Previous History Of Depression Research Articles

Ingestão dietética de ácidos graxos ômega-3 por mulheres climatéricas e fatores associados

Objetivo: Estimar a ingestão dietética de ácidos graxos ômega-3 (n-3) e identificar fatores associados à mesma em mulheres climatéricas. Métodos: Estudo transversal com 80 mulheres climatéricas de três municípios do Sudoeste do Paraná. Foram realizadas avaliação antropométrica; avaliação dos sintomas climatéricos, por meio do índice menopausal de Kupperman; avaliação dos sintomas depressivos, através da Escala de Rastreamento Populacional para Depressão; e aplicação de um diário alimentar de três dias, para avaliar a ingestão de n-3. Utilizaram-se testes de diferença de médias e modelo de regressão logística para avaliação de fatores associados à ingestão de n-3. Resultados: A ingestão média de n-3 foi de 1,07±0,95g/dia e não se observou diferença significativa entre as mulheres com e sem sintomas de depressão. Verificou-se, entretanto, que aquelas com histórico prévio da doença (OR=0,07; IC=0,01-0,70; p=0,02) e que apresentavam sobrepeso/obesidade (OR=0,13; IC=0,02-0,84; p=0,03) possuíam maiores chances de ingerir o nutriente abaixo do valor correspondente ao percentil 50 (1,07g/dia) de ingestão pela amostra estudada. Além disso, notou-se que as mulheres que apresentavam risco de complicações metabólicas, avaliado por meio da circunferência da cintura aumentada (OR=8,42; IC=1,04-68,24; p=0,05) apresentaram maiores chances de consumir ácidos graxos n-3 em quantidades adequadas (≥ 1,07g/dia). Conclusão: Verificou-se elevada frequência de baixa ingestão de ácidos graxos n-3, especialmente nas mulheres com histórico prévio de depressão e excesso de peso.

A Cross-Cultural Analysis of the Prevalence and Risk Factors for Prenatal Depression in Spain and Mexico.

The prevalence and risk factors associated with prenatal depression among Spanish-speaking women in Spain and Mexico are examined and compared through a cross-cultural study. The study utilizes secondary data from 563 participants who received prenatal care in Madrid (N = 283) and in Mexico City (N = 280), assessed with the PHQ-9 and the PDPI-R. Spanish women reported a lower prevalence of depressive symptoms (10.0%) than Mexican women (20.3%). Regression analyses showed that previous prenatal anxiety and lack of family emotional support were common risk factors to the two countries. Within each country, significant risk factors included: (a) previous depression history (β = 0.224; p < 0.001) in Spain; and (b) unplanned pregnancy (β = -0.116; p < 0.027), lack of emotional support from others (β = 0.129; p < 0.032), marital dissatisfaction (β = 0.186; p < 0.009), and life stress due to financial problems (β = 0.117; p < 0.026), and life stress due to marital problems (β = 0.114; p < 0.040) in Mexico. Health professionals can tailor interventions to their particular risk factors to reduce the adverse effects on mothers and infants.

The impact of hospital-diagnosed depression or use of antidepressants on treatment initiation, adherence and HbA1c/LDL target achievement in newly diagnosed type 2 diabetes.

We aimed to assess whether current antidepressant therapy or a history of hospital-diagnosed depression affects diabetes treatment initiation, adherence, and HbA1c and LDL-cholesterol target achievement. In this register-based study, we included all individuals from Central and Northern Denmark with newly diagnosed type 2 diabetes, defined as a first-ever HbA1c measurement of ≥48mmol/mol (6.5%), between 2000 and 2016. Individuals either diagnosed with depression at a psychiatric hospital in the 2years prior to their diabetes diagnosis or currently receiving treatment with an antidepressant were compared with individuals with type 2 diabetes, but without depression treatment or previous history of depression. Outcome measures included initiation of glucose-lowering drugs and lipid-modifying agents, adherence to these medications (medication possession ratio >80%), and HbA1c (<53mmol/mol [7%]) and LDL-cholesterol (<2.6mmol/l) target achievement. The assessment of association between depression or antidepressant treatment and these outcomes was conducted using regression analyses with adjustment for potential confounders. We included a total of 87,650 individuals with first-ever HbA1c-diagnosed type 2 diabetes, of whom 0.9% (n = 784) had hospital-diagnosed depression and 11.4% (n = 9963) currently received antidepressant treatment. Compared with those without depression treatment, treatment with an antidepressant was associated with increased likelihood of glucose-lowering drug initiation (HR 1.39 [95% CI 1.34, 1.44]) and adherence (OR 1.27 [95% CI 1.18, 1.36]), lipid-modifying agent initiation (HR 1.17 [95% CI 1.11, 1.23]) and adherence (OR 1.25 [95% CI 1.09, 1.43]), and achievement of LDL (OR 1.08 [95% CI 1.03, 1.14]) but not HbA1c target (OR 0.99 [95% CI 0.93, 1.06]). The findings were similar for individuals who had hospital-diagnosed depression. In individuals with newly diagnosed type 2 diabetes, antidepressant treatment and depression were associated with improved diabetes treatment quality. Graphical abstract.

Inverse autonomic stress reactivity in depressed patients with and without prior history of depression

BackgroundThere is a considerable association between major depressive disorder (MDD) and cardiovascular disease, most possibly relying on abnormalities in the autonomic nervous system (ANS)-related cardiac reactivity, although the exact underlying pathophysiological pathway is unclear. This study tends to shed some additional light on this background by investigating ANS reactivity in MDD with respect to previous depression history through an objective stress challenge paradigm. MethodsThe study assessed the effects of an overnight hypothalamus-pituitary-adrenal (HPA) axis stimulation with metyrapone (MET) on baseline ANS activity through linear and non-linear heart rate variability (HRV) measures in the morning of two continuous days in a group of 14 physically healthy, antidepressant-free patients with clinical, non-psychotic MDD, to investigate differences in autonomic reactivity with respect to prior MDD history. ResultsThe main findings of this study include statistically significant time × group interactions with respect to several HRV measures, suggesting substantial differences on autonomic reactivity between patients with and without depression history. Hereby, recurrent-episode MDD patients showed lower vagal activity, while first-episode MDD patients increased PNS activity after HPA axis stimulation. ConclusionsThese findings indicate that HPA axis stimulation in MDD patients leads to inverse vagal response according to MDD history. We suggest that chronic stress system overactivation, as found in MDD, might lead to a progressive inversion of the original stress response through HPA axis and ANS divergence over the course of a recurrent illness. HRV could, thus, represent a significant biomarker in MDD with temporal sensitivity.

Effect of supervised group exercise on psychological well-being among pregnant women with or at high risk of depression (the EWE Study): A randomized controlled trial.

Depression is expected to be the leading cause of disability worldwide by 2030. The prevalence is increasing and is two-fold higher in women than in men, women being at particularly high risk during hormonal transition phases such as pregnancy and the postpartum period. The objective for this trial was to assess the effect of supervised group exercise on psychological well-being and symptoms of depression among pregnant women with or at high risk of depression. This study was undertaken at the Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Denmark, from August 2016 to September 2018. Pregnant women with a current or previous history of depression and/or anxiety requiring treatment within the last 10years, or use of antidepressants 3months before or during pregnancy, were randomly assigned to 12weeks of supervised group exercise from 17 to 22weeks of gestation twice weekly, or to a control group. The primary outcome was self-reported psychological well-being at 29-34weeks of gestation, measured by the five-item World Health Organization Well-being Index (WHO-5). Secondary outcomes included delivery outcomes and psychological well-being (WHO-5) 8weeks postpartum. The intention-to-treat analysis showed no significant effect on psychological well-being on the primary outcome. Mean WHO-5 score in the intervention group was 2.0 (95% CI -1.3 to 5.2, P=.2) higher than in the control group. Per protocol analysis of women who attended ≥75% of the exercise sessions showed a statistically significant higher mean WHO-5 score relative to the control group at gestational weeks 29-34. Eight weeks postpartum the intervention group reported higher psychological well-being than the control group, mean difference in WHO-5 score of 5.5 (95% CI 1.0-10.1, P=.04). Supervised group exercise did not improve psychological well-being for women with or at high risk of depression at 29-34weeks of gestation. Eight weeks postpartum the intervention group reported significantly higher psychological well-being than the control group. Based on our results, supervised exercise in groups is a safe complementary course of treatment alongside the existing antenatal care.

