Diagnosis Of Depressive Disorder Research Articles

Psychotherapy for adult depression in low- and middle-income countries: an updated systematic review and meta-analysis.

Previous meta-analyses on psychotherapy for adult depression have found a larger treatment effect in non-Western trials compared to Western trials (i.e. North America, Europe, and Australia). However, factors contributing to this difference remain unclear. This study investigated different study characteristics between Western and non-Western trials and examined their association with effect size estimates. We systematically searched PubMed, PsycINFO, Embase, and Cochrane Library (01-09-2022). We included randomized-controlled trials (RCTs) that compared psychotherapy with a control condition. The validity of included RCTs was assessed by the Cochrane risk of bias assessment tool (RoB 1). Effect sizes were pooled using the random-effects model. Subgroup analyses and meta-regressions were also conducted. We identified 405 eligible trials, among which 105 trials (117 comparisons, 16 304 participants) were from non-Western countries. We confirmed that non-Western trials had a larger treatment effect (g = 1.10, 95% CI 0.90-1.31) than Western trials (g = 0.57, 95% CI 0.52-0.62). Trials from non-Western countries also had more usual care controls, higher risk of bias, larger sample sizes, lower mean ages, younger adults, more group-based interventions, and other recruitment methods (e.g. systematic screening; p < 0.05). The larger effect sizes found in non-Western trials were related to the presence of wait-list controls, high risk of bias, cognitive-behavioral therapy, and clinician-diagnosed depression (p < 0.05). The larger treatment effects observed in non-Western trials may result from the high heterogeneous study design and relatively low validity. Further research on long-term effects, adolescent groups, and individual-level data are still needed.

Shoulder arthroplasty outcomes in patients with major depressive disorder or generalized anxiety disorder

BackgroundAnxiety and depression are among the most common mental health disorders in the United States and have been linked to increased health-care utilization and poorer clinical outcomes. However, data on the relationship between anxiety and depression and outcomes after shoulder arthroplasty (SA) are both limited and conflicting. MethodsThis retrospective cohort study examined the influence of a preoperative diagnosis of anxiety and/or major depressive disorder (MDD) on outcomes following shoulder arthroplasty, such as range of motion, pain, perioperative and postoperative complications, and readmission rates. A retrospective chart review of our health system’s electronic medical record was performed for dates of service January 2014–December 2019. Patients who underwent primary total shoulder arthroplasty or reverse total shoulder arthroplasty were considered for inclusion. These patients were then divided into two groups based on the presence or absence of an anxiety disorder and/or MDD in their past medical history. Results595 patients with a minimum follow-up of one year were considered for analysis. Of these, 205 patients (34.5%) had diagnoses of an anxiety and/or MDD and were assigned to the psychiatric comorbidity group, while 390 (65.5%) were assigned to the control group. The psychiatric comorbidity group was significantly younger (68.3 ± 9.3 vs. 70.5 ± 10.0, P = .008) and more heavily female (68.7% vs. 48.7%, P < .001). The length of stay was significantly longer in the psychiatric comorbidity group than in the control group (1.9 ± 2.4 vs. 1.5 ± 0.9 days, P = .023). Postoperative range of motion, visual analog scale pain scores (1.8 ± 2.7 vs. 1.3 ± 2.3, P = .059), complication rates (7.8% vs. 6.9%, P = .681), and revision rates (4.9% vs. 3.6%, P = .448) were not significantly different between the psychiatric comorbidity and control groups, respectively. All-cause emergency department visitation and hospital readmission rates were also similar between the two groups at 30, 60, and 90 days postoperatively. ConclusionOur results suggest that a preoperative diagnosis of MDD or anxiety does not affect pain, postoperative outcomes, complications, or readmission rates following shoulder arthroplasty.

