Number Of Depressed Patients Research Articles

Community-based group rehabilitation program for stroke patients with dysphagia on quality of life, depression symptoms, and swallowing function: a randomized controlled trial

BackgroundCommunity-based exercise programs have demonstrated potential for implementation in older adults; however, it remains imperative to ascertain whether this strategy will yield comparable benefit in stroke patients with dysphagia.MethodsThis was a single blinded, randomized, matched pairs clinical trial. Sixty-four stroke patients with dysphagia were recruited from patients who had been discharged the Rehabilitation Department of the Third Affiliated Hospital of Sun Yat-sen University. A single blinded, randomized and controlled trial was conducted. Participants were randomly assigned to either the intervention group (n = 32) or the control group (n = 32). Patients in the intervention group received health education followed by swallowing function training in community public spaces for 5 days every week over an eight-week period (60 minutes per day). Patients in the control group received swallowing rehabilitation training, and booster educational information about dysphagia, as well as instructions on how to improve quality of life. Swallowing function (Functional Oral Intake Scale (FOIS) and Standardized Swallowing Assessment (SSA)), depressive symptoms (Geriatric Depression Scale-15), and quality of life (Swallowing-Quality of Life, SWAL-QOL) were assessed before and after all the treatment.ResultsBefore treatment, the two groups did not differ statistically. After the intervention, the swallowing function (SSA and FOIS) showed a significant improvement in both groups (All p < 0.001). But there was no significant difference in Functional Oral Intake Scale change between groups (P = 0.479). Compared with the control group, the intervention group had a significant improvement in depressive symptoms (P = 0.002), with a greater reduction in the number of depressed patients (13 to 6).The control group showed no significant improvements in depressive symptoms or a reduction in the number of depressed patients before and after treatment (P = 0.265, 14 to 12). The Swallowing-Quality of Life scores showed significant improvement in both the intervention and control group (P < 0.001). Specifically within Swallowing-Quality of Life sub-domains, greater changes were observed in symptoms and frequency (P < 0.001), communication (P = 0.012), and sleep (P = 0.006) for participants in the intervention group. And the cost-effectiveness of group rehabilitation surpasses that of rehabilitation training.ConclusionCommunity-based group rehabilitation program is more effective than traditional treatment in improving patients’ depressive symptoms and quality of life, as well as being more cost-effective.

Classification of high-risk depressed mood groups in cancer patients based on Health Ecology Model

BackgroundDepressed mood affects a significant number of patients with cancer, and can impair their quality of life and interfere with successful treatment. Our study aims to create a predictive model for identifying high-risk groups of depressed mood in cancer patients, offering a theoretical support for preventing depressed mood in these individuals. MethodsThe China Health and Retirement Longitudinal Study (CHARLS) provided the data for this research, which used CES-D as a tool to identify individuals with depressed mood. Influencing factors of depressed mood in cancer patients was analyzed using a binary logistic regression model. Using the Harvard Cancer Index, we classified the high-risk patients for depressed mood. ResultsIn present study, 52.96 % of cancer patients met criteria for depressed mood based on the CES-D. Significant correlations were found between depressed mood and factors such as gender, self-rated health, sleep duration, exercise, satisfaction with family, residence, education, life satisfaction, and medical insurance. Utilizing the Harvard Cancer Index, we classified patients into five risk levels for depressed mood, revealing a significant variation in the number of depressive patients across these levels (x2=99.82, P < 0.05). Notably, the incidence of depressed mood increased with the risk level among cancer patients (x2=103.40, P < 0.05). LimitationsLack of data on tumor typing and subgroups makes it unlikely to explore the specifics of depressed mood in patients with various types of cancer. ConclusionThe determinants of depressed mood in cancer patients are multi-dimensional. The Harvard Cancer Index may be helpful in identifying high-risk populations.

