Hamilton Depression Rating Scale Research Articles

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

BACKGROUND The treatment of adolescent patients with anxiety, depression and insomnia is challenging, and there is no ideal treatment method. AIM To evaluate the clinical efficacy of Wuling capsule combined with sertraline in the treatment of adolescent anxiety, depression and insomnia. METHODS 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. RESULTS 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). CONCLUSION 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.

The role of gut microbiota and metabolomic pathways in modulating the efficacy of SSRIs for major depressive disorder

This study aims to explore the mechanism by which gut microbiota influences the antidepressant effects of serotonin reuptake inhibitors (SSRIs) through metabolic pathways. A total of 126 patients were analyzed for their gut microbiota and metabolomics. Patients received SSRI treatment and were categorized into responder and non-responder groups based on changes in their Hamilton Depression Rating Scale (HAMD-17) scores before and after treatment. The association between gut microbiota composition and the efficacy of SSRIs was investigated through 16S rRNA gene sequencing and metabolomic analysis, and a predictive model was developed. As a result, the study found significant differences in gut microbiota composition between the responder and resistant groups. Specific taxa, such as Ruminococcus, Bifidobacterium, and Faecalibacterium, were more abundant in the responder group. Functional analysis revealed upregulation of acetate degradation and neurotransmitter synthesis pathways in the responder group. The machine learning model indicated that gut microbiota and metabolites are potential biomarkers for predicting SSRIs efficacy. In conclusion, gut microbiota influences the antidepressant effects of SSRIs through metabolic pathways. The diversity and function of gut microbiota can serve as biomarkers for predicting the treatment response, providing new insights for personalized treatment.

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.

Efficacy and safety of transcutaneous auricular vagus nerve stimulation in patients with constipation-predominant irritable bowel syndrome: a single-center, single-blind, randomized controlled trial.

Transcutaneous auricular vagus nerve stimulation (taVNS) is a promising therapy for irritable bowel syndrome (IBS). This clinical trial aims to evaluate the influence of taVNS on autonomic functions, rectal sensation, and acetylcholine (Ach) levels and to explore potential mechanisms involving gut microbiota and metabolic profiles. This study was a single-center, single-blind, randomized controlled trial executed at the First Affiliated Hospital of USTC, Anhui, China. Individual patients' IBS-C-related symptoms and mental health were assessed and scored using questionnaires at baseline and at week 4. Levels of Serum Ach and nitric oxide (NO), anorectal manometry, and heart rate variability (HRV) were assessed both prior to and following the therapy. Fecal samples from each group were assessed to compare the gut microbiota, short-chain fatty acids, and gut microbiota-derived tryptophan metabolites. Between September 2023 and May 2024, 40 participants (n=20 in both taVNS and sham-taVNS group) completed the four-week study by performing an intention-to-treat (ITT) analysis. No differences in all parameters between taVNS and sham-taVNS groups at the baseline was found. The taVNS significantly improved the VAS score (P < 0.001), IBS Severity Scoring System (IBS-SSS) (P < 0.001), weekly frequency of spontaneous bowel movements (SBMs) (P < 0.001), weekly frequency of complete SBMs (CSBMs) (P = 0.004), Bristol Stool Form Scale (BSFS) (P < 0.001), Hamilton Anxiety Scale (HAMA) (P < 0.001), Hamilton Depression Scale (HAMD) (P < 0.001), and IBS-QOL scores (P < 0.001). Furthermore, taVNS improved rectal sensation in IBS-C patients, including improvements in the threshold volume for initial sensation (P = 0.033), the urge to defecate (P = 0.022), and rectoanal inhibitory reflex (P = 0.002). Moreover, taVNS elevated serum levels of Ach (P = 0.005) and reduced NO (P = 0.016) while also enhancing vagal activity (P < 0.001) as determined by spectral analysis of HRV. Three individuals in the taVNS group and two in the control group had adverse consequences, which were manageable. Additionally, taVNS led to a significant rise in the level of the genus Bifidobacterium (P = 0.038), increased levels of acetic (P = 0.003), butyric (P = 0.011), and propionic acids (P = 0.005). It also decreased tryptophan metabolism content, including 3-hydroxyanthranilic acid (P = 0.007), anthranilic acid (P = 0.026) and L-tryptophan (P = 0.002). The study manifested that non-invasive taVNS effectively improved constipation and abdominal pain symptoms in IBS-C patients. The alleviation of IBS-C symptoms may be attributed to the integrative effects of taVNS on rectal functions, mediated through vagal, cholinergic, and multi-omics mechanisms.

