BDI Scores Research Articles

Health-related quality of life and depressive symptoms in Friedreich ataxia.

Friedreich ataxia (FRDA) is a chronic, progressive and highly disabling cerebellar degenerative disease. Despite this, little attention has been paid to the health-related quality of life (HRQOL) in this disease. The aim of the present study was to assess FRDA patients' perception of HRQOL and to determine the influence of depression, and demographic and clinical variables. The sample consisted of 62 patients with genetically confirmed FRDA. The SF-36 Health Survey was used to assess HRQOL. Depressive symptoms were evaluated with the Beck Depression Inventory-II. FRDA patients' mean scores were significantly lower than the values for the Spanish population in all SF36 dimensions. Average z scores ranged from - 5.5 in physical functioning to - 0.48 in mental health. Age and clinical variables were significant predictors of HRQOL in only several dimensions, whereas BDI scores were able to predict a significant percentage of variance in all SF36 dimensions, except physical functioning. Our study demonstrates the high impact of Friedreich ataxia on quality of life. This impact does not only occur in those aspects most related to motor disability but it is also present in non-motor dimensions. Depressive symptomatology is the most relevant variable for predicting quality of life.

Longitudinal Analysis of Depression and Anxiety Symptoms as Independent Predictors of Neurocognitive Function: Prospective Trial of Brain Tumor Patients Receiving Radiotherapy [RT

Brain tumor patients commonly experience depression and anxiety. In other neurologic conditions (e.g. Huntington’s) these symptoms are associated with neurocognitive decline. Since neurocognitive function is a critical outcome for brain tumor patients, we hypothesized that increased depression and anxiety symptoms will be independently associated with worsened neurocognition after brain RT. On a prospective trial, 54 primary brain tumor patients receiving brain RT underwent comprehensive neurocognitive evaluation prior to and at 3, 6, and 12 months post-RT. Attention/processing speed was assessed with Delis Kaplan Executive Function Trail Making Test [DKEFS TMT] and Wechsler Adult Intelligence Scale IV [WAIS-IV], executive functioning with DKEFS Verbal Fluency [DKEFS VF] and Wisconsin Card Sort Test [WCST], and memory with Hopkins Verbal Learning Test [HVLT] and Brief Visuospatial Memory Test Revised [BVMT-R]. Patients also completed the Beck Anxiety Inventory [BAI] and Beck Depression Inventory-II [BDI] at each time point, where higher scores reflect a greater number of symptoms. Associations between baseline BAI and BDI scores and covariates (age, sex, highest education level, tumor characteristics, chemotherapy, antiepileptic use, history of anxiety or depression) were assessed by independent samples t-test, one-way ANOVA, and Pearson correlations. Univariable and stepwise multivariable linear mixed-effects [LME] models assessed BAI and BDI as longitudinal predictors of neurocognitive t-scores. Statistical significance was set at α<0.05. Patients with a history of depression had higher baseline BDI scores (p= 0.011). Female sex (p=0.048) and high school education level (p=0.036) were associated with higher baseline BAI scores. Higher BAI was associated with decline in attention/processing speed on univariable LME: DKEFS TMT Visual Scanning (p=0.003), Number Sequencing (p=0.011), and Letter Sequencing (p<0.001). This remained significant on multivariable analyses for all 3 tests, p<0.001, p=0.011, and p=0.003, respectively. Higher BDI was associated with decline in DKEFS TMT Letter Sequencing in univariable (p=0.002) and multivariable (p=0.013) models. Increased BAI was associated with poorer BVMT Delayed Recall memory in univariable (p=0.012) but not multivariable (p=0.383) models. Increased BDI was associated with decline in executive functioning in DKEFS VF Category Switching univariable (p=0.031) but not multivariable (p=0.198) models. Among brain tumor patients receiving RT, increased depression and anxiety symptoms independently predicted for worsening neurocognitive function, particularly in attention and processing speed. Evaluating and treating symptoms of depression and anxiety may optimize neurocognitive functioning in these patients.

