Depressant Research Articles

Emotional, mental disorders and depression in adolescents

Introduction: Adolescence is an essential period in an individual's development characterized by significant physical, emotional, and social changes. Mental, emotional, and depressive disorders are common mental health problems in adolescents and can have a severe impact on their quality of life. This study aims to examine the prevalence, risk factors, symptoms, and strategies for preventing and treating mental and emotional disorders and depression in adolescents. Methods: The design is descriptive and quantitative. Sampling was carried out using a total sampling technique on 68 nursing students. Results: Most of the respondents did not experience mental or emotional disorders, 75%, and did not experience depression, 48.5%, while those who experienced mild depression, 26.5%, moderate depression, 13.2%, and severe depression, 11.8%. Conclusions: It was found that academic pressure, family problems, bullying, and hormonal changes are some of the factors that contribute to the increased risk of mental disorders in adolescents. Symptoms that often appear include profound feelings of sadness, loss of interest or pleasure in daily activities, changes in sleep and eating patterns, and difficulty concentrating. Effective prevention and treatment strategies include mental health education, social support, psychological interventions, and if needed, medical treatment. Parents, educators, and health workers need to work together in early detection and provide appropriate support to reduce the negative impact of mental-emotional disorders and depression on adolescent development.

Depression anxiety stress and fear of COVID-19 among adolescent students and its relationship with possible predictors

Background: During the COVID-19 pandemic prolonged lockdowns, school closures requiring online education support, and uncertainty about examinations caused stress in students. Aim: To estimate the levels of depression, anxiety, stress, and fear of COVID-19 in adolescent students of Jamnagar and its relationship with possible predictors. Materials and Methods: This is a cross-sectional study using a proportionate probability sampling method during the third wave of COVID-19 of 4423 adolescent students of Jamnagar, Gujarat. The Fear of COVID-19 Scale (FCV-19S) and Depression, Anxiety, and Stress Scale-21 (DASS-21) measured the main construct. T-tests for two independent samples and multiple linear regression analysis were used to assess the relationship. Results: Among the adolescent students, 14.81% had moderate fear, while severe fear was found in 3.37%. Moderate or severe depression was observed in 1.31% and 0.16% of students, respectively; severe and extremely severe anxiety was present in 0.65% and 0.11% of students; and stress was found to be moderate in 0.23%. Depression was associated with education, anxiety with education, gender, and a history of COVID-19 in the family and stress with a history of COVID-19 infection in the family and fear of COVID-19 with gender, standard of class, geographical area, socioeconomic class, and father’s education. Conclusion: In our study, the students having a higher fear of COVID-19 were found to have higher depression, anxiety, and stress. The factors associated with a lower level of psychological impact can be used to formulate the interventions needed for the betterment of adolescent mental health.

The emergence of bromazolam in Jefferson County, AL: a case series.

Postmortem toxicology is an ever-changing landscape presenting challenges for toxicologists and medical examiners. Trends can vary for certain benzodiazepines. While diazepam use tends to remain constant, alprazolam and clonazepam ebb and flow depending on prescription trends and street popularity. Novel benzodiazepines like etizolam vary in casework depending on legal restrictions and black market availability. In May 2022, the first case of the designer benzodiazepine, bromazolam, was detected in Jefferson County Coroner/Medical Examiner's Office casework. Between then and December 2023, an additional nine cases have been observed. Bromazolam is the brominated analog of the low-dose benzodiazepine, alprazolam, and is likely similar in potency. As bromazolam is a potent benzodiazepine, low concentrations of this novel drug are likely to contribute to central nervous system depression in opioid overdose cases. We present 10 cases in which bromazolam was detected in postmortem samples at the University of Alabama at Birmingham toxicology laboratory. The decedents ranged in age from 20 to 41 years. Most of the decedents were White (n = 8; 80%) and male (n = 7; 70%). Bromazolam concentrations ranged from 21 to 3220 ng/mL (mean 401 ng/mL). All but one case were polydrug, and all deaths were related to drug toxicity. Fentanyl was detected in 8 of the 10 decedents, with concentrations ranging from <2.5 to 97 ng/mL (mean 30 ng/mL). Additional drugs detected were methamphetamine, ethanol, oxycodone, methadone, cocaine, amphetamine, morphine, and diphenhydramine. While all manners of death were ruled as accidental, bromazolam was included in the cause of death statements in 9 of the 10 cases. Capturing important emerging drug trends in the death certificate is critical to help inform public health and medical colleagues for preventive measures and treatment in the continued drug epidemic.

A Systematic Review on Sedative and Hypnotics

Abstract: Sedative and hypnotic drugs are central nervous system depressants primarily used to induce calmness, reduce anxiety, and promote sleep. These medications include benzodiazepines, barbiturates, and various non-benzodiazepine sleep aids, each varying in their mechanism of action, efficacy, and safety profiles. Benzodiazepines, such as diazepam and alprazolam, enhance the effect of the neurotransmitter gamma-aminobutyric acid (GABA) at the GABA-A receptor, resulting in sedative, anxiolytic, muscle relaxant, and anticonvulsant effects. They are commonly prescribed for anxiety disorders, insomnia, seizures, and muscle spasms. However, their use is associated with risks of tolerance, dependence, and withdrawal symptoms. Barbiturates, such as phenobarbital, were once widely used for their sedative and hypnotic properties but have largely been replaced by benzodiazepines and other safer alternatives due to their higher risk of overdose and dependence. Barbiturates enhance GABAergic transmission but also directly activate GABA receptors, leading to more profound central nervous system depression. Non-benzodiazepine sleep aids, including drugs like zolpidem, eszopiclone, and zaleplon, act on the benzodiazepine receptor site but have a different chemical structure. These drugs are often preferred for short-term treatment of insomnia due to their relatively lower risk of dependence and adverse effects compared to benzodiazepines.

PERCEIVED STIGMA, BEHAVIOURAL PROBLEM AND DEPRESSION AMONG INDIVIDUALS WITH SUBSTANCE ABUSE ATTENDING SELECTED DE-ADDICTION CENTRES, KOLKATA, WEST BENGAL

Substance abuse is a considerable public health problem throughout the world with vast implication on public health. Its real impact is on the social and family dynamics that underlie its communities.Aim: This study aims to assess Perceived stigma, behavioural problem and depression among individuals with substance abuse attending selected de-addiction centers, Kolkata, West Bengal.Methods: A Descriptive survey design was adopted and 200 individuals with substance abuse were selected using simple random sampling technique. Data were collected using semi structured demographic Proforma, standardized perceived stigma of substance abuse scale (PSAS), standardized behavioural problem scale (BPS) and Beck’s depression Inventry.Result: The findings revealed that majority 81% individual with substance abuse had moderate perceived stigma whereas 18% had high perceived stigma and 1 % had low perceived stigma and (85% ) individuals with substance abuse were mild behavioural problem and (15%) in individuals with substance abuse were moderate behavioural problem and (41.5% ) individuals had moderate depression , ( 28% ) had borderline clinical depression , (27.5%) had mild mood disturbance ,(3%) had these ups and downs were considered normal. Result showed that there was significant association between level of depression with Regularity of treatment, life style practices with monthly family income and educational status of participants.Conclusion: The current study concludes that perceived stigma, behavioural problems and depression among individuals with substance abuse is effective to motivational prevention in the field of psychiatry nursing.

Transforming Veteran Rehabilitation Care: Learnings from a Remote Digital Approach for Musculoskeletal Pain.

While musculoskeletal pain (MSP) stands as the most prevalent health condition among Veterans, timely and high-quality care is often hindered due to access barriers. Team Red, White & Blue (Team RWB), a nonprofit organization dedicated to promoting a healthier lifestyle among Veterans, aimed to assess innovative approaches to veteran care. This is a single-arm pilot study investigating the feasibility, clinical outcomes, engagement, and satisfaction of a remote multimodal digital care program among Veterans with MSP. The impact of deployment experience on outcomes was explored as a secondary aim. From 75 eligible Veterans, 61 started the program, reporting baseline pain frequently comorbid with mental distress. Program acceptance was suggested by the high completion rate (82%) and engagement levels, alongside high satisfaction (9.5/10, SD 1.0). Significant improvements were reported in all clinical outcomes: pain (1.98 points, 95%CI 0.13; 3.84, p = 0.036); mental distress, with those reporting at least moderate baseline depression ending the program with mild symptoms (8.50 points, 95%CI: 6.49; 10.51, p = 0.012); daily activity impairment (13.33 points, 95%CI 1.31; 25.34, p = 0.030). Deployed Veterans recovered similarly to their counterparts. Overall, the above results underscore the potential of a remote digital intervention to expand Veterans' access to timely MSP care.

Mental Disorders, Social Media Addiction, and Academic Performance in Romanian Undergraduate Nursing Students.

Introduction: We aimed to evaluate social media addiction in Romanian undergraduate nursing students and its association with academic performance, depression, and anxiety. Methods: We used a cross-sectional online survey to collect data among nursing undergraduate students enrolled at the University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania. The Social Media Addiction Scale-Student Form (SMAS-SF), Beck Depression Inventory (BDI), and State-Trait Anxiety Inventory (STAI) were used to assess social media addiction, depression, and anxiety, respectively. Results: A total of 90 nursing students participated in the study, of which 82 (91.1%) were females and 81 (90%) were of Romanian ethnicity. The median age of participants was 21 years (18-40). Males showed higher BDI total scores, SMAS-SF total scores, and STAI scale A state anxiety compared to females, and females showed higher STAI scale A trait anxiety compared to males, although these results were not statistically significant. Also, we found no significant difference in these variables between participants from different study years. Participants with no or mild depression had a significantly higher academic performance (p-value = 0.001), lower SMAS-SF (p-value = 0.004), and lower STAI scores (p-value < 0.001) compared to participants with borderline, moderate, or severe depression after performing multivariate regression analysis. Conclusions: Our study demonstrated that depression was significantly associated with social media addiction, anxiety, and lower academic performance in Romanian undergraduate nursing students.

A multi-school study in England, to assess problematic smartphone usage and anxiety and depression.

To assess the association between problematic smartphone usage and anxiety and depression in adolescents. A cross-sectional study in five schools in the UK were included. The primary outcome was moderate anxiety (GAD-7 ≥10) symptoms and secondary outcomes were moderate depression symptoms (PHQ-9 ≥10) and insomnia. Problematic smartphone usage was assessed using screentime and the Smartphone Addiction Scale. A multi-level logistic regression was fitted and adjusted Odds Ratio (aOR) with 95% confidence intervals (95% CI) reported. A mediation analysis was conducted. Of the five included schools, 657 adolescents aged 16-18 years were enrolled. The median age was 17.5 years (17-18 [IQR]) and 508 (77.3%) were female. Of these 188 (28.6%) exhibited moderate anxiety and 226 (34.4%) moderate depression symptoms. Almost two thirds (421, 64.1%) have tried to cut down their smartphone use and 81 (12.5%) wanted help to reduce use. Problematic smartphone use was associated with increased anxiety (aOR = 2.03, 95% CI 1.28-3.23); depression (aOR = 2.96, 95% CI 1.80-4.86); and insomnia (aOR = 1.64, 95% CI 1.08-2.50). Screentime was not associated with anxiety (β = 0.99, 95% CI 0.91-1.08); or depression (β = 0.98, 95% CI 0.89-1.07). Problematic smartphone use had a significant direct, indirect and total effect on both anxiety and depression. Problematic smartphone usage was associated with anxiety and depression, independent of screentime. Interventions are needed to reduce problematic use.

Prevalence of drugs used for chronic conditions after diagnosis of thyroid cancer: a register-based cohort study.

Little is known about thyroid cancer survivors' risk of chronic conditions. We, therefore, investigated the prevalence of drugs used for chronic conditions among thyroid cancer patients using population-wide register data. We linked data from the Cancer Registry of Norway to the Norwegian Prescription Database and other databases for a study population of 3.52 million individuals, including 3486 individuals with thyroid cancer diagnosed during 2005-2019. Prevalence ratios (PRs) with 95% CIs of reimbursed prescribed drugs in thyroid cancer patients up to 15 years after thyroid cancer diagnosis were estimated by log-binomial regression, with the cancer-free population as reference. Individuals (both males and females) with thyroid cancer had higher use of drugs for several chronic conditions in the years after diagnosis; eg, 5 years after thyroid cancer diagnosis, there was elevated use of drugs for hypoparathyroidism (PRmales = 35.4, 95% CI, 25.2-49.7; PRfemales = 42.8, 95% CI, 34.2-53.6), hypertension (PRfemales = 1.20, 95% CI, 1.12-1.28), anxiety and tension (PRmales = 4.01, 95% CI, 1.80-8.92; PRfemales = 2.01, 95% CI, 1.15-3.52), gastric acid disorders (PRmales = 1.52, 95% CI, 1.22-1.91; PRfemales = 1.45, 95% CI, 1.27-1.66), and pain (PRmales = 1.48, 95% CI, 1.11-1.97; PRfemales = 1.24, 95% CI, 1.08-1.42) as compared with the cancer-free population. In addition, males with thyroid cancer had long-term elevated use of drugs for depression (eg, year 10+, PRmales = 1.66, 95% CI, 1.06-2.59). Individuals with thyroid cancer also had higher use of drugs for several conditions prior to the thyroid cancer diagnosis, eg, hypertension, gastric acid disorders, and pain. Individuals diagnosed with thyroid cancer had elevated long-term use of drugs for several chronic conditions, as compared with the cancer-free population.

The relationship between the frequency of use of non-medication coping strategies with urinary incontinence and depression in older adults.

The aim of this study is to examine the relationship between the frequency of use of non-medication coping strategies with urinary incontinence (UI) and depression in older adults. This study followed a descriptive design and was conducted with 345 older adults over the age of 65. The data of the study were collected using the Geriatric Depression Scale Short Form and the Frequency of Non-Medication Coping Strategies with Urinary Incontinence Scale. The data analysis of the study was conducted using descriptive statistics, Pearson correlation analysis, and hierarchical multiple regression analysis. The significance level was accepted as P < 0.05. The mean age of the participants was 71.86 ± 5.43 years. Among the older adults, 58.8% were male and 50.2% were primary school graduates. It was determined that 43.8% of the participants experienced the frequency of UI more than once a week, 36.2% experienced stress incontinence, 51.9% consulted a physician due to UI, 53.6% received treatment for UI, and 47.8% reported that UI had an impact on their social life. The relationship between the frequency of use of non-medication coping strategies with UI and geriatric depression (β = -0.017; P = 0.043) was found to be significant and negative. It was found that there was a significant and positive relationship between age, frequency of UI, type of UI, the impact of UI on social life, and geriatric depression (P < 0.05). The older adults in this study were found to have moderate depression. It was determined that the level of depression was higher in the older adults who experienced UI more than once a week, those who experienced stress UI, those whose social lives were impacted, and those who had a higher frequency of non-medication coping strategies.

Antihyperalgesic effect of γ-terpinene complexed in β-cyclodextrin on neuropathic pain model induced by tumor cells

Neuropathic pain is a high-intensity pain that can be caused by compression, transection, injury, nerve infiltration and drug treatment of cancer. Furthermore, drug therapy has low clinical efficacy, many adverse effects and remission of painful symptoms. In this way, natural products derived from plants constitute a promising therapeutic alternative. Therefore, the aim of this study was to evaluate the antihyperalgesic effect of γ-terpinene (γ-TPN) e γ-terpinene in β-cyclodextrin inclusion complexes (TPN/CD) on neuropathic pain induced by tumor cells. Complexation extended the effect time for another 5 h and daily treatment for six days with γ-TPN (50 mg/kg, p.o.) and γ-TPN/β-CD (50 mg/kg, p.o.) significantly reduced (p < 0.001) the mechanical hyperalgesia induced by the administration of 2x106 sarcoma cells 180 in the around the sciatic nerve. In addition, the Grip and Rota-rod techniques demonstrated that there was no interference on the muscle strength and motor coordination of the animals, suggesting that the compound under study does not have central nervous system depressant effects at the doses used. Molecular docking studies demonstrate favorable binding energies between γ-TPN and β-CD, and alpha-2 adrenergic, glutamatergic, opioid and cholinergic receptors. Thus, this study demonstrates the potential of terpinene complexation in controlling neuropathic pain induced by tumor cells.

Uncommon Millettia pachycarpa Benth poisoning: A case report.

Millettia pachycarpa Benth, rich in rotenone, can disrupt the mitochondrial electron transport chain. Ingestion may cause respiratory and central nervous system depression, and in severe cases, lead to death. This is the first detailed clinical case report of M. pachycarpa Benth poisoning, aiming to help systematization of diagnosis and treatment. An elderly male who lost consciousness for 3 hours after consuming the fruit of M. pachycarpa Benth. Arterial blood gas analysis indicated a significant decrease in pH, a sharp increase in lactate levels, and elevated CO2 partial pressure with normal O2 partial pressure. The patient was diagnosed with food intoxication by M. pachycarpa Benth, concomitant with aspiration pneumonia and distributive shock. The patient was given continuous renal replacement therapy (CRRT) and invasive mechanical ventilation. The patient was successfully discharged after 5 days of hospitalization. Follow-up after 2 weeks showed no significant discomfort. Isolated CO2 retention without hypoxemia, significantly reduced pH, and markedly elevated lactate levels strongly suggest poisoning by M. pachycarpa Benth. CRRT and invasive mechanical ventilation are beneficial for patients. Early implementation of CRRT to remove toxins and early initiation of assisted ventilation to improve respiratory failure are recommended upon suspicion of the disease.

DETEKSI DINI KELUHAN YANG LAZIM MUNCUL PADA LANSIA DI UPT PESANGGRAHAN PMKS MOJOPAHIT KABUPATEN MOJOKERTO

The decision to live at Pesanggrahan PMKS Mojopahit can come from the family or the wishes of the elderly themselves. Many elderly people experience physical and psychological complaints, some of which cannot be conveyed. Sometimes this complaint will cause depression. At this time, early detection of these complaints is needed. The method used for physical health examination is blood pressure measurement, a simple laboratory form random blood sugar levels and uric acid levels, mental health using a questionnairegeriatric depression scale. The target is all 48 elderly people at Pesanggrahan PMKS Mojopahit. The results show that the blood pressure of the elderly has a tendency to increase starting from grade 1 to grade 2 hypertension and isolated systolic hypertension as much as 29%. Uric acid levels show that the majority have uric acid levels within normal limits (56%), but 36% have uric acid levels that are high. high, blood glucose levels tend to lead to pre-diabetes mellitus as much as 21% and as many as 12% of elderly people have diabetes mellitus status. The results of mental health detection using GDS show that the majority of elderly people experience moderate depression. It is hoped that the management of the PMKS Mojopahit guesthouse will pay attention to these findings with the following steps; regular check-ups to maintain the health of the elderly, physical activity, leisurely walking and cardio exercise for the elderly, treatment of depression problems through group activity therapy and psychoreligious therapy.

Study on the mechanisms of acupuncture combined with paroxetine in the treatment of mild to moderate depression based on DNA methylation analysis.

To explore the therapeutic effect of acupuncture combined with paroxetine for mild to moderate depression and the regulatory role of brain derived neurotrophic factor (BDNF) in patients based on DNA methylation. A total of 66 patients with mild to moderate depression who met the inclusion and exclusion criteria were randomly divided into an observation (acupuncture+medication) group and a control (medication) group, with 33 patients in each group, and other 25 healthy volunteers were taken as the healthy group. The patients of the control group were treated by oral administration of paroxetine 20 mg/d for 4 weeks. The patients of the observation group were treated by acupuncture stimulation of Zhongwan (CV12), Qihai (CV6), Zusanli (ST36), Sanyinjiao (SP6), Shangxing (GV23), Shuigou (GV26), Shaoshang (LU11), Yinbai (SP1) and Daling (PC7) (for 20 min, 3 times a week for 4 weeks) on the basis of medication treatment (the same as that of the control group). Before treatment, 2 and 4 weeks of treatment, and 2 weeks of follow-up, the therapeutic effect was assessed using Hamilton Depression Scale 17 (HAMD-17). The SPSS25.0 software was used to form a randomized grouping and to randomly select 25 patients from the observation group and 25 patients from the control group for blood collecting and data analysis. The blood samples were taken for assaying serum BDNF content and the methylation degree of BDNF gene promotor I with ELISA and MassARRAY techniques, respectively. 1) In comparison with those before treatment, the total score of HAMD-17, sleep disorder factor score, and anxiety somatization factor score of both the observation and control groups were significantly decreased after 2 and 4 weeks of treatment, and 2 weeks of follow-up (P<0.05), except sleep disorder factor score in the control group after 2 weeks of the treatment. Compared with the same time-points of the control group, the HAMD-17 total score and sleep disorder factor score of the observation group were decreased after 2 and 4 weeks of treatment, and 2 weeks of follow-up (P<0.05), while the anxiety somatization factor score was evidently decreased after 2 weeks of treatment (P<0.05). 2) Following 2 weeks of treatment, the total effective rate and markedly effective rate of the observation group were 80%(24/30)and 36.67% (11/30), respectively, being significantly higher than those ［(26.67% and 0 %)］ of the control group. After 4 weeks of treatment, the markedly effective rate of the observation group was 70.00% (21/30), being significantly higher than that 40% (12/30) of the control group (P<0.05), while the total effective rates of the observation and control groups were the same (100%). 3) Before the treatment, comparison among the healthy, observation and control groups showed no statistical significance in the methylation degree of each site (CpG1.2, CpG5.6, CpG8.9, CpG26, CpG27, CpG31, and CpG33.34) of BDNF gene promotor I, while after 4 weeks of the treatment, the methylation degree of CpG31 was considerably lower in the observation group than in the control group (P<0.05). 4) Before the treatment, the contents of serum BDNF of both observation and control group had no significant difference, but were evidently lower than that of the healthy group (P<0.05). Compared with that before treatment, the serum BDNF contents in both observation and control groups were significantly increased after the treatment (P<0.05), and was significantly higher in the observation group than in the control group (P<0.05). 5) The correlation analysis showed a negative correlation between the BDNF protein content and HAMD-17 score (correlation coefficient ρ=-0.686, P<0.01). Acupuncture may have an antidepressant role by decreasing CpG31 methylation of BDNF and increasing the serum content of BDNF protein in patients with depression. In addition, acupuncture combined with paroxetine has more advantages in treating mild to moderate depression than oral paroxetine alone, and can improve sleep disorders and anxiety somatization symptoms more quickly.

Hardiness Shields Against Depression in Iraqi Dialysis Patients

Background: Renal dialysis patients face numerous challenges throughout treatment and experience significant psychological pressures, including depression. The positive impact of psychological hardiness on mental health is notable and can lead to improved outcomes for individuals with depression. Specific Background: Depression is prevalent among renal failure patients, often going unrecognized and adversely affecting daily routines, social interactions, and overall well-being, potentially leading to higher mortality rates. Knowledge Gap: While the relationship between psychological hardiness and depression in renal failure patients has been suggested, comprehensive data quantifying this relationship is lacking. Aims: This study aims to determine the prevalence of depression symptoms and their correlation with psychological hardiness in renal failure patients undergoing hemodialysis. Results: Conducted as a descriptive correlational study from December 2023 to May 2024, 200 patients from Baghdad hospitals participated. The average age was 48.21 years, with 53% being male. Depression symptoms were reported at minimal (29.5%) and moderate (25.5%) levels, with an overall mean depression score indicating a moderate level (20.335±10.783). Psychological hardiness was moderate in 52.5% of patients. A significant negative correlation was found between psychological hardiness and depression symptoms (p-value = 0.001). Novelty: This study highlights the moderate levels of both psychological hardiness and depression symptoms among renal failure patients and establishes a significant inverse relationship between the two variables, suggesting that higher psychological hardiness is associated with lower depression symptoms. Implications: The findings suggest the need for community institutions to provide comprehensive support, boost self-confidence, and enhance life satisfaction for renal failure patients. Hiighligt: Moderate depression and psychological hardiness levels in renal failure patients. Significant negative correlation between psychological hardiness and depression symptoms. Support and counseling programs recommended to enhance mental health and resilience Keyword: Renal dialysis, depression, psychological hardiness, hemodialysis, mental health

Correlates of disability among primary care patients with common mental disorders and chronic medical conditions- a cross-sectional study from rural South India.

We examined the correlates of disability among people with non-communicable diseases (NCDs) and comorbid common mental disorders (CMDs) from rural India. The sample comprised 2,486 participants enrolled in a cluster randomized trial (cRCT), Healthier OPtions through Empowerment (HOPE). Participants were 30 years or older, with a diagnosis of major depressive disorder, dysthymia, generalized anxiety disorder, and/or panic disorder on the MINI-International Neuropsychiatric Interview, with hypertension, diabetes, dsylipidemia and/ or ischemic heart disease. Disability was measured with the 12-item version of WHODAS 2.0. The severity of depression and anxiety was measured using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7), respectively. Multiple linear regression analyses were used to examine associations. The mean age was 59 ± 10.0 years, three quarters (1864) of the participants were female, and 64.0% were married. More than half of the participants had no formal education (57.9%). Most of the participants had two or more chronic medical conditions (73.0%). The mean disability score was 24.3. The mean depression score was 8.5, and the mean anxiety score was 6.7. Higher levels of disability were reported by participants ≥ 60 years of age, those with moderate and severe depression, and moderate anxiety. Among female participants, being unmarried was associated with greater disability. Male participants without formal education reported greater levels of disability. Higher severity of CMDs is significantly associated with higher levels of disability. For women, being unmarried and for men having no formal education was associated with higher levels of disability. ClinicalTrials.gov NCT02310932 [URL: https://clinicaltrials.gov/ct2/show/record/NCT02310932 ] registered on December 8, 2014, and Clinical Trials Registry India CTRI/2018/04/013001, registered on April 4, 2018. Retrospectively registered.

The impact of the new model of day care on the mental health status and cognitive functions of patients with disabilities treated in day medical care homes in Poland, 2017-2023.

Day Medical Care Home is a care and treatment institution providing day care services for people with disabilities (mainly older adults), implemented in Poland since 2015. This study aimed to analyze the impact of the new model of day care on the mental health status and cognitive functions of older adults with disabilities treated in Day Medical Care Homes in Poland, 2017-2023. Admission and discharge reports of 949 patients treated in Day Medical Care Homes between 2017 and 2023 were analyzed. Geriatric Depression Scale (GDS-15) and Hamilton Rating Scale for Depression (HAM-D) were used to assess mental health. Cognitive functions were assessed using Mini-Mental State Examination (MMSE). The mean age was 74.3 ± 8.5 years, 76.6% were women. and 62.6% lived in rural areas. The percentage of patients with moderate or severe depression measured with a GDS-15 score decreased from 58.3% on admission to 34.6% on discharge (p<0.001). The percentage of patients with depressive disorders measured with HAM-D score decreased from 48.3% on admission to 37.2% on discharge (p<0.001). The percentage of patients with dementia or cognitive disorders measured with the MMSE score decreased from 54.3% on admission to 40.5% on discharge (p<0.001). Improvement in mental health status and cognitive functions was observed in all sociodemographic groups. Day Medical Care Home is an effective model of day care that improves the mental health status and cognitive functions of older adults with disabilities.

Polypharmacy in spinal cord injury: Matched cohort analysis comparing drug classes, medical complications, and healthcare utilization metrics with 24-month follow-up

Objective: Polypharmacy in spinal cord injury (SCI) is common and predisposes patients to increased risk of adverse events. Evaluation of long-term health consequences and economic burden of polypharmacy in patients with SCI is explored. Design: Retrospective cohort. Methods: The IBM Marketscan Research Databases claims-based dataset was queried to search for adult patients with SCI with a 2-year follow-up. Participants: Two matched cohorts were analyzed: those with and without polypharmacy, analyzing index hospitalization, readmissions, payments, and health outcomes. Results: A total of 11 569 individuals with SCI were included, of which 7235 (63%) were in the polypharmacy group who took a median of 11 separate drugs over two years. Opioid analgesics were the most common medication, present in 57% of patients with SCI meeting the criteria of polypharmacy, followed by antidepressant medications (46%) and muscle relaxants (40%). Risk of pneumonia was increased for the polypharmacy group (58%) compared to the non-polypharmacy group (45%), as were urinary tract infection (79% versus 63%), wound infection (30% versus 21%), depression (76% versus 57%), and adverse drug events (24% versus 15%) at 2 years. Combined median healthcare payments were higher in polypharmacy at 2 years ($44 333 vs. $10 937, P < .0001). Conclusion: Majority of individuals with SCI met the criteria for polypharmacy with nearly 60% of those prescribed opioids and taking drugs from high-risk side effect profiles. Polypharmacy in SCI was associated with a greater risk of pneumonia, depression, urinary tract infections, adverse drug events, and emergency room visits over two years with four times higher overall healthcare payments at 1-year post-injury.

Antidepressant advantage of Chaihushugan san in female mice: A novel signaling mechanism in hippocampus

Ethnopharmacological relevancyChaihushugan san (CSS), a classic formula for soothing the liver and relieving depression, has been identified to produce rapid antidepressant-like effects in female mice. However, the gender predominance and underlying mechanisms of CSS's antidepressant remain unclear. Aim of the studyIn this study, we focused on unraveling the gender predominance of CSS in antidepressant and the specific neuronal mechanisms that mediate this predominance. Methods and materialsTail suspension test (TST), forced swimming test (FST) and sucrose preference test (SPT) were used to evaluate depressive phenotypes or antidepressant-like effects of CSS in female and male chronic unpredictable mild stress (CUMS) mice model. RNA-sequencing was used to screen specific target for CSS antidepressant gender dominance. RT-PCR and elisa were used to detect the expressions of specific molecule, hormones, and inflammatory factors in the hippocampus. hippocampal viral overactivation and pharmacological blockade were used to detect the correlation between CSS antidepressant gender dominance and related targets. ResultsIn the present study, both female and male mice displayed depressive phenotypes including significant increasing immobility time in TST and reducing sucrose preference ratio in SPT after exposing CUMS for 3 weeks. However, acute administration of CSS (2, 4 g/kg) improved the depressive phenotypes only in female mice or not male mice at 2 h later. Moreover, the expressions of TC2N were increased only in female mice after exposing CUMS for 3 weeks, which were also reversed by CSS after a single administration 2 h later, but no alterations in male mice. The hippocampal expressions of estrogen receptor β (Erβ), pro-inflammatory factors (IL-1β and TNF-α) and anti-inflammatory factors (IL-10, TGF-β and IL-1Rα) were all abnormal in female CUMS mice model, which were all normalized by CSS. Furthermore, overactivation of hippocampal TC2N by AAV-TC2N+/+ blocked the antidepressant-like effects of CSS and the up-regulation of hippocampal Erβ in female mice. However, inhibition of Erβ blunted the antidepressant-like effects of CSS and CSS's suppression of pro-inflammatory factors (IL-1β and TNF-α), which had no any effect on hippocampal TC2N and anti-inflammatory factors (IL-10 and TGF-β). ConclusionsThe study revealed that CSS had antidepressant superiority in female mice depending on inhibiting hippocampal TC2N and then activating Erβ, further inhibiting the release of pro-inflammatory factors to produce antidepressant effects, which provided a basis for the guidance of CSS in clinical application, new ideas and targets for the development of drugs for depression with gender differences.

Interaction between antidepressant drug trazodone with double-stranded DNA: Multi-spectroscopic and computational analysis

Trazodone (TZD) is an antidepressant drug used to treat major depressive and sleeping disorders. Elevated doses of trazodone are associated with central nervous system depression, which manifests as nausea, drowsiness, confusion, vertigo, exhaustion, etc. To develop a clinically viable active pharmaceutical compound with minimal adverse effects, it is imperative to possess a comprehensive knowledge of the drug's action mechanism on DNA. Hence, we investigate the mode of interaction between trazodone and DNA utilizing various spectroscopic and computational techniques. Studies using UV–vis titration showed that the DNA and trazodone have an effective interaction. The magnitude of the Stern-Volmer constant (KSV) has been calculated to be 5.84 × 106 M−1 by the Lehrer equation from a steady-state fluorescence study. UV–vis absorption, DNA melting, dye displacement, and circular dichroism studies suggested that trazodone binds with DNA in minor grooves. Molecular docking and molecular dynamic simulation demonstrated that the TZD-DNA system was stable, and the mode of binding was minor groove. Furthermore, ionic strength investigation demonstrates that DNA and trazodone do not have a substantial electrostatic binding interaction.