HAMD Scores Research Articles

Exploration of neurometabolic alterations in adolescent patients with bipolar depression and non-suicidal self-injury based on proton magnetic resonance spectroscopy

BackgroundAdolescent bipolar depression (ABD) refers to depressive episodes that arise in adolescent patients with bipolar disorder. Its identification and diagnosis are challenging, and it is characterized by a high rate of misdiagnosis and disability. Studies have revealed that patients with ABD are more prone to non-suicidal self-injury (NSSI) compared to those with unipolar depression. However, the neuropathophysiological mechanisms behind NSSI in ABD remain unclear. Therefore, this study employed proton magnetic resonance spectroscopy (1H-MRS) technology to investigate the potential relationship between NSSI and neurometabolism in the ventromedial prefrontal cortex (vmPFC) of patients with ABD.MethodsThis study compared brain biochemical metabolism between ABD with and without NSSI. Forty ABD were recruited and divided into groups with (n=21) and without NSSI (n=19). Proton magnetic resonance spectroscopy (1H-MRS) was used to detect the ratio of biochemical metabolites in the ventromedial prefrontal cortex (vmPFC) of all patients.ResultsThere was no statistically significant difference (P>0.05) in the age, gender, only child status, residential status, education level, age of onset, disease course, family history, and 24-item Hamilton Depression Scale (HAMD) score between patients in the NSSI group and those without NSSI group. The N-acetylaspartate (NAA)/creatine (Cr) of patients with NSSI was lower than that of patients without NSSI, and the difference was statistically significant (Z=-4.347,P<0.001). There was no statistically significant difference in choline (Cho)/Cr and myo-inositol (mI)/Cr between the group with NSSI and the group without NSSI (P>0.05).There is a positive correlation (r=0.703,P<0.00625) between Cho/Cr and HAMD scores in patients with NSSI, while there is a varying degree of negative correlation (r=-0.605,P=0.006;r=0.624,P=0.004) between mI/Cr and age and onset age in patients without NSSI. There is no correlation (P>0.05) between other indicators.ConclusionCompared with ABD without NSSI, ABD with NSSI have reduced NAA/Cr metabolism in the vmPFC brain area. The level of membrane phospholipid breakdown metabolism in the vmPFC brain area of ABD with NSSI may be related to the severity of depression. The level of phosphoinositol cycle in the vmPFC brain area of ABD without NSSI may be related to age or onset age. Therefore, further validation was required.

Clinical value of combining epirubicin with mindfulness intervention in patients with urinary system tumors and depression.

Urinary system tumors often cause negative psychological symptoms, such as depression and dysphoria which significantly impact immune function and indirectly affect cancer prognosis. While epirubicin (EPI) is recommended by the European Association of Urology and can improve prognosis, its long-term use can cause toxic side effects, reduce treatment compliance, and increase psychological burden. Therefore, an appropriate intervention mode is necessary. To explore the clinical value of EPI combined with mindfulness intervention in patients with urinary system tumors and depression. This was a retrospective study including 110 patients with urinary system tumors and depression admitted to Zhumadian Central Hospital between March 2021 and July 2023. Patients were divided into conventional (n = 55) and joint intervention (n = 55) groups. The conventional group received mitomycin and routine nursing, while the joint intervention group received EPI and mindfulness intervention. Both groups underwent three cycles of chemotherapy. Immune function (CD4+ cells, CD8+ cells, CD4+/CD8+ ratio), tumor marker levels [urinary bladder cancer antigen (UBC), bladder tumor antigen (BTA) and nuclear matrix protein 22 (NMP22)], quality of life questionnaire-core 30 (QLQ-C30), 17-item Hamilton depression scale (HAMD-17), and cancer-related fatigue [cancer fatigue scale (CFS)] were assessed. Adverse reactions and nursing satisfaction were recorded and evaluated. Post-intervention, CD4+, CD8+, and CD4+/CD8+ levels increased in both groups, with the joint intervention group showing more significant improvement (P < 0.05). Tumor marker levels (NMP22, BTA, and UBC) were lower in the joint intervention group compared to the conventional group (P < 0.05). The joint intervention group also showed a greater reduction in HAMD-17 scores (9.38 ± 3.12 vs 15.45 ± 4.86, P < 0.05), higher QLQ-C30 scores, and lower CFS scores (both P < 0.05). Additionally, the joint intervention group had a lower incidence of adverse reactions and higher nursing satisfaction (P < 0.05). EPI combined with mindfulness intervention significantly improved clinical outcomes in patients with urinary system tumors and depression and is worthy of clinical application.

Correlation between anxiety, depression, and social stress in young patients with thoracolumbar spine fractures.

