Depressant Research Articles

Co-occurrence of problematic facebook and video game use: prevalence and association with mental health disorders among adolescents

IntroductionThe rapid proliferation of technology and its impact on adolescents’ lives have raised concerns about addictive behaviors and its potential consequences, including behavioral and mental health problems. This study investigates the prevalence and risk factors associated with the co-occurrence of Problematic Facebook Use and Problematic Video game Use among Tunisian adolescents.MethodologyWe conducted a cross-sectional study in the urban area of Sousse governorate in Tunisia during the 2018/2019 school year. We selected a representative sample of high school students enrolled in public educational institutions in Sousse. Data collection was performed through a self-administered structured questionnaire, which gathered information on sociodemographic characteristics, lifestyle behaviors, and mental health disorders. Problematic Facebook Use was assessed using the validated Arabic version of the Bergen Scale, while Problematic Video Game Use was measured using the 21-point Lemmens Scale, which was translated into Arabic. Statistical analysis was carried out using the SPSS program (version 20).ResultsWe enrolled a total of 1342 high school students in our study, of whom, 63.2% were female with a mean age of 17.5 ± 1.44 years. The prevalence of Problematic Facebook Use and Problematic Video Game Use was 28.3% and 13% respectively. Regarding the co-occurrence of the two problematic behaviors, 31.3% of participants faced a singular addictive behavior, either related to problematic Facebook or video game use, while 5% had both addictive behaviors simultaneously. In a multivariate analysis, risk factors for the co-occurrence of Problematic Facebook and Video Game Use, in decreasing order of significance, included severe depression (AOR = 4.527; p = 0.003), anxiety (AOR = 4.216; p = 0.001), male gender (AOR = 4.130; p < 0.001), problematic internet use (AOR = 3.477; p = 0.006), as well as moderate depression (AOR = 3.048; p = 0.007).ConclusionOur study found that Problematic Facebook and Video Game Use were prevalent among Tunisian adolescents. The co-occurrence of these disorders is strongly linked to male gender, problematic internet use, depression, and anxiety disorders. These findings underscore the urgency of implementing tailored and effective awareness and prevention programs to address these emerging challenges.

Effect of Zinc Supplementation on Serum Brain-Derived Neurotrophic Factor Level and Geriatric Depression Scale among Elderly Persons with Mild to Moderate Depression

Effect of Zinc Supplementation on Serum Brain-Derived Neurotrophic Factor Level and Geriatric Depression Scale among Elderly Persons with Mild to Moderate Depression

Chronic Neuropathic Pain and Comorbid Depression Syndrome: From Neural Circuit Mechanisms to Treatment.

Chronic neuropathic pain and comorbid depression syndrome (CDS) is a major worldwide health problem that affects the quality of life of patients and imposes a tremendous socioeconomic burden. More than half of patients with chronic neuropathic pain also suffer from moderate or severe depression. Due to the complex pathogenesis of CDS, there are no effective therapeutic drugs available. The lack of research on the neural circuit mechanisms of CDS limits the development of treatments. The purpose of this article is to provide an overview of the various circuits involved in CDS. Notably, activating some neural circuits can alleviate pain and/or depression, while activating other circuits can exacerbate these conditions. Moreover, we discuss current and emerging pharmacotherapies for CDS, such as ketamine. Understanding the circuit mechanisms of CDS may provide clues for the development of novel drug treatments for improved CDS management.