Electroconvulsive therapy-specific volume changes in nuclei of the amygdala and their relationship to long-term anxiety improvement in depression.

Electroconvulsive therapy (ECT) is one of the most effective treatments for depression. ECT induces volume changes in the amygdala, a key center of anxiety. However, the clinical relevance of ECT-induced changes in amygdala volume remains uncertain. We hypothesized that nuclei-specific amygdala volumes and anxiety symptoms in depression could explain the clinical correlates of ECT-induced volume changes. To test this hypothesis, we enrolled patients with depression who underwent ECT (N = 20) in this multicenter observational study and collected MRI data at three time points: before and after treatment and a 6-month follow-up. Patients who received medication (N = 52), cognitive behavioral therapy (N = 63), or transcranial magnetic stimulation (N = 20), and healthy participants (N = 147) were included for comparison. Amygdala nuclei were identified using FreeSurfer and clustered into three subdivisions to enhance reliability and interpretability. Anxiety symptoms were quantified using the anxiety factor scores derived from the Hamilton Depression Rating Scale. Before treatment, basolateral and basomedial subdivisions of the right amygdala were smaller than those of healthy controls. The volumes of the amygdala subdivisions increased after ECT and decreased during the follow-up period, but the volumes at 6-month follow-up were larger than those observed before treatment. These volume changes were specific to ECT. Long-term volume changes in the right basomedial amygdala correlated with improvements in anxiety symptoms. Baseline volumes in the right basolateral amygdala correlated with long-term improvements in anxiety symptoms. These findings demonstrate that clinical correlates of ECT-induced amygdala volume changes are existent, but in a nucleus and symptom-specific manner.

The efficacy and cerebral mechanism of intradermal acupuncture for major depressive disorder: a multicenter randomized controlled trial

AbstractNew combinations or alternative therapies for major depressive disorder (MDD) are necessary. Intradermal acupuncture (IA) shows promise but requires further investigation regarding its efficacy, safety, and mechanisms. Conducted across 3 centers from November 2022 to January 2024, our randomized controlled trial included 120 participants with moderate to severe MDD, divided into the selective serotonin reuptake inhibitors (SSRIs), SSRIs plus sham IA (SSRIs + SIA), and SSRIs plus active IA (SSRIs + AIA) groups. Acupuncture groups received 10 sessions over 6 weeks at Shenmen (HT7), Neiguan (PC6), Sanyinjiao (SP6) and Taichong (LR3) bilaterally, followed by a 4-week follow-up. The primary outcome was changes in Hamilton Depression Rating Scale-17 (HAMD-17) scores at week 6. Furthermore, healthy controls (HCs) and MDD patients underwent magnetic resonance imaging (MRI) scans for functional connectivity (FC) analysis. After 6 weeks of treatment, the SSRIs + AIA group showed a greater reduction in HAMD-17 score than the SSRIs + SIA group (MD, −4.9 [CI, −7.6 to −2.2], P &lt; 0.001) and SSRIs group (MD, −5.1 [CI, −7.8 to −2.3], P &lt; 0.001). No serious adverse events occurred. SSRIs + AIA resulted in lower incidences of palpitations (vs.SSRIs + SIA: OR, 0.1% [CI, 0.0–1.0%]; vs. SSRIs: OR, 0.1% [CI, 0.0–0.7%]; P &lt; 0.05), somnolence (vs.SSRIs + SIA: OR, 0.1% [CI, 0.0–0.9%]; vs.SSRIs: OR, 0.1% [CI, 0.0–0.7%]; P &lt; 0.05), and nausea (vs.SSRIs + SIA: OR, 0.1% [CI, 0.0–1.0%]; vs. SSRIs: OR, 0.1% [CI, 0.0–0.9%]; P &lt; 0.05). MDD patients showed abnormal FCs, and IA enhanced FCs between striatum and frontal_inf_tri, and striatum and cerebellum in the MRI study. Overall, IA as adjunctive therapy provides clinical efficacy and safety for MDD, and it may exert antidepressant effects by modulating striatal FCs.