Traumatic injuries, such as falling, car accidents, and crushing mostly cause spinal fractures in young and middle-aged people, and > 50% of them are thoracolumbar fractures. This kind of fracture is easily combined with serious injuries to peripheral nerves and soft tissues, which causes paralysis of the lower limbs if there is no timely rehabilitation treatment. Young patients with thoracolumbar fractures find it difficult to recover after the operation, and they are prone to depression, low self-esteem, and other negative emotions. To investigate the association between anxiety, depression, and social stress in young patients with thoracolumbar spine fractures and the effect on rehabilitation outcomes. This study retrospectively analyzed 100 patients admitted to the orthopedic department of Honghui Hospital, Xi'an Jiaotong University who underwent thoracolumbar spine fracture surgery from January 2022 to June 2023. The general data of the patients were assessed with the Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), life events scale, and social support rating scale (SSRS) to identify the correlation between anxiety, depression scores, and social stress and social support. The Japanese Orthopedic Association (JOA) was utilized to evaluate the rehabilitation outcomes of the patients and to analyze the effects of anxiety and depression scores on rehabilitation. According to the scores of HAMD and HAMA in all patients, the prevalence of depression in patients was 39% (39/100), and the prevalence of anxiety was 49% (49/100). Patients were categorized into non-depression (n = 61) and depression (n = 39), non-anxiety (n = 51), and anxiety (n = 49) groups. Statistically significant differences in gender, occupation, Pittsburgh Sleep Quality Index (PSQI) score, and monthly family income were observed between the non-depression and depression groups (P < 0.05). A significant difference in occupation and PSQI score was found between the non-anxiety and anxiety groups. Both depression (r = 0.207, P = 0.038) and anxiety scores (r = 0.473, P < 0.001) were significantly and positively correlated with negative life events. The difference in negative life event scores as well as SSRS total and item scores was statistically significant between patients in the non-depression and depression groups (P < 0.05). The difference between the non-anxiety and anxiety groups was statistically significant (P < 0.05) in the negative life event scores as well as the total SSRS scores. Additionally, JOA scores were significantly lower in both anxious and depressed patients. Young patients with thoracolumbar fractures are prone to anxiety and depression. Patients' anxiety and depression are closely associated with social pressure, which reduces the life pressure of young patients with thoracolumbar fractures, enhances social support, and improves the psychology of anxiety and depression., which affects patients' recovery.

Associations between serum cytokine levels and postmenopausal depression in postmenopausal women with and without menopause hormone therapy

BackgroundThe etiology of depression involves many biological and environmental factors, among which the inflammatory process is an important contributor. However, the role of pro-inflammatory cytokines in postmenopausal depression is unclear. Therefore, we aimed to explore the association between the serum concentrations of four pro-inflammatory cytokines (IL-1β, IL-6, IL-18, and TNF-α) and depressive symptoms in postmenopausal women who had been receiving menopause hormone therapy (MHT) for at least 6 months and postmenopausal women who had not received MHT.MethodsThis study included a total of 136 Chinese postmenopausal women aged 40 to 65 years who visited the gynecology outpatient department between June 2020 and December 2022. They were divided into the POST group (n = 94) and the POST + MHT (n = 42) group. Demographic information was collected, and the Hamilton Rating Scale for Depression (HAMD) was used to assess depression. The circulating levels of IL-1β, IL-6, IL-18, and TNF-α were determined using ELISA kits.ResultsAccording to the HAMD score, 39.36% of the participants in the POST group and 14.29% in the POST + MHT group were considered to have depression. The POST + MHT group had significantly lower serum concentrations of IL-18 and TNF-α than the POST group. Multiple linear regression analysis showed that the serum IL-18 (β = 3.996, 95% CI = 0.508–7.484), and TNF-α levels (β = 4.784, 95% CI = 0.939–8.629) were significant predictors of the HAMD-24 scores in women in the POST group. In addition, age was found to be positively related with the level of depression (β = 0.531, 95% CI = 0.063–0.999).ConclusionsPostmenopausal women who received MHT had a lower HAMD-24 score as well as lower serum TNF-α and IL-18 levels than women who did not receive MHT. Further, the TNF-α and IL-18 level were positively associated with the HAMD-24 score in women who had not received MHT.