Chlorpromazine overdose: a case series

Introduction Chlorpromazine, one of the oldest antipsychotic medications, remains widely available and is still taken in overdose. We aimed to investigate the clinical effects of chlorpromazine overdose and determine if there is a relationship between the reported dose ingested and intensive care unit admission or endotracheal intubation. Methods We performed a retrospective analysis of patients admitted to our toxicology tertiary referral hospital with chlorpromazine overdose (reported dose ingested greater than 300 mg) between 1987 and 2023. We extracted demographic information, details of ingestion, clinical effects and complications (Glasgow Coma Scale, hypotension [systolic blood pressure less than 90 mmHg], delirium, dysrhythmias), length of stay, intensive care unit admission, and endotracheal intubation. Results There were 218 chlorpromazine overdose cases, with presentations decreasing in frequency over the 36 years. The median age at presentation was 32 years (interquartile range: 25–40 years) and 143 (61 per cent) were female. The median reported dose ingested was 1,250 mg (interquartile range; 700–2,500 mg). The majority of presentations (135; 62 per cent) involved reported co-ingestion of other medications, typically benzodiazepines, paracetamol or antipsychotics. There were 76 (35 per cent) chlorpromazine alone ingestions in which there was a slightly higher median reported dose ingested of 1,650 mg (interquartile range: 763–3,000 mg) compared to the reported co-ingestion group, median reported dose ingested of 1,200 mg (interquartile range: 700–2,100 mg). Of all presentations, 36 (27 per cent) had a Glasgow Coma Scale less than 9, 50 (23 per cent) were admitted to the intensive care unit, and 32 (15 per cent) were endotracheally intubated. There was a significant difference in the median reported dose ingested between patients intubated (2,000 mg; interquartile range: 1,388–3,375 mg) and those not intubated (1,200 mg; interquartile range: 644–2,050mg; P < 0.001), and between those admitted to the intensive care unit and not admitted to the intensive care unit (P < 0.0001). The median reported dose ingested in seven chlorpromazine alone presentations who were intubated was 2,500 mg (interquartile range: 2,000–8,000 mg, range: 1,800–20,000 mg). Eighteen (8 per cent) patients developed delirium, eight (4 per cent) had hypotension, three had seizures, and there was one death. Discussion Almost one quarter of cases were admitted to the intensive care unit and over half of these were intubated. Whist the decision to admit to an intensive care unit or intubate a patient is based on clinical need, there was a significant association between reported dose ingested and requirement for endotracheal intubation. Both the frequency of presentation and reported dose ingested declined after 2013. The major limitations of the study were a retrospective design and no analytical confirmation of ingestion. Conclusions We found that the most common effect of chlorpromazine overdose was central nervous system depression and that endotracheal intubation was associated with larger reported doses ingested, particularly in single chlorpromazine ingestions.

Pharmacovigilance of esketamine nasal spray: an analysis of the FDA adverse event reporting system database

Pharmacovigilance of esketamine nasal spray: an analysis of the FDA adverse event reporting system database

Exploring the prevalence of depression, anxiety, and stress among university students in Bangladesh and their determinants

BackgroundDepression, anxiety and stress among university students present a growing global challenge. This study aims to explore the prevalence of depression, anxiety, and stress and identifying their associated factors among university students in Bangladesh. MethodsWe analyzed data of 738 university students collected through a cross-sectional survey. Outcome variables considered were depression, anxiety, and stress levels. Explanatory variables considered were several socio-demographic characteristics. Multinomial logistic regression analysis was employed to explore the association of the outcome variables with explanatory variables. ResultsWe found a notable prevalence of moderate to severe levels of depression, anxiety, and stress among university students in Bangladesh, ranging from 25 % to 71 %. Among students from extended families, there was a 32 % lower likelihood of experiencing moderate depression (relative risk ratio [RRR], 0.68; 95 % confidence interval [CI], 0.47–0.97) and a 35 % lower likelihood of experiencing stress (RRR, 0.65; 95 % CI, 0.44–0.97) compared to their counterparts without depression and stress. Furthermore, students enrolled in the business faculty reported a significantly higher likelihood of stress, with a 2.28 times greater odds (95 % CI, 1.32–3.93) compared to students in the Science and Engineering faculty. ConclusionThis study underscores the pressing necessity for tailored interventions to address the elevated prevalence of depression, anxiety, and stress among university students in Bangladesh. The findings accentuate the importance of recognizing diverse risk factors and implementing mental health support programs.

Unlocking nitrogen compounds' promise against malaria: A comprehensive review.