FMRI used to observe the acute craniocerebral response of esophageal cancer related depressive patients treated by rTMS: Initial experience.

To observe the immediate craniocerebral response, changes of spontaneous nerve activity and functional connection after repeated transcranial magnetic stimulation (rTMS) in esophageal cancer patients with depression (ECPD) by functional magnetic resonance imaging (fMRI), and to explore the therapeutic effect, neuroactivity response and mechanism. Eleven patients with ECPD were enrolled to treated with single rTMS. The patients were examined by fMRI before and after the treatment. The changes of low frequency amplitude (ALFF) and the functional connection network between different brain regions of ALFF in patients were compared before and after rTMS treatment. Compared with those before rTMS treatment, the Hamilton Depression Rating Scale (HAMD) score decreased significantly after rTMS treatment (t = -7.63, P = .0001). The ALFF of bilateral putamen, left thalamus, left posterior cingulate gyrus and right middle temporal gyrus decreased significantly (P = .02). In addition, the functional connection between the cortex-limbic system-striatum-thalamus nerve loop increased in patients after rTMS treatment. rTMS may achieve the effect of rehabilitation treatment by improving the spontaneous neural activity and regulating the neural connection network of cortical-limbic systems-triatum-thalamus loop in ECPD.

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.

Psychosocial and psychopathological dimensions of patients with Takotsubo Syndrome.

Takotsubo syndrome (TTS) is an acute reversible heart dysfunction affecting mostly post-menopausal women, frequently precipitated by a significant stressful event, presenting as an acute coronary syndrome (ACS) in the absence of obstructive coronary artery disease. The pathogenesis is not fully understood, but a close relationship between individual's mind, brain, neuroendocrine system and the heart may be involved in a mind-heart axis. The purpose of this study was to compare the prevalence of psychopathological findings in TTS patients as compared to healthy subjects, patients affected by psychiatric diseases and patients affected by ACS. This observational study enrolled 40 female subjects divided into 4 subgroups: TTS patients, healthy subjects, psychiatric patients and ACS patients, matched for age. Psychosocial factors and psychopathological dimensions have been evaluated. Patients who signed informed consent were interviewed by the administration of a complex psychometric battery, including Mini International Neuropsychiatric Interview, Hamilton Rating Scale for Depression, State Trait Anxiety Inventory, Form Y. Comparing the groups, the TTS group showed a statistically significant difference vs. ACS group concerning psychological violence subscale (P=0.049) of the Childhood Trauma Questionnaire, while significant statistical difference emerged in TTS group vs. healthy subjects control group, regarding cyclothymia subscale (P=0.008). Statistically significant differences were documented in TTS group vs. psychiatric cohort in cyclothymia subscale (P=0.012). Moreover, comparison between TTS and ACS group, revealed a statistically significant difference in the sub-scale of self-confidence and management of negative emotions (P=0.0028). One of the most significant features was the evidence of statistically significant differences in TTS vs. ACS group, concerning total and average value of anxiety (P=0.014 and P=0.031 respectively) and in the comparison of TTS group vs healthy subjects (P=0.005 for the total anxiety value and P=0.021 for the average value). Finally, both depression and mania were statistically significant raised in the TTS group compared to the healthy subjects' group (P=0.00 and P=0.013, respectively). Psychosocial and psychopathological dimensions of TTS patients have been explored and analyzed in a cohort of TTS patients vs. ACS, healthy subjects and psychiatric patients, showing statistically significant differences among the various groups. Psychopathological symptoms were more frequent in TTS patients, suggesting an evident involvement of mind-heart axis in this disease. Future studies are needed to investigate the cause-effect relationship between psychopathological features and the occurrence of TTS.