Depression among Male and Female Adolescents: A Review

Introduction: Over the years, there has been a steady increase in the number of depressive patients in India. It has been understood that there are a lot of psychological and social factors that contribute to the development of depression among male and female adolescents in the Indian environment. In the current time due to the competitive lifestyle and changes in social and psychological factors, everyone wants to do the best in their life cycle. Depression typically presents at intervals the sort of medically unexplained physical symptoms. Rates of depression are high in women attending medicine clinics and qualitative studies demonstrate a robust relationship between discharge, weakness, neurotic symptoms, and psychosocial stress. One in each of these symptoms ought to be a core symptom: either depressed mood or loss of interest or pleasure. Objective: To study depression among male and female adolescents. Method: A systematic review with a focus on predictive research was carried out between 1983 to 2021 using Pubmed, Psychinfo, and Google Scholar. Conclusion: This review paper concludes that prevention and intervention programs must be developed and should be aimed at adolescents who are exposed to the numerous dangers revealed in the present paper.

Predicting non-response to multimodal day clinic treatment in severely impaired depressed patients: a machine learning approach

A considerable number of depressed patients do not respond to treatment. Accurate prediction of non-response to routine clinical care may help in treatment planning and improve results. A longitudinal sample of N = 239 depressed patients was assessed at admission to multi-modal day clinic treatment, after six weeks, and at discharge. First, patient’s treatment response was modelled by identifying longitudinal trajectories using the Hamilton Depression Rating Scale (HDRS-17). Then, individual items of the HDRS-17 at admission as well as individual patient characteristics were entered as predictors of response/non-response trajectories into the binary classification model (eXtremeGradient Boosting; XGBoost). The model was evaluated on a hold-out set and explained in human-interpretable form by SHapley Additive explanation (SHAP) values. The prediction model yielded a multi-class AUC = 0.80 in the hold-out set. The predictive power for the binary classification yielded an AUC = 0.83 (sensitivity = .80, specificity = .77). Most relevant predictors for non-response were insomnia symptoms, younger age, anxiety symptoms, depressed mood, being unemployed, suicidal ideation and somatic symptoms of depressive disorder. Non-responders to routine treatment for depression can be identified and screened for potential next-generation treatments. Such predictors may help personalize treatment and improve treatment response.

Depression and Dementia in Older Adults: A Neuropsychological Review.

Depression and dementia are the most common neuropsychiatric disorders in the older adult population. There are a certain number of depressed patients who visit outpatient clinics because they suspect dementia due to similarities in the clinical symptoms in both disorders. Depressive symptoms associated with dementia may be diagnosed with depression, and treatment with antidepressants is continued for a long time. Depression and dementia differ in their treatment approaches and subsequent courses, and it is necessary to carefully differentiate between the two in the clinical practice of dementia treatment. In this review, I describe the similarities between depression and dementia and how to differentiate depression in dementia treatment based on the differences and emphasize that there is a significant potential to cure depression, in contrast to dementia, for which there is currently no fundamental therapy. Therefore, it is important to recognize that depression and dementia may present with common symptoms and to appropriately differentiate depressed patients who are suspected of having dementia. Dementia is a disorder in which cognitive dysfunction is caused by a variety of causative diseases and conditions, resulting in impairment of activities of daily living. However, current medical science has had difficulty finding a cure for the causative disease. Based on clinical findings, it has also been shown that the degree of symptoms for preexisting psychiatric disorders is alleviated as the brain ages. In the presence of dementia, the speed of the alleviation will increase. The importance of focusing on the positive aspects of aging is also discussed.