Plasmodium parasites are the primary cause of malaria, leading to high mortality rates, which require clinical attention. Many of the medications used in the treatment have resulted in resistance over time. Artemisinin combination therapy (ACT) has shown significant results for the treatment. However, mutations in the parasite have resulted in resistance, leading to decreased efficiency of the medications that are currently being used. Therefore, there is a critical need to find novel scaffolds that are safe, effective, and of economic advantage. Literature has reported several potent molecules with diverse scaffolds designed, synthesized, and evaluated against different strains of Plasmodium. With this growing list of compounds, it is essential to collect the data in one place to gain a concise overview of the emerging scaffolds in recent years. For this purpose, nitrogen-containing heterocycles such as β-carboline, imidazole, quinazoline, quinoline, thiazole, and thiophene have been highly explored due to their wide biological applications. Besides these, another scaffold, benzodiazepine, which is majorly used as a central nervous system depressant, is emerging as an anti-malarial agent. Hence, this review centers on the latest medication advancements designed to combat malaria, emphasizing special attention to 1,4-benzodiazepines as a novel scaffold for antimalarial drug discovery.

Investigating the effect of depression on clinical symptoms of temporomandibular disorder in young stressful men.

The objective of this study was to investigate the relationship of the depression level with temporomandibular disorders (TMDs) in young conscripts as a population with chronic stresses. A total number of 144 male conscripts with chronic stress and different levels of depression were assigned to four groups according to the Beck's Depression Inventory (BDI). The control group consisted of age-matched male conscripts without chronic stress. The diagnosis of TMD was made according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Data were analyzed usingMann-Whitney and chi-square tests. The participants with severe depression were significantly more susceptible to have TMD (p = .001) followed by the moderate depression, borderline clinical depression, mild mood disturbance, and control groups. The TMD diagnoses were more prevalent within depression groups compared with the control population (p = .01). The level of depression is directly associated with the presence of TMD in young men with chronic stress.

Caregiver Burden and Depression Among Caregivers of Patients with Chronic Disease

Introduction: Caring for people with chronic diseases is physically and emotionally demanding. It can also have adverse effects on the caretaker, such as depression. Caregiver burden describes the psychological and financial strains of providing care. Depression in caregivers’ manifests as concern, indecision, and an inability to feel the future. Chronic disease is a condition that takes a long time to treat and may progressively get worse over time. This study aims to identify the level of caregiver burden and depression and the correlation between burden and depression among caregivers of patients with chronic diseases. Methods: A self-administered questionnaire containing the Caregiver Burden Inventory and Beck Depression Inventory was used to measure caregiver burden and depression among 217 caregivers of patients with chronic diseases in a teaching hospital in the Klang Valley. Results: The findings showed that the majority of caregivers experienced a mild burden (n = 168, 77.4%), a moderate burden (n = 43, 19.8%), and a severe burden (n = 6, 2.8%). Following mild depression (n = 17, 7.8%), moderate depression (n = 15, 6.9%), and severe depression (n = 4, 1.8%), some caregivers experienced minimal depression (n = 181, 83.4%). According to Pearson's analysis, the link between caregiver burden and depression was statistically significant (p&lt;0.000) with a positive correlation (r = 0.408). Conclusion: In this study, caregivers experienced burden and depression due to providing care. Future studies should incorporate support and resources for caregivers, including respite care and counselling that can promote overall well-being.

A Review on Divine Tree Nyctanthes Arbor-Tristis Linn – A Treasure House of Therapeutic Components

Nyctanthes arbor-tristis Linn is a short ancient tree believed to be a divine tree in India. The tree bears beautiful white flowers known for its aura. It is extensively cultivated in tropical and subtropical regions across the world. Since time immemorial, crude extracts of each part of the tree is used as a classical medicine in treatment of organ disorders, fevers, infections, expectorant, allergies, gynaecological problems, and various other diseases. Nyctanthes arbor-tristis Linn possess phytochemicals such as Alkaloids, steroids, Glycosides, flavonoids, Terpenes, essential oils, proteins that exhibit pharmacological activities like anti-inflammatory, anti-cancer, anti-diabetic, hepato-protective, CNS depressant, anti-anaemic, antipyretic, sedative and many more. This review article has included all the possible details about the plant, its distribution phytochemical constituents, and pharmacological activities. Phytochemical studies and Nyctanthes arbor-tristis Linn’s pharmacological activities indicated it as a potential medicinal plant for various elements. However, more research is crucial to investigate the mode of action of the plant’s bioactive constituents and its therapeutic potential.

