ-12 scores, the median GHQ-12 score in the counselling group was significantly lower than the control group at 6 weeks (median score 3 versus 4.5 in counselling and control groups; P = 0.04) and 3 months (median score 1 versus 2.5 in counselling and control groups; P = 0.03). Similarly, for women with high baseline BDI scores (BDI > 12), the proportion for women continuing to score high was significantly lower in the counselling group 6 weeks after miscarriage (33.3 versus 61.1% in counselling group and control group; P = 0.03). Although the results of current study do not justify routine counselling of all women following miscarriage, a supportive counselling programme for selected women with high levels of psychological distress is promising and merits further investigation.