Association Between 5-Alpha Reductase Inhibitor Use and The Risk of Depression: A Meta-Analysis.

To explore the association between 5α-reductase inhibitors (5ARIs) use and risk of depression based on published literature through a meta-analysis. A comprehensive literature search was conducted by searching Pubmed, Embase, Cochrane Library, CBM, CNKI, and VIP databases up to June, 2019. Summarized risk ratios (RRs) with 95% confidence intervals (CIs) were calculated to evaluate the strength of association between 5ARIs and depression. Subgroup analyses were performed according to population, 5ARI types, degree of depression, and publication date. Registered in PROSPERO under number CRD42018096147. A total of 6 clinical studies with 265672 participants were included in our meta-analysis. The application of 5ARIs could significantly increase the risk of depression based on both pooled unadjusted (95% CI: 1.28-2.78, RR = 1.89, P = .001) and multivariable adjusted RRs (95% CI: 1.01-1.17, RR = 1.09, P = .03). In subgroup analyses, dutasteride was associated with depression significantly (95% CI: 1.37-1.70, RR = 1.53, P < .001), while finasteride was not. As to the degree of depression, 5ARIs mainly caused mild depression (95% CI: 1.91-2.33, RR = 2.11, P < .001), instead of moderate or severe depression. We concluded that 5ARIs could potentially increase the risk of depression. Clinicians need to carefully consider the use of 5ARIs for benign prostatic hyperplasia and androgenic alopecia patients, especially those exhibiting risk factors for depression or those who have a previous history of depression. More studies with larger sample size and comprehensive study design are needed to further verify our outcomes.

Double blind, randomised trial to compare efficacy of escitalopram versus citalopram for interferon induced depression in hepatitis C patients

ObjectivesThe objective of the study was to compare the two antidepressant drugs citalopram and escitalopram on the basis of efficacy in depressed patients of Hepatitis C patients receiving interferons. MethodsIn this double blind randomized trial, the hepatitis C patients visited National institute of liver and Gastro intestinal diseases (NILGID), Dow University Hospital, were screened for depression before starting treatment with interferons. The Institutional review board approval was obtained and its letter reference no.is: IRB-682/DUHS/Approval/2016/169. Patients with previous history of depression were excluded from the study. The patients who started with Interferon therapy were assessed for depression on baseline and then on each visit. Those who developed depression were randomly assigned to receive either citalopram or escitalopram. Treatment groups were assessed with depression scale each time they visit the clinic. Two antidepressants were compared for their efficacy at an interval of 4 weeks, 8weeks and then 12 weeks. ResultsIn the current study 80 patients were randomized to receive either citalopram or escitalopram. The study outcome was better in patients treated with escitalopram. The mean change in depression score from baseline to the end of the study was greater in escitalopram group i.e. 10.41 as compared to citalopram group i.e. 14.17. The difference in depression score was also calculated as 4.28 and.3.76 (p < 0.001) for both the drugs at week 8 and week 12 respectively, which was statistically significant. Difference in depression score were also calculated for gender 0.576 (p = 0.497) and age 0.950 (p = 0.265), which were found to be non-significant, statistically. ConclusionThe results demonstrated superiority of escitalopram over citalopram, the drug is twice as potent as the racemic mixture. Additionally the drug is well tolerated and exhibited better effects. Escitalopram proved to be a safer alternative to citalopram.

Differential Association of Serum BDNF With Poststroke Depression and Poststroke Anxiety

ObjectivesTo investigate the correlation between brain-derived neurotrophic factor (BDNF) and risk factors, as well as functional outcome in poststroke depression (PSD) or poststroke anxiety (PSA). DesignCohort study. SettingStroke patients admitted to an urban rehabilitation hospital. ParticipantsStroke patients (N=162) without any previous history of depression and anxiety. InterventionsNot applicable. Main Outcome MeasuresSociodemographic information and comorbidities were recorded during hospital admission. Functional outcomes were assessed using FIM scores at time of admission and discharge. The influence of various factors such as BDNF and patient characteristics on functional outcome was investigated. Single-factor effect was examined using simple logistic regression, as was multi-factor effect using multiple logistic regression. The goodness-of-fit of those regression models was evaluated by the integrated area under ROC curve. ResultsPSD was diagnosed in 61 (37.7%) patients, and PSA was diagnosed in 40 (24.7%). Multiple logistic analysis showed that BDNF, divorce or separation, and history of smoking were significantly associated with the occurrence of PSD but not with the occurrence of PSA. The model combining low BDNF level and divorce or separation improved the prediction for PSD. Among the variables analyzed for prediction of functional outcome, serum BDNF had a minimum correlation with motor FIM scores in PSD but no significant correlation with motor FIM scores in PSA. ConclusionsBDNF is a valuable prediction for the occurrence of PSD but not for PSA. More strikingly, ischemic stroke patients who are divorced or separated with low serum BDNF have a much higher risk for PSD. BDNF has a minimum correlation with motor function outcome in PSD but no significant correlation with motor outcome in PSA.

Preservation of Gray Matter Volume in Early Stage of Bipolar Disorder: A Case for Early Intervention: Préservation du volume de matière grise au stade précoce du trouble bipolaire: un cas pour intervention précoce.

It has been proposed that different stages of the bipolar disorder might have distinct neurobiological changes. However, the evidence for this has not been consistent, as the studies in early stages of the illness are limited by small sample sizes. The purpose of this study was to investigate the gray matter volume changes in bipolar patients who recently recovered from their first episode of mania (FEM). Using a whole-brain voxel-based analysis, we compared the regional gray matter volumes of 61 bipolar patients who have recovered from their FEM in the past 3 months with 43 age- and gender-matched healthy participants. We also performed a series of subgroup analyses to determine the effects of hospitalization during the FEM, history of depressive episodes, and exposure to lithium. No statistically significant difference was found between gray matter volumes of FEM patients and healthy participants, even at a more liberal threshold (P < 0.001, uncorrected for multiple comparisons). Voxel-based subgroup analyses did not reveal significant gray matter differences except for a trend toward decreased gray matter volume in left lateral occipital cortex (P < 0.001, uncorrected) in patients with a previous history of depression. This study represents the largest structural neuroimaging investigation of FEM published to date. Early stage of bipolar disorder was not found to be associated with significant gray matter volume changes. Our findings suggest that there might be a window of opportunity for early intervention strategies to prevent or delay neuroprogression in bipolar disorder.

Alterations in transcranial sonography among Huntington\u2019s disease patients with psychiatric symptoms

Transcranial sonography (TCS) is a diagnostic tool in mood and movement disorders. Alterations within the raphe mesencephalic nucleus in the brain have been reported not only in patients with major depression but in patients with depressive symptoms accompanying several neurodegenerative disorders. The aim of the study was to assess the echogenicity of the nucleus raphe and other basal ganglia in patients with Huntington’s disease (HD). TCS was performed in 127 HD patients participating in observational studies (Registry/Enroll-HD) in the Institute of Psychiatry and Neurology (Warsaw, Poland). Raphe hypoechogenicity was found in 78% of HD patients with current symptoms of depression (according to DSM-IV criteria), 57% of patients with a previous history of depression, and 56.8% patients who lacked signs or history of depression. Patients with hypoechogenic raphe reported significantly higher depression as measured on the BDI (15.6 ± 1.7) as compared to patients with normal echogenicity (9.5 ± 1.2), (p = 0.023). The diameter of the third ventricle was negatively correlated with Mini-Mental State Examination (MMSE) (rho − 0.37) and total functional capacity (TFC) scores (rho − 0.26). Hyperechogenic substantia nigra was visualized in 66,4% patients with HD and the degree of hyperechogenicity was correlated with the total motor score (TMS) (rho − 0.38). Changes in echogenicity of the basal ganglia are related to both depressive and motor symptoms among patients with HD.

A descriptive study to assess the depression among geriatric people in selected rural area of district Panchkula (Haryana)

Objectives: To assess the knowledge regarding depression among geriatric people in selected rural area of district Panchkula(Haryana). Methodology: A quantitative study by using descriptive design was used, a sample size of 50 geriatric peoplewere selected by using simple random Sampling technique, Semi structured questionnaire were used to assess the level of knowledge regarding depression among geriatric people in selected rural area of district Panchkula (Haryana). Results: The study revealed that among 50 geriatric people the majority 48% of geriatric communications were in the age group of 60-75 years .88% were male 72% were from rural area. Majority (74%) of families’ monthly income was 0-10,000 had previous history of depression 44% of population was male, 56% of female.

Relationships between depression and food intake in climacteric women

Objective: This study evaluated the associations between food intake – especially omega-3 (n-3) – and depressive symptoms in climacteric women.Methods: Four hundred climacteric women were included in this research. The Kupperman Index, the Center for Epidemiologic Studies Depression Scale, and a 3-day food diary were used to investigate climacteric symptoms, depressive symptoms, and food intake, respectively. Sociodemographic, clinical, and anthropometric variables were also explored.Results: Statistically significant associations were observed between depression and climacteric symptoms, climacteric phase, previous history of depression, antidepressant drug use, family income, sleep pattern, and consumption of carbohydrates, fiber, polyunsaturated fatty acids, magnesium, zinc, and vitamins C, D, and B12. No association was observed between n-3 consumption and depression.Conclusion: Climacteric symptoms and food intake are important factors linked to depression during the climacteric period. Further studies are needed to clarify the changes in this phase of women’s lives, as well as to investigate the role of the diet in the depression treatment or prevention.

Improving Accuracy of Sentiment Analysis for Depression Recommendation using Multi-Domain Fuzzy Rules

Social media &amp; e-commerce has opened up the doors for human behavioral analysis in ways which were not possible before. Companies have the ability to track user’s mood and suggest advertisements which can trigger buying decisions based on it. This is possible due to user’s real time social media updates. Users nowadays are willing to provide information like their location, their age, nearby friends information, their mood, their buying patterns, etc. Companies do not intentionally collect all this information, but it has become a matter of social pride to post it as social media status and updates. The information available can be put to use in multiple forms- predict election results, movie success, product liking/disliking, travel destination recommendation, health care, etc. In our work, we utilize this textual information posted by different users and analyze their depression level focusing on negative sentiments. In order to perform this task, we have considered user’s tweets, any links which they might have posted, the time of the tweet, their age group and any previous depression history of the user. All these parameters are given to a novel fuzzy decision tree that uses sentiment analysis and game theory-based scoring in order to evaluate the depression score for the user. We analyzed the system on different real-time users, and observed that the system predicts depression level with more than 90% accuracy. Our work can be used to generate a prototype to identify if a person is in a depressive state and figure out the intensity of his/her depression.

A meta-analysis of poststroke depression risk factors comparing depressive-related factors versus others

Poststroke depression (PSD) is a public health issue, affecting one-third of stroke survivors, and is associated with multiple negative consequences. Reviews tried to identify PSD risk factors with discrepant results, highlighting the lack of comparability of the analyzed studies. We carried out a meta-analysis in order to identify clinical risk factors that can predict PSD. PubMed and Web of Science were searched for papers. Only papers with a strictly defined Diagnostic and Statistical Manual of Mental Disorders depression assessment, at least 2 weeks after stroke, were selected. Two authors independently evaluated potentially eligible studies that were identified by our search and independently extracted data using standardized spreadsheets. Analyses were performed using MetaWin®, the role of each variable being given as a risk ratio (RR). Eighteen studies were included in the meta-analysis. Identified risk factors for PSD with RR significantly above 1 were previous history of depression (RR 2.19, confidence interval (CI) 1.52-3.15), disability (RR 2.00, CI 1.58-2.52), previous history of stroke (RR 1.68, CI 1.06-2.66), aphasia (RR 1.47, CI 1.13-1.91), and female gender (RR 1.35, CI 1.14-1.61). Fixed effects model leads to identification of two more risk factors: early depressive symptoms with an RR of 2.32 (CI 1.43-3.79) and tobacco consumption (RR 1.40, CI 1.09-1.81). Time bias was found for alcohol consumption. Sample size was significantly involved to explain the role of "alcohol consumption" and "cognitive impairment." Five items were significantly predictive of PSD. It might be of clinical interest that depressive-related risk factors (such as past depressive episodes) were having the largest impact.

Magnitude of Antenatal Depression and Associated Factors among Pregnant Women in West Badewacho Woreda, Hadiyya Zone, South Ethiopia: Community Based Cross Sectional Study.

Background Antenatal depression is prevalent and serious problems that is associated with psychosocial factors, obstetric history, and history of psychiatric illness. Evidence on prevalence and factors associated with antenatal depression at community level is limited in Ethiopia. The aim of this study was assessing the prevalence of antenatal depression and associated factors among pregnant women in West Badewacho Woreda, Hadiyya Zone, South Ethiopia, 2018. Methods A community based cross sectional study was conducted from March 15 to April 12, 2018. To draw a total sample size of 541 pregnant women, multistage sampling technique was used. Pretested semi-structured questionnaire and standardized scale was used to collect data from each study subject. Data were entered and cleaned using Epi-Data version 3.1 and exported to SPSS version 23 for analysis. Bivariate analysis was carried out to see crude association between each independent variable and outcome variable. Odds ratios at 95%CI were computed to measure the strength of the association between the outcome and the independent variables. P-value < 0.05 was considered as statistically significant in multivariate analysis. Results The prevalence of antenatal depression in the study population was 23.3% (CI: 19.8–26.8). Factors significantly associated with antenatal depression were marital status other than married (single, widowed, divorced) [AOR: (2.807; 95%CI: (1.268, 6.227); p-value = 0.042], history of previous depression [AOR: 3.414; 95%CI: (1.154, 12.999); p-value = 0.001] family history of mental illness [AOR: 3.874; 95%CI: (1.653, 7.052); p-value = 0.028], recent violence from intimate partner [AOR: 3.223; 95%CI: (1.359, 7.643); p-value = 0.008], unsatisfactory marital relation [AOR: 7.568; 95%CI: (3.943, 14.523); p-value < 0.001], lack of adequate social support [AOR: 5.491; 95%CI: (2.086, 14.451); p-value < 0.001] and unplanned current pregnancy [AOR: 2.013; 95%CI: (1.025, 3.953); p-value = 0.042]. Conclusion The prevalence of antenatal depression in west Badewacho woreda was high and it is associated with marital status, unplanned current pregnancy, history of previous depression, family history of mental illness, recent violence from intimate partner, poor marital satisfaction level, and poor social support. Improving maternal and child health services and introducing screening for depression as part of routine antenatal assessment to curb antenatal depression should get due attention.

Depresión posparto en mujeres puérperas del Hospital General Materno Infantil San Pablo: La información cruda anonimizada se compartirá a solicitud por el autor corresponsal. . Los autores declaran que no hubo financiamiento para la realización de este trabajo. .La información cruda anonimizada se compartirá a solicitud por el autor corresponsal.

Objectives: To determine the prevalence of postpartum depression in women attended at the San Pablo Maternal and Child General Hospital between June and August 2018, describe the sociodemographic characteristics of patients and identify diseaserelated factors. Materials and methods: Observational, descriptive crosssectional prospective study performed on 140 women who had a newlyborn between June and August 2018 at the San Pablo Maternal and Child General Hospital, public hospital from Asuncion, Paraguay, dependency of the Public Health and Social Welfare Secretary. The diagnosis of postpartum depression was made by applying the Edinburgh postpartum depression scale. It measures age, ethnicity, previous illnesses, prenatal complications, pregnancy planning, toxicological habits, living with the newborns father or with a family member, relationship with newborns father, personal and family history of depression, support family, parity, origin, area, birth route, marital status, schooling, number of pregnancies, history of parental separation in childhood and newborns hospitalization. Descriptive statistics and univariate analysis were performed in order to determine diseaserelated factors. Results: Among the 140 women studied, 47 women had an Edinburgh scale score greater than or equal to 10, therefore, a prevalence of 34% of postpartum depression was found among respondents. Among women with positive score, 15% (7) reported suicidal ideation in the previous week. The univariate analysis showed that the personal history of previous depression (p <0.05; OR: 3.17), newborns hospitalization (p <0.05; OR: 2.34), domestic violence (p <0.05; 0R: 6.15), prior and postpartum stress due to various circumstances (p <0.05; OR: 3.01) and live outside the city (p <0.05; OR: 5.37) are significantly related to the development of postpartum depression. Conclusion: the prevalence of depressive traits was high in the study population, pregnant women with a history of prior depression have a high risk of developing the disease and will need additional evaluations and the establishment of preventive treatment. In adittion, there are diseaserelated factors identified in the development of postpartum depression such as newborns hospitalization, being a victim of domestic violence, prior and postpartum stress, and living outside the city.