Biomarkers of Oxidative Stress in Major Depressive Disorder

BACKGROUND: Many data support that oxidative stress and inflammation represent a pathway to pathology in a number of depressed patients. Therefore, investigating this pathway presents an area for developing potential therapeutic strategies for depression.&#x0D; AIM: This study compares the serum level of malondialdehyde (MDA), superoxide dismutase (SOD), and nuclear factor erythroid 2-related factor 2 (Nrf2) in depressed and non-depressed subjects and correlate between their levels with severity of disorder, socio-demographic characteristics, previous hospitalization, and number of episodes.&#x0D; METHODS: A total of 60 patients diagnosed with major depressive disorder (MDD) from the Psychiatric Outpatient Clinic in Al-Zahra University Hospital, Cairo, Egypt, during the period from July 1, 2018, to December 31, 2018. A cross-matched control group of 60 subjects was selected from employers working in the hospital, complete psychiatric history, Hamilton Depression rating scale was done and serum levels of MDA, Nrf2, and SOD were estimated.&#x0D; RESULTS: No statistical difference between patient and control group was observed regarding age, sex, education, and marital status. The number of patients with mild depression was 28 (46.7%), moderate depression 18 (30%), and severe depression 14 (23.3%). The mean duration of illness in years was 6.13, and mean number of episodes was 3.66. MDA level was significantly elevated in the patient group than the control one. Meanwhile, SOD and Nrf2 were significantly lower in the patient group than the control. There was significant relationship between duration of illness and number of episodes and MDA, Nrf2, and SOD levels.&#x0D; CONCLUSION: Our results indicate that oxidative stress can attribute to the occurrence of MDD.

Manajemen Stres Dan Ansietas Warga Di Kelurahan Bencongan Indah Tangerang

Kesehatan jiwa merupakan kondisi dimana seseorang dapat berkembang secara fisik, mental, spiritual serta sosial, serta mampu memberikan kontribusi bagi masyarakatnya. Individu tidak dapat bebas dari stres. Apabila stress tidak dikelola dengan baik dapat berlanjut menjadi ansietas dan masalah kesehatan jiwa lainnya. Data Riskesdas 2018 menunjukkan terjadi peningkatan jumlah penderita psikosis dari 1,7% menjadi 7% per mil, sedangkan penderita gangguan mental emosional meningkat dari 6 menjadi 9% per mil. Jumlah penderita depresi di provinsi Banten mencapai 8.7%. Tingginya jumlah penderita gangguan jiwa dari waktu ke waktu membutuhkan tindakan promosi dan pencegahan gangguan jiwa. Pengabdian kepada masyarakat berupa pengelolaan stress dan ansietas warga ini bertujuan agar warga masyarakat mampu mengenali tanda dan gejala stress dan ansietas serta dapat melakukan cara pengelolaannya. Hasil kegiatan diukur dengan membandingkan nila pre-test dan post-test pengetahuan pasien sebelum dan sesudah dilakukan pemberian materi. Hasilnya, terdapat peningkatan pengetahuan warga terkait kesehatan, kesehatan jiwa, tanda gejala stress dan ansietas. Warga juga mampu melakukan tindakan yang diajarkan untuk mengelola stress dan ansietas. Kegiatan ini diharapkan dapat dilaksanakan secara berkelanjutan dengan bantuan para kader masyarakat.

The evaluation of depression in multiple sclerosis using the newly proposed Multiple Sclerosis Depression Rating Scale

Fatigue and depression are frequent symptoms in multiple sclerosis (MS). Both are overlapping and shadowing each other and may impair the quality of life. For detection of depression symptoms in MS, the Multiple Sclerosis Depression Rating Scale (MSDRS) has been proposed recently. Here, we compare the performance of MSDRS in MS patients with and without fatigue to that of established rating scales, i.e. Hospital Anxiety and Depression Scale and Beck Depression Inventory. Twenty-nine MS patients were screened for fatigue and depression symptoms. Patients with fatigue showed significantly higher depression scores compared to patients without fatigue, whereas the number of depressed patients did not differ between the two groups. MSDRS seems to have higher sensitivity to detect severe depression than established rating scales. However, one should keep in mind that such a finding might be due to an increase in false positive cases when using MSDRS. Implementing this scale in future studies might be of help to enhance the understanding of its potential utility.