Reward (BIS/BAS) mechanisms and fatigue in patients on chronic hemodialysis

ABSTRACT Recently, it has been demonstrated that chronic inflammation could have a role on fatigue onset in chronic hemodialysis (HD). Research on neuro-immune interactions highlighted that an alteration of basal ganglia functioning, secondary to chronic inflammation, may translate in a reduced motivation and altered reward processes in chronic diseases. This study investigated a possible correlation between fatigue severity and reward mechanisms, that regulate motivational dispositions, in HD patients. Evaluation scales were administered to ninety-four patients on HD (54 Male, 40 Female; Mdage = 67±26.5; Dialytic Mdage in years = 4±6.3. Fatigue was assessed by using Fatigue Severity Scale (FSS). Behavioural Inhibition System (BIS) and Behavioural Activation System (BAS) Scale was administered to investigate approach/avoidance behaviours. Anxiety and depression were measured by State-Trait Anxiety Inventory (STAI-Y) and Beck Depression Inventory (BDI-II). Results show that the distribution of HD patients for FSS score did not show a normal pattern. FSS score was significantly higher in patients with high BIS Z-score than in patients with low and medium BIS Z-score. BDI score and STAI-Y scores were similar among BIS Z-score groups of patients. Findings suggest that in patients on chronic hemodialysis there is a correlation between fatigue severity symptoms and motivational disposition mechanisms that predispose to action inhibition.

Neurodevelopmental outcome of monochorionic twins with selective intrauterine growth restriction (SIUGR) type II: laser versus expectant management

Objective To compare the neurodevelopmental outcome of monochorionic-diamniotic twins (MCDA) with type II selective intrauterine growth restriction (SIUGR-II) managed in utero either expectantly or with laser. Materials and methods Postnatal neurodevelopmental assessment was conducted on the children of patients that had been antenatally diagnosed with SIUGR-II between 16 and 26 weeks gestational age (GA) and that had been randomly assigned to expectant management (EM) versus laser therapy (LT). The assessment was conducted by trained specialists using the Battelle Developmental Inventory (BDI-2). BDI-2 total and domain (adaptive, personal–social, communication, motor, and cognitive) composite scores for the appropriately grown (AGA) and growth-restricted (IUGR) twins were compared by treatment arm. Results Twenty patients diagnosed with SIUGR had undergone block randomization between two centers to either expectant management (EM) (6) or laser therapy (LT) (14). The mean (SD) GA at diagnosis was no different between the EM and LT groups [21.5 (2.0) versus 21.1 (2.8) weeks, p = .7414, respectively]. However, GA at delivery was significantly lower in the EM versus LT groups [28.3 (1.8) versus 33.4 (3.8) weeks, p = .0039]. At 6 months, all 20 AGA babies were alive, whereas only 3/6 (50%) of the IUGR babies in the EM group and 4/14 (29%) in the LT group were alive (p = .6126). One family in the EM group and two families in the LT group declined BDI-2 assessment. The mean (SD) age at BDI-2 assessment was no different between the EM and LT groups [75.6 (14.4) versus 70.7 (18.2) months, p = .5618, respectively]. For the AGA children, there were no significant differences in total BDI-2 scores for the EM versus LT [97.4 (10.4) versus 98.0 (19.6), p = .8741], nor in any of the domain composite scores. For the IUGR children, no statistically significant differences were detected in total BDI-2 scores between the EM and LT [72.0 (31.1) versus 92.8 (22.1), p = .643], nor in any of the domain composite scores. The comparison of standardized scores between the AGA and IUGR pairs was significantly different, but within the normal range. Conclusions Neurodevelopmental outcomes for SIUGR-II MCDA twins were similarly favorable, whether managed expectantly or with laser treated. However, the significantly different GA at delivery (28.3 versus 33.4 weeks, p = .0039, expectant versus laser, respectively) may suggest improved outcomes in laser-treated patients in a larger cohort.

Therapeutic effect of the combined treatment with acupuncture and venlafaxine hydrochloride on depression based on diffusion tensor imaging technology