Return to work following meningioma surgery: a Swedish nationwide registry-based matched cohort study.

BackgroundMeningioma is the most common primary intracranial tumor. It is usually slow growing and benign, and surgery is the main treatment modality. There are limited data on return to work following meningioma surgery. The objective of this study was to determine the patterns of sick-leave rate prior to surgery, and up to 2 years after, in patients compared to matched controls.MethodsData on patients ages 18 to 60 years with histologically verified intracranial meningioma between 2009 and 2015 were identified in the Swedish Brain Tumor Registry (SBTR) and linked to 3 national registries after 5 matched controls were assigned to each patient.ResultsWe analyzed 956 patients and 4765 controls. One year prior to surgery, 79% of meningioma patients and 86% of controls were working (P < .001). The proportion of patients at work 2 years after surgery was 57%, in contrast to 84% of controls (P < .001). Statistically significant negative predictors for return to work in patients 2 years after surgery were high (vs low) tumor grade, previous history of depression, amount of sick leave in the year preceding surgery, and surgically acquired neurological deficits.ConclusionThere is a considerable risk for long term sick leave 2 years after meningioma surgery. Neurological impairment following surgery was a modifiable risk factor increasing the risk for long-term sick leave. More effective treatment of depression may facilitate return to work in this patient group.

Magnitude and associated factors of postpartum depression among women in Nekemte town, East Wollega zone, west Ethiopia, 2019: A community-based study.

BackgroundPostpartum depression is a non-psychotic disorder that happens during the first 1year after childbirth. It affects both the mother’s health and child’s development and is given significant public health concern in developed countries. However, in developing countries including Ethiopia, postnatal care is mainly concerned with obstetric problems and the baby’s health, while the psychological well-being of the mother is given little attention. Therefore, this study was aimed to assess the magnitude and associated factors of postpartum depression among women in Nekemte town, East Wollega zone, West Ethiopia, 2019.MethodsCommunity-based cross-sectional study was conducted on 295 postnatal women, from May 15 to June 5, 2019, in Nekemte town. The study participants were selected by a simple random sampling method and interviewed using structured questionnaires. Multivariable logistic regression was used to find the independent variables which are associated with postnatal depression. All associations between dependent and independent variables and statistical significance were measured using odds ratio at 95% confidence interval and p-value less than 0.05.ResultsFrom the total of 295 women sampled, 287 were participated in the study. Out of these 287 women participated, 20.9% had developed postnatal depression. Unplanned pregnancy (AOR = 7.84, 95% CI: 3.19, 19.26), Being first time mother (AOR = 4.99, 95% CI: 1.54, 16.09), History of previous depression (AOR = 3.06, 95% CI: 1.06, 8.82), Domestic violence (AOR = 5.92, 95% CI: 2.44, 14.40), History of substance use (AOR = 3.95, 95% CI: 1.52, 10.30) and poor social support (AOR = 6.59, 95% CI: 2.25, 19.29) were significantly associated with postnatal depression.ConclusionIn this study, the magnitude of postnatal depression was found moderate compared to other studies. Perinatal depression screening and intervention need to be integrated with maternal health care services, especially for mothers at risk of postnatal depression.