A multisite observational real-world study on the effectiveness of repetitive transcranial magnetic stimulation therapy for patients with treatment-resistant depression in Japan

The objective of this study was to reveal the effectiveness of repetitive transcranial magnetic stimulation (rTMS) for Japanese patients with treatment-resistant depression (TRD) in clinical practice, based on real-world data from a nationwide multicenter observational study in Japan.Clinical data of patients with TRD treated with rTMS (NeuroStar TMS treatment system) under public insurance coverage were retrospectively collected from 21 institutes nationwide between June, 2019 and December, 2023. Depression severity was assessed by the 17-item Hamilton Depression Rating Scale (HAMD-17). Response and remission were defined as ≥50% reduction from baseline and ≤7 points on the HAMD-17, respectively. The primary outcome was the changes in the HAMD-17 score from baseline to the endpoint following rTMS. Data from 497 patients with TRD were candidates for this study. The HAMD-17 scores (mean (SD)) improved significantly from 18.9 (5.3) to 9.7 (6.6), respectively. The response and remission rates at the end of rTMS therapy as assessed by the HAMD-17 were 53.5% and 42.8%, respectively. The dropout rate due to adverse effects was 4.2%, and the treatment was generally well tolerated. No convulsive seizures or manic changes were observed. These results indicate that conventional rTMS is effective and safe in Japanese patients with TRD.

Efficacy of comprehensive nursing intervention on nursing outcomes and prognostic quality of life in elderly patients with chronic heart failure.

To explore the effect of comprehensive nursing intervention on nursing outcomes, self-efficacy, and quality of life in elderly patients with chronic heart failure (CHF). A retrospective analysis was conducted on the clinical data from 120 elderly patients with CHF admitted to Baoding No.1 Central Hospital from June 2019 to June 2022. Patients were divided into a control group and an observation group based on different nursing methods (n= 60 each group). The clinical data of the two groups were analyzed, comparing changes in heart function, psychological status, and quality of life before and after intervention. After intervention, both groups exhibited decreased scores on the Hamilton Anxiety Scale and the Hamilton Depression Rating Scale compared to the pre-intervention levels, with the observation group showing a significantly lower degree of decline compared to the control group during the same period (P<0.05, respectively). The overall compliance rate of medical adherence in the observation group was 85.00%, significantly higher than the 70.00% in the control group (P<0.05). After intervention, both groups exhibited improvement in left ventricular ejection fraction, left ventricular end-systolic diameter, and left ventricular end-diastolic diameter compared to the pre-intervention levels, with the observation group showing a more significant improvement than the control group (P < 0.05, respectively). For elderly patients with CHF, comprehensive nursing intervention may reduce negative emotions, improve sleep quality, self-care ability, and self-efficacy, and enhance patient compliance, quality of life, and heart function.

Continuous nursing care improving outcomes of patients after percutaneous coronary intervention.

