Frequency Of Depressive Disorders Research Articles

Depression in the field of tension of gender roles

The distribution of depression and suicidal ideation by gender reveals agender paradox: women are at least twice as likely to be diagnosed with depressive disorders but have alower suicide rate than men. In contrast, the suicide rate of men is at least three times higher than women, while the prevalence of depressive disorders is only half as high. Although these differences have long been known the reasons for this paradox are still not fully understood. The aim of this narrative review article is to discuss possible explanatory models regarding gender differences in depressive disorders. Aspects related to stress processing and traumatization are considered as well as sociological and biological factors. This article summarizes information that was considered particularly relevant in the interdisciplinary dialogue regarding possible explanatory factors for gender differences in depressive disorders. The summarized studies indicate that women and men differ in certain aspects of stress processing and trauma exposure but men do not have alower risk of disease as aresult. On the contrary, the frequency of depressive disorders in men seems to be underestimated due to an atypical symptom manifestation. The implementation of knowledge about gender-specific vulnerability in the training of physicians and psychotherapists, the systematic assessment of gender beyond binary classifications as well as further diversity domains in research and healthcare as well as gender-sensitive and diversity-sensitive prevention strategies could contribute to the resolution of the gender paradox.

Menstrual function and mental health of medical students during the COVID-19 pandemic: a continuous cross-sectional study

Aim. To assess the impact of new coronavirus infection (NCI) and COVID-19 vaccination on menstrual function in comparison with the frequency of depressive disorders during the COVID-19 pandemic among female students of a medical university.
 Materials and methods. Data for a continuous transverse (cross-sectional) study were obtained using an online survey. The questions included demographics, characteristics of menstrual function, the history of COVID-19 and vaccinations against it, and the standard CES-D (Center for Epidemiologic Studies Depression Scale) questionnaire. The survey included 1.879 female medical students. The exclusion criteria were age under 18 and over 25 years, hormonal contraceptives, pregnancy, childbirth during the last year, and vaccination after COVID-19. After applying the exclusion criteria, three study groups were formed. Group 1 included female students with a history of NCI (n=140), group 2 included students with no history of NCI, who were initially vaccinated against COVID-19 (n=647), group 3 (control group) included unvaccinated students with no history of NCI (n=55).
 Results. There were no differences in the prevalence of changes in menstrual function in female students after the NCI (49.3%) and after COVID-19 vaccination (39.6%) compared to the control group (43.6%); p=0.477. The rate of depression in the overall study cohort was 43.3%, without any significant differences between the study groups. Significant predictors of changes in menstrual function during the pandemic were marriage (odds ratio OR 2.33 [1.513.61]), depression (OR 1.72 [1.282.3]), a history of menstrual dysfunction (OR 1.5 [0.121.99]), and later menarche (OR 1.76 [1.023.04]). Multivariate analysis did not show the significance of the history of NCI and vaccination as factors of menstrual dysfunction (OR 1.61 [0.892.90] and OR 0.91 [0.591.41], respectively).
 Conclusion. During the COVID-19 pandemic, female medical students reported frequent changes in menstrual function and depressive disorders. During the pandemic, the most significant predictors of menstrual disorders in female students were depression, a history of menstrual dysfunction, and marriage. A multicenter prospective study is necessary to clarify the mechanisms of the pandemic's impact on menstrual function.

ВЫРАЖЕННОСТЬ ДЕПРЕССИВНЫХ СИМПТОМОВ У СПОРТСМЕНОВ: РОЛЬ ПЕРФЕКЦИОНИЗМА, ЭМОЦИОНАЛЬНОГО ВЫГОРАНИЯ И ПЕРЕЖИВАНИЯ СТРЕССА

The frequency of depressive disorders in the modern world is increasing. These disorders have a range of symptoms that affect quality of life. Athletes, because of the nature of their activity, are also subject to these symptoms, as they have to expend a lot of energy, both physically and psychologically. The objective of the study was to identify the specific factors associated with depressive symptoms that are characteristic of athletes and to explore their relation to the level of depression. A total of 46 athletes aged from 18 to 54 years (Mage = 24, SDage = 6.49) of different sports participated in the study. Several methods were chosen as diagnostic tools to study the level of depression, the level of perceived stress, emotional burnout and perfectionism in athletes. It was shown that the higher the level of emotional burnout, stress, perfectionism and decrease in performance were, the higher the level of depressive symptoms was. The conducted research confirmed the importance of studying the factors of depression symptoms and revealed the necessity of developing ways to control these factors in athletes in order to avoid increasing depressive tendencies.