A network pharmacology approach to decipher the mechanisms of anti-depression of Xiaoyaosan formula

Objective: Depression is one of the prevalent and prominent complex psychiatric diseases, and the number of depressed patients has been on the rise globally during the recent decades. Xiaoyaosan, as a famous Chinese herbal formula, has been widely used in depression patients for a long time. However, the therapeutic mechanisms remain uncertain because of the difficulty of depression pathophysiology and the lack of bioinformatic approach to understand the molecular connection. Materials and Methods: In this thesis, we applied a network pharmacology approach to explain the potential mechanisms between Xiaoyaosan and depression involved in oral bioavailability screening, drug-likeness assessment, caco-2 permeability, blood–brain barrier target recognition, and network analysis. Results: Sixty-six active compounds in Xiaoyaosan formula with favorable pharmacokinetic profiles are predicted as active compounds for antidepression treatment. Network analyses showed that these 66 compounds target 40 depression-associated proteins including especially HTR2A, NR 3C1, monoamine oxidase inhibitor B, XDH, and CNR2. These proteins are mainly involved in the neuroactive ligand–receptor interaction, serotonergic synapse, cAMP signaling pathways, and calcium signaling pathways. Conclusion: The integrated network pharmacology method can provide a new approach for understanding the pathogenesis of depression and uncovering the molecular mechanisms of Xiaoyansan, which will also facilitate the application of traditional Chinese herbs in modern medicine.

Investigation on the antidepressant effect of sea buckthorn seed oil through the GC-MS-based metabolomics approach coupled with multivariate analysis.

Depression is one of the prevalent and serious mental disorders and the number of depressed patients has been on the rise globally during the recent decades. Sea buckthorn seed oil from traditional Chinese medicine (TCM) is edible and has been widely used for treatment of different diseases for a long time. However, there are few published reports on the antidepressant effect of sea buckthorn seed oil. With the objective of finding potential biomarkers of the therapeutic response of sea buckthorn seed oil in chronic unpredictable mild stress (CUMS) rats, urine metabolomics based on gas chromatography-mass spectrometry (GC-MS) coupled with multivariate analysis was applied. In this study, we discovered a higher level of pimelic acid as well as palmitic acid and a lower level of suberic acid, citrate, phthalic acid, cinnamic acid and Sumiki's acid in urine of rats exposed to CUMS procedures after sea buckthorn seed oil was administered. These changes of metabolites are involved in energy metabolism, fatty acid metabolism and other metabolic pathways as well as in the synthesis of neurotransmitters and it is helpful to facilitate the efficacy evaluation and mechanism elucidating the effect of sea buckthorn seed oil for depression management.

Pattern of Tobacco Use among Outdoor Depressed Patients Reported for Private Psychiatric Consultation at Karachi

Objective: To estimate the pattern of tobacco use among outdoor, depressed patients reported for private psychiatric consultation at Karachi. Method: This observational study is based on cases reported at a private psychiatric clinic in Karachi from 1stJanuary, 2012 to 31st December 2012. A total of 178 patients, consecutively diagnosed as Depressive disorder according to ICD-10 were selected. All patients were male and their age range was from 18 years to 70 years. Their mean age with standard deviation was 36.16 ± 12.01 years. Informed consent, in all the patients, was taken. Approval from IRB (Institutional Review Board) Jinnah Postgraduate Medical Centre, Karachi was obtained. The approved protocol was used in the study overseeing the ethical and legal aspects of the clinical investigations. Data was tabulated and analysed using SPSS version 20. Descriptive statistics were used to describe the data. Results: Total number of depressed patients screened was1445. Out of these 178 patients was using tobacco. Their average age ± SD were 36.16 ± 12.01 years .The age range was from 18 to 70 years. Out of 178 cases, 139(78.1%) cases were married, 28(15.7%) were unmarried, and 6(3.4%) had second marriages, and the rest were engaged, divorced or separated. Their ethnic languages were Pushto (65.7%); Urdu (12.4%), Punjabi (5.1%), Sindhi (7.3%), Balochi (3.4%), and the rest were from other ethnic languages. The pattern of tobacco use was, smoking only (32.58%), chewing Paan (37.07%), using Naswar (14.60%), while the rest (15.73%) chewed and smoked in combination. Conclusion: This study revealed that depressive disorder has co-morbidity of tobacco use invariably among younger married males. Contrary to the western pattern, majority of the cases were using tobacco in forms other than smoking only.