To explore the effectiveness and safety of the combined treatment with acupuncture and venlafaxine hydrochloride on depression in terms of the microstructure change of white matter fiber tracts of brain based on diffusion tensor imaging technology (DTI). The prospective study design was adopted. All of 60 patients with depression were randomized into an acupuncture-medication group and a medication group, 30 cases in each one. In the medication group, venlafaxine hydrochloride was used, 75 mg per day in the 1st week, 150 mg per day in the 2nd week and 225 mg per day from the 3rd to 6th week. In the acupuncture-medication group, on the base of the treatment in the medication group, acupuncture was combined. Baihui (GV 20) and Yintang (GV 29) were the main acupoints. The supplementary acupoints were selected according to the clinical symptoms of individuals. The needles were retained for 30 min. Acupuncture was provided once every 2 days, 3 times a week. The consecutive 12 weeks of treatment were required in the two groups. Additionally, a normal group was prepared with 30 healthy volunteers. Separately, before treatment, in 2, 8 and 12 weeks of treatment, Hamilton's depression scale (HAMD-17), Beck depression inventory scale (BDI) and the antidepressant side effect scale (SERS) were adopted to evaluate the effectiveness and safety of the two groups. Moreover, before and after 12 weeks of treatment, DTI was adopted to detect the fractional anisotropy score (FA) of each brain region in the patients. After treatment, the scores of HAMD-17 and BDI were all reduced in the two groups (P<0.05). In 8 and 12 weeks of treatment, the scores of HAMD-17 and BDI in the acupuncture-medication group were less than those in the medication group (P<0.05). The difference in SERS score was not significant statistically between the two groups (P>0.05). Compared with the healthy volunteers, FA scores in 6 brain regions changed obviously in the patients with depression, including the white matter of bilateral frontal lobes, splenium of corpus callosum, left cingulated gyrus, white matter of bilateral inferior temporal gyrus, white matter of bilateral inferior parietal lobe and white matter of bilateral deep temporal occipital region separately. Before treatment, the differences in FA scores of these 6 brain regions were not significant statistically between the two groups (P>0.05). After treatment, FA scores in the white matter of bilateral frontal lobes, white matter of bilateral inferior temporal gyrus and white matter of bilateral deep temporal occipital region in the acupuncture-medication group were all higher than those in the medication group (P<0.05). Acupuncture repairs the brain white matter fiber tracts in some brain regions to certain extent and the therapeutic effects are enhanced with the adjuvant medication of venlafaxine hydrochloride.

Submissive Behaviour and Depression: A Case-Control Study Done at Tertiary Care Centre in Jaipur

Background: The construct of submissive behaviour and its association with psychopathology especially with depression has been explored extensively in western countries but in India literature on this subject is conspicuous by its absence. Objectives: This article explores the phenomenon of submissive behaviour and its correlation with depression. Materials and Methods: This study was conducted at Psychiatric Centre Jaipur (SMS Medical College, Jaipur) on OPD basis from July, 1998 to December, 1999. This was a case control study, 50 matched subjects with age range 15-60 years were included in study and control group. Study Group consisted of 50 depressed patients as per ICD-10 criteria (F32 and F33), controls were selected from general population randomly and were free from any psychiatric illness. Beck depression inventory and Submissive behaviour scale were used in the study. Statistical Analysis: Mean, Standard deviation, Student ‘t’ test, Pearson’s correlation co-efficient were used to analyse the data. Results: Mean submissive behaviour score of study group was 27.76 and control group was 11.46, the difference between these scores in study and control group was found to be statistically significant. There was positive correlation between depression BDI scores and submissive behaviour scores at r=+0.2875. Conclusion: This research shows that submissive behavior is an important construct in relation to depression even in Indian population. However, further research is needed to support the findings of this study in Indian depressives.

Characteristics Associated with Food Insecurity in Patients Presenting for Bariatric Surgery (P21-019-19)

ObjectivesBariatric surgery is an effective treatment for patients with severe obesity (e.g., BMI > 35). To prevent complications, postoperative patients must comply with dietary requirements and nutritional supplementation. A potential barrier to adherence to dietary requirements is food insecurity (FI). In 2017, the national prevalence of FI was 11.8% and a recent study of a pre-bariatric sample found 18% were FI and 27% were marginally FI. Despite this high prevalence, the characteristics associated with FI in preoperative bariatric patients is not known. The purpose of this study was to identify characteristics associated with FI in a sample of patients presenting to an academic medical center for preoperative bariatric surgery assessment. Methods238 participants aged 17–70 with a BMI > 35 were included in the study. Height and weight were measured by clinical staff. Participants completed questionnaires including demographics, the 10-item USDA Adult FI Survey Module (score range 0–10, 0 = food secure, 1–2 = marginal FI, and >3 = FI), the Beck Depression Inventory-II (BDI, range 0–68), the Binge Eating Scale (BES, range 0–48), and the Night Eating Questionnaire (NEQ, range 0–52). An ordinal logistic generalized linear model (GLM) was used with FI as the dependent variable (ordinal, 3 levels) and all variables above as independent variables. ResultsThe overall sample had a mean age of 41.1 years and a mean BMI of 48.3. It was predominantly female (75%, n = 180), white (71.3%, n = 171), and had less than a college education (77.1%, n = 185). The overall mean FI, BDI, BES, and NEQ scores were 1.1, 9.0, 13.7, 15.2, respectively. The prevalence of marginal FI was 26% (n = 62) and FI was 15.8% (n = 38). In the GLM, FI was significantly associated with having less than a college education (OR 2.08, P = .04), being non-white (OR 2.12, P = .01), younger age (OR 1.05, P = .002), higher depression scores (1.05, P = .03) and higher night eating scores (1.06, P = .04). ConclusionsIn our sample, the proportion of patients reporting FI was similar to previously reported bariatric samples, and higher than national estimates. Bariatric programs should consider screening for FI as part of routine preoperative evaluations. Further studies are needed to understand the impact of FI on postoperative outcomes. Funding SourcesNone.