Major depressive disorder diagnosis from electroencephalogram data and potential treatment with dimethyltryptamine

In recent times, there has been increasing interest in utilizing EEG-based techniques for studying Major Depressive Disorder as a dynamic method. Although it is frequently used for identifying depression, the method is still difficult to interpret. The conventional treatment of MDD involves medications such as Selective Serotonin Reuptake Inhibitors, which often have adverse effects. On the other hand, the use of dimethyltryptamine to stimulate brain activity in regions where MDD patients show lower activity has demonstrated promising results. This study analyzed resting-state EEG signals from MDD patients, DMT users, and healthy controls to evaluate and validated a computer-aided approach. The brain activity of DMT users was recorded and compared with MDD individuals and healthy controls. Using Welch's method, the power of several frequency bands was analyzed from the EEG dataset for comparison and diagnosis. The extracted EEG data underwent noise removal and feature extraction. The features from all controls were concatenated to form a data matrix. Furthermore, the data matrix was standardized using the Z-score standardization method. The classifier model logistic regression was employed to train and test the extracted features. The results of the investigations have demonstrated the most important features, such as signal power of the EEG data from the frontal, temporal, parietal, and occipital brain areas, to be significant.

Capturing the Individual Deviations From Normative Models of Brain Structure for Depression Diagnosis and Treatment

BackgroundThe high heterogeneity of depression prevents us from obtaining reproducible and definite anatomical maps of brain structural changes associated with the disorder, which limits the individualized diagnosis and treatment of patients. In this study, we investigated the clinical issues related to depression according to individual deviations from normative ranges of gray matter volume. MethodsWe enrolled 1092 participants, including 187 patients with depression and 905 healthy control participants. Structural magnetic resonance imaging data of healthy control participants from the Human Connectome Project (n = 510) and REST-meta-MDD Project (n = 229) were used to establish a normative model across the life span in adults 18 to 65 years old for each brain region. Deviations from the normative range for 187 patients and 166 healthy control participants recruited from two local hospitals were captured as normative probability maps, which were used to identify the disease risk and treatment-related latent factors. ResultsIn contrast to case-control results, our normative modeling approach revealed highly individualized patterns of anatomic abnormalities in depressed patients (less than 11% extreme deviation overlapping for any regions). Based on our classification framework, models trained with individual normative probability maps (area under the receiver operating characteristic curve range, 0.7146–0.7836) showed better performance than models trained with original gray matter volume values (area under the receiver operating characteristic curve range, 0.6800–0.7036), which was verified in an independent external test set. Furthermore, different latent brain structural factors in relation to antidepressant treatment were revealed by a Bayesian model based on normative probability maps, suggesting distinct treatment response and inclination. ConclusionsCapturing personalized deviations from a normative range could help in understanding the heterogeneous neurobiology of depression and thus guide clinical diagnosis and treatment of depression.

Rest-activity rhythm associated with depressive symptom severity and attention among patients with major depressive disorder: a 12-month follow-up study.

Patients with depressive disorder demonstrate rest-activity rhythm disturbances and cognitive function impairment. This study examined the association of individual rest-activity rhythm changes over time with mood symptoms and attention. We recruited 15 adult outpatients with a diagnosis of major depressive disorder from a single medical center and observed them for 12 months. Weekly rest-activity parameters, including rhythm characteristics generated from nonparametric circadian rhythm analysis, were retrieved from actigraphy data. Attention was evaluated weekly with a smartphone-based psychomotor vigilance test upon awakening. Depressive symptom severity was evaluated using the Beck Depression Inventory (BDI) fortnightly. The association of rest-activity parameters with BDI score and attention was examined using generalized linear mixed regression. A fixed-effects analysis was used to examine the association between rest-activity parameters and depressive episodes. An advanced bedtime and most active continuous 10 h starting time were associated with depressive symptom severity but also associated with higher vigilance test performance. A longer sleep duration, mainly due to an earlier bedtime, was associated with depressive symptom severity. Compared to remission, sleep duration was 27.8 min longer during depressive episodes, and bed time was 24 min earlier. A shorter sleep duration and increased activity during sleep were associated with poorer attention. Rest-activity rhythms change with mood symptoms among patients with depressive disorder. The circadian rhythms of rest-activity among patients with depressive disorder should be distinguished during various mood states in future studies.