Prevalence and Associated Factors of Depression Symptoms Among Aquaculture Workers in Hai Phong, Vietnam: A Cross-Sectional Study

Objective: This study aimed to determine the prevalence and factors associated with depression symptoms among aquaculture workers in Hai Phong, Vietnam. Material and Methods: The study involved 1,220 aquaculture workers in coastal and offshore areas of Hai Phong, Vietnam; from March 2022 to September 2022. It was a cross-sectional descriptive epidemiological study, utilizing direct interviews with aquaculture workers to identify depression symptoms and associated factors. The Depression-Anxiety- Stress Scale (DASS 21) was used to assess depression symptoms. Results: The prevalence of depression symptoms among aquaculture workers was 28.7%, with 20.9% experiencing mild depression, 6.3% moderate depression and 1.5% severe depression. Several factors were associated with depression symptoms; including gender (OR=2.03; 95% CI 1.56-2.63), being single or divorced (OR=1.44; 95% CI 1.04-1.99), age ≥60 (OR=1.63; 95% CI 1.05-2.55) compared to those under 40, chronic illnesses (OR=3.16; 95% CI 2.43-4.11), poor sleep quality (OR=2.84; 95% CI 2.13-3.79), alcohol abuse (OR=1.36; 95% CI 1.06-1.75), and irregular physical exercise (OR=2.09; 95% CI 1.62-2.70). Conclusion: Depression disorder is a mental health concern among aquaculture workers. To alleviate depression symptoms, workers should consider lifestyle adjustments, incorporate regular physical exercise, and undergo routine health check-ups for timely counseling and treatment.

Illicit over the counter availability and recreational use of Zolpidem by young adults: A letter to the editor

Dear Editor, Zolpidem is a sedative-hypnotic drug that acts as a Central Nervous System (CNS) depressant by acting on GABA receptors. This drug, brand name Ambien, is prescribed mainly for short-term treatment of sleeping problems. However, recent trials and research also show its efficacy in treating various neurological disorders. It is one of the safest drug choices for insomnia, but like any other drug, it has various side effects that include nausea, vomiting, allergies, dizziness, metallic taste, etc. However, some of the concerning side effects include amnesia, parasomnia, and behaviour changes, including hallucinations, delusions, and depression (1). ‘Ambien Zombie’ was a term coined to describe people under the effect of the medication as they got involved in embarrassing activities including sleepwalking. It is a Schedule 4 drug, which means ‘prescription only medicine’ as it has viable medical use but also a low probability of misuse or abuse. Despite the potentially alarming side effects in addition to dependence, which has been reported several times (1), it is becoming increasingly popular among young adults, including students, to use it for various purposes, including and especially recreational. These purposes are sleep, relief from anxiety or depression, feeling good, getting high, relaxing or zoning out, and out of curiosity, while some also use it to perform better at school (2,3). The calming effect of zolpidem on the brain gives a drugged effect, allowing the person to carry out compulsive activities and behaviour, hence called an ‘Ambien Zombie’ while most of the time, forgetting about it the next day (anterograde amnesia) (4). Even after realising this side of drug use, young adults use it for fun to feel disinhibited, or to achieve a euphoric state without any embarrassment. The issue of concern is the widespread availability of this drug in pharmacies. As it is a class 4 drug, it should be given on a doctor’s prescription only. However, it is unfortunate that this is not being followed, especially in Pakistan. While some pharmacies ask for a prescription, the majority give it away freely to anyone asking for it, be it a student or a young doctor prescribing himself. This was mainly due to nonqualified salesmen in the pharmacies becoming a source of illicit sale practice for nonmedical prescription drug use (5). This easy accessibility of Zolpidem has rendered it to be a recreational drug for the youth. ---Continue