Effect of long-term transcutaneous auricular vagus nerve stimulation in multiple system atrophy-cerebellar subtype: a case report

BackgroundMultiple system atrophy-cerebellar subtype (MSA-C) is a predominance of cerebellar ataxia and autonomic failure. MSA-C has a rapid progression, with average 9 years from symptom onset to death. Despite its prevalence, there is still a lack of effective treatments. In recent years, it has been established that taVNS has significant therapeutic effects on epilepsy, depression, migraine, insomnia, and other diseases. Hence, we performed taVNS treatment for one MSA-C patient to explore whether taVNS could alleviate patient’s motor and non-motor symptoms.Case presentationA 65-year-old woman diagnosed with MSA-C received taVNS treatment for the following duration and course: once a day, 40 min a time, 20 times a month continually for 12 months. Meanwhile, she received assessments of motor and non-motor symptoms at baseline, 4-weeks and 12-months after taVNS treatment. Motor symptoms assessments was made by Scale for the Assessment and Rating of Ataxia (SARA) and Unified Multiple System Atrophy Rating Scale (UMSARS), non-motor symptoms assessment by Pittsburgh Sleep Quality Index (PSQI), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD). After 4-weeks and 12-months of taVNS treatment, compared to baseline assessments, SARA scores decreased from 13 to 11 and then to 10.5, UMSARS scores from 28 to 24 and then to 23, PSQI scores from 19 to 13 and then to 6, HAMA scores from 13 to 3 and then remained unchanged, and HAMD scores from 7 to 4 and then remained unchanged.ConclusionIn the case, we found that short-term taVNS treatment can alleviate ataxia, sleep problem, anxiety and depression of the MSA-C patient. The effects can be maintained and some symptoms may be further improved after receiving long-term treatment. Our case report supports the feasibility and effectiveness of taVNS treatment in MSA-C patients.

Homoarginine concentrations correlate with early depressive symptoms and the reduction in physical functioning within the first days after myocardial infarction

Early depressive symptoms within the first days after acute myocardial infarction (AMI) are mainly manifested with performance parameters (lack of energy, concentration difficulties, reduction in physical functioning). Homoarginine (hArg), a non-proteinogenic amino acid, might increase the availability of nitric oxide (NO). NO controls vasodilatation, blood flow, mitochondrial respiration and improves performance. Therefore, low plasma hArg levels after an AMI might impact performance-related early depressive symptoms. This longitudinal study aims to determine the course of plasma hArg concentrations immediately, on the fourth day and 6 months after AMI and investigates the associations between hArg and early depressive symptoms. A decrease in hArg levels, as observed in AMI patients on the fourth day after AMI, was independent of gender, age, body-mass-index and AMI type. After six months, hArg concentrations no longer differed significantly from baseline values. Females had lower hArg concentrations shortly after and also four days after the AMI compared to males. Within the first days after AMI HAMD-17 and BDI-II total depression scores and performance-related early depressive symptoms such as lack of energy, concentration difficulties and reduction in physical functioning correlated with low hArg concentrations.

The Effect of Biofeedback on Constipation, Sleep, Depression, Anxiety and Quality of Life in Patients with Dyssynergic Defecation: a QUASI Experimental Study (Before and After Study).

Dyssynergic defecation(DD) is the inability to coordinate abdominal and anorectal muscle contraction during defecation. Patients with constipation often report poor quality of life, sleep issues, and increased risk of mood disorders. Biofeedback is a recommended treatment for DD. we evaluated the effect of EMG-biofeedback on constipation symptoms as the primary outcome and also on insomnia, mood disorders (depression and anxiety), and quality of life as secondary outcomes in patients with dyssynergic defecation. Thirty-one patients with DD (74.2% women, mean age 46.23 ± 13.42years), diagnosed using Rome IV criteria, Bristol Stool Form Scale, and anorectal manometry, were included. Patients underwent six to ten sessions of EMG-based biofeedback. We evaluated symptoms using the Wexner constipation questionnaire, Visual Analog Scale (VAS), SF-36 for quality of life, Insomnia Severity Index (ISI), and Hamilton questionnaires for anxiety and depression (HAM-A and HAM-D) before and after treatment. As consistent with study hypotheses, the Wexner scores significantly improved after biofeedback (p < 0.0001, t = 6.98). ISI scores improved (p = 0.01, t = 2.74), as did VAS scores (p < 0.0001, t = 5.14). HAM-A and HAM-D scores showed significant reductions (HAM-A: p = 0.0001, t = 5.01; HAM-D: p = 0.003, t = 2.17). However, SF-36 did not show significant improvement in quality of life (p > 0.05, t = -0.93). Biofeedback effectively improved constipation symptoms, insomnia, and mood disorders but did not impact quality of life.

Sex differences in the prevalence and correlates of suicide attempts in patients with first-episode and drug-naïve psychotic major depression.

Sex differences play an important role in depression prevalence, symptom profile, treatment response, and disease course. However, sex differences in factors associated with suicide attempts (SAs) in first-episode and drug-naïve (FEDN) patients with psychotic major depression (PMD) remain unclear. In this study, 171 patients with FEDN PMD were recruited. Patients' symptoms were assessed using the Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Positive and Negative Syndrome Scale (PANSS) positive subscale. In addition, metabolic parameters and thyroid hormone levels were measured. The prevalence of SA was remarkably high in both male and female PMD patients (53.19% vs. 50.81%), without significant differences between the two groups. In male PMD patients, the combination of marital status and TSH levels was found to effectively distinguish between SA and non-SA cases, with an AUC value of 0.87. In addition, the HAMD score and diastolic blood pressure (BP) were significantly associated with the frequency of SAs in this subgroup. For female PMD patients, the combination of positive score, diastolic BP, TSH, and TgAb was found to be a very effective discriminator between SA and non-SA cases, with an AUC of 0.91. Furthermore, duration of illness, positive score, systolic BP, and TPOAb were found to be significantly associated with the frequency of SAs in this subgroup. Our results indicate a high incidence of suicide attempts in both men and women with PMD. Several clinically relevant factors, metabolic parameters, and thyroid hormone function contribute to sex differences in suicide attempts in FEDN PMD patients.

Association between deep gray matter iron deposition and clinical symptoms in Parkinson's disease: a quantitative susceptibility mapping study.

This study aimed to assess the association between motor and non-motor symptoms of Parkinson's disease (PD) and iron accumulation within the deep gray matter of the brain by Quantitative Susceptibility Mapping (QSM). Fifty-six PD patients and twenty-nine healthy controls were recruited in this study. According to the Hoehn and Yahr (H-Y) stage score, PD patients were divided into early stage (H-Y ≤ 2) and advanced stage (H-Y > 2) groups. Specifically, the Regions of Interest (ROIs) encompassed the substantia nigra (SN), red nucleus (RN), caudate nucleus (CN), globus pallidus (GP) and putamen (PT). Meanwhile, various rating scales were used to assess the clinical symptoms of PD. Compared to healthy controls (HCs), PD patients showed a significant increase in magnetic susceptibility values (MSVs) within the SN and GP. Further comparisons indicated that the MSVs of the SN, PT, GP and CN are all higher in advanced stages than in early stages. Significant positive correlations were observed between the MSVs of the SN and scores on the UPDRS-III, HAMA, and HAMD (r = 0.310, p = 0.020; r = 0.273, p = 0.042; r = 0.342, p = 0.010, respectively). Likewise, the MSVs of the GP demonstrated notable correlations with HAMA and HAMD scores (r = 0.275, p = 0.040; r = 0.415, p = 0.001). Additionally, a significant correlation was found between the MSVs of the PT and HAMD scores (r = 0.360, p = 0.006). Furthermore, we identified a significant negative correlation between MMSE scores and the MSVs of both the PT and GP (r = -0.268, p = 0.046; r = -0.305, p = 0.022). Our study revealed that QSM possesses the capability to serve as a biomarker for PD. Significant correlations were found between clinical features and the iron deposition in the nigrostriatal system.

The Significance of Psychological Support in Managing Depression in Parkinson's Disease: Combining Venlafaxine with Pramipexole and Psychological Care.

Depression is a common comorbidity in patients with Parkinson's disease (PD) and can significantly impact their overall well-being. The combination of venlafaxine and pramipexole is a standard treatment approach for depression in PD. However, the effects of incorporating psychological care into the treatment regimen remain unclear. This study aimed to investigate the impact of psychological intervention in the treatment of depression in Parkinson's disease, using a combination of venlafaxine and pramipexole. The clinical data of 151 patients with both Parkinson's disease (PD) and depression, treated in Geriatric Hospital of Hainan from May 2021 to May 2023, were analyzed retrospectively. Among the 151 patients, 71 received routine nursing care and were allocated to the control group, while the remaining 80 patients received psychological nursing care based on routine nursing care and were assigned to the study group. The Hamilton Depression Rating Scale (HAMD) and the Hamilton Anxiety Scale (HAMA) were used to evaluate the degree of depression and anxiety in both groups before and after care. The MOS 36-Item Short-Form Health Survey (SF-36) was employed to assess the quality of life of both groups before and after care. The efficacy and adverse reactions in both groups were also analyzed. Before care, the HAMD and HAMA scores did not significantly differ between the two groups (p > 0.05). However, after care, both groups exhibited a significant reduction in HAMD and HAMA scores (p < 0.0001), with a more pronounced decrease observed in the study group (p < 0.0001). Prior to care, there was no significant difference in SF-36 scores between the two groups (p > 0.05). However, following care, the SF-36 scores markedly increased in both groups (p < 0.0001), with a more pronounced increase in the study group (p < 0.0001). Additionally, a significantly lower overall response rate was noted in the control group compared to the study group (p = 0.013), while no significant difference was observed in the total incidence of adverse reactions between the two groups (p = 0.273). Utilizing venlafaxine combined with pramipexole in the treatment of depression in PD, supplemented by psychological nursing care, significantly enhances therapeutic efficacy. This combined approach effectively alleviates symptoms of depression and anxiety in patients without introducing additional side effects. Hence, it emerges as a valuable clinical treatment option.

Sleep structure of short-term insomnia disorder with mild cognitive impairment in older adults and their correlation with cognitive function: a case-control study.

This study seeks to delineate the sleep architecture characteristics in older adults with short-term insomnia and mild cognitive impairment (MCI) and to explore their association with cognitive performance. Ninety elderly individuals with short-term insomnia were enrolled and stratified into two cohorts based on their Montreal Cognitive Assessment (MoCA) scores: the Short-Term Insomnia Group (STID) comprising 35 participants and the Short-Term Insomnia with Cognitive Impairment Group (STID-MCI) with 55 participants. Demographic data, Pittsburgh Sleep Quality Index (PSQI), MoCA, Hamilton Depression Rating Scale (HAMD-17), Hamilton Anxiety Rating Scale (HAMA), and polysomnography (PSG) parameters were compared between groups. Correlations between MoCA scores and PSG metrics were also analyzed. No significant disparities were noted between groups in terms of HAMD-17, HAMA, and PSQI scores (p > 0.05). However, marked differences were identified in MoCA scores and its subdomains (p < 0.05). Significant variations were also observed in the duration and proportion of slow-wave sleep (N3) between groups (p < 0.05). In STID-MCI patients, memory scores correlated positively with N3 duration and percentage (p < 0.05), while verbal functions and attention were positively associated with rapid eye movement (REM) sleep duration. This study highlights the potential of PSG in the clinical assessment of cognitive function and underscores the need for targeted interventions to improve sleep quality in this vulnerable population.

The Application of Self-Made Disseminating and Descending Breathing Exercises in Home Rehabilitation of Stable COPD

To investigate the clinical effects and application value of self-made disseminating and descending breathing exercises on home rehabilitation of patients with stable chronic obstructive pulmonary disease (COPD). Seeking to generate concepts for creating novel, convenient, and efficient COPD prognosis rehabilitation exercises aimed at enhancing the well-being and rehabilitation confidence of both COPD patients and their families. A total of 70 COPD patients admitted to our outpatient department from July 2019 to September 2021 were randomly divided into the exercise group (n = 35) and the control group (n = 35). The control group received routine breathing training, while the exercise group was treated with self-made disseminating and descending breathing exercises. The respiratory function, including pulmonary function (FVC, FEV1, FEV1/FVC) and respiratory muscle strength (MIP, MEP), exercise tolerance (6-min walking distance, 6MWT), Modified Medical Research Council Dyspnea Scale (mMRC, Borg), COPD quality of life score (CAT, SGRQ), anxiety and depression scores (HAMA, HAMD) were compared between the two groups after 12-week exercise. After 12-week training, the FEV1, MIP, and MEP in the exercise group were significantly higher than those in the control group (p < 0.001), and the 6MWT was significantly increased in the exercise group compared to the control group (p < 0.001); while the mMRC, Borg score, the scores of CAT, SGRQ, HAMA, and HAMD were found significantly lower than those in the control group (p < 0.001). The self-made disseminating and descending breathing exercises can improve respiratory function and reduce symptoms of dyspnea in COPD patients, while enhancing exercise tolerance and relieving anxiety and depression, and are worthy of clinical application.

The Impact of Continuity of Care on Negative Emotions and Self-Efficacy in Patients Undergoing Digestive Endoscopic Tumor Resection

Objective: To explore the impact of a continuity of care model on negative emotions and self-efficacy in patients undergoing digestive endoscopic tumor resection. Methods: A retrospective analysis was conducted on 80 patients who underwent digestive endoscopic tumor resection in the Gastroenterology Department of Baoying County People’s Hospital between October 2022 and October 2024. Patients were randomly divided into a control group (n = 40) and an observation group (n = 40) using a random number table. The control group received routine nursing care, while the observation group was additionally provided with continuity of care interventions. After two months of intervention, the negative emotions and self-efficacy of the two groups were compared and statistically analyzed. Results: There was no statistically significant difference in baseline data between the two groups (P &gt; 0.05). After two months of intervention, the observation group demonstrated significantly lower HAMD and HAMA scores compared to the control group (both P = 0.000), and significantly higher GSES scores (P = 0.000). Conclusion: Applying a continuity of care model to patients undergoing digestive endoscopic tumor resection can alleviate negative emotions, enhance self-efficacy, and improve self-care abilities.