Sex-specific roles of cellular inflammation and cardiometabolism in obesity-associated depressive symptomatology.

Background:Obesity and depression are complex conditions with stronger comorbid relationships among women than men. Inflammation and cardiometabolic dysfunction are likely mechanistic candidates for increased depression risk, and their prevalence differs by sex. Whether these relationships extend to depressive symptoms is poorly understood. Therefore, we analyzed sex in associations between inflammation and metabolic syndrome (MetS) criteria on depressive symptomatology. Specifically, we examined whether sex positively moderates the relationship between depressive symptoms and inflammation among women, and whether MetS has parallel effects among men.Methods:Depressive symptoms, MetS, and inflammation were assessed in 129 otherwise healthy adults. Depressive symptoms were assessed using Beck Depression Inventory (BDI-Ia). Monocyte inflammation regulation (BARIC) was quantified using flow cytometry measurement of TNF-α suppression by β-agonist. Moderation effects of sex on associations between BARIC, MetS criteria, and BDI were estimated using two-way ANOVA and linear regression, adjusting for BMI, and by sex subgroup analyses.Results:Obese individuals reported more depressive symptoms. Sex did not formally moderate this relationship, though BDI scores tended to differ by BMI among women, but not men, in subgroup analysis. Poorer inflammation control and higher MetS criteria were correlated with somatic depressive symptoms. Sex moderated associations between MetS criteria and somatic symptoms; among men, MetS criteria predicted somatic symptoms, not among women. Subgroup analysis further indicated that poorer inflammation control tended to be associated with higher somatic symptoms in women.Conclusions:These results indicate that obesity-related inflammation and MetS factors have sex-specific effects on depressive symptoms in a non-clinical population. Although pathophysiological mechanisms underlying sex differences remain to be elucidated, our findings suggest that distinct vulnerabilities to depressive symptoms exist between women and men, and highlight the need to consider sex as a key biological variable in obesity-depression relationships. Future clinical studies on comorbid obesity and depression should account for sex, which may optimize therapeutic strategies.

Gender Differences in Depression, Coping, Stigma, and Quality of Life in Patients of Vitiligo.

Though vitiligo is one of the psychodermatological disorders which do not cause direct physical impairment, it is cosmetically disfiguring leading to serious psychological problems in daily life. We undertook this research to study patients of vitiligo the prevalence of depression, coping, stigma, and quality of life and comparison of the same in both genders. Patients diagnosed clinically as having vitiligo by consultant dermatologist were enrolled after informed consent and ethics approval. 156 patients were screened, of which 100 satisfying criteria were taken up for the study. A semistructured proforma was designed to collect the necessary information with administration of Beck's depression inventory, participation scale, dermatology life quality index, and adjustment to chronic skin diseases questionnaire. Depression prevalence was 63.64% in females and 42.86% in males (p<0.0457); the total mean BDI scores were significant with females having higher scores than males (p<0.0083). No significant differences were seen on participation scale though 52% females felt stigmatized as compared to 45% males (p <0.5779). While almost 97% of our patients had impaired quality of life there was no significant difference in both genders on the total score (p<0.3547). Females had significantly higher faulty coping style than males with significant differences on all domains and total scores (p< 0.0094). There was a strong association of depression with faulty coping and stigma (p< 0.0001) in both genders. Also association of stigma with quality of life showed highly significant findings in both genders (p< 0.0001) on all the domains of DLQI. This study helps in early identification of psychological problems in vitiligo patients and planning their future course of management, hence improving the prognosis and quality of life.