High frequency of Depressive Disorders and Suicidal Phenomena in Late-Stage Parkinson´s Disease - A Cross-Sectional Study.

Depressive disorders (DD) are widely recognized as one of the most frequent neuropsychiatric disorders in Parkinson´s disease. Patients with late-stage Parkinson´s disease (LSPD) continue to be a neglected population, and little is known about DD frequency in LSPD. To determine the frequency of DD in LSPD patients through a clinical diagnostic interview (CDI) and according to diagnostic DSM- 5 criteria. Secondary objectives were to determine the predictive ability of depressive scales to detect DD, to identify potential predictors of DD in LSPD and, to evaluate suicidal phenomena in LSPD. A cross-sectional study including LSPD patients (≥7years from symptom onset and Hoehn and Yahr scale score >3 or a Schwab and England scale score <50% in the ON condition) was conducted. Patients were subjected to psychiatric, neurological, and neuropsychological evaluations. Six depression scales were applied. 92 LSPD patients were included. 59.78% of LSPD patients had a current diagnosis of DD according to CDI, 38.04% patients had a diagnosis of major depressive disorder, and 21.72% non-major depressive disorder. Suicidal ideation was present in 36.96% of patients. All applied scales were able to detect depressive disorders. More than half of LSPD patients met DD diagnostic criteria and over one-third were diagnosed with major depressive disorder. Overall, the LSPD population seem to have a unique clinical phenotype regarding the frequency and features of DD, whose early identification and treatment could improve the quality of life of patients and caregivers.

Prevalence and severity of Anxiety and Depression among Primary caregivers with correlation to their Psychiatric outpatients diagnostic entity according to ICD-10

IntroductionThe impact of psychiatric patients on their primary caregivers is important. Outcome of different psychiatric disorders may also depends open the mental health of their caregivers. Therefore assessment of the prevalence and severity of Anxiety and depressive disorders may help to improve the wellbeing the caregivers as well as their sufferers.ObjectivesTo assess the prevalence and severity of Anxiety and Depression among primary caregivers of psychiatric outpatients. To correlate the psychiatric diagnosis according to ICD-10, of the patients with their caregivers anxiety and depression.MethodsThe study was carried out in private Psychiatric Hospital with primary caregivers of psychiatric outpatients. One hundred and eighty consecutive and consenting participants were selected. Besides, applying semi-structured preform, designed for this purpose, anxiety and depression levels of these individuals were assessed using the locally validated version of HOSPITAL ANXIETY AND DEPRESSION SCALE (HADS). For the diagnostic categorization ICD-10 of WHO was used. Data was tabulated and analyzed using SPPS 17 version.ResultsAmong the 180 caregivers, between the age range of 18 to 92 years, 44% were found to be suffering from anxiety, and 68.56% were suffering from depressive disorders. Anxiety and Depression (combined) existed among 74.85% of the caregivers of psychiatric outpatients. Frequency of depressive disorder was found higher among the brothers (19.08%) as caregivers, followed by mother (18.32%), relatives (16.03%), and in spouses (15.26%).ConclusionsCaregivers of psychiatric patients, especially females, are more vulnerable to anxiety and depression irrespective of the type of their patients’ illness.DisclosureNo significant relationships.