Diabulimia: A Risky Trend Among Adults with Type 1 Diabetes Mellitus

ObjectivePoor adherence leads to worse glycemic control and increased complications in patients with type 1 diabetes mellitus (T1DM). Diabulimia characterizes patients with T1DM who skip or use less insulin for weight loss purposes. The study objectives were to determine: (1) the prevalence of diabulimia among adult patients with T1DM, (2) compare patients with and without diabulimia, and (3) identify factors that may place individuals at higher risk of diabulimia. MethodsA 40-item, web-based survey was administered to 21 T1DM discussion boards, Listservs, and social media outlets. The survey assessed demographics, diabetes management, psychiatric diagnoses, and screened for diabulimia. Individuals who reported intentionally skipping or using less insulin than directed for the purpose of weight loss or to prevent weight gain in the past 12 months were classified as having diabulimia. ResultsOf the 225 participants who completed the survey, 8.9% had diabulimia. Patients with diabulimia had elevated hemoglobin A1C (A1C) levels (8.4% vs 6.9%; P = .014), higher rates of a diabetes-related emergency department visits or hospitalization (30.0% vs 13.2%; P = .042), and higher rates of a major depressive disorder diagnosis (40.0% vs 11.5%; P < .001) than patients without diabulimia. Factors associated with diabulimia included high A1C levels (odds ratio, 1.43; 95% CI [1.08-1.91]; P = .014) and a major depressive disorder diagnosis (odds ratio, 4.87; 95% CI [1.31-18.22]; P = .018). ConclusionApproximately 1 in 11 adult patients with T1DM screened positive for diabulimia. Higher A1C levels and a diagnosis of major depressive disorder were associated with diabulimia.

The effect of obstructive sleep apnea severity on PTSD symptoms during the course of esketamine treatment: a retrospective clinical study.

Intranasal administration of esketamine is Food and Drug Administration-approved for treatment-resistant depression. In a recent retrospective case series, we show that it has promise in reducing symptoms of posttraumatic stress disorder (PTSD) as well. Untreated obstructive sleep apnea (OSA) is prevalent among veterans with PTSD and has been shown to interfere with other PTSD treatments. In the current study, we examined whether OSA impacts esketamine's effectiveness in reducing symptoms of PTSD or depression. Participants were 60 veterans with a diagnosis of major depressive disorder and PTSD who received intranasal esketamine treatment at the San Diego Veterans Affairs (VA) Medical Center. We used growth-curve modeling to examine changes in depression and PTSD symptoms following esketamine treatments and, in the subset of individuals screened for OSA (n = 24, all prescribed positive airway pressure therapy), examined the impacts of OSA severity on these trajectories. We first showed that both PTSD and depressive symptoms significantly decreased over the course of esketamine treatment. In the subset of veterans screened for OSA, individuals with lower OSA severity reported the greatest reduction in PTSD symptoms, while veterans with the most severe OSA reported the least reduction in PTSD symptoms. Depression response was not affected by severity of OSA in this analysis. Veterans with PTSD and depression tend to benefit from esketamine treatment, but OSA may interfere with esketamine effectiveness. Comorbid OSA should be assessed for and treated to maximize esketamine's benefits in PTSD. Titone MK, Hunt C, Bismark A, etal. The effect of obstructive sleep apnea severity on PTSD symptoms during the course of esketamine treatment: a retrospective clinical study. J Clin Sleep Med. 2023;19(12):2043-2051.

Identifying circulating biomarkers for major depressive disorder.