Telehealth Therapy Effects of Nurses and Mental Health Professionals From 2 Randomized Controlled Trials for Chronic Back Pain.

To compare the efficacy of mental health professional versus primary care nurse-delivered telehealth cognitive-behavioral therapy (CBT) and supportive care (SC) treatments for chronic low back pain, using data from 2 separate randomized controlled trials. Both trials were completed in the same hospital and used the same study design, research team, and outcome measures. Participants from Study 1 (Mental Health Professional Study) (N=66; 2007 to 2011) and Study 2 (Nursing Study) (N=61; 2012 to 2016) were patients with chronic low back pain (≥4/10 intensity) randomized to either an 8-week CBT or an SC telehealth condition matched for contact frequency, format, and time. Participants completed validated measures of improvement in back pain disability (Roland Morris Disability Questionnaire [RMDQ]), pain intensity (Numeric Rating Scale [NRS]), depressive symptoms (Beck Depression Inventory 2 [BDI-2]), pain catastrophizing (Pain Catastrophizing Scale [PCS]), and overall improvement (Global Clinical Impressions [GCI]). Intent-to-treat analyses at posttreatment showed that scores on the RMDQ (Cohen d=0.33 to 0.55), NRS (d=0.45 to 0.90), PCS (d=0.21 to 0.41), and GCI (18.5% to 39.1%) improved significantly in both studies and in both treatments from pretreatment to posttreatment. Changes in BDI scores were inconsistent (d=-0.06 to 0.51). The analyses revealed no significant differences in treatment efficacy between the trained nurse versus the mental health professionals on the RMDQ, NRS, PCS, or GCI measures (P>0.20). Results from these clinical trials suggest that the benefits of home-based, telehealth-delivered CBT and SC treatments for chronic back pain were comparable when delivered by a primary care nurse or mental health professional.

Age and leptinemia association with anxiety and depression symptoms in overweight middle-aged women.

The aim of the study was to investigate the effect of menopause and of postmenopausal stages on depression and anxiety symptoms, and whether these symptoms associate with anthropometric, metabolic, and hormonal parameters in midlife women. Postmenopausal women (age 50-65), either at early (EPM, n=33) or late (LPM, n = 23) postmenopause, and 23 premenopausal controls (PreM, age 40-50), matched for BMI with the PM groups, were studied. Blood biochemical and hormonal determinations, bioimpedance anthropometry, and depression and anxiety symptoms (Beck's depression [BDI] and anxiety [BAI] inventories) were conducted. The BAI score was higher in both PM groups than in the PreM group. In contrast, only the LPM group showed a significantly elevated BDI score. All groups presented overweight and abdominal obesity, having similar BMI and waist/hip ratio values. Both PM groups showed insulin resistance, whereas only the LPM group presented decreased skeletal muscle mass and basal metabolic rate. Correlation analysis, including all 79 middle-aged women, showed age, percentage body fat, waist/hip ratio, and leptinemia to correlate positively with the anxiety and depression scores. Multivariate regression showed leptin and age to associate positively with depressive- and anxious-like symptoms. Postmenopausal women presented impaired body composition, energy expenditure, insulin sensitivity, and mental symptoms, in comparison to similarly overweight premenopausal women. Among all the overweight midlife women, these symptoms were more strongly associated with age and leptin levels than with reproductive aging itself. The data indicate that, among overweight middle-aged women with abdominal obesity, the aging process and the development of leptin resistance are associated with impairment of mental health.

The association of type D personality and depression with infertility in women

Purpose: Type D personality—defined as the presence of two personality characters, namely negative affectivity (NA) and social inhibition (SI)—is associated with various disorders. The 14-item Type D Scale (DS14), which consists of NA and SI subscales, can be used for the detection of the presence of Type D personality. The aim of our study was to investigate the association of Type D personality and depression with infertility in women.Method: A total of 324 women, 168 primary unexplained infertile women (92 patients undergoing in vitro fertilization (IVF) treatment and 76 undergoing intrauterine insemination (IUI) treatment) and 156 fertile controls were recruited. The 21-item Beck Depression Inventory (BDI-21) and DS14 were completed by all participants. The study was approved by Local Ethics Committee with the protocol number 72867572-050-218.Results: Depression and Type D personality were found to be significantly more prevalent in the infertile group than the fertile group. Type D was positively associated with infertility (OR = 2.34, 95% CI = 1.45–3.78, p < .0001), especially in the younger-aged (<35 years) population (OR = 2.59, 95% CI = 1.48–4.5, p = .001). After adjusting for the duration of marriage, age, obesity, educational level, and the same characteristics of the partner, the association between Type D personality and infertility persisted (OR = 2.56, 95% CI = 1.52–4.29, p < .001). The scores of the BDI-21 and NA subscale were found to be negatively correlated with age and partner’s age. The BDI and SI scores, and the NA, SI, and Type D personality rates were similar between the IUI and the IVF groups; however, the NA score was higher, and depression was found to be more prevalent and severe in the IUI group than the IVF group.Conclusions: Type D personality could be positively associated with infertility, especially in younger-aged women.