Percutaneous coronary intervention (PCI) is an effective method for the treatment of coronary heart disease. Cardiac rehabilitation and continuous nursing management after discharge are the key to ensure the quality of treatment and the quality of life of patients. This study aimed to explore the significance of WeChat platform in continuous care after PCI. We collected the clinical data of 90 PCI patients in 2 centers from January 2020 to July 2023, and divided the patients into 2 groups: the continuous nursing care group based on the WeChat platform and the control group. Continuous nursing care was implemented immediately after discharge. After 1-year follow-up, we compared the outcomes of the 2 groups, including postoperative complications, lifestyle changes and psychological status. There were no heart-related postoperative complications in either group. The incidence of vagal reflex was significantly decreased in the continuous nursing group (P = .042). The improvement of life style, such as smoking cessation (P = .001) and alcohol withdrawal (P = .003), was significantly better than that of the control group. The continuous nursing group was better than the control group in improving psychological status based on the Hamilton's depression scale. Continuous nursing care based on WeChat platform could reduce the incidence of complications of patients after PCI, alleviate patients' depression, and improve patients' quality of life.

Clinical Study of Psycho-cardiology Combined with FNS in the Treatment of SCAD with Depression

To investigate the effects of psycho-cardiology combined with fastigial nucleus stimulation (FNS) on patients with stable coronary artery disease (SCAD) complicated with depression, we observed the changes of concentrations of N-terminal pro-B type natriuretic peptide (NT-proBNP), tumor necrosis factor-α(TNF-α), 5-hydroxytryptamine (5-HT), dopamine (DA) and depressive symptoms in these patients. One hundred and fifty patients, who were hospitalized the Department of Cardiology at the Third People&amp;apos;s Hospital of Mianyang from February 2020 to October 2021 with a confirmed diagnosis of SCAD combined with depression, were selected as study subjects. Patients were randomly divided into a control group, a psycho-cardiology treatment group and a combined treatment group. The control group was given conventional treatment of SCAD and pseudo-stimulation of the fastigial nucleus, the psycho-cardiology treatment group was given conventional treatment of SCAD, psychological interventions and pseudo-stimulation of the fastigial nucleus, and the combined treatment group was given conventional treatment of SCAD, psychological intervention and FNS. The changes of concentrations of TNF-α, NT-proBNP, 5-HT and DA were observed in the three groups of patients, and the changes of the state of depression were assessed by Hamilton Depression Scale (HAMD). Serum NT-proBNP and TNF-α concentrations decreased significantly after treatment in the three groups. Especially, the decrease in the combined treatment group was the most significant(&amp;lt;i&amp;gt;p&amp;lt;0.05&amp;lt;/i&amp;gt;). Serum 5-HT and DA concentrations were not statistically different in the three groups before and after treatment (&amp;lt;i&amp;gt;p&amp;gt;0.05&amp;lt;/i&amp;gt;). However, they were significantly higher in the psycho-cardiology treatment group and the combined treatment group(&amp;lt;i&amp;gt;p&amp;lt;0.05&amp;lt;/i&amp;gt;) and the increase in the combined treatment group was more significant than in the psycho-cardiology treatment group. In the control group, the difference of HAMD scores was not statistically significant before and after treatment (&amp;lt;i&amp;gt;p&amp;gt;0.05&amp;lt;/i&amp;gt;), in the psycho-cardiology treatment group and the combined treatment group, the scores decreased significantly after treatment compared to before treatment (&amp;lt;i&amp;gt;p&amp;lt;0.05&amp;lt;/i&amp;gt;). Furthermore, compared to the psycho-cardiology treatment group, the decrease was more significant in the combined treatment group (&amp;lt;i&amp;gt;p&amp;lt;0.05&amp;lt;/i&amp;gt;). Our data suggested that Psycho-cardiology medicine combined with FNS can effectively reduce the level of serum NT-proBNP and TNF-α, increase the serum concentrations of 5-HT and DA and improve the symptoms of depression in patients with SCAD complicated with depression.

Four weeks standard vs. one week accelerated intermittent Theta Burst Stimulation for the treatment of depression – A retrospective analysis

IntroductionIntermittent Theta Burst Stimulation (iTBS), a specific form of repetitive transcranial magnetic stimulation (rTMS) is increasingly used for treating affective disorders. Accelerated iTBS protocols (aiTBS) with shorter treatment duration may lead to equal but faster response rates compared to standard protocols. MethodsHere, we retrospectively analyzed the records of 66 rTMS in- and out-patients with major depressive disorder in a tertiary care hospital between April 2023 and September 2023. All patients received left prefrontal iTBS with 1200 pulses, either one session/workday over 4 weeks (n = 34) or left prefrontal aiTBS on five sessions/workday for one week (n = 32). Depressive symptoms were assessed with the 21-item Hamilton Depression Rating Scale (HAMD-21) and the Major Depression Inventory (MDI) before and at the end of the respective treatment. ResultsWith both treatments, iTBS and aiTBS, the severity of depression improved significantly according to HAMD-21 and MDI. Response rates for iTBS were 38 % (HAMD-21) and 35 % (MDI), for aiTBS 19 % (HAMD-21) and 16 % (MDI), respectively. Remission rates showed a similar pattern. Effect sizes for group differences were small to medium. No serious adverse events occurred in any group. Tolerability was lower in aiTBS. Overall satisfaction was low for aiTBS on a qualitative and subjective level. ConclusionaiTBS with 1200 pulses and five daily sessions lead to amelioration of symptoms within one week. But benefit, satisfaction, tolerability was slightly lower in contrast to four weeks of iTBS. For everyday clinical practice, aiTBS protocols can be considered after weighing up the logistical disadvantages, such as possible longer waiting time for new patients that want to start a therapy with TMS. Future studies should explore the optimal dosage regime (number of sessions per day, number of pulses per session) for fast and effective symptom reduction.

Effectiveness of acupuncture treatment in post-stroke depression and anxiety disorders: a prospective, randomized, controlled, single-blind study.

Our aim was to examine the effectiveness of acupuncture in post-stroke depression/anxiety disorders and to determine whether it reduces the need for anxiolytic and sedative drug use. This study included 54 stroke patients with depression and/or anxiety disorder. Patients were randomly assigned to the acupuncture treatment group (n = 27) or the control group (n = 27). A conventional rehabilitation program was applied to all patients and acupuncture was performed twice a week for 4 weeks. Patients were evaluated blindly by a psychiatrist at baseline (week 0), week 4 and week 8, using the Hamilton depression rating scale (HAM-D) and Hamilton anxiety rating scale (HAM-A), and drug doses were adjusted when necessary. The HAM-D and HAM-A scores at week 4 were pre-specified as the two primary outcome measures. Within each group, there was a significant decrease in the mean scores of HAM-D and HAM-A at weeks 4 and 8. No between-group differences in HAM-A or HAM-D scores were seen at 4 weeks but there was a significant decrease in HAM-D scores in favor of the acupuncture group at week 8 (p < 0.025). At week 4, the number of cases whose selective serotonin reuptake inhibitor (SSRI) dose was increased was found to be significantly higher in the control group. While the study was negative with respect to its primary outcomes, the findings with respect to certain secondary outcomes suggests further research is warranted to determine if acupuncture treatment is an effective/safe treatment to alleviate post-stroke depression/anxiety. NCT04283591 (ClinicalTrials.gov).

Effectiveness of Guided Imagery on Level of Perceived Stress and Depression Among Sober Alcohol Dependents Admitted in De-Addiction Centers of Selected Areas