Assessment of depression symptoms among cancer patients: a cross-sectional study from a developing country

Cancer patients experience psychological symptoms such as depression during the cancer treatment period, which increases the burden of symptoms. Depression severity can be assessed using the beck depression inventory (BDI II). The purpose of the study was to use BDI-II scores to measure depression symptoms in cancer patients at a large tertiary hospital in Palestine. A convenience sample of 271 cancer patients was used for a cross-sectional survey. There are descriptions of demographic, clinical, and lifestyle aspects. In addition, the BDI-II is a tool for determining the severity of depression. Two hundred seventy-one patients participated in the survey, for a 95% response rate. Patients ranged in age from 18 to 84 years, with an average age of 47 years. The male-to-female ratio was approximately 1:1, and 59.4% of the patients were outpatients, 153 (56.5%) of whom had hematologic malignancies. Most cancer patients (n = 104, 38.4%) had minimal depression, while 22.5%, 22.1%, and 17.0% had mild, moderate, and severe depression, respectively. Education level, economic status, smoking status, and age were significantly associated with depression. The BDI-II is a useful instrument for monitoring depressive symptoms. The findings support the practice of routinely testing cancer patients for depressive symptoms as part of standard care and referring patients who are at a higher risk of developing psychological morbidity to specialists for treatment as needed.

#366 Humanistic burden of immunoglobulin A nephropathy and focal segmental glomerulosclerosis on patients and care-partners (HONUS): results for Europe

Abstract Background and Aims Rare proteinuric kidney diseases are associated with clinical and economic burden, however, the humanistic burden associated with these conditions has not been directly evaluated. HONUS is a multi-national, cross-sectional survey study designed to evaluate the humanistic burden associated with two rare kidney diseases, immunoglobulin A nephropathy (IgAN) and focal segmental glomerulosclerosis (FSGS), from the patient and caregiver perspectives in the United States and Europe. The current analysis presents preliminary results from adults with IgAN or FSGS and their care-partners in Spain, Germany, France, or the United Kingdom. Method The study recruited adult patients (≥ 18 years old) with IgAN or FSGS and their adult care-partners. Participants completed an online survey including demographic and clinical characteristics, health-related quality of life (HRQoL) (i.e., Kidney Disease Quality of Life Instrument [KDQoL] including 12-Item Short Form Survey [SF-12]), anxiety and depression (i.e., Generalized Anxiety Disorder Assessment [GAD-7], Patient Health Questionnaire [PHQ-9]), and disease impact on work productivity (i.e., Work Productivity and Activity Impairment [WPAI]). Descriptive analyses were conducted. Results From Europe, 26 IgAN patients, 9 FSGS patients, and their care-partners (4 IgAN and 2 FSGS patients did not report having a care-partner) participated in the survey before November 2023. Mean age for IgAN and FSGS patients was 42.2 years and 51.4 years, with 61.5% and 44.4% being female, respectively. Over two-fifths of both IgAN (42.3%) and FSGS patients (44.4%) were in chronic kidney disease (CKD) stage 3, 4 or 5 (on dialysis), while over one-quarter had received a kidney transplant (IgAN: 26.9%; FSGS: 44.4%). Most patients had worse CKD status since diagnosis (IgAN: 61.5%; FSGS: 77.8%). Hypertension and anemia were the most common comorbidities in both groups. In terms of HRQoL, mean (SD) SF-12 physical and mental component scores (PCS, MCS) indicated IgAN patients were more impacted on the mental component (PCS: 47.3 [11.6], MCS: 43.2 [10.9]), with FSGS patients more impacted on the physical component (PCS: 40.6 [6.0], MCS: 43.8 [9.1]), reflecting generally worse HRQoL (lower scores) than previously published European general population scores (50.0 for PCS and MCS). Moderate to severe anxiety was reported by 30.8% of IgAN and 33.3% of FSGS patients, and moderate to severe depression by 30.8% of IgAN and 44.4% of FSGS patients. Among employed IgAN patients (69.2%), mean percent absenteeism (work time missed) was reported at 13.3%, presenteeism (impairment while working) at 17.7%, and overall work productivity loss at 17.7% due to IgAN-related reasons (only 3 FSGS patients [33.3%] were employed; outcomes not shown). Mean percent activity impairment was reported at 27.3% in IgAN and 43.3% in FSGS patients. Most paired care-partners were partners of patients (IgAN: 81.8%, FSGS: 71.4%), with a mean age of 46.6 years (IgAN) and 50.1 years (FSGS). Mean (SD) SF-12 PCS and MCS of IgAN care-partners were 53.3 (8.8) and 47.9 (10.8), respectively (FSGS: 47.0 [10.6], 49.4 [9.5]). Mild to moderate anxiety was reported in 31.8% (IgAN) and 42.9% (FSGS) of care-partners, with one IgAN care-partner (4.6%) reporting severe anxiety. Mild to moderate depression was reported in 27.3% (IgAN) and 71.4% (FSGS) of care-partners, with two IgAN care-partners (9.1%) reporting moderately severe or severe depression. Among employed IgAN care-partners (86.4%), mean percent absenteeism was reported at 14.2%, presenteeism at 9.3%, and overall work productivity loss at 9.9% due to IgAN-related reasons. Mean percent activity impairment was reported at 18.6% in IgAN and 17.1% in FSGS care-partners. Conclusion Patients with IgAN and FSGS in Europe experience impaired HRQoL compared to previously published European population estimates, as well as anxiety, depression, and impaired productivity. Care-partners of these patients also experience impaired HRQoL, in terms of mental components, and reduced overall productivity.