Efficacy of perindopril/amlodipine and valsartan/amlodipine combinations in patients with a combination of arterial hypertension and chronic obstructive pulmonary disease

Objective: to study the comparative efficacy and safety of the use of perindopril/amlodipine and valsartan/amlodipine combinations in patients with a combination of arterial hypertension and chronic obstructive pulmonary disease. Materials and methods: 85 patients with a verified diagnosis of arterial hypertension and chronic obstructive pulmonary disease were examined, the average age of patients was 60.9±1.1 years; 54% of men and 46% of women who were prescribed two variants of combination therapy (group A amlodipine/perindopril, group B amlodipine/valsartan). At the first visit and 6 weeks after the start of therapy, all patients underwent clinical, laboratory and instrumental examinations in accordance with the current protocols for the treatment of hypertension and chronic obstructive pulmonary disease, a daily blood pressure study, the frequency of depressive disorders was assessed on the Beck scale and the quality of life according to the SF-36 questionnaire. Results: the use of both antihypertensive regimens in comorbid patients was accompanied by comparable antihypertensive efficacy of therapy, contributed to the same statistically significant decrease in daily, day and night blood pressure indicators. The analysis of the indicators of the function of external respiration revealed the absence of negative dynamics of spirographic indicators in both groups. The use of both combinations of antihypertensive drugs contributed to the statistically identical recovery of both physical and mental components of the patient's quality of life. The improvement in the quality of life of comorbid patients was accompanied by a decrease in the manifestations of depressive disorders in the studied patients according to the Beck scale. The average score of the Beck scale in patients of group A before treatment was 11.6±0.97, against the background of therapy — 9.1±0.77, p &lt;0.001. In patients of group B, it decreased from 13.0±1.06 to 9.3±0.78, p &lt;0.001. Conclusion: the use of antihypertensive combined strategies amlodipine / perindopril and amlodipine / valsartan for the treatment of hypertension in patients with chronic obstructive pulmonary disease is characterized by comparable effectiveness of blood pressure control, which is confirmed by the data of daily monitoring of blood pressure. Effective control of blood pressure was accompanied by statistically significant (p&lt;0.001) positive dynamics of most indicators of the quality of life of patients in both study groups and the severity of manifestations of depression. Any of the studied combinations, which demonstrated comparable efficacy and tolerability in the study, can be recommended as the first step of antihypertensive therapy in patients with arterial hypertension in combination with chronic obstructive pulmonary disease.

The influence of weight loss interventions on psycho-emotional state of young men with obesity

To assess the relationship of psychoemotional changes with obesity in young men, depending on the age of manifestation of the disease and against the background of the program of weight loss. The study included 48 young men with obesity, aged 17 to 24 years. The subjects were divided into two groups. Group A consisted of 26 men with manifestation of obesity since childhood, group B 22 patients with onset of the disease from puberty. Subsequently, the study patients were subdivided depending on the type of obesity treatment (complex and non-pharmacological). The psychological status and anthropometric parameters were assessed on screening and after 12 weeks of treatment. Depressive disorders were initially observed in 40.9% of patients in group B and in 19.2% of patients in group A. In young men who underwent complex treatment of obesity, regardless of the time of manifestation of the disease, a clinically significant decrease in symptoms of depression was revealed. All types of eating behavior were revealed in the subjects, and these manifestations are more common in patients with manifestation of the disease since childhood. In group A, the restrained eating was in 50% of young men, external eating in 42.3%, and emotional eating in 30.7%. In group B, emotional eating in 9% of patients, external eating in 40.9%, and restrained eating in 31.8% of young obese men. In the group of patients with manifestation of obesity since puberty, the frequency of depressive disorders was higher than in the group of young men with onset of obesity since childhood.