Disease characteristics in patients with and without psoriatic arthritis treated with etanercept

Patients with psoriasis (PsO) and psoriatic arthritis (PsA) have functional disability, pain and emotional problems, and experience lower quality of life (QoL) than patients with PsO alone. Examine effectiveness of etanercept (ETN) in patients with PsO alone, and with PsA, and determine whether PsA patients on ETN experience rapid QoL improvement. Data from three phase III trials using ETN in adults with moderate-to-severe PsO were pooled. Patients with (n = 523) and without (n = 1330) PsA received ETN 25 mg once weekly to 50 mg twice weekly or placebo for 12-24 weeks. Assessments included Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI), EuroQoL-5D (EQ-5D), Study 36-item Short Form Health Survey (SF-36) and Hamilton Depression Rating Scale (HAM-D). Baseline PASI, EQ-5D and SF-36 physical component summary scores were worse for PsA patients. With ETN, PASI for PsA and non-PsA groups improved as early as week 2. Scores for both groups converged by week 12. EQ-5D and SF-36 physical component improved faster in PsA patients, with EQ-5D scores converged by week 2. For total DLQI and most components, both groups had similar baseline scores and improved over 24 weeks on ETN. While the PsA group had more depressed patients at baseline, after 24 weeks on ETN it showed a greater reduction in the number of depressed patients than the non-PsA group. In patients with PsO involving ≥10% of body surface area, skin disease and QoL are worse in PsA patients. With ETN, QoL improved rapidly in PsA patients.

Antidepressants and Sleep: Neurophysiology and Clinical Correlates

Introduction: Depression is a common disorder associated with significant disability and is a substantial burden on the individual, their relatives and friends, and on society as a whole. Sleep disturbances are key features of depressive symptomatology, with more than 80% of depressed patients complaining of poor quality sleep. Methods: The range of available antidepressants is here reviewed in relation to mechanisms of action and the evidence of sleep alteration in patients with depression. Results: The available treatments are largely effective but their use is compromised by poor tolerability and low adherence to treatment. It is also clear that currently used antidepressant agents tend to disrupt sleep architecture. Agomelatine, a novel antidepressant, has been found successful in treating depressed patients. Because of its dual mechanism of action on MT1 and MT2 melatonin receptors in the SCN and its 5-HT2c antagonist properties, agomelatine has been effective in improving both quality of sleep and mood in depressed patients. Conclusions: There is clinical and epidemiological evidence that sleep disturbances in depression constitute a risk factor for poor clinical outcomes. Specifically, insomnia complaints precede the onset and recurrence of depression. For this rea- son antidepressants with a faster onset of action, with less interferences on sleep architecture would be expected to bring larger numbers of depressed patients to full remission.

Actitudes y opiniones de los médicos de familia frente a la depresión: una aproximación con el Depression Attitudes Questionnaire (DAQ)

Aim To describe the attitudes of General Practitioners (GPs) towards depression in Primary Health Care Centres. Design Cross-sectional study based on the application of a standard questionnaire. Setting and participants A total of 112 GPs from all of the 20 Primary Health Care Centres in the Tarragona-Reus Primary Care Area (Catalan Health Institute). Measurements A Spanish adaptation of Depression Attitudes Questionnaire was used. Results A total of 88.4% of doctors agreed there was an increase in the number of depressive patients in recent years. Around half of the GPs thought that depression in Primary Health Care Centres are due to the adversities of life, but 72.3% considers that there is a biological root in severe depressions. A large majority (81.2%) of doctors believed that antidepressants used in Primary Care are efficient and the majority values psychotherapy as a useful therapeutic option. There is an agreement in the role of nursing staff when attending depressed patients. The role of psychiatric referral when a satisfactory result is not obtained in Primary Care is recognised. Although 64.3% of doctors consider that dealing with depressed patients is hard work, but 57.1% feel comfortable and only 19.7% think it is an unpleasant job. Conclusions In general, there is a favourable predisposition to deal with depression in Primary Care where training and organisational initiatives can be introduced to improve clinical outcomes of depression in Primary Care.