Potentially Life-Threatening Interaction between Opioids and Intrathecal Baclofen in Individuals with a Childhood-Onset Neurological Disorder: A Case Series and Review of the Literature.

Spasticity and dystonia are movement impairments that can occur in childhood-onset neurological disorders. Severely affected individuals can be treated with intrathecal baclofen (ITB). Concomitant use of ITB and opioids has been associated with central nervous system (CNS) depression. This study aims to describe the clinical management of this interaction, based on a case series and review of literature. Four individuals with childhood-onset CNS disorders (age 8-24) and CNS-depressant overdose symptoms after the concomitant use of ITB and opioids are described. The Drug Interaction Probability Scale (DIPS) was calculated to assess the cause-relationship (doubtful <2, possible 2-4, probable 5-8, and highly probable >8) of the potential drug-drug interaction. A literature review of similar previously reported cases and the possible pharmacological mechanisms of opioid-baclofen interaction is provided. After ITB and opioid co-administration, three out of four patients had decreased consciousness, and three developed respiratory depression. DIPS scores indicated a possible cause-relationship in one patient (DIPS: 4) and a probable cause-relationship in the others (DIPS: 6, 6, and 8). Discontinuation or adjusting ITB or opioid dosages resulted in clinical recovery. All patients recovered completely. In the literature, two articles describing nine unique cases were found. Although the opioid-ITB interaction is incompletely understood, concomitant use may enhance the risk of symptoms of CNS-depressant overdose, which are potentially life-threatening. If concomitant use is desirable, we strongly recommend to closely monitor these patients to detect interaction symptoms early. Awareness and monitoring of the potential opioid-ITB interaction is essential to reduce the risk of severe complications.

Prospective Acceptability of Digital Therapy for Major Depressive Disorder in France: Multicentric Real-Life Study.