State-Related Alterations of Spontaneous Neural Activity in Current and Remitted Depression Revealed by Resting-State fMRI.

Purpose: Although efforts have been made to identify neurobiological characteristic of major depressive disorder (MDD) in recent years, trait- and state-related biological characteristics of MDD still remains unclear. Using functional magnetic resonance imaging (fMRI), the aim of this study was to explore whether altered spontaneous neural activities in MDD are trait- or state- related.Materials and Methods: Resting-state fMRI data were analyzed for 72 current MDD (cMDD) patients (first-episode, medication-naïve), 49 remitted MDD (rMDD) patients, and 78 age- and sex- matched healthy control (HC) subjects. The values of amplitude of low-frequency fluctuation (ALFF) were compared between groups.Results: Compared with the cMDD group, the rMDD group had increased ALFF values in the left middle occipital gyrus, left middle temporal gyrus and right cerebellum anterior lobe. Besides, compared with the HC group, the cMDD group had decreased ALFF values in the left middle occipital gyrus. Further analysis explored that the mean ALFF values in the left middle occipital gyrus, left middle temporal gyrus and right cerebellum anterior lobe were correlated positively with BDI scores in rMDD patients.Conclusion: Abnormal activity in the left middle occipital gyrus, left middle temporal gyrus and right cerebellum anterior lobe may be state-specific in current (first-episode, medication-naïve) and remitted (medication-naïve) depression patients. Furthermore, the state-related compensatory effect was found in these brain areas.

Differentiating PTSD from anxiety and depression: Lessons from the ICD-11 PTSD diagnostic criteria.

Posttraumatic stress disorder (PTSD) is frequently associated with depression and anxiety, but the nature of the relationship is unclear. By removing mood and anxiety diagnostic criteria, the 11th edition of the International Classification of Diseases (ICD-11) aims to delineate a distinct PTSD phenotype. We examined the effect of implementing ICD-11 criteria on rates of codiagnosed depression and anxiety in survivors with recent PTSD. Participants were 1,061 survivors of traumatic injury admitted to acute care centers in Israel. ICD-10 and ICD-11 diagnostic rules were applied to the Clinician-Administered PTSD Scale for DSM-IV. Co-occurring disorders were identified using the Structured Clinical Interview for DSM-IV (SCID). Depression severity was measured by the Beck Depression Inventory-II (BDI-II). Assessments were performed 0-60 ("wave 1") and 90-240 ("wave 2") days after trauma exposure. Participants identified by ICD-11 PTSD criteria were equally or more likely than those identified by the ICD-10 alone to meet depression or anxiety disorder diagnostic criteria (for wave 1: depressive disorders, OR[odds ratio]=1.98, 95% CI[confidence interval] =[1.36, 2.87]; anxiety disorders, OR=1.04, 95% CI=[0.67, 1.64]; for wave 2: depressive disorders, OR=1.70, 95% CI=[1.00, 2.91]; anxiety disorders, OR=1.04, 95% CI=[0.54, 2.01]). ICD-11 PTSD was associated with higher BDI scores (M=23.15vs. 17.93, P<0.001 for wave 1; M=23.93vs. 17.94, P<0.001 for wave 2). PTSD symptom severity accounted for the higher levels of depression in ICD-11 PTSD. Despite excluding depression and anxiety symptom criteria, the ICD-11 identified equal or higher proportion of depression and anxiety disorders, suggesting that those are inherently associated with PTSD.