Effect of subanesthetic dose of esketamine on early postoperative depression in elderly patients with Sarcopenia

ObjectiveTo explore the effects of subanesthetic dose of esketamine on serum inflammatory factor levels and depressive mood in elderly patients with sarcopenia postoperatively.MethodsThis study retrospectively included 102 elderly patients who underwent elective total knee arthroplasty from April 2023 to June 2024 with skeletal muscle mass index (SMI) meeting the diagnostic criteria for sarcopenia (male SMI < 42.6 cm2/m2, female SMI < 30.6 cm2/m2). They were divided into two groups according to whether esketamine was used: esketamine group (ESK group, n = 51) and control group (CON group, n = 51). The Hamilton Depression Scale (HAMD) scores of the patients in the two groups were completed on preoperative day 1, postoperative day 1 and day 7, and serum ceramide (Cer), NOD-like receptor thermoprotein structural domain-related protein 3 (NLRP3) and interleukin-6 (IL-6) were detected. The length of hospital stay, time to first ambulation and pain VAS scores of 4 h, 8 h and 24 h after surgery were recorded. The incidence of adverse reactions was recorded in the postoperative period of 48 h.ResultsThere were no significant differences in HAMD scores, Cer, NLRP3 and IL-6 levels between the two groups preoperatively (P > 0.05). Compared with CON group, HAMD score, Cer, NLRP3 and IL-6 levels, and pain VAS scores (postoperative 4 h and 8 h) were significantly decreased in ESK group at postoperative day 1 and day 7 (P < 0.05). In addition, the number of postoperative remedial analgesia and length of hospital stay in the ESK group were significantly shorter than those in the CON group (P < 0.05). HAMD scores and levels of Cer, IL-6 and NLRP3 were higher at postoperative day 1 and day 7 than those preoperatively in both two groups (P < 0.05), and there was no statistically significant difference in the incidence of adverse reactions at postoperative 48 h between the two groups.ConclusionsThe subanesthetic dose of esketamine can effectively reduce the serum Cer, NLRP3 and IL-6 levels after knee arthroplasty in elderly patients with sarcopenia, and may improve the patients’ depression in the early postoperative period.

Effect of Shengyang Yiwei Decoction combined with selective serotonin reuptake inhibitor antidepressants on HAMD-17 score and somatic symptoms in patients with depression.

To investigate the efficacy of Shengyang Yiwei Decoction (SYD) combined with selective serotonin reuptake inhibitor(SSRI) antidepressants on the total score and scores of factors of the Hamilton Rating Scale for Depression(HAMD-17) and somatic symptoms in patients with depression. This was a retrospective study. One hundred and twenty patients with depression were treated in Hebei Provincial Mental Health Center between December 2020 and May 2022 and randomly divided into the experimental group and the control group, with 60 patients in each group. Patients in the control group were treated with selective serotonin reuptake inhibitor (SSRI) antidepressants and those in the experimental group were treated with modified SYD in addition to SSRIs for eight weeks. Explored the efficacy and adverse drug reactions of the two treatment options. After eight weeks of treatment, there was no statistically significant difference in the total efficacy between the two groups(p>0.05); the total score of HAMD-17 and scores of factors except body weight were decreased in the experimental group compared with those in the control group, and the differences were statistically significant(p<0.05). The SSI score of the experimental group was decreased compared with that of the control group, and the difference was statistically significant(p<0.05). SYD combined with SSRI antidepressants in the treatment of depression can reduce the total score and the scores of factors of HAMD-17 without increasing the incidence of adverse drug reactions. This combination can be used as an integrated traditional Chinese and Western medicine treatment for depression.

Wuling capsule combined with sertraline in the therapy of anxiety and depression with insomnia in adolescents.