Prevalence of psychoemotional disorders in patients with pathological kinking of the internal carotid arteries

IntroductionPathological kinking of the internal carotid arteries (PK ICA) is a controversial issue of angioneurology. Patients with PK ICA often present a variety of complaints, such as headache, dizziness, decreased concentration, memory impairment, and general weakness [1].ObjectivesTo study the prevalence of anxiety and depression in patients with PK ICA.MethodsWe studied 132 patients who had PK ICA (main group) and 86 patients without brachiocephalic artery pathology (control group). Hospital Anxiety and Depression Scale (HADS) was used to evaluate anxiety and depression, considering depression or anxiety if the score was ≥10. Statistical analysis was performed with SPSS software, p-value&lt;0.05 was considered statistically significant.ResultsThe mean age of the patients in the main group was 38.4±5.2 years, in patients of the control group 41.2±4.8 years, respectively. Anxiety disorders were detected significantly more frequently in the main group of patients than in the control group (35.7% and 10.2%, p=0.017 respectively). The frequency of depressive disorders was comparable in both groups – 13.6% and 14.3%, p=0.061, respectively. The level of anxiety was also significantly higher in the group of patients with PK compared to the control group (14.2±4.3 and 9.7±3.1 points, p=0.019). patients with PK ICA with anxiety are more likely suffered from depression (10.2% and 5.8%, p&lt;0.001).ConclusionsAnxiety disorders were present in one-third of patients with PK ICA, while depressive disorders were not typical for this group. In patients with PK ICA, in addition to collecting complaints, anamnesis, and evaluating the neurological status, it is advisable to conduct neuropsychological testing.

Behaviours of general practitioners in the city of douala’s in cameroon in front of depressive disorders

IntroductionIn Cameroon, skepticism and neglect of doctors towards patients with mental disorders is noted. In order to change this, it was important to have an objective assessment. Depressive disorders are the most common form of mental disorders and Douala has the second largest number of general practitioners in the country. Thus, we proposed to evaluate the behaviour of general practitioners in Douala in front of patients with depressive disorders.ObjectivesEvaluate the frequency of depressive disorders in outpatient general consultation Evaluate the competence of general practitioners at diagnosing depressive disorders Evaluate the practices of general practitioners towards depressive disorders Evaluate obstacles faced by general practitioners regarding depressive disordersMethodsWe conducted a cross-sectional descriptive study from February to June 2017 in the outpatient department. For each general practitioner include, we had 3 patients who complete the patient health questionnaire to find out if the patient has depression. During each consultation, we filled out a clinical fact sheet to determine if the general practitioner had diagnosed a depressive disorder. If so, what care has he taken? Finally, we gave the general practitioner a questionnaire to know his difficulties when facing depression.ResultsWe obtained a frequency of 32.5% of depressive disorders in consultation of general medicine in Douala and a rate of diagnosis by general practitioners of 1.92%. Diagnosed cases have just received counseling.Conclusionsin Cameroon, despite the low interest in depressive disorders, they constitute a public health issue in Douala, and surely in Cameroon; Because of its frequency and the harm, they inflict on patients.Conflict of interestI don’t have any conflict of interest

CHARACTERISTICS OF CORRELATION BETWEEN COGNITIVE AND PSYCHOEMOTIONAL IMPAIRMENTS IN PATIENTS IN ACUTE PERIOD OF CEREBRAL ISCHEMIC STROKE IN DIFFERENT CAROTID SYSTEMS