EEG Oscillations Response To Dual-Target rTMS Therapy of Parkinson Disease and Co-Occuring Depression

The approach intended evaluating neurophysiological concomitants of treatment response to dual-target navigated TMS in patients with Parkinson’s disease and co-occuring depression. Patients with PD (n=46) were initially enrolled for a placebo-controlled study and randomly assigned to either an actively treated (rTMS, n = 23) or a sham-stimulation (sTMS, n=23) groups. Every TMS session was performed sequentially over the primary motor cortex (20 min) followed by the DLPFC (20 min). The patients received a total of 20 sessions on 20 consecutive days. For every participant the main outcome measure included the MDS-UPDRS Motor Examination Part (Part 3) scale score, BDI-II and DASS depression scores as well as spectral parameters of the resting EEG (the last ones were available for fewer patients - rTMS, n=15; sTMS, n=16). After the stimulation course the Part 3 scale scores demonstrated clinically meaningful improvement which was larger in the rTMS group (GROUP by TIME: F1,88= 44,06 p<.001). The BDI-2 and DASS scores showed significantly attenuated negative affect for both groups (TIME: BDI-2 - F1,44=4.48, p <.040; DASS - F1,44=15.34, p <.000). According to sLORETA, beneficial treatment response to the TMS course was accounted by selective EEG power increase over the theta, high beta and gamma frequency bands and significantly locked only to the rTMS group. Using source analysis, the generators of this power difference were localized to somatosensory and visual functional networks, as well as to separate nodes of the salience and default mode networks. There was an increased frontal lobe activation (the 9thand 10thBrodman areas). The main EEG power differences were locked to the ranges of 18-30 Hz and 30-45 Hz (sLORETA statistics at p < .05).The findings demonstrate the beneficial effects of the dual-target TMS in PD and hints to some EEG oscillatory signatures as putative predictors of the treatment response.

Poorer Self-Reported Physical Health and Higher Anxiety in Young Adults with Previous Coarctation Repair

Background: Little is known about the impact of a coarctation repair on the functional outcomes of young adults. This study aimed to determine (1) the functional and mental health status of young adults with previous coarctation repair, and (2) the impact of late hypertension on their quality of life. Methods: A cross-sectional study using validated self-reported questionnaires (Short Form 36 version 2 [SF-36v2], Beck Depression Inventory [BDI], and State-Trait Anxiety Inventory [STAI]) was performed in 54 patients aged 15–47 years with previous paediatric coarctation repair. Questionnaire scores were compared to healthy age- and gender-matched controls. Patients’ previously published 24-hour blood pressure monitoring results were included. Results: Late hypertension was present in 64% (34/54) at a mean of 29 ± 8 years after coarctation repair. SF-36v2 mean physical component summary score was significantly lower in coarctation patients compared with controls (53.1 ± 6.8 vs. 56.0 ± 4.7, p = 0.02), but there was no significant difference in mean mental component summary score (p = 0.2). SF-36v2 mean role emotional score tended to be associated with 10 mmHg increases in mean 24-hour systolic blood pressure (regression coefficient 4.3, p = 0.06). STAI mean trait anxiety score tended to be higher in coarctation patients compared with controls (36.6 ± 9.0 vs. 33.5 ± 7.8, p = 0.06). There was no significant difference in BDI scores between patients and controls. Conclusion: Young adults with previous coarctation repair report poorer physical health and higher anxiety compared to healthy controls. Strategies to improve self-reported physical health and anxiety should be explored. Long-term assessment of quality of life outcomes in coarctation patients is warranted.

Effects of adverse childhood events over metacognitions, rumination, depression and worry in healthy university students

Aim: Adverse childhood experiences observed the various physical and mental problems that emerged in the later periods of life were found to be significantly associated. The aim of this study is to compare anxiety and depression, rumination and metacognitions of individuals who experienced adverse childhood events and individuals with no adverse childhood events, even though they do not develop any psychopathology. Material and Methods: The sample of the study consisted of 275 university students who were applied SCID-I and SCID-II and no psychopathology. Adverse Childhood Experiences Scale Turkish Form (ACE-TR), Metacognition Questionnaire-30 (MCQ-30), Ruminative Thought Style Questionnaire (RTSQ), Positive-Negative Beliefs about Rumination Scale, Penn State Worry Scale, Generalized Anxiety Disorder-7, Beck Depression Inventory were applied to volunteers who met the criteria of inclusion in the study. Results: Participant with ACE-TR score greater than 0, ‘Negative Beliefs about Uncontrollability and Danger’, ‘Lack of Cognitive Confidence’, ‘Need to Control Thoughts’, ‘Cognitive Self Consciousness’ and total scores were statistically higher than those with ACE-TR score 0. The participant with ACE-TR scores greater than 0 had RTSQ, PBRS, NBRS, NBRS -1, PSWQ, GAD-7 and BDI scores were statistically higher than those with ACE-TR score 0. Discussion: Even though negative childhood experiences do not lead to psychopathology, they may trigger the emergence of dysfunctional metacognitions which leads to more anxiety and rumination and make the individual vulnerable for further stressful life events and might decrease resilience.

Depression in Survivors of Acute Myocardial Infarction.

Introduction:There was growing evidence of increased cardiovascular risk in patients with depressive disorders.Aim:To determinate the percentage of depression of the three investigated groups of patients with myocardial infarction and to determinate the correlation between sociodemographic characteristic and level of depression in survivors of AMI.Methods:The study was designed as observation cross-section including 120 patients treated at the University Clinic of Cardiology Skopje during 2018-2019 year, observed as 3 groups: group 1 was presented with patients during hospitalization for AMI, group 2 were patients survivors after 3 months of the acute coronary event and group 3 patients survivors after 12 months of the acute coronary event, Depression status was assessed using BDI.Results:the three groups presented almost equal representation of depression according BDI (X²=1,182, df=2, p=0,913) presented with 34,1 %, 30,8% and 30% respectively. The three groups of patients did not show significant difference according distribution of gender smoking , physical activity, stress, diabetes mellitus, age, mean BDI, BMI, Systolic BP, age of education and marital status . Only group 3 presented significantly higher diastole BP comparing in group 1 and group 2 (F=9,532, df=2,p< 0,001). The depression (BDI score) in examination groups was associated with sociodemographic and clinical parameters where female gender, higher education level, decreased BMI, smoking, decreased physical activity, younger age and single status are independent predictors of depression in patients who survived acute myocardial infarction.Conclusion:The results obtained in our study showed indicative representation of depression in patients survivors of AMI and significant association with sociodemographic and clinical parameters as predictors of depressive disorder. Regular screening for depression in patients survivors of AMI may improve the therapy decision, prognosis and the quality of patients’ life.

Coping Styles in Group Reality Therapy among Cardiac Women Patients with Depression

Depression will be the number one major cause of illness by the year 2020. Depression has been the main factor of morbidity since a decade ago. The aim of this study is to investigate the coping styles among cardiac women patients with depression experiencing Reality Therapy. The respondents of this study are taken from Pusat Jantung Sarawak, Kota Samarahan. The respondents are four cardiac women patients waiting four heart surgery. Their age range are from 22 to 64 years old. Three respondents are from Iban ethnicity and one respondent is from Malay ethnicity. The method of the study is Qualitative method whereby four session of Reality Therapy are conducted. The data analysis method is descriptive phenomenology whereby the researcher investigates the important criterion that make up a whole structure of an experience. The findings from this study are the respondents’ coping styles during the WDEP (wants, doing, evaluation and planning) intervention. Their BDI score before and after Reality therapy are also recorded. The implication of this study is Reality Therapy and WDEP intervention can be used to help people with depression. In conclusion, the depression level in cardiac women patients are reduced after experiencing Reality Therapy.

Sleep Disorders in Menopause: Review of the Literature and Occurrence through Menopausal Stages

We here review principal literature data about sleep disorders in menopause and we compared it with data obtained from a systematical screening of a sample of 161 menopausal women through questionnaires and clinical evaluation. Our data reveal high occurrence of sleep disorders in this group of women if compared to literature data about general population, in the absence of statistically significant differences among the three menopausal stages: we find only a trend toward a higher risk of OSAS (Obstructive Sleep Apnea Syndrome) in PM versus early PM and MT. However, none of women in our survey underwent PSG (polysomnography), essential to confirm the diagnosis of OSAS and none was diagnosed with RLS (Restless Legs Syndrome) (prior to our survey) by the Gynecologist or General Pratictioner: these data reveal the issue of too low attention towards sleep disorders in this contest. Generic “sleep complaints” are clearly associated with depressed mood and worse-quality life along the menopausal process. In our sample, a non-specific definition of insomnia shows a peculiar relationship with a mood disorder: it is only variable not associated with higher BDI and KI scores, in fact. This might suggest that the conditions linked to depression of these women could be more specific sleep disturbances, such as RLS and OSAS.