Introduction: Alcohol abuse poses significant health challenges, affecting individuals and families. Guided imagery therapy offers a promising approach to manage stress and emotions, potentially mitigating the impacts of alcoholism and depression. Methodology: This study employed a quasi-experimental, non-randomized control group design with a quantitative approach to assess the effectiveness of guided imagery therapy on perceived stress and depression in sober alcohol dependents at selected de-addiction centers. Baseline characteristics, including age, gender, education, family type, occupation, income, and duration of alcohol use, were collected using Tool I. Stress levels were measured with the 5-point Perceived Stress Scale (Tool II), while the 4-point Hamilton Depression Scale (Tool III) assessed depression. Written permission from de-addiction authorities and informed consent from participants were obtained. The sample included 60 sober alcohol dependents from Maharashtra, selected via non-probability purposive sampling. Test-retest reliability for stress and depression was confirmed, with scores of 0.89 and 0.90, respectively. Result: The study assessed the effectiveness of guided imagery therapy on perceived stress and depression among sober alcohol dependents using a quasi- experimental design. In the experimental group, pre-test data revealed that 60% experienced severe perceived stress, which decreased to 66.66% at moderate levels post-intervention, demonstrating significant improvement (t-value: 20.018). Conversely, the control group showed no change, with 80% remaining in the severe category pre- and post-test (t-value: 0.1054). Similarly, for depression, the experimental group reported 63.34% severe depression pre-test, reducing to 70% at moderate levels post-test (t-value: 7.907), while the control group exhibited no significant change. Analysis of associations with demographic variables revealed no significant correlations for age, education, family type, or occupation; however, a significant relationship was found between the duration of alcohol consumption and depression levels (chi-square: 8.948). Conclusion: Thus, guided imagery therapy effectively perceived stress and depression reduced among the experimental group.

Alkaline phosphatase is associated with vascular depression in patients with severe white matter hyperintensities.

Cerebrovascular disease (CVD) poses a substantial risk for depression. Elevated levels of alkaline phosphatase (ALP) serve not only as an independent predictive factor for acute cerebrovascular events and unfavorable prognoses but also as a significant predictor of depression in premenopausal women. Nevertheless, the association between elevated ALP levels and vascular depression (VDe) in patients presenting with white matter hyperintensities (WMHs) remains unclear. In a cross-sectional survey, 265 individuals diagnosed with CVD were incorporated. Baseline demographic information, fasting blood parameters, and MRI data were systematically gathered for analysis. All patients were divided into a severe WMHs (sWMHs) group and a mild WMHs (mWMHs) group based on their Fazekas score. Univariate analysis of potential variables among different subgroups of patients with scores of Hamilton Rating Scale for Depression (HAMD) was performed. Subsequently, the diagnostic effectiveness of multivariables for positive VDe within two WMHs groups was assessed using binary logistic regression. The diagnostic capability of the multivariate approach for VDe was further scrutinized through ordinal logistic regression. (1) Hypersensitivity C-reactive protein (hs-CRP, p = 0.031), high-density lipoprotein cholesterol (HDL-C, p = 0.038), apolipoprotein A1 (APOA1, p = 0.009), and ALP (p = 0.011) exhibited distinct expression in patients with mWMHs across varying HAMD scores. In contrast, erythrocyte counts (p = 0.024), hemoglobin (Hb, p = 0.011), hs-CRP (p = 0.002), and ALP (p = 0.021) displayed differential expression in patients with sWMHs across different HAMD scores. (2) ALP and hs-CRP combined with APOA1 or Hb can improve the diagnostic efficiency of positive VDe in sWMHs [AUC = 0.849, 95% CI (0.753, 0.946), p < 0.001] or mWMHs [AUC = 0.718, 95% CI (0.603, 0.834), p = 0.002] patients, respectively. (3) Alkaline phosphatase (ALP) [OR = 1.016, 95% CI (1.003, 1.028), p = 0.016] is correlated with VDe in patients with sWMHs, a relationship that persisted even following adjustments for age and sex. The amalgamation of multiple markers enhances the diagnostic efficacy of VDe through WMHs classification. Serum ALP is associated with VDe in sWMHs patients.