Depression and Apathy After Transient Ischemic Attack or Minor Stroke: Prevalence, Evolution and Predictors

Few previous studies have focused on affective impairment after transient ischemic attack (TIA) and/or minor stroke. The aim was to establish the prevalence, evolution and predictors of post-stroke depression (PSD) and post-stroke apathy (PSA) over a 12-month follow-up period. We prospectively included TIA and minor stroke patients (NIHSS ≤4) who had undergone magnetic resonance imaging <7 days. PSD was diagnosed according to DSM-5 criteria and PSA was defined based on an Apathy Evaluation Scale (AES-C) score of ≥37. Clinical and neuroimaging variables (presence and patterns of lesion, cerebral bleeds and white matter disease) were analysed in order to find potential predictors for PSD and PSA. Follow-up was performed at 10 days and after 2, 6, 9 and 12 months. 82 patients were included (mean 66.4 [standard deviation11.0] years) of whom 70 completed the follow-up. At 10 days, 36 (43.9%) and 28 (34.1%) patients respectively were diagnosed with PSD and PSA. At 12 months, 25 of 70 (35.7%) patients still had PSA, but only 6 of 70 (8.6%) had PSD. Beck Depression Inventory-II score, mini mental state examination (MMSE) and a previous history of depression or anxiety were predictors for PSD. While MMSE score, The Montgomery Asberg Depression Rating Scale and having previously suffered a stroke were also risk factors for PSA. Acute basal ganglia lesion and periventricular leukoaraiosis were associated with PSA while deep leukorariosis with PSD. Despite the presence of few or only transient symptoms, PSD and PSA frequent appear early after TIA and minor stroke. Unlike PSD, apathy tends to persist during follow-up.

P877Comparing the MINOCA and MIOCA patients risk profile and prognosis according to definitions of 2016 ESC position paper

Abstract Introduction MINOCA (myocardial infarction with non-obstructive coronary arteries) has been recently redefined by the last ESC guidelines. The aim of this study is to analyze clinical profile and long-term prognosis of these patients. Methods Retrospectively, between 1/2010 and 12/2016 all consecutive patients with the definitive diagnosis of MI in tertiary center were included in this observational study. Patients with unstable angina with non-obstructive coronary artery disease and those who died in-hospital were excluded. Patients were stratified according to the number of significant coronary vessel disease seen by coronary angiography into: 0 (MINOCA); 1; 2; ≥3 vessels. The definition of MINOCA was based on dedicated the 2016 ESC Working Group position paper. Patients with MINOCA were compared to their counterpounds (MIOCA; MI with obstructive CAD) regarding baseline clinical characteristics, on-admission and laboratory data and treatment at hospital discharge. The prognostic meaning of MINOCA vs MIOCA was ascertained by comparing the composite endpoint (re-ACS, stroke and death) rate among groups, using Kaplan-Meier and multivariate Cox regression analyses. Results 13.8% (n=597) pts were classified as MINOCA. They were older and more frequently women than the obstructive group. MINOCA group also had a worse cardiovascular risk profile than pts with obstructive coronary lesions. They were associated more frequently with atrial fibrillation during hospitalization (11.2% vs. 6.8%, p&lt;0.01). Peak of troponin I was lower in the MINOCA group [median 12 (IQR: 1.4–42.0 vs 20 (2.3–95.5), p&lt;0.01]. MINOCA pts had more frequently a previous history of depression (34.1% vs 19.3%, p&lt;0.01), and malignancy (9.2% vs. 7.6%, p=0.18). During 15 months (IQR: 12,3–25,5), 613 (14.2) pts had a new ACS, stroke or died (251 pts developed a new ACS, 81 had stroke, and 281 died). The incidence of the composite endpoint was 4.2% in the MINOCA pts, 4.1% in pts with 1-significant coronary vessel disease, 6.3% in the 2-significant coronary vessel disease, and 9.5% in the ≥3-significant coronary vessel disease (p&lt;0.01) (Figure). After adjusting for age, ACS type, sex, Killip class, age, HTA, DM, stroke, peripheral artery disease, smoking, prior CAD, COPD, prior malignancy, baseline hemoglobin and creatinine values, DES vs BMS, history of atrial fibrillation, and treatment at discharge, and considering MINOCA as a reference group, HR for the composite endpoint was 1.02 (0.60–1.78; p=0.93) for the 1-vessel group, 1.3 (0.7–2.2; p=0.41) for the 2-vessels group, and 1.6 (0.93–2.8; p=0.08) for the ≥3-vessels group. Figure 1. Composite endpoint Conclusions In the present cohort MINOCA was approximately found in one of each 14 patients admitted with MI. These patients had worse CV risk profile and more history of depression. MINOCA pts have similar prognostic impact in terms of hospitalization for a new ACS, stroke and death than the obstructive group.