Recognition and subsequent treatment of patients with sub-threshold symptoms of depression in primary care

BackgroundNon-psychiatric physicians are better at correctly ruling out depressive disorders than appropriately recognising them. However, given large numbers of non-depressed patients, a small percentage of false positives equates to a greater number of patients than the number of depressed patients that GPs fail to detect. Concern thus arises that substantial numbers of patients with falsely identified depression may receive inappropriate interventions. MethodsUnselected GP consulters were screened with the Hospital Anxiety and Depression Scale (HADS). GPs' perceptions of depression were independently rated on an ICD-10 scale. Case records were reviewed. Analysis related to participants with HADS-D<8. Data were assessed of 660 participants with sub-threshold symptoms. Factors were assessed according to GP ratings. ResultsGP perceived depression in false positive cases were more likely at index visit, to have a mental health presenting problem (OR=6.74 (95% CI=3.21, 14.16); receive antidepressant prescriptions (OR 3.79 (95% CI=1.69, 8.49) and have greater severity of HADS-D score (OR 1.18 (95% CI=1.01, 1.38). Subthreshold cases that GPs identified as depressed, more often had a recording, over subsequent six months, of: depressive symptoms (16 (35%) versus 26 (7%), p<0.001); antidepressant prescriptions (11 (24%) versus 25 (7%), p=0.001); and Community Mental Health Team referrals (4 (9%) versus 1 (<1%), p=0.001). They also consulted GPs more frequently than those not identified (median=5 (IQR 2.8, 6.3) versus median=3 (IQR=2, 5), p=0.004 over six months. LimitationsThe HADS is not a diagnostic tool. ConclusionsGPs' diagnoses of depressive disorder in patients with sub-threshold symptoms were appropriate. Interventions offered to this group were consistent with documented previous histories.

Lamotrigine augmentation for the treatment-resistant mood disorder

Purpose: A number of depressed patients do not respond adequately to standard antidepressant treatments, and some of them subsequently suffer from treatment-resistant mood disorder (TRMD). Lamotrigine (LTG) is the only mood stabilizer that is effective for preventing depressive episodes of bipolar disorders. This study aimed to evaluate the efficacy of LTG augmentation in Japanese patients with TRMD. Methods: The subjects were 30 patients with refractory depression who had already shown insufficient response to multiple pharmacotherapy including antidepressants, mood stabilizers and atypical antipsychotics. The diagnoses were major depressive disorder (n=16), bipolar disorder (n=10) and dysthymic disorder (n=4). All patients gave written informed consent to receive LTG as an off-label indication in Japan after explanation for possible risks of unwanted skin reactions. The daily dose of LTG was titrated by the clinician's decision (88.0±61.9 mg/day). Treatment response was assessed by Montgomery-Asberg Depression Rating Scale (MADRS) and Global Assessments of Functioning (GAF) before and after the 8-week LTG augmentation. Results: Significant improvements were observed in the scores of MADRS (25.3±10.1 → 14.7±10.5) and GAF (49.2±12.3 → 64.1±11.7) after the 8-week LTG augmentation (p=0.0010). Greater number of the past mood episodes and shorter duration of the present depressive episode are associated with better response to LTG. Mild adverse skin reactions developed in 10 patients although 8 out of them were treatment responders. Discussion: LTG augmentation may be effective for the treatment of TRMD, especially with shorter duration of unremitted depression and more recurrent episodes. However, attention should be paid to the development of adverse skin reactions in LTG responders.

What is the “mask” of depressed inpatients from the viewpoint of surgeons and internal medicine physicians?