Major depressive disorder is one of the leading causes of disability worldwide. Although most international guidelines recommend psychological and psychosocial interventions as first-line treatment for mild to moderate depression, access remains limited in France due to the limited availability of trained clinicians, high costs for patients in the context of nonreimbursement, and the fear of stigmatization. Therefore, online blended psychological treatment such as Deprexis could improve access to care for people with depression. It has several advantages, such as easy accessibility and scalability, and it is supported by evidence. This study aims to evaluate the real-life acceptability of Deprexis for people with depression in France outside of a reimbursement pathway. Deprexis Acceptability Study Measure in Real Life (DARE) was designed as a multicenter cross-sectional study in which Deprexis was offered to any patient meeting the inclusion criteria during the fixed inclusion period (June 2022-March 2023). Inclusion criteria were (1) depression, (2) age between 18 and 65 years, (3) sufficient French language skills, and (4) access to the internet with a device to connect to the Deprexis platform. Exclusion criteria were previous or current diagnoses of bipolar disorder, psychotic symptoms, and suicidal thoughts during the current episode. The primary objective was to measure the prospective acceptability of Deprexis, a new digital therapy. Secondary objectives were to examine differences in acceptability according to patient and clinician characteristics and to identify reasons for refusal. All investigators received video-based training on Deprexis before enrollment to ensure that they all had the same level of information and understanding of the program. A total of 245 patients were eligible (n=159, 64.9% were women and n=138, 56.3% were single). The mean age was 40.7 (SD 14.1) years. A total of 78% (n=191) of the patients had moderate to severe depression (according to the Patient Health Questionnaire-9 [PHQ-9]). More than half of the population had another psychiatric comorbidity (excluding bipolar disorder, psychotic disorders, and suicidal ideation). A total of 33.9% (n=83) of patients accepted the idea of using Deprexis; the main reason for refusal was financial at 83.3% (n=135). Multivariate logistic regression identified factors that might favor the acceptability of Deprexis. Among these, being a couple, being treated with an antidepressant, or having a low severity level favored the acceptance of Deprexis. DARE is the first French study aiming at evaluating the prospective acceptability of digital therapy in the treatment of depression. The main reason for the refusal of Deprexis was financial. DARE will allow better identification of factors influencing acceptability in a natural setting. This study highlights the importance of investigating factors that may be associated with the acceptability of digital interventions, such as marital status, medication use, and severity of depression.

The Role of Family Functioning in the Prevention of Depressive Symptoms and Drug Use Among Hispanic Youth

ABSTRACT Background There is an established link between depression and drug use among adolescents. This relationship holds true for Hispanic youth, for whom familial relationships are especially impactful toward health outcomes. Purpose Our purpose was to examine the relationships between family functioning and adolescent and parent depressive symptoms, and the indirect effects of depressive symptoms on the relationship between family functioning and adolescent drug use. Methods Participants were 231 Hispanic adolescents (52.9% female, Mage = 13.90 ± 1.37) and their parents (93.0% female, Mage = 43.24 ± 6.64) enrolled in an RCT. Data on depressive symptoms, drug use, and family functioning were collected and a latent variable was specified using four indicators of family functioning (positive parenting, monitoring, communication, and involvement). A structural equation model approach was utilized. Results Youth family functioning predicted youths’ depressive symptoms which predicted their own drug use. Youths’ depressive symptoms mediated the relationship between youth family functioning and drug use. Discussion Findings suggest that adolescents’ perceptions of family functioning plays a role in preventing depressive symptoms and drug use among Hispanic youth. Translation to Health Education Practice Teaching students of the role that family support and depressive symptoms play in the manifestation of drug use may be an effective approach to preventing drug use.

The relationship of limited mobility of the cervical spinewith postural and mental reactions of students

Introduction: Previous studies have found that, in addition to the general factors for the occurrence of pain and reduced mobility of the cervical spine, the use of electronic devices promotes these, the excessive use of which can also lead to the occurrence of depressive symptoms in students. The aim of this study was to determine the mobility limitation of the cervical spine in students with reported neck pain, to determine the degree of disability and depression due to neck pain, to determine the correlation of mobility limitation of the cervical spine with the degree of disability and depression of students, and to determine the correlation of the degree of disability with the degree of depression. Methods: The research was conducted as a cross-sectional study from May to July 2021 at the University of Zenica in four faculties. The study used the General Questionnaire and two standardized questionnaires to assess disability due to neck pain (Index of Disability due to Neck Pain) and the degree of depression (patient health questionnaire). Results: A total of 147 students with reported neck pain participated in the study. A limitation of mobility was found in 30.6% of the students in flexion, 25.2% in rotation, 23.8% in lateral flexion, and 20.4% on extension. Mild disability due to neck pain was found in 58.5% of students, moderate in 23.8%, and severe in 2.7%. 45.6% of the students had mild depression, 18.4% had moderate depression, and 5.4% had severe depression.Conclusion: Restricted flexion and rotation are more common than restricted lateral flexion and extension of the cervical spine. About half of the students who reported neck pain had a mild degree of disability and mild depression. A strong positive correlation was found between the degree of disability and depression in students with neck pain.