Cerebral stroke is one of the most common causes of death; in most countries it is ranking the third position by the incidence rate. The prevalence of strokes in Ukraine is one of the highest in Europe. In recent years, there has been an increase in the prevalence of post-stroke cognitive and anxiety-depressive disorders. The aim of the study is to identify and analyze the features of correlations between cognitive and psycho-emotional disorders in people in the acute period of cerebral ischemic stroke of different hemispheric localization. Materials and methods. The study included 43 post-stroke patients, average age 59.81±1.28 years. The dextrocerebral ischemic stroke was diagnosed in 20 patients (46.5%, group 1; average age 61.25±1.98 years), sinistrocerebral ischemic stroke was detected in 23 patients (53.5%, group 2; average age 58.57±1.67 years). The control group consisted of 16 healthy individuals (10 men and 6 women, the average age 59.5±1.74 years). All patients underwent comprehensive neuropsychological testing. The examination was carried out on the 3rd - 7th days following the cerebrovascular event. Assessment of neurocognitive status was performed by using the Mini-Mental State Examination, the Montreal Cognitive Assessment Scoring, Beck’s Depression Scale, and the Spielberger-Khanin Reactive and Personal Anxiety Questionnaire. The analysis of the results obtained showed that the patients with sinistrocerebral ischemic stroke have a positive correlation between post-stroke cognitive impairment (total score Mini-Mental State Examination = 21.3±0.61, Montreal Cognitive Assessment Scoring = 18.22±0.9) and indicators of language, speech and memory dysfunctions as compared to the individuals with ischemic stroke in the right carotid pool, who have positive correlations between indicators of post-stroke cognitive impairment (total score Mini-Mental State Examination = 24.05±0.52, Montreal Cognitive Assessment Scoring = 21.35±0.84) and indicators of attention and abstract thinking dysfunction. Indicators of depressive disorders positively correlate with indicators of post-stroke cognitive dysfunction only in the group of sinistrocerebral ischemic stroke, while the degree and frequency of depressive disorders are significantly more often observed when ischemic focus is localized in the right hemisphere, and their indicators have direct correlations in both groups of patients. The features of correlations between psychodiagnostic indicators taking into account lateralization of the ischemic centre, investigated in the study, can serve as a ground for applying separate subtest-blocks of the specified psychodiagnostic scales for patients with hemispheric ischemic stroke. This approach is time-saving, and can make the scale more widely available and accelerate the screening of neurocognitive status in order to optimize therapeutic and rehabilitation interventions.

Frequency of Depressive Disorders According to Cognitive Continuum in the Elderly Living in the Community

Frequency of Depressive Disorders According to Cognitive Continuum in the Elderly Living in the Community

The trait anxiety as a predictor of the suicidal risk in patients with cancer.

Studies investigating the psychological aspects of cancer have gained importance in recent years. In these studies, the rates of depression and anxiety in cancer patients were examined, but the risk of suicide had not been examined. This study investigated the psychiatric diagnoses of depression, anxiety, and suicide risk in cancer patients. Eighty patients who met the inclusion criteria were administered the Beck Depression Inventory, State-Trait Anxiety Inventory, Structured Clinical Interview for DSM (SCID), and Suicide Probability Scale. The examination of the relationships across variables was assessed with Pearson's correlation analysis and stepwise multiple regression analysis. Due to SCID assessment, 45% of patients were found to have depression diagnosis, and 11.25% were found to have anxiety diagnosis. In the patients who had previous psychiatric diagnosis and treatment, total suicide probability scores demonstrated statistically significant differences. The frequency of depressive disorders and anxiety disorders in cancer patients is high. The studies investigating that suicide are rare, and in our findings, previous psychiatric diagnosis and treatment were risk factors. In the past studies, depression has been reported to be the most important factor in increasing the risk of suicide in cancer. Contrary to previous findings, according to the data obtained from this study, anxiety is the most important predictor of suicidal risk among all the determinants.

Психоемоційний стан жінок зі спонтанною вагітністю та після застосування допоміжних репродуктивних технологій