Objective. Depressed inpatients are easily misrecognized by general hospital physicians. Therefore, our study aimed to examine the following issues: (1) how primary care doctors recognize depressed inpatients; (2) if there are any differences between internal medicine physicians and surgeons with regard to this recognition; (3) the factors associated with the accurate recognition of depression. Methods. Four hundred and twenty-five consecutive patients from internal medical or surgical wards who had been diagnosed with depression were enrolled in this study. The reasons for referral were recorded from the referral sheet. Accurate recognition of depression was defined as depressive disorder or depressed core symptoms, which were the reasons for referral. Results. The rate of correct recognition of depression was the same for both physicians and surgeons. Depressed inpatients from the internal medicine wards were referred more commonly for suicide problems and unexplained physical symptoms, while a greater number of depressed patients from the surgical wards were referred for insomnia, agitation/irritability, cognitive impairment, and past psychiatric history. Multiple physical comorbidities, depression treatment history, and depression of a higher severity were independent factors associated with accurate recognition. Conclusions. Postgraduate education is still needed with regarded to understanding depression. The educational content should be specific to the different specialties and the patient characteristics in different wards

Depression before and after uterine cervix and breast cancer neoadjuvant chemotherapy

Depression in cancer patients is common and may affect treatment outcome either directly (by lowering defenses) or indirectly (by lowering compliance). Neoadjuvant chemotherapy for advanced uterine cervix or breast cancer is a strenuous undertaking and may lead to depression and impair patients' willingness to comply with the rest of the treatment (eg, surgery or radiotherapy).We compare Beck Depression Inventory (BDI) scores both before and after neoadjuvant chemotherapy in order to verify if depression influences treatment outcome. We studied 22 advanced uterine cervix and 20 breast cancer patients submitted to three courses of neoadjuvant chemotherapy. We used cisplatin and ifosfamide for cervix, and fluorouracil, adriamycin, and cyclophosphamide for breast cancer. We did not identify significant differences in the number of depressed patients, before and after treatment. Cognitive affective, somatic-performance, and total BDI scores were not significantly different from before to after chemotherapy for both breast and uterine cervix cancer. After treatment, the number of depressive breast cancer patients increased while the number of uterine cervix cancer patients decreased. This trend to depression was found more often in less responsive breast cancer patients than in the more responsive cervix cancer patients. We were not able to link depression to treatment failure or success, but patients who responded to treatment were less depressed at the end of treatment.

Depression before and after uterine cervix and breast cancer neoadjuvant chemotherapy.

Depression in cancer patients is common and may affect treatment outcome either directly (by lowering defenses) or indirectly (by lowering compliance). Neoadjuvant chemotherapy for advanced uterine cervix or breast cancer is a strenuous undertaking and may lead to depression and impair patients' willingness to comply with the rest of the treatment (eg, surgery or radiotherapy). We compare Beck Depression Inventory (BDI) scores both before and after neoadjuvant chemotherapy in order to verify if depression influences treatment outcome. We studied 22 advanced uterine cervix and 20 breast cancer patients submitted to three courses of neoadjuvant chemotherapy. We used cisplatin and ifosfamide for cervix, and fluorouracil, adriamycin, and cyclophosphamide for breast cancer. We did not identify significant differences in the number of depressed patients, before and after treatment. Cognitive affective, somatic-performance, and total BDI scores were not significantly different from before to after chemotherapy for both breast and uterine cervix cancer. After treatment, the number of depressive breast cancer patients increased while the number of uterine cervix cancer patients decreased. This trend to depression was found more often in less responsive breast cancer patients than in the more responsive cervix cancer patients. We were not able to link depression to treatment failure or success, but patients who responded to treatment were less depressed at the end of treatment.

NEW DEPRESSION FOLLOWING CORONARY ARTERY BYPASS SURGERY

INTRODUCTION: As the incidence of perioperative stroke has fallen, the use of tests of cognitive or neuropsychological function as a means of detecting neurological injury after cardiac surgery has become widespread. A number of confounding factors, including depressed mