Beck Scores Research Articles

The effect of online cognitive behavioral therapy on depressive symptoms in recovered patients with COVID-19.

BACKGROUND:COVID-19 virus is on the rise globally, and people with the disease experience a variety of physical and mental problems. According to studies, depression can be a complication of the virus. So far, limited measures have been taken to prevent and treat emotional–psychological complications of COVID-19. The aim of this study was to evaluate the effect of online cognitive behavioral therapy (CBT) on depressive symptoms in recovered patients with COVID-19.MATERIALS AND METHODS:This study was conducted in a quasi-experimental design. A sample of 150 recovered patients with COVID-19 who referred to Imam Reza Hospital in Tabriz city, were selected by random sampling method. The patients’ emotional–psychological status was assessed by the Beck Depression Inventory, and they entered the treatment process according to the inclusion criteria. As a therapeutic intervention, a scientific and valid approach called CBT was implemented, which two occupational therapists performed in eight treatment sessions in the context of a social communication application. Paired sample t-test was used to analyze the time sequence of quantitative data due to its normality.RESULTS:After the last session of the intervention, the effect of this therapeutic approach on reducing the depressive symptoms of patients was evaluated. According to the findings, the Beck score of the participants decreased significantly after the intervention (MD = −45/9, P < 0/001).CONCLUSION:Therefore, in order to promote the recovery of patients with COVID-19 and help health authorities to develop preventive measures and effective treatment of emotional–psychological problems caused by this virus, it is recommended to use the online CBT approach.

Anticipation of High-Sensitivity C-Reactive Protein Effect on Post Myocardial Infarction Depression Disorder

Background: The natural history of acute myocardial infarction (AMI) as the most prevalent public health issue in Iran has changed with the introduction of novel therapeutic strategies that have reduced its mortality significantly. Major depressive disorder (MDD) is a prevalent and disabling psychiatric disorder and frequently co-exist with AMI. There are proposed pathophysiological links between the two diseases among which inflammation is the most important. With more patients surviving a myocardial infarction (MI) event, post-MI depression has become an important determinant of disability and mortality. Materials and Methods: In this study we defined a 1-month post-MI depressive scale of 200 patients using Beck’s inventory questionnaire II and measured serum high Sensitivity C-Reactive Protein (hs-CRP) and carotid intima-media thickness (CIMT) to look for the association between inflammatory state and atherosclerosis in different depression score categories. Results: Minimum and maximum Beck scores were 1 and 43, respectively with a mean of 13±8. The mean CIMT was 0.77±0.26 mm. Serum hs-CRP level was measured with a mean of 1.51±1.6 mg/L. According to BDI-II scores, 44.2% of patients 1-month post-MI suffered from more than mild depression. Being affected was not correlated with either the level of hs-CRP or CIMT. Nearly 44 percent of patients suffered more than mild depression. There was a negative association between serum hs-CRP level and CIMT as a measure of atherosclerosis in groups of depressed versus non-depressed patients. This may indicate that the extent of atherosclerosis is not correlated with the inflammatory state after MI in depressed versus non-depressed patients. Conclusions: The results of this study indicate that the extent of atherosclerosis is not correlated with the inflammatory state after MI in depressed versus non-depressed patients. Nonetheless, the prognostic indications of increased hs-CRP and depression after AMI remains to be investigated further. [GMJ.2021;10:e1512]

Anticipation of High-Sensitivity C-Reactive Protein Effect on Post Myocardial Infarction Depression Disorder.

Background: The natural history of acute myocardial infarction (AMI) as the most prevalent public health issue in Iran has changed with the introduction of novel therapeutic strategies that have reduced its mortality significantly. Major depressive disorder (MDD) is a prevalent and disabling psychiatric disorder and frequently co-exist with AMI. There are proposed pathophysiological links between the two diseases among which inflammation is the most important. With more patients surviving a myocardial infarction (MI) event, post-MI depression has become an important determinant of disability and mortality. Materials and Methods: In this study we defined a 1-month post-MI depressive scale of 200 patients using Beck’s inventory questionnaire II and measured serum high Sensitivity C-Reactive Protein (hs-CRP) and carotid intima-media thickness (CIMT) to look for the association between inflammatory state and atherosclerosis in different depression score categories. Results: Minimum and maximum Beck scores were 1 and 43, respectively with a mean of 13±8. The mean CIMT was 0.77±0.26 mm. Serum hs-CRP level was measured with a mean of 1.51±1.6 mg/L. According to BDI-II scores, 44.2% of patients 1-month post-MI suffered from more than mild depression. Being affected was not correlated with either the level of hs-CRP or CIMT. Nearly 44 percent of patients suffered more than mild depression. There was a negative association between serum hs-CRP level and CIMT as a measure of atherosclerosis in groups of depressed versus non-depressed patients. This may indicate that the extent of atherosclerosis is not correlated with the inflammatory state after MI in depressed versus non-depressed patients. Conclusion: The results of this study indicate that the extent of atherosclerosis is not correlated with the inflammatory state after MI in depressed versus non-depressed patients. Nonetheless, the prognostic indications of increased hs-CRP and depression after AMI remains to be investigated further.

Analysis of the effect of weight loss through bariatric surgery on depression

Bariatric surgery results in significant improvement in health related quality of life and depressive symptoms irrespective of the wide range of weight change. This experiment was planned to assess the incidence of depression in obese respondents and to analyse the change in depression after weight loss through bariatric surgery.To analyse the incidence of depression in obese individuals undergoing bariatric surgery and the significance of change in depression status after weight loss.The study was conducted in a multispecialty hospital having obesity clinic and bariatric surgery unit. The depression level before the study and at six months post surgery was assessed using a standard tool named Beck’s inventory. Study period was from 2015 to 2017.Respondents having BMI of 33-50 Kg/m belonging to both the genders in the age range of 18-65 years. The respondents having BMI more than 50Kg/m were excluded in this study.18 respondents who underwent bariatric surgery were included in the study. Percentage distribution, Pearson correlation coefficient, ANOVA, and Paired t test were the tools utilised in statistical analysis of the data.Schedule to assess change in nutritional status using a structured questionnaire considering anthropometric, biochemical, clinical and dietary parameters, and standard tool named Beck’s Depression Inventory, which is a tool for depression status. The surgery patients had initial Beck Score ranging from 1 to 14 indicating mild depression which on follow up reduced to 0 to 7. The weight loss in both genders were similar to each other. The change in intake of nutrients and the scores of depression were more prominent in men than that of women. Respondents pre operatively had mild mood disturbances which after weight loss, became a normal mood.Thus it can be concluded that weight loss through bariatric surgery is effective in reducing depression.

Preliminary results of the cohort study of cognitive impairment associated with Parkinson’s disease

Background: Cognitive impairment (CI) is frequent in Parkinson’s disease (PD). CI patients have particular features. These are preliminary data of a cohort study of Moldovan patients with incident Parkinson’s disease. Material and methods: 65 out of 111 consecutive PD patients (mean age 64.87 ± 7.69 y.o.; disease duration 50.21 ± 38.61 mo.; 48 women (43.2%), 63 men (56.8%)) underwent Montreal Cognitive Assessment (MoCA) test. Cognitive status graded as: (1) normal and (2) impaired cognition. Results: There were similar: ages (65.79 ± 7.13 vs 62.17 ± 12.21 y.o.), onset ages (61.44 ± 7.61 vs 57.00 ± 12.95 years), disease duration (49.63 ± 36.78 vs 66.00 ± 26.48) months), levodopa (574.58 ± 129 vs 249.55) and agonists doses (5.19 ± 3.02 vs 1.05 ± 0.05) and Beck scores (8.13 ± 6.21 vs 7.4 ± 3.85), in groups. CI was present in 59 (90.8%) patients; more frequent in patients with cardiovascular risk factors (91.7%, p&gt; 0.05), symmetrical Parkinsonism (93.2%, p&gt; 0.05), and in first disease symptom bradykinesia patients (93.8%, p&gt; 0.05). Upper / Lower Asymmetry Index were lower in CI patients, all lower type patients (p&gt; 0.05) having CI. MoCA scores correlated with Unified Parkinson’s Disease Rating Scale in ON fase (UPDRSon), (r = -0.320, p &lt;0.022), and red flags number (r = -0.590, p &lt; 0.006). Conclusions: Cognitive impairment is more expectable in akinetic, symmetric and lower type Parkinsonism, also in patients with cardiovascular risk factors, with probable PD, and a more motor impairment.

PREDICTING CLINICAL RESPONSE TO TRANSCRANIAL MAGNETIC STIMULATION IN MAJOR DEPRESSION USING TIME-FREQUENCY EEG SIGNAL PROCESSING

Repetitive transcranial magnetic stimulation (rTMS) is defined as a noninvasive technique of brain stimulation conducted for both diagnostic and therapeutic purposes. rTMS can effectively excite the brain neurons and increase brain plasticity, which becomes particularly useful in psychiatric and neurological fields. Biomarkers that predict clinical outcomes in depression are essential for increasing the precision of treatments and clinical outcomes. The electroencephalogram (EEG) is a noninvasive neurophysiological test that is promising as a biomarker sensitive to treatment effects. The aim of our study was to investigate a novel nonlinear index of the resting state EEG activity as a predictor of clinical outcome and compare its predictive capacity to traditional frequency-based indices. EEG was recorded from 50 patients with treatment resistant depression (TRD) and 24 healthy comparison (HC) subjects. TRD patients were treated with excitatory rTMS to the dorsolateral prefrontal cortex (DLPFC) for 4–6 weeks. EEG signals were first decomposed using the ICA algorithm and the extracted components were then processed by time-frequency analysis. We then go on to compare the participants’ depression severity before, after, and 2 months after finishing the last treatment session using the proposed rTMS therapy. Absolute powers (APs), band powers (BPs), and theta and beta band entropies (BAs), which were extracted from the EEG, are used as features for the classification of changes in patients and normal cases after applying rTMS. Accordingly, we can go beyond the Beck score and clinically classify the EEG signal into two classes: depression and normal. The results demonstrated 78.37%, 74.32%, and 82.43% accuracy for artificial neural network (ANN), [Formula: see text]-nearest neighbor (KNN), and support vector machine (SVM) classifiers, respectively, indicating the superiority of the proposed method to those mentioned in similar studies. Also, the electrophysiological changes are shown to be evident in patients with major depression. Our data show that the time-frequency index yields superior outcome prediction performance compared to the traditional frequency band indices. Our findings warrant further investigation of EEG-based biomarkers in depression.

Эффективность медико-социальной реабилитации постинсультных пациентов с нарушениями средней степени тяжести

The importance of post-stroke rehabilitation cannot be overestimated. The aim of this study was to assess the effectiveness of a standardized post-stroke rehabilitation program for patients with moderate impairments. A total of 122 stroke survivors participated in the study. Group 1 (the comparison group) consisted of 59 patients undergoing standard rehabilitation. Group 2 (the main group) consisted of 63 patients participating in a specially designed social rehabilitation program. The functional, cognitive, psychological and emotional states and the level of social activity were monitored for 6 months. Group 2 demonstrated more pronounced improvement than group 1 after 6 months of follow-up, confirmed by higher Rivermead (p = 0.011) and SS-QOL (p &lt; 0.05) scores and lower DASH and Beck scores (p = 0.015 and p &lt; 0.001, respectively). In both groups, MMSE (cognitive function) scores slightly increased, but the differences between the groups were insignificant. The proposed post-stroke rehabilitation program is effective in helping patients regain their independence and improve social adaptation. The scales and scores used in the study, especially DASH and SS-QOL, are sensitive to changes in the functional state of stroke survivors with moderate impairments.

Anjiotensin Dönüştürücü Enzim İnhibitörü ya da Anjiotensin Reseptör Blokörü Kullanan Kardiyovasküler Hastalarda COVID-19 Pandemisinin Sosyal, Psikolojik ve Klinik Etkileri

Objective: The heart expresses angiotensin converting enzyme (ACE)-2 that makes it vulnerable to severe acute respiratory syndrome-coronavirus-2. Besides ACE inhibitors/angiotensin receptor blockers (ARBs) are used for cardiovascular diseases. Although no significant increase in the risk of coronavirus disease-2019 (COVID-19) infection and no increase in the severity of disease in patients receving ACE inhibitor/ARB therapy were shown, it has been noticed that some patients have tendency to stop the use of these agents. The aim of this study is to determine the behavior attitude of the cardiovascular outpatients during pandemic who use ACE inhibitor/ARB and to asses the impact of COVID19 on them. Material and Methods: One hundred outpatients were included. A survey questioning the social, psychological and the clinical implications of COVID-19 was applied to volunteers. To measure the anxiety and despair levels, Beck scorings were used. Results: A small number of patients stopped using ACE inhibitors/ARBs. Severe hopelessness and severe anxiety levels were seen in a few patient. Gender, fear of getting sick, thinking to have enough information about COVID-19 and accessibilty to cardiovascular drugs were the factors affecting the Beck scores. Social distancing and cleaning hands are stated as the best measures for protection. Most of the patients preferred primary health clinics for routine controls and a few patient had knowledge about tele-medicine. Conclusion: Although a confusion has occured in the public about the use of ACE inhibitors/ARBs, drug release rates were found to be low. The anxiety and disparity levels are subsantially not severe. But it is still important to continue informing patients about the precautions and the use of tele-medicine.

The effect of adding duloxetine to lansoprazole on symptom and quality of life improvement in patients with gastroesophageal reflux diseases: A randomized double-blind clinical trial.

Background: Gastroesophageal reflux disease (GERD) is a common upper gastrointestinal disorder with a negative impact on the quality of life. This study was aimed to assess the effect of adding duloxetine to lansoprazole on the symptom and quality of life improvement in GERD patients.Materials and Methods: Seventy adult patients with a complaint of heartburn and regurgitation were enrolled in this randomized trial. Patients with a history of atypical symptoms, advanced systemic disease, medication-induced symptom, structural lesion in endoscopy, allergy to the medication, and unco-operative were excluded. The patients randomly (computer generated table) assigned in Groups A who received lansoprazole 30 mg plus placebo daily and Group B, in which duloxetine 30 mg daily replaced by placebo during 4 weeks. All of participants, care-givers, and outcomes assessors were blinded. Basic demographic data, symptom severity score, depression and anxiety Beck score, and quality of life questionnaire were recorded at the starting and ending of treatment.Results: Fifty-four patients have completed the study. The mean difference of Anxiety Beck score (13, 95% confidence interval [CI] [10–16], P = 0.001) and total raw score of quality of life (7, 95% CI [3.89–10.11], P = 0.043) were significantly improved in Group B. Complete and overall heartburn improvement rates were significantly better in Group B (odds ratio [OR] Adj: 2.01, 95% CI [1.06–2.97] and OR Adj: 1.31, 95% CI [1.05–1.57], respectively).Conclusion: We found that the combination of duloxetine and lansoprazole is a safe and tolerable regimen, and it can significantly improve anxiety, heartburn, coffee consumption, the quality of sleep, and life in patients who suffer from the symptoms of GERD.

Interstitial Lung Disease and Depression – A Questionnaire Based Study

Background and Objective: Interstitial lung disease (ILD) causes depression due to its painful course in patients. The aim of this study was to determine the prevalence of depression and find the association of depression with selected clinical variables in patients with ILD. Methods: This questionnaire based cross-sectional study was done at the department of pulmonology, District head quarter hospital Sahiwal from 1st Oct 2019 to 31st March 2020. The questionnaire was distributed among the diagnosed cases of ILD who presented in outpatient department of DHQ Sahiwal after taking informed consent. The depression scoring was done in them according to Beck depression inventory II. Frequency distribution statistics and inferential statistics were done by using Statistical Package for Social Sciences (SPSS) version 20. P-value &lt; 0.05 was taken as statistically significant. Results: Depression was graded into four types according to Beck depression inventory II scoring system. Depression levels of minimal, mild, severe and extremely severe were found to have frequencies of 42.90, 14.30, 31.40 and 11.4% respectively. Depression was more prevalent in females (77.14%). Sixty two percent of severely depressed had rural background. Three fourth (75%) of severely depressed patients were from lower class group. Half of the severely depressed patients were suffering from hypertension. One fourth had ischemic heart disease. Illiteracy dominated in severely depressed where 3/4th of the participants had not received any education. Our study found statistically significant result of Beck score with socioeconomic groups (P = 0.037). High statistically significant result was also found when Beck scoring was associated with co-morbidities (P = 0.001). Conclusions: The increased frequency of depression in the patients of ILD was associated with many demographic factors. The development of improved methods for the assessment of ILD and its co-morbidities could have profound effects on the quality of life and expected survival of ILD patients.

Interstitial Lung Disease and Depression &amp;ndash; A Questionnaire Based Study

&lt;p&gt;Background and Objective: &amp;nbsp;Interstitial lung disease (ILD) causes depression due to its painful course in patients. The aim of this study was to determine the prevalence of depression and find the association of depression with selected clinical variables in patients with ILD.&lt;/p&gt;&#x0D; &lt;p&gt;Methods: &amp;nbsp;This questionnaire based cross-sectional study was done at the department of pulmonology, District head quarter hospital Sahiwal from 1st Oct 2019 to 31st March 2020. The questionnaire was distributed among the diagnosed cases of ILD who presented in outpatient department of DHQ Sahiwal after taking informed consent. The depression scoring was done in them according to Beck depression inventory II. Frequency distribution statistics and inferential statistics were done by using Statistical Package for Social Sciences (SPSS) version 20. P-value &amp;lt; 0.05 was taken as statistically significant.&lt;/p&gt;&#x0D; &lt;p&gt;Results: &amp;nbsp;Depression was graded into four types according to Beck depression inventory II scoring system. Depression levels of minimal, mild, severe and extremely severe were found to have frequencies of 42.90, 14.30, 31.40 and 11.4% respectively. Depression was more prevalent in females (77.14%). Sixty two percent of severely depressed had rural background. Three fourth (75%) of severely depressed patients were from lower class group. Half of the severely depressed patients were suffering from hypertension. One fourth had ischemic heart disease. Illiteracy dominated in severely depressed where 3/4th of the participants had not received any education. Our study found statistically significant result of Beck score with socioeconomic groups (P = 0.037). High statistically significant result was also found when Beck scoring was associated with co-morbidities (P = 0.001).&lt;/p&gt;&#x0D; &lt;p&gt;Conclusions: &amp;nbsp;The increased frequency of depression in the patients of ILD was associated with many demographic factors. The development of improved methods for the assessment of ILD and its co-morbidities could have profound effects on the quality of life and expected survival of ILD patients.&lt;/p&gt;

The Psychosocial Impact of Modifying Face and Body Photographs in Social Media

Social media usage has become widespread in the past decade, and studying its far-reaching impacts requires an interdisciplinary approach. This pilot study takes the first step in discovering the psychosocial impact of specific media content, modified face and body photographs, and the act of modifying in this context with a mixed-method assessment. The analysis is based on structured interviews with ten social media users with various demographic traits (such as gender, age, or education) who were presented eight pairs of "before-and-after modification" photographs and completed the Beck Depression Inventory (BDI) to assess a possible relationship between modified face and body photographs in social media and depression. All the participants encountered such face and body photographs that they considered "modified". The definition of modification was "retouching, editing, using filters or any kind of digital altering mechanism". Seventy per cent of users admitted that they took the opportunity to modify photographs of their face and body. The average Beck score of the image modifiers was 7.14, while non-modifiers' was 2.33. Thirty per cent of the interviewees probably had mild depression or were in a mildly depressive state during the data collection based on their Beck scores; all were image modifiers exposed to modified pictures. Besides the fully structured interviews with social media users, half-structured interviews were also recorded with four experts – a social psychologist, a clinical psychologist, a plastic surgeon, and a professional photographer – to gain a deeper understanding of this complex topic and contribute to further, more extensive research on this area.

The beneficial effects of sumac (Rhus coriaria L.) supplementation along with restricted calorie diet on anthropometric indices, oxidative stress, and inflammation in overweight or obese women with depression: A randomized clinical trial.

Oxidative stress and inflammation play pivotal roles in the pathophysiology of obesity and depression. This study aimed to evaluate the effects of sumac (Rhus coriaria L.) on anthropometric indices, oxidative stress, inflammation, and depression in overweight or obese depressed women. This randomized, double-blind, placebo-controlled clinical trial was conducted on overweight or obese women aged 20-65 years with mild to moderate depression. The participants (n = 62) were assigned to receive a restricted calorie diet (RCD) plus 3 g/day of either sumac or placebo for 12 weeks. Anthropometric measurements, biochemical biomarkers, and the Beck depression inventory were assessed during the study. Sumac significantly reduced weight, body mass index, body fat (p < .001), visceral fat level (p = .03), waist and hip circumference, and malondialdehyde levels (p = .03, p = .002, and p = .006, respectively) in comparison with the placebo group. The levels of interleukin-6 and tumor necrosis factor-α decreased only in the sumac group (11 and 32%, respectively); however, these reductions were not significant. The high-sensitivity c-reactive protein levels (p = .007 and p = .01, respectively) and Beck scores (p < .001) decreased significantly in both the sumac and the placebo group without any significant difference between the two groups. Sumac can be considered as a functional food that along with RCD could have beneficial effects on obesity management, through the possible modulatory effects on oxidative stress in overweight or obese depressed women.

DOP38 Prevalence of fatigue in a severe inflammatory bowel disease cohort highly exposed to biologics

Abstract Background In addition to physical and psychological factors, systemic inflammation, anaemia and/or malnutrition contribute to fatigue in Crohn’s disease (CD) and ulcerative colitis (UC). Despite recent advances in the management of the disease activity, fatigue is a major disabling symptom for inflammatory bowel disease (IBD) patients. Methods The aim of this prospective study is to evaluate the prevalence of IBD patients suffering from fatigue in a tertiary IBD referral centre and delineate its contributing factors. All patients with a confirmed IBD diagnosis were eligible. A given written consent has been obtained for each patient (P2019/053). Fatigue evaluation was assessed by FACIT-F. Self-report questionnaires were used to assess different factors related to fatigue: disease activity was assessed by patient-reported outcomes (PRO), anxiety by State and Trait Spielberger scores, depression by Beck score (BDI-II), sleep quality by Insomnia severity index (ISI) and Epworth scale, and quality of life by the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). Biological values including haemoglobin, C-reactive protein (CRP), thyroid-stimulating hormone (TSH), folic acid and B12 vitamin were collected when available. Results Demographic data of the 128 included patients are presented in Table 1. This cohort was characterised by a high prevalence of CD complicated behaviours and UC pancolitis. 84.4% of patients (n = 108) were exposed to biologics at the time of completion of the questionnaire. The prevalence of fatigue was 65.6% stratified as severe (FACIT-F &amp;lt;20) and moderate (FACIT-F 20–40) in 21.1% and 44.5%, respectively. Fatigue was clearly associated with active disease in CD, anxiety, depression, poor quality of life, insomnia and somnolence but not with active disease in UC. All biological values were within normal ranges and did not influence fatigue. Older age at diagnosis was associated with lower FACIT-F score while disease duration was not (Table 2). No correlation was found between fatigue and any specific biologics (p = 0.08). Conclusion This prospective study reported a fatigue prevalence of 65.6% in a severe IBD cohort highly exposed to biologics. Beyond disease activity in CD, psychological factors (whether they are causes or consequences) such as anxiety, depression, poor quality of life and insomnia were associated with fatigue.

Comparison of prevalence of depression among medical, dental, and engineering students in Patna using Beck's Depression Inventory II: A cross-sectional study.

Background:Depression, a multi-dimensional disorder adversely affects the interpersonal, social and occupational spheres of students’ life. It is the 11th leading cause of global disease burden.Aims and Objectives:To assess the prevalence of depressive symptoms among various professional course students including medical, dental, and engineering students in Patna, Bihar.Materials and Methods:The present investigation was a questionnaire-based cross-sectional descriptive study. A total of 3,100 students attending government and private medical, dental, and engineering colleges in Patna were approached during the course of this study. Students were briefed about the study and questionnaire. BDI-II (Beck's Depression Inventory-II) was administered to the students and they were instructed to fill it. Beck's scores were recorded and a descriptive analysis performed.Results:2798 students out of 3,100 responded positively to the survey by completely filling out the form. The overall response rate was 90.25%. The overall prevalence of depressive symptoms was found to be 47.78%. Of the three streams, students belonging to the engineering stream (40.28%) showed a maximum prevalence of depressive symptoms followed by dental (38.50%) and medical students (34.74%).Conclusion:Our study showed an alarming prevalence of depression among professional course seeking students. This multi-dimensional disorder continues to affect student's performance and professionalism, thus, extending its negative impact to the community at large. This may carry out later in their lives, thus leaving a long-term negative impact. Considering the high rate of depressive symptoms, establishing a unit or facility to identify or diagnose it at an early stage and providing psychological support to students is recommended.

The Role of Zinc in Depressed Pregnant and Non-Pregnant Women: A Systematic Review and Meta-Analysis

AbstractPerinatal depression is a depressive illness that affects 10–15% of women in the UK with an estimated cost of £1.8 billion/year. Zinc deficiency is associated with the development of mood disorders and zinc supplementation has been shown to help reduce the symptoms of depression. Women who are pregnant and breastfeeding are at risk of lower levels of zinc because of the high demand from the developing and feeding baby. However, studies in the perinatal period are limited. With a long-term aim of designing a randomised controlled trial (RCT) to examine if zinc supplementation reduces depressive symptoms in pregnant and lactating women;the objective of this review was to systematically evaluate previous RCTs assessing zinc supplementation and depressive symptoms, in order to establish a zinc dosing regimen with regards to Galenic formulation, unit dose and frequency. The review was conducted by independent reviewers in accordance with PRISMA guidelines and is registered at Prospero (CRD42017059205). The Allied and Complimentary Medicine, CINAHL, Embase, MEDLINE, PsycINFO, PubMed, and Cochrane databases were searched since records began, with no restrictions, for intervention trials assessing Galenic formulation, unit dose and frequency of zinc supplementation to reduce the symptoms of depression. From a total of 66 identified records, 7 articles met the inclusion and exclusion criteria; all assessed the effect of zinc supplementation on mood. Risk of bias was independently assessed using the standard ‘Cochrane risk of bias tool’. Overall, 5 of the 7 papers were rated as high-quality trials; of the other two, one was rated poor and the other fair but both had a number of learning points. Preliminary findings indicate at the end of supplementing zinc, depression scores were reduced significantly. In one study, the Beck score decreased in the placebo group, but this reduction was not significant compared to the baseline. In two of the studies there was a significant correlation between serum zinc and self-reported mood questionnaires. Results also suggest that 25 mg zinc supplementation combined with antidepressant drugs can be effective in the treatment of major depression in women. This supports other work where researchers supplemented 25 mg of elemental zinc for 12 weeks or longer and found a reduction of symptoms in both pregnant and non-pregnant women. Thus, an early conclusion is that 25 mg of elemental zinc is an effective dose for improving low mood and is achievable in a trial setting.

Prediction of Depression Scores From Aerobic Fitness, Body Fatness, Physical Activity, and Vagal Indices in Non-exercising, Female Workers.

Background: Depression is associated with a decreased cardiorespiratory fitness, and physical activity [PA] levels, higher rates of obesity, and dysfunction in autonomic control of heart rate [HR]. However, these parameters were mostly recorded with indirect methods. Thus, the aim of the current study was to investigate the relationships between depression scores and objective measures of body fatness, autonomic indices (i.e. HRV and HRR), cardiorespiratory fitness and PA levels; and subsequently to present the best predictive models of depression scores for this population, based on these variables.Methods: Thirty-five non-exercising women (26–43 years; maximal oxygen consumption [VO2max] ~ 17.4–38.3 mL/kg/min) volunteered for participation in this study. All participants responded to the Beck Depression Inventory [DBI] and were evaluated for body mass index [BMI], percentage of body fat, sum of skinfolds, and VO2max. Subsequently, over four consecutive days, an orthostatic test and a submaximal exercise on a cycle ergometer were performed to record HRV and HRR, respectively. In addition, incidental PA was recorded during 5 consecutive days using accelerometers.Results: depression scores were related to VO2max (r = −0.446, p = 0.007) and the sum of skinfolds (r = 0.434, p = 0.009). Several stepwise multiple linear regression models were performed and only VO2max was revealed as an independent predictor of the Beck scores (ß = −0.446, R2 = 0.199, p = 0.007).Conclusion: The present study revealed that VO2max and the sum of skinfolds were moderately related to depression scores, while VO2max was the only independent predictor of depression scores in female workers.

Determining Reliability of Arthroscopic Classifications for Hip Labral Tears.

Evaluate interobserver and intraobserver reliability of hip arthroscopic classifications for labral tears. Retrospective diagnostic study of nonconsecutive patients. Institutional study. From a database of 278 hip arthroscopy videos for treatment of femoroacetabular impingement, 70 videos were chosen by simple random sampling. Exclusion criteria included presence of radiological arthrosis (Tonnis > 2), previous hip surgery, inadequate lesion palpation, poor image quality, and refusal to participate in the study. The final sample included 60 videos. Four hip surgeons evaluated the videos twice at 1-month intervals and classified the lesions according to Lage, Seldes, and Beck classifications for hip labral tears. Interobserver and intraobserver reliability with the percent of agreement and weighted Cohen kappa values. Patients had a mean age of 33 years (SD, 7; range, 18-47 years), and 32 (53%) were men. Femoroacetabular impingement types included combined (CAM and pincer) in 31 (52%), CAM in 27 (45%), and pincer in 2 (3%). For interobserver reliability, the average weighted kappa values were 0.68, 0.65, and 0.78 for the Lage, Seldes, and Beck classifications, respectively. For intraobserver reliability, the mean weighted kappa values were 0.87, 0.64, and 0.93 for the Lage, Seldes, and Beck classifications, respectively. Beck classification had the highest average values for interobserver and intraobserver agreements. Lage, Seldes, and Beck scores for acetabular labrum tears showed substantial interobserver agreement. In the intraobserver evaluation, the Seldes system presented substantial agreement, whereas Lage and Beck classifications were considered excellent agreement.

Sleep patterns among bipolar disorder patients

Background Bipolar disorder (BD) is a lifelong, potentially treatable psychiatric disorder with substantial morbidity and mortality. Sleep is a very important factor for the quality of life, risk for relapse, affective functioning, cognitive functioning, impulsivity, and general health. It is important to note that a bidirectional relationship likely exists between sleep disturbance and mood disorders, as symptoms of mood disorders may disrupt sleep, and disrupted sleep can increase symptoms of mood disorders. Moreover, the sources of inflammation and immune activation, which play a role in depression, may contribute to the inflammatory burden in patients with mania. Aim The aim of this study was to study the nature of sleep disturbance in bipolar patients and to detect the correlation between the severity of BD and sleep disturbance. Patients and methods In this case–control study, fifty BD patients (28 male patients and 22 female patients) and 20 age-matched controls were recruited for this study. Structured Clinical Interview for DSM-IV Axis I Disorders for diagnosis of BD; Beck Depression Inventory-II and Young Mania Rating Scale (YMRS) were used to assess the severity of BD. Assessment of sleep pattern was carried out by Pittsburgh Sleep Quality Index (PSQI), and C-reactive protein (CRP) was measured. Results In the current study, with regard to Beck scores before medication, there were inverse relations with YMRS and PSQI. These relations become direct after medication. As regards YMRS scores before medication, there was an inverse relation with Beck, direct relations with PSQI, which did not show any change after medication, except for sleep disturbance, which become an inverse relation. As regards PSQI’s total scores before medication, it showed an inverse relation with Beck, direct relations with YMRS and the relation with Beck scores became direct after medication. As regards CRP levels, there was a significant difference between cases before and after medication and significant difference between the case and control groups. Conclusion PSQI is a cheap valid test that can be used in Egypt to report sleep profile and abnormalities, to follow-up the patients and prevent relapse. Hence, bipolar patients with depressive symptoms improved and responded better on treatment, with better improvement in sleep profile than patients with manic symptoms. Moreover, a definite correlation between sleep disturbance and CRP levels could not be concluded.

Evaluation of Psychological and Sexual Effects of Female Genital Mutilation (Circumcision)

Background: female genital mutilation (FGM), also known as female circumcision (FC), but more recently as female genital mutilation/cutting (FGM/C) according to the World Health Organization (WHO), has occurred in many forms in all societies. The psychosocial consequences include post-traumatic stress disorder (PTSD), anxiety disorders, panic disorders, depression and suppression of feeling and thinking, and sometimes attempted suicide. Objective: To evaluate sexual and psychological effects of female genital mutilation. Patients and Methods: The two groups were compared as regard many demographic data such as age, level of education, associated chronic diseases and previous gynecological history. The results revealed no significant difference between the two groups in the educational level. The females in the two groups also showed significant difference in their agreement with the process and subsequently in their future decision in performing circumcision for their daughters. Other demographic data included in this study revealed no difference between the studied groups. Results: The study used different questionnaires and scores to compare the sexual satisfaction and psychological effects of the females in the study. For assessment of sexual satisfaction, Female Sexual Function Index (FSFI) questionnaire translated into Arabic was used and showed no significant difference between the two groups except for only a single domain lubrication. Conclusion: Concerning the psychiatric analysis of the two groups, Anxiety Hamilton score and Depression Beck score were used and showed no statistically significant difference between the two groups in the two scores. Also 19% of the females in the group of FGM showed positive symptoms for post-traumatic stress disorder (PTSD).