The treatment of adolescent patients with anxiety, depression and insomnia is challenging, and there is no ideal treatment method. To evaluate the clinical efficacy of Wuling capsule combined with sertraline in the treatment of adolescent anxiety, depression and insomnia. Eighty adolescent patients with anxiety, depression with insomnia who were admitted to our hospital from April 1, 2022 to March 30, 2024. And the subjects were randomly classified into the control group (n = 40) and the observational group (n = 40). The control group was treated with a combination of sertraline and placebo. The observation group was treated with Wuling capsule in addition to sertraline. The two groups were cured continuously for 8 weeks. Insomnia severity index (ISI), Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were used to evaluate the clinical symptoms before treatment and at 2, 4, 6 and 8 weeks after treatment. The Treatment Emergent Symptom Scale (TESS) was used to evaluate adverse reactions during treatment. There was no obvious difference in HAMD, HAMA and ISI scores between the two groups before treatment (P > 0.05). After treatment, the HAMD, HAMA and ISI scores of patients in both groups decreased compared with before treatment, and HAMD, HAMA and ISI scores of patients in the observation group were remarkedly lower than those in the control group at each time point after treatment (P < 0.05). Compared with the control group, the TESS score of the study group were sharply lower (t = 18.239, P < 0.001). Wuling capsule can further alleviate the insomnia symptoms of adolescents with anxiety and depression, and the efficacy and safety are high. It is recommended to promote the application.

Biological links between psychological factors and adolescent depression: childhood trauma, rumination, and resilience

BackgroundThe psychosocial factors play an important role in the development of depression in adolescents. we used metabolomics techniques to explore the links among childhood trauma, rumination, resilience, and adolescent depression.MethodsWe selected 57 adolescent depression patients and 53 healthy adolescents. The Childhood Trauma Questionnaire (CTQ), Hamilton Depression Scale (HAMD), Resilience Scale (CD-RISC), and Redundant Thinking Response Scale (RRS) were employed for the purpose of psychological assessment. The patients were regrouped according to their scores using the 27% high-low grouping method. Blood specimens were collected from all adolescents and metabolic data were obtained using LC–MS.ResultsWe found no statistically significant difference between the groups in terms of age, gender, and body mass index (BMI). HAMD, CTQ, and RRS scores were significantly higher in the adolescent depression group (MDD) than in the adolescent healthy control group (HC), and CD-RISP scores were significantly lower than in the HC group (P < 0.001). There were significant differences between the low childhood trauma group (LCT) and high childhood trauma group (HCT), the low rumination group (LRR) and high rumination group (HRR), and the low resilience group (LPR) and high resilience group (HPR) (P < 0.001). RRS, CTQ and HAMD scores were positively correlated, RRS and CTQ scores were positively correlated, CD-RIS was negatively correlated with HAMD, RRS and CTQ scores (P < 0.01). More importantly, we found that DHEAS and LPA (22:6) were identified as significant differential metabolites in both the depressed and normal groups, as well as in the high and low childhood trauma groups. N-Acetyl-L-aspartic acid and DHEAS were identified as significant differential metabolites in both the depressed and normal groups, as well as in the high and low childhood rumination groups. Pseudouridine and LPA(22:6) were identified as significant differential metabolites in both the depressed and normal groups, as well as in the high and low childhood resilience groups.ConclusionPsychological factors (childhood trauma, rumination, resilience) are biologically linked to the development of depression in adolescents. The impact of rumination on adolescent depression may be associated with DHEA. The impact of childhood trauma and resilience on adolescent depression may be associated with LPA (22:6).

Antidepressant and anxiolytic efficacy and tolerability of agomelatine in the treatment of depression after COVID-19 in daily clinical practice (non-interventional study TELESPHOR)

Depression and anxiety are among the most common disorders observed in patients after COVID-19 coronavirus infection.Objective: to evaluate the antidepressant efficacy and tolerability of agomelatine in patients with a depressive episode (DE) after COVID-19 infection in everyday clinical practice.Material and methods. The multicenter observational study TELESPHOR included outpatients aged 18 to 65 years who developed DE (Hamilton Depression Rating Scale (HAMD-17) score of 8–24) within 3 months of the resolution of a laboratory-confirmed COVID-19 infection and started monotherapy with agomelatine. Patients were assessed at enrolment and subsequently at weeks 2, 4 and 8 of the observation period. The primary endpoint was the change in HAMD-17 scores by week 8 of the observation in patients taking agomelatine as an antidepressant. The main secondary outcome variables were the dynamics of scores for items 10 (psychic anxiety) and 11 (somatic anxiety) of the HAMD-17 scale, the proportion of responders and remitters (according to the HAMD-17 scale) and the impact on quality of life (QOL) according to the SF-36 questionnaire. The tolerability of agomelatine was assessed at each visit. Data from all patients who participated in the study and took agomelatine at least once were included in the efficacy and safety analysis. The final analysis included data from 103 patients, including 73 women (70.9%).Results. Treatment with agomelatine was associated with a significant improvement in depression severity: the mean HAMD-17 total score decreased statistically significantly at weeks 2, 4 and 8 from 16.3±4.7 at study inclusion to 13.7±4.5, 9.5±4.9 and 5.4±3.6 points – by 2.6±3.3, 6.7±5.3 and 10.9±4.9 points, respectively, compared to baseline (p&lt;0.0001 for all time points). The average score for item 10 (psychic anxiety) and item 11 (somatic anxiety) of the HAMD-17 scale also decreased significantly from 1.4±0.9 and 1.3±0.8 at baseline to 0.5±0.6 and 0.6±0.6 points by the eighth week of observation (p&lt;0.0001). The indicators of the scales for physical functioning and mental health of the SF-36 questionnaire improved significantly compared to the initial values – from 39.7±8.4 to 50.5±5.7 points (p&lt;0.0001) and from 37.3±8.6 to 58.7±6.9 points (p&lt;0.0001) respectively, by the eighth week. The proportion of responders was 81.4 %, the proportion of remitters was 71.6%. Agomelatine was well tolerated during the entire observation period. No adverse events were recorded that led to discontinuation of the drug. One patient showed inefficacy of the treatment, so he discontinued participation in the study.Conclusion. The treatment of patients with DE after COVID-19 with agomelatine is characterized by significant antidepressant and anxiolytic efficacy, improved QOL and good tolerability.