Effect of "Xingshen-Jieyu" electroacupuncture on serum differential metabolites in patients with depression based on metabolomics

To explore the effect of "Xingshen-Jieyu" (inducing resuscitation and dispel ling melancholy) electroacupuncture (EA) on serum metabolites in patients with depression and its underlying mechanisms through serum non-targeted metabolomics. Fifteen depression patients were subjected into the EA group, and 15 healthy volunteers were matched into the healthy group. EA (2 Hz/15 Hz, a tolerable strength) was applied to Baihui (GV20), Shenting (GV24), Toulinqi (GB15), Benshen (GB13), Touwei (ST8), Xuanli (GB6) and Qubin (GB7) for 30 min, 3 times a week for 6 weeks. The severity of depression was assessed using Hamilton Depression Scale-17 (HAMD-17) and Hamilton Anxiety Scale (HAMA), the degree of fatigue was evaluated using Fatigue Scale-14 (FS-14). The subjects sleep quality was assessed using Pittsburgh sleep quality index (PSQI). Blood samples were collected before and after the treatment for processing serum to perform non-targeted metabolomics profile detection using ultra-high-performance liquid chromatography coupled with mass spectrometry (UPLC-MS), and Partial Least Squares Discriminant Analysis (PLS-DA, a statistical approach). Differential metabolites were screened and pathway enrichment analysis was performed. After the treatment, the scores of HAMD-17, HAMA, PSQI and FS-14 of depression patients were significantly lowered in the EA group (P<0.05). Compared with the healthy subjects, 46 differential metabolites (21 up-regulated, 25 down-regulated) were screened in patients with depression. Compared with pre-treatment in the EA group, 19 differential (17 up-regulated, and 2 down-regulated) metabolites were screened. Four down-regulated metabolites of the 46 differential metabolites in depression patients were recovered after EA treatment. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis of differential metabolites before and after EA showed that 19 metabolic pathways were enriched, mainly involving glutaminergic synapses, GABAergic synapses and several amino acid metabolism related pathways. "Xingshen-Jieyu" EA mainly regulates the metabolism of amino acids, and activities of neurotransmitter glutamate and GABA, and restores the excitatory/inhibitory balance, thus playing a role in improving depression.

Serum neurotransmitter analysis of motor and non-motor symptoms in Parkinson's patients.

Clinical symptoms of Parkinson's disease (PD) are classified into motor and non-motor symptoms. Mental disorders, especially depression, are one of the major non-motor manifestations of PD. However, the underlying mechanisms remain poorly understood. In the present study, 21 neurotransmitters associated with mental disorders were measured in serum samples from patients and controls using the ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) assay. Additionally, five clinical scales-the MDS Unified Parkinson's Disease Rating Scale (UPDRS), the Non-Motor Symptoms Scale (NMSS), the Mini-Mental State Examination (MMSE), the Hamilton Anxiety Scale (HAMA), and the Hamilton Depression Scale (HAMD)-were used to evaluate the severity of both motor and non-motor symptoms in PD patients. Analysis of neurotransmitter metabolism revealed significant changes in the tryptophan (Trp) metabolic pathway in PD patients. Specifically, levels of Trp, kynurenine (KYN), kynurenic acid (KA), nicotinamide (NAM), and 5-methoxyltryptamine (MeOTA) were substantially decreased. Additionally, three other excitation/inhibiting amino acids-glutamic acid (Glu), 4-aminobutyric acid (GABA), and aspartic acid (Asp)-also declined. Moreover, neurotransmitter conversion ratios, such as KA/KYN, nicotinamide/niacin (NAM/NA), 5-hydroxytryptophan/tryptophan (5-HTP/Trp), and quinolinic acid/kynurenic acid (QA/KA), provided more dynamic insights into disrupted neurotransmitter metabolism. Correlation analyses between scale scores and neurotransmitter levels showed that concentrations of xanthurenic acid (XA) and the turnover rate of 3-hydroxykynurenine (3-HK) were negatively correlated with UPDRS scores, while 5-hydroxytryptamine (5-HT) and GABA levels were negatively correlated with non-motor symptoms in PD patients. In summary, this study elucidates, for the first time, the potential association and dynamics between altered neurotransmitter metabolism and the etiology of PD in terms of motor and non-motor functions. These findings offer novel biomarkers and therapeutic targets for the treatment of PD.