Drug-Cannabinoid Interactions in Selected Therapeutics for Symptoms Associated with Epilepsy, Autism Spectrum Disorder, Cancer, Multiple Sclerosis, and Pain.

Clinical practice entails a translation of research that assists in the use of scientific data and therapeutic evidence for the benefit of the patient. This review critically summarizes the potential impact of cannabinoids in conjunction with other drugs when associated with treatments for epilepsy, autism spectrum disorder, cancer, multiple sclerosis, and chronic pain. In these associations, potential drug interactions may occur and alter the predicted clinical results. Therefore, the potential for drug interactions must always be assessed to avoid therapeutic failures and/or increased side effects. Some effects may be additive, synergistic, or antagonistic, but changes in absorption, distribution, metabolism, particularly through cytochrome P450 (CYP) isoenzymes (e.g., CYP2C9 and CYP3A4), and excretion may also occur. For example, the combination of cannabis-derived compounds and the antifungal drug ketoconazole, a CYP3A4 inhibitor, increases the plasma concentration of Δ-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). In contrast, rifampicin, a CYP3A4 inducer, stands out for reducing plasma THC levels by approximately 20-40% and 50% to 60% for CBD. Other CYP3A4 inhibitors and inducers are likely to have a similar effect on plasma concentrations if co-administered. Pharmacokinetic interactions with anticonvulsant medications have also been reported, as have pharmacodynamic interactions between cannabinoids and medications with sympathomimetic effects (e.g., tachycardia, hypertension), central nervous system depressants (e.g., drowsiness, ataxia), and anticholinergics (e.g., tachycardia and somnolence). Although further studies are still pending, there is currently clinical evidence supporting drug interactions with cannabinoids, requiring doctors to evaluate the risk of drug combinations with cannabinoids and vice versa. The tables provided here were designed to facilitate the identification of biorelevant interactions that may compromise therapeutic efficacy and toxicity.

Anxiety and depression in nasopharyngeal carcinoma patients and network analysis to identify central symptoms: A cross-sectional study from a high-incidence area

PurposeTo determine the prevalence of anxiety and depression in patients with nasopharyngeal carcinoma (NPC) and to identify central symptoms and bridge symptoms among psychiatric disorders. MethodsThis cross-sectional study recruited patients with NPC in Guangzhou, China from May 2022, to October 2022. The General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were used for screening anxiety and depression, respectively. Network analysis was conducted to evaluate the centrality and connectivity of the symptoms of anxiety, depression, quality of life (QoL) and insomnia. ResultsA total of 2806 respondents with complete GAD-7 and PHQ-9 scores out of 3828 were enrolled. The incidence of anxiety in the whole population was 26.5% (depression, 28.5%; either anxiety or depression, 34.8%). Anxiety was highest at caner diagnosis (34.2%), while depression reached a peak at late-stage radiotherapy (48.5%). Both moderate and severe anxiety and depression were exacerbated during radiotherapy. Coexisting anxiety and depression occurred in 58.3% of those with either anxiety or depression. The generated network showed that anxiety and depression symptoms were closely connected; insomnia was strongly connected with QoL. “Sad mood”, “Lack of energy”, and “Trouble relaxing” were the most important items in the network. Insomnia was the most significant bridge item that connected symptom groups. ConclusionPatients with NPC are facing alarming disturbances of psychiatric disorders; tailored strategies should be implemented for high-risk patients. Besides, central symptoms (sad mood, lack of energy, and trouble relaxing) and bridge symptoms (insomnia) may be potential interventional targets in future clinical practice.