Prevalence, demographics, and clinical characteristics of suicide attempts in first episode drug-naïve schizophrenia patients with comorbid severe depression

Background Suicide attempts have been intensively examined in chronic schizophrenia (SCZ) patients with comorbid depression. This study aimed to investigate the prevalence and clinical correlates of suicide attempts in Chinese first episode drug-naïve (FEDN) SCZ patients with comorbid severe depression. Methods Totally 317 FEDN SCZ patients were recruited into the study. Patients were assessed for symptoms using the 24-item Hamilton Depression Scale (HAMD24), the Hamilton Anxiety Scale (HAMA), and the Positive and Negative Syndrome Scale (PANSS). Plasma glucose and lipids were measured. A score of more than 35 on the HAMD24 was defined as severe depression. Results Suicide attempts occurred at a higher rate in patients with severe depression than in those without (33.4% vs 16.7%). Among patients with severe depression, HAMD and PANSS total score were higher in suicide attempters compared to non-attempters (all p < 0.05). PANSS total score was independently related to suicide attempts in FEDN SCZ patients who had severe depression (OR = 1.02, p < 0.05). Conclusion Suicide attempts are more prevalent in FEDN SCZ patients with comorbid severe depression than in those without. Psychotic symptoms might be involved in suicide attempts in FEDN SCZ patients with severe depression, while depressive symptoms might not.

Altered brain regional homogeneity, depressive symptoms, and cognitive impairments in medication-free female patients with current depressive episodes in bipolar disorder and major depressive disorder

BackgroundAlthough symptoms of depressive episodes in patients with bipolar depressive episodes (BDE) and major depressive disorder (MDD) are similar, the treatment strategies for these disorders are completely different, suggesting that BDE and MDD have different neurobiological backgrounds. In this study, we examined the relationship between brain function and clinical symptoms, particularly cognitive function, in female individuals with bipolar disorder and MDD experiencing depressive episodes.MethodsRegional homogeneity (ReHo) was analyzed in 51 medication-free female patients with BDE, 63 medication-free female patients with MDD, and 45 female healthy controls (HCs). Depressive symptom severity was assessed using the 24-item Hamilton Depression Rating Scale (HAMD-24), and multidimensional cognitive function was evaluated using the MATRICS Consensus Cognition Battery. Partial correlation analysis was used to explore the links between the brain regions and clinical characteristics. A support vector machine (SVM) was used to assess the classification accuracy.ResultsCompared with HCs, patients with BDE and MDD had decreased ReHo in the left lobule VI of the cerebellum and increased ReHo in the left precuneus. Patients with BDE also had reduced ReHo in the left lobules IV–V of the cerebellum and increased ReHo in the right putamen, unlike patients with MDD who had no significant differences in these regions. Patients with BDE exhibited more severe cognitive deficits in processing speed, attention, word learning, and overall cognitive function than those with MDD. In patients with BDE, a significant negative correlation was found between the right putamen and HAMD-24 scores. However, no significant association was observed between abnormal ReHo levels and cognitive function. The SVM effectively differentiated between patients with BDE, MDD, and HCs.ConclusionCognitive impairment was more severe in female patients with BDE than in those with MDD. Changes in the ReHo values of the right putamen and left lobules IV–V may serve as unique neuroimaging markers for BDE. Alterations in the ReHo values of the left precuneus and left lobule VI could serve as common pathophysiological mechanisms for BDE and MDD in women and indicate depressive states.