To date, the current diagnosis of major depressive disorder (MDD) still depends on clinical symptomatologic criteria, misdiagnosis and ineffective treatment are common. The study aimed to explore circulating biomarkers for MDD diagnosis. A high-throughput antibody array technology was utilized to detect 440 circulating cytokines in eight MDD patients and eight age-and gender-matched healthy controls. LASSO regression was conducted for MDD-related characteristic proteins selection. Enzyme-linked immunosorbent assay (ELISA) was used to validate the characteristic proteins in 40 MDD patients and 40 healthy controls. Receiver operating characteristic (ROC) curve was employed to evaluate the diagnostic values of characteristic proteins for discriminating MDD patients from healthy controls. Correlations between the levels of characteristic proteins and depression severity (HAMD-17 scores) were evaluated using linear regression. The levels of 59 proteins were found aberrant in MDD patients compared with healthy controls. LASSO regression found six MDD-related characteristic proteins including insulin, CD40L, CD155, Lipocalin-2, HGF and LIGHT. ROC curve analysis showed that the area under curve (AUC) values of six characteristic proteins were more than 0.85 in discriminating patients with MDD from healthy controls. Furthermore, significant relationship was found between the levels of insulin, CD155, Lipocalin-2, HGF, LIGHT and HAMD-17 scores in MDD group. These results suggested that six characteristic proteins screened from 59 proteins differential in MDD may hold promise as diagnostic biomarkers in discriminating patients with MDD. Among six characteristic proteins, insulin, CD155, Lipocalin-2, HGF and LIGHT might be useful to estimate the severity of depressive symptoms.

Graph Self-Supervised Learning With Application to Brain Networks Analysis.

The less training data and insufficient supervision limit the performance of the deep supervised models for brain disease diagnosis. It is significant to construct a learning framework that can capture more information in limited data and insufficient supervision. To address these issues, we focus on self-supervised learning and aim to generalize the self-supervised learning to the brain networks, which are non-Euclidean graph data. More specifically, we propose an ensemble masked graph self-supervised framework named BrainGSLs, which incorporates 1) a local topological-aware encoder that takes the partially visible nodes as input and learns these latent representations, 2) a node-edge bi-decoder that reconstructs the masked edges by the representations of both the masked and visible nodes, 3) a signal representation learning module for capturing temporal representations from BOLD signals and 4) a classifier used for the classification. We evaluate our model on three real medical clinical applications: diagnosis of Autism Spectrum Disorder (ASD), diagnosis of Bipolar Disorder (BD) and diagnosis of Major Depressive Disorder (MDD). The results suggest that the proposed self-supervised training has led to remarkable improvement and outperforms state-of-the-art methods. Moreover, our method is able to identify the biomarkers associated with the diseases, which is consistent with the previous studies. We also explore the correlation of these three diseases and find the strong association between ASD and BD. To the best of our knowledge, our work is the first attempt of applying the idea of self-supervised learning with masked autoencoder on the brain network analysis.

Depression and Cost-Related Health Care Utilization Among Persons with Diabetes.

The presence of depression among people with diabetes can substantially increase health care costs and reduce health care utilization. This study aimed at further elucidating the factors underlying the relationship between depressive disorders and health care utilization among people with diabetes. Data were obtained from the 2019 Behavioral Risk Factor Surveillance System, and the sample was limited to people with diabetes (n = 22,642). The independent variable was assessed by a lifetime diagnosis of depressive disorder, including depression, major depression, dysthymia, or minor depression. The dependent variable was cost-related health care utilization assessed as a response (yes/no) to whether participants had not seen a doctor due to costs in the past year. Logistic regression models examined the association between depressive disorders and health care utilization, adjusting for covariates incorporating weighting to account for study design. Overall, 25.2% of the people with diabetes reported having had a depressive disorder in their lifetime. People with diabetes who had ever been diagnosed with a depressive disorder were more likely to have reported not seeing a doctor due to costs in the past year (adjusted odds ratio: 1.82 [1.49, 2.28]). Findings from this study suggest a need for further research regarding the relationship between depression and cost-related health care utilization among people with diabetes.

A replication and extension of bifactor modelling of perseverative thought in an at-risk community sample: Exploring sex differences in the structure of PT.

Perseverative thought (PT) is a transdiagnostic construct associated with internalizing disorders. Bifactor models have shown that PT can be split into a general PT factor and lower-order factors for specific forms of PT, such as rumination and worry. No bifactor study to date has investigated if the structure of PT differs across sexes. The study consisted of 280 individuals recruited for a larger study targeting risk factors for suicidal ideation and behaviours. Participants completed a diagnostic interview and self-report questionnaires. A two-factor model of PT fit best in males, whereas a bifactor model fit best in females. In a structural equation model, worry was associated with generalized anxiety disorder diagnoses in females, but not males. Rumination was associated with depressive disorder diagnoses in females, but not males. The present study contributes to a growing literature on PT; we found that dimensionality of PT varied by sex. We also found that relations between PT factors and generalized anxiety disorder differed by sex. Sex differences in the internalizing spectrum and related risk factors need to be considered when examining the structure and function of risk factors.

Anxious distress in people with major depressive episodes: a cross-sectional analysis of clinical correlates.

Most people with major depressive episodes meet the criteria for the anxious distress (AD) specifier defined by DSM-5 as the presence of symptoms such as feelings of tension, restlessness, difficulty concentrating, and fear that something awful may happen. This cross-sectional study was aimed at identifying clinical correlates of AD in people with unipolar or bipolar depression. Inpatients with a current major depressive episode were included. Data on socio-demographic and clinical variables were collected. The SCID-5 was used to diagnose depressive episodes and relevant specifiers. The Montgomery-Åsberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS) were used to assess the severity of depressive and manic (mixed) symptoms, respectively. Multiple logistic regression analyses were carried out to identify clinical correlates of AD. We included 206 people (mean age: 48.4±18.6yrs.; males: 38.8%) admitted for a major depressive episode (155 with major depressive disorder and 51 with bipolar disorder). Around two-thirds of the sample (N=137; 66.5%) had AD. Multiple logistic regression models showed that AD was associated with mixed features, higher YMRS scores, psychotic features, and a diagnosis of major depressive disorder (p<0.05). Despite some limitations, including the cross-sectional design and the inpatient setting, our study shows that AD is likely to be associated with mixed and psychotic features, as well as with unipolar depression. The identification of these clinical domains may help clinicians to better contextualize AD in the context of major depressive episodes.

Marcadores Moleculares do Transtorno Depressivo (TD) e sua utilização clínica

Introduction: Depressive disorder (DD) is one of the most prevalent disorders in Brazil, it is characterized as an affective disorder whose symptoms include depressive mood, insecurity, distorted view of reality that may or may not be accompanied by psychotic symptoms. The diagnosis for TD is complex and involves several variables, such as environmental, biological and psychosocial. In view of this, the search for molecular markers that can contribute to the diagnoses and prognoses of patients with depressive disorder can help the doctor's therapeutic approach. Methodology: This is an integrative review of the literature, allowing the analysis of the scientific bibliography on molecular markers of Depressive Disorder in the general population available between 2010-2022 in a systematic and expanded manner. Objectives: The objective of the research is to review the publications available in the literature on the molecular and genetic analysis of Depressive Disorder. Result: The survey of molecular markers is extremely important to enable easier diagnosis and more effective treatment, which is personalized for each situation. Markers such as cortisol, p11, BRAF and interleukin have shown to be promising markers for the diagnosis and/or prognosis of depressive disorder. Conclusion: Molecular markers are extremely important for early detection and choosing the best treatment for each individual. In this way, the markers found, for the most part, can be obtained through blood or saliva tests, which generates less costs for the Unified Health System (SUS), optimizing diagnosis and guaranteeing access to diagnosis and treatment in a more efficient way. assertive.

Mental disorders in patients with systemic lupus erythematosus: association with activity and the course of rheumatic disease

To clarify the relationship between the clinical and psychopathological features of mental disorders, clinical and laboratory manifestations of activity and the nature of the course of systemic lupus erythematosus (SLE). The study included 119 patients - 98 (82.4%) women, mean age 36.5±12.4 years (M±SD) - with a reliable diagnosis of SLE (EULAR/ACR 2019 criteria), 51 (29.5%) of them - with secondary antiphospholipid syndrome - APS (International criteria of 2006). Among patients with SLE a high frequency of anxiety-depressive spectrum disorders (ADSD) and cognitive impairment (CI) was revealed. There was an association of greater severity of depression with high SLE activity index, acute/subacute onset of the disease course according to the classification of V.A. Nasonova, relapsing-remitting and chronic active current disease activity patterns of SLE according to the classification of S. Barr - M. Petri. Anxiety disorders were associated with subacute onset and relapsing-remitting disease activity patterns of SLE and were not associated with SLE activity index. Bipolar disorder was detected more often in patients with chronic SLE. Acute psychosis/delirium was associated with acute onset of SLE. Organic CI was associated with APS, chronic onset and long quiescent disease activity patterns of SLE. The episindrome and schizotypal disorder in patients with SLE are more often caused by concomitant APS. Patients with high SLE activity index should be of particular concern to rheumatologists regarding the diagnosis of depressive disorders. Patients with concomitant APS need timely diagnosis and treatment of CI and episindrome in order to improve the prognosis of the disease and the overall quality of life.

Self-compassion and neural activity during self-appraisals in depressed and healthy adolescents

BackgroundDepression is one of the most concerning mental disorders in youth. Because atypical excessive neural activity during self-referential processing is often implicated in depression, identifying psychological factors that link to lower depression and less excessive neural activity during self-referential processing is critical for treatment development. This study examined the relationship between self-compassion – a protective factor of youth depression – and neural activity during self-appraisals, a well-established experimental paradigm for studying self-referential processing, and their associations with depression severity in depressed and healthy youth. MethodsThe sample consisted of 115 youth (79 met the clinical diagnosis of depression; 36 were matched healthy controls) aged from 11 to 17 years (68 females). Self-compassion and depression severity were measured with self-reported scales. In the scanner, participants were asked to judge whether the phrases they heard described them from four perspectives (self, mother, classmate, and best friend). ResultsHigher self-compassion was associated with lower PCC/precuneus activity especially during negatively-valenced self-appraisals and explained its association with reduced depression severity. In depressed youth, higher self-compassion was associated with lower superior temporal gyrus/operculum/postcentral gyrus/insula activity especially during positively-valenced self-appraisals. In healthy youth, higher self-compassion was associated with higher activity in these regions. ConclusionsSelf-compassion was associated with less excessive experiential immersion and/or autobiographical memory retrieval during negative self-appraisals. Neural stimulation interventions targeting PCC/precuneus activity during negative self-appraisals combined with behavioral interventions targeting self-compassion could be a promising approach to youth depression treatment.

Effectiveness of family-based therapy for depressive symptoms in children and adolescents: A systematic review and meta-analysis.

Early-onset depression contributes significantly to the global health burden and has long-term negative effects. This meta-analysis collates and examines the effectiveness of family-based interventions, where family members are involved in the treatment of depression in children and adolescents. A literature search was performed up to 8th March 2023. Randomised controlled trials of family-based interventions were included for participants aged 3-18 years with a diagnosis of major depressive disorder or dysthymia, according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013) or with a score above a cut-off on a standardised self-report depression measure. The overall effect size for treatment versus active control was g = 0.22 (95% confidence interval [CI]: -0.05-0.50) (nine studies; 659 participants), and for treatment versus non-active control it was g = 0.46 (95% CI: -0.09-1.01) (four studies; 385 participants). Effect sizes were not statistically significant, and heterogeneity was high, ranging between I2 = 64.3-81.1%. Subgroup analysis comparing attachment-based family therapy with family therapy using other theoretical frameworks did not yield a significant difference between the two. The effects of family-based therapies were larger than those in the comparison groups, but family-based therapy did not demonstrate a significant treatment benefit compared to the controls. More randomised controlled trials are warranted, considering that evidence for other psychotherapies for depression in children and adolescents, indicates modest effects. Family-based therapy may be an alternative for children and adolescents whose needs are not addressed by these treatments.

Serum alkaline phosphatase was independently associated with depression in patients with cerebrovascular disease.

Blood markers have important value in the diagnosis of depressive disorders. Serum alkaline phosphatase (ALP) not only predicts stroke recurrence and poor functional prognosis in cerebrovascular disease (CVD) patients but also increases significantly in middle-aged women with depression. Thus, it has not been reported whether serum ALP is associated with the development of depression and/or vascular depression (VDe) in CVD patients. This was a cross-sectional study of 353 CVD patients (stroke patients, n = 291; cerebral small vessel disease (CSVD) patients, n = 62). Baseline demographic information, fasting blood markers (such as blood counts, liver function, kidney function and lipids), and brain CT/MRI scans were collected. CVD patients were divided into non-depression, suspected vascular depression (SVD), and positive vascular depression (PVD) groups according to their Hamilton Rating Scale for Depression (HAMD) scores. Univariate analysis of baseline data, blood markers, and the prevalence of lesions (> 1.5 cm) was performed. Subsequently, the diagnostic performance of the univariate and combined variables for SVD and PVD was analyzed using binary logistic regression. The diagnostic value of the multivariate model for VDe was analyzed by ordinal logistic regression. (1) Serum ALP (p = 0.003) and hypersensitive C-reactive protein (hs-CRP, p = 0.001) concentrations increased as HAMD scores increased, and the prevalence of brain atrophy (p = 0.016) and lesions in the basal ganglia (p = 0.001) and parietal (p = 0.001), temporal (p = 0.002), and frontal lobes (p = 0.003) also increased, whereas the concentrations of hemoglobin (Hb, p = 0.003), cholinesterase (ChE, p = 0.001), and high-density lipoprotein cholesterol (HDL-C, p = 0.005) declined. Among these variables, hs-CRP (r = 0.218, p < 0.001) had a weak positively association with HAMD scores, and ChE (r = -0.226, p < 0.001) had a weak negative association. (2) The combination of Hb, hs-CRP, ChE, ALP, and HDL-C improved diagnostic performance for VDe [AUC = 0.775, 95% CI (0.706, 0.844), p < 0.001]. (3) Hb (OR = 0.986, p = 0.049), ChE (OR = 0.999, p = 0.020), ALP (OR = 1.017, p = 0.003), and basal ganglia lesions (OR = 2.197, p < 0.001) were important factors impacting VDe development. After adjusting for Hb, hs-CRP, ChE, HDL-C, lesions in the above mentioned four locations, sex, age and the prevalence of CSVD and brain atrophy, ALP [OR = 1.016, 95% CI (1.005, 1.027), p = 0.004] was independently associated with VDe. Hb, hs-CRP, ChE, ALP, and HDL-C concentrations are potential blood markers of depression in CVD patients and, when combined, may improve diagnostic performance for VDe. Serum ALP was independently associated with VDe in patients with CVD.

Increased 10-year cardiovascular disease risk in depressed patients with coexisting subclinical hypothyroidism.

The prevalence of depressive disorder (DD) and subclinical hypothyroidism (SH) was almost twofold higher in women compared with men, both of which are confirmed to be related to cardiovascular disease (CVD) risk. The current study aimed to identify the prevalence of CVD risk factors and evaluate the 10-year CVD risk in female depressed patients with and without comorbid SH. We recruited 1744 female inpatients with a diagnosis of DD. Venous blood samples were taken from all patients for lipid and thyroid hormones. Framingham Risk Score (FRS) was used to estimate the 10-year CVD risk. Female depressed patients with SH had increased BMI, higher Hamilton Anxiety Scale (HAMA) scores, higher LDL-C, TC, UA, and a higher 10-year CVD risk than euthyroid DD groups. Serum TSH levels and HAMA scores were critical predictive variables for 10-year CVD risk in female depressed patients with comorbid SH. Our study suggests that female depressed patients with SH have a high 10-year CVD risk. Serum TSH levels and HAMA scores may be helpful to predict cardiovascular risk in female patients with SH. The increased CVD risk in female depressed patients with comorbid SH requires more attention from researchers and clinicians.

A Study to Assess the Prevalence of Depression among Alcoholics, among Patients, Admitted to Christian Institute of Health Sciences and Research, Dimapur, Nagaland

Abstract Background: Alcohol abuse is a significant global burden. Many families have been affected, and many are victims of its abuse. The effect ripple down not only in the life of the person abusing alcohol but also to the immediate and extended family members, which can be multiple and detrimental. Depression is one of the effects which can lead to further alcohol abuse. A vicious cycle is observed among the individual abusing alcohol, which in turn affects the other family members of the individual. Depression symptoms are common in alcohol abusing patients of all ages and are much more common than the diagnosable depressive disorder. Aims and Objectives: The current study aims to assess the prevalence of depression among alcoholics, among inpatients and also find the associations between the prevalence of depression and selected socio and clinical demographic variables. Materials and Methods: The method adopted by the study was descriptive study method using the total enumerative sampling technique. The CAGE questionnaire was used to screen out the patients for level of dependence. The tool used is the Patient Health Questionnaire-9 (PHQ-) to assess the prevalence. Descriptive and inferential statistics were used to analyze the study. Results: The study results revealed that 74.2% of the participants were depressed widely distributed in all the levels with severity assessed by the PHQ9 questionnaire. The study also indicated that a family history of alcohol abuse is significantly associated with the prevalence of depression among alcoholics. The study result strongly indicates that depression is very much prevalent among alcoholics, along with other multiple co morbidities. Conclusion: Patients abusing alcohol needs continuous and regular assessment for early identification and adopts strategies for the management of the same. The management of depressive symptoms through the adoption of various therapies such as psychotherapy, other alternative systems of therapies and recreational therapies are much recommended. The treating health care team should consider strongly the use of pharmacological means, if the patient is found to be having depression, in the course of treatment in the hospital.

Poster 192: Depressive and Anxiety Disorders Increase Risk for Continued Biceps Pain Following Arthroscopic Biceps Tenodesis

Objectives: Arthroscopic suprapectoral biceps tenodesis (ASPBT) may result in postoperative biceps pain. Previous studies have revealed associations between demographic or intraoperative factors and shoulder pain, but with conflicting results. No study has exclusively investigated predictors of biceps pain following ASPBT. The purpose of this study was to evaluate factors associated with postoperative biceps pain following ASPBT while also determining the clinical impact of postoperative biceps pain. We hypothesized that younger age and pre-existing diagnoses of chronic pain syndromes would be associated with increased postoperative biceps pain. Methods: A retrospective study comprised of patients that underwent ASPBT was completed. Groups were categorized by the presence (BP+) or absence (BP-) of postoperative biceps pain. Differences between continuous variables were tested with two-sample t-tests and differences between categorical variables were tested with the chi-squared or Fisher’s exact test. Variables collected at different postoperative timepoints were first analyzed using a linear mixed model or generalized linear mixed model with fixed effects for group, timepoint, the group*timepoint interaction, and a random subject effect. Post-hoc comparisons were analyzed and p-values were adjusted for multiple testing with the Benjamini-Hochberg procedure. Results: A total of 461 (47 BP+, 414 BP-) patients met criteria for analysis. A lower mean age was observed in the BP+ group (p&lt;0.01). Diagnoses of major depressive disorder (MDD) (p=0.03) and any anxiety disorder (p&lt;0.01) were more prevalent in the BP+ group. Prescription medication with selective serotonin reuptake inhibitors or selective norepinephrine reuptake inhibitors (p&lt;0.01) and atypical antidepressants (p=0.01) was more prevalent in the BP+ group. Subacromial decompression (SAD) was performed less frequently in the BP+ group (p&lt;0.01). Conclusions: Younger age, diagnosis of MDD or any anxiety disorder, as well as the use of psychotropic medications were predictive of postoperative biceps pain following ASPBT. The study also observed lower odds of developing postoperative biceps pain in patients undergoing concomitant SAD. Postoperative biceps pain after ASPBT resulted in prolonged recovery, inferior PROs, and a higher incidence of repeat surgical procedures. The decision to perform ASPBT in younger patients, patients diagnosed with MDD or anxiety, and patients taking psychotropic medications should be carefully considered given the correlation to postoperative biceps pain and inferior outcomes. [Table: see text][Table: see text]