The article represents the relationship of psychological processes which accompany physiological changes in the body of a pregnant woman. After all, pregnancy is a state of functional tension of all systems and organs of a pregnant woman. Of course, increased stress is reflected on the psychological state of the pregnant woman. From the point of view of psychology during pregnancy a woman passes a certain series of sequential psychological changes – a decision on continuation of the pregnancy, pregnancy before fetal movements appearance, the period after fetal movements appeared, the prenatal period and childbirth. According to the literature review, each trimester of pregnancy has a certain psychological «portrait» of the pregnant woman. So in the first trimester for many women is common an increase in psychological passivity and there is a sense of satisfaction and pleasure, but other women note depression and increased physical activity which is associated with the awareness of the pregnancy fact. The second trimester of pregnancy is characterized by normalization of mental state and increased efficiency. However, at this time there is a restructuring in the system of worldview and formation of motivation of motherhood, and the appearance of fetal movements allows concretize the image of the child and provides a basis for the interpretation of her subjective state. The third trimester of pregnancy is characterized by increased levels of anxiety and anxiety-fear of childbirth, the health of the unborn child and an increase in the frequency of depressive disorders. Activity during this period is aimed at preparing for childbirth and the postpartum period, and activity not related to the birth of a child – decreases. The prenatal period is characterized by a decrease in the activity of the pregnant woman, General relaxation and emotional «exhaustion», which protects the mother and child from unnecessary stress and experiences. In a pregnant woman, the fear of childbirth decreases and the ability to concentrate on only one dominant essence increases, which will be absolutely necessary during childbirth and postpartum interaction with the child. The postpartum period is characterized by adaptation to a sense of emptiness and a sense of inner. The psychological state is of leading importance in pregnancy. Leading researchers show that it is impossible to explain premature birth only physiological and chemical changes during pregnancy. Taking into account a number of physiological changes in the psychological sphere of women with spontaneous pregnancy, we analyzed the psychological state of 249 pregnant women after the use of assisted reproductive technologies and 50 pregnant women with spontaneous pregnancy. The study of the psycho-emotional state of pregnant women after the use of assisted reproductive technologies revealed deviations in the level of personal and reactive anxiety that are inherent in pregnant women after the use of assisted reproductive technologies. Taking this into account, we consider it appropriate to involve a psychologist to work with pregnant women after the use of assisted reproductive technologies in order to correct the identified abnormalities. Key words: pregnancy, assisted reproductive technologies, psychological state, personal anxiety, reactive anxiety.

Clinical profiles of late-onset psychiatric patients exhibiting incidental REM sleep without atonia.

Rapid eye movement (REM) sleep without atonia (RWA), which is a hallmark of REM sleep behavior disorder (RBD) on polysomnography (PSG), may represent specific characteristics of prodromal Parkinson's disease (PD)/dementia with Lewy bodies (DLB), even when dream-enactment behavior is absent. We investigated the clinical profiles associated with PD/DLB in late-onset psychiatric patients exhibiting incidental RWA. Among patients who underwent PSG in our psychiatric ward, eight with incidental RWA, nine with idiopathic RBD, and seven with PD or DLB who had preceding RBD were included. Clinical variables, including the percentage of RWA in the total REM sleep (%RWA), were compared among the three groups. The frequency of depressive disorders as a primary psychiatric diagnosis and antidepressant usage were significantly higher in the incidental RWA group than in the other groups. There were no differences in the prevalence of supportive features of DLB among the three groups. The median %RWA was significantly lower in the incidental RWA group than in the other groups. Although the cardiac 123I-metaiodobenzylguanidine uptake was significantly higher in the incidental RWA group compared with the other groups, the groups showed overlap in the specific binding ratios on dopamine transporter imaging. All patients in the three groups exhibited cingulate island sign ratios on brain perfusion single-photon emission computed tomography within a threshold of 0.281, which is the optimal cut-off value for a diagnosis of DLB. In this series, late-onset psychiatric patients with incidental RWA partially shared common clinical profiles with idiopathic RBD and PD/DLB.

FEMALE SEXUAL DYSFUNCTION IN WOMEN OF DIFFERENT REPRODUCTIVE AGE

Decreased sexual attraction in women are related to female sexual dysfunction, which has a direct effect on both the health status of a woman and its role in society.Аim of the study: to study the factors contributing to the formation of female sexual dysfunction in different periods of reproductive age.Material and methods of research. Study design: analysis of a survey of 100 women of different reproductive age. The diagnosis of the examined “Violation of female sexual desire / arousal” according to the DSM-5 classification. The time of clinical manifestation of sexual dysfunction is> 6 months. Statistical data processing was performed using the STATISTICA for WINDOWS software package (version 5.5). To process the data of the obtained results, Microsoft Excell 7.0 was used.The results and discussion. The study found that there is a direct negative correlation between age and frequency of female sexual dysfunction r -0.47. Symptoms of vaginal dysfunction are not specific to women with FSD.Conclusions. For the early diagnosis of urogenital dystrophy (dyspareunia, dryness), it is necessary to begin a comprehensive examination of women with an emphasis on the age characteristics of the patterns found. The presence of a high frequency of depressive disorders in women with sexual dysfunction in the active reproductive age indicates the need for counseling and timely treatment by a neuropathologist and the appointment of complex therapy. For women of late reproductive age, it is important to establish the etiology of the pain syndrome, so special attention should be paid to the study of blood microcirculation in the pelvic organs, the identification of pathology that contributes to the pathological innervation of the lumbosacral spine.

Personality Disorders and Value Orientation as Predictors for Male Depression in Military and Civilian Patients

The aim of this clinical study was to detect differences between a civil and a military inpatient population with depressive disorders with respect to traits of male depression, personality disorders and value orientations. Fifty civil and fifty military participants answered various psychometric testings at the beginning of treatment. No differences were found concerning male depression. Personality traits and value orientations were found to be predictive for severity and frequency of depressive disorders in different depression inventories.

Frequency of depressive disorders in a representative sample of Nicosia, Cyprus

Introduction“Health Profile” of Nicosia was conducted in 2013–2014, within the framework of the program “Healthy Cities” in order to collect and analyse information on the state of health and health-related behaviors of the citizens of Nicosia in Cyprus.AimsTo estimate the frequency of self-reported depressive disorders and examine burdening as well as factors influencing it.MethodsBased on the 2011 census, a cross-sectional study was carried out on a representative random stratified sample, which was selected to be interviewed, including 477 men and 525 women, from the city area. Participants answered a questionnaire, which required among other items on self-perceived physical and mental health. Participants were also asked the following questions: “Do you have/had in the past depression or/and anxiety?” and “Have you received a medical diagnosis for this disorder?”ResultsApproximately 70% of the sample reported they had experienced anxiety and depression (37% moderate and 33% severe episodes). Diagnosed depression was reported by 4%. Severe depressive disorders were more frequently reported by women (41%, P &lt; 0.001), older aged citizens (70.2%, P &lt; 0.001) widowed/divorced (45.5%, P &lt; 0.001), persons with lower family income (&lt; 1000 €, 79.7%, P &lt; 0.001) and among people with chronic diseases (45.3%, P &lt; 0.001).ConclusionsThe self-reported prevalence of anxiety and depression in the citizens of Nicosia is very high – probably reflecting a negative effect of the economic crisis –, and contrariwise diagnosis of the disorder is rarely provided and consequently therapy rarely offered. Specific population groups, such as women, elderly citizens, patients with chronic diseases are more vulnerable to depressive disorders requiring specialized medical attention.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A Snapshot of Treatment of Inpatients with A Mood Disorder Episode: Does Theory Match Everyday Clinical Practice?

Mood disorders represent a major cause of hospitalization in psychiatric ward. We focused on sex differences, therapies and rehospitalization rates/length of stay in inpatients with mood disorders. Rehospitalization is often observed in patients with mental disorders, with rates up to 80%. Socio-demographic features, clinical features and treatment type influence the length of stay. The objective of this study was to assess how the literature findings match everyday clinical practice in an acute psychiatric ward. We performed a retrospective observational study extracting data from our medical records from 1st July 2012 to 1st July 2014. 85 patients were eligible for the study; the overall number of admittances to the ward was 103. We have not found any difference in the rates of Bipolar Disorder between males and females, we failed to find an higher frequency of Depressive disorders in females. In our sample the rates of early readmission is 17.5%. Patients with an involuntary admission included exclusively those with a manic or hypomanic episode; patients with depressive episodes were more likely to have committed a suicide attempt.

Cognitive behavioural therapy best prevents postpartum depression.

Multiple birth is associated with a doubling of the risk of maternal mental health disorders. This investigation recognises the substantial impact that maternal depression can have on successful parenting, child health, and family functioning. The authors explore whether a supportive/educational midwifery intervention can reduce the risk of postpartum depression (PPD). I provide this commentary believing that nurse midwives bring substantial value to the care of women with twins (Ellings et al., Obstet Gynecol 1993;81:387–91). Unfortunately, the author's results are not conclusive. Women received care in an antenatal multidisciplinary twin clinic with specialist midwives and additional pre- and postnatal visits. Participants and spouses in the intervention group attended a series of educational programmes on parenting multiples. The intervention group reported greater maternal wellbeing, family support, mood, self-confidence, and felt better prepared for parenting; however, the primary outcome was a reduction in maternal depression as measured by the Edinburgh Postnatal Depression Scale (EPDS). The mean maternal EPDS was lower at 26 weeks postpartum, but it was not significantly different from the control group scores. Nor were there any differences in maternal anxiety or parenting stress. Unfortunately, the study was substantially underpowered. A recent meta-analysis of 19 studies (5806 patients), including seven designed to prevent PPD, reviewed the efficacy of cognitive behavioural therapy (CBT) or interpersonal psychotherapy (Cuijpers et al., Am J Psychiatry 2008;165:1272–80). These interventions were associated with an overall 22% reduction in the incidence of depressive disorders. The number needed to treat (NNT) to prevent one depressive disorder was 22. Psychological interventions worked best for those at highest risk, and interpersonal psychotherapy may be slightly more effective than CBT. It concluded that prevention of depressive disorders is possible, and is associated with an enormous reduction in public health burden. Another relevant study screened first-time pregnant women and randomised the women who screened positive to a Preparing for Parenthood educational programme designed to increase social support and problem-solving skills. Assignment to the intervention group did not significantly affect postnatal depression at 3 months (Brugha et al., Psychol Med 2000;30:1273–81). In the absence of a specific therapy designed to reduce maternal stress, the likelihood of preventing PPD with education and support alone is probably low. Another systematic review of 15 trials (7697 women) offering psychological interventions revealed a non-significant reduction (RR 0.81, 95% CI 0.65–1.02) in the frequency of depressive disorders. The most effective intervention was intensive postpartum support provided by a health professional (RR 0.68, 95% CI 0.55–0.84), and individually based interventions were more effective than group interventions (Dennis, BMJ 2005;331:7507–15). Women carrying twins are at high risk for PPD and good candidates for preventative interventions. The development of novel, cost-effective interventions deserves further research attention. This intervention may have shown greater efficacy by focusing on even higher risk multiples such as those with a history of mental illness, prior fetal or infant death, or antenatal depression. CBT interventions designed to reduce postnatal maternal stress and/or anxiety appear to be more effective than education-based interventions. Midwives involved in pre- and postnatal care could absolutely be trained to provide CBT, and are likely to be more acceptable to parturients than either psychologists or psychiatrists. The author has no conflict of interests or disclosures.

Does isotretinoin therapy of acne cure or cause depression?

Cosmetic defects in acne may provoke a wide range of mental disorders (depressive, social-phobic, etc.). Isotretinoin is a very effective acne treatment; hence, it usually resolves the associated mental disorders. However, more available data show the possible association of taking isotretinoin and the onset of a depressive syndrome that includes frank depression and even suicidal ideation. The frequency of depressive disorders during isotretinoin treatment varies from 1% to 11% in different studies, and it is unclear whether this is a consequence of isotretinoin therapy. Since it crosses the blood-brain barrier, isotretinoin affects the expression of a broad spectrum of genes in the limbic structures, thus affecting the function of the dopaminergic, serotonergic, and noradrenergic neurons involved in the regulation of mood and emotion. It was suggested that isotretinoin in high concentrations inhibits hippocampal neurogenesis and induces apoptosis of hippocampal cells. However, some studies do not confirm this pathogenic role, and isotretinoin was even reported to have a therapeutic effect in acne-associated depression. In this review, we highlight epidemiological data, the underlying molecular pathogenesis, and the aspects of prevention concerning retinoid-induced depression in acne from the practical point of view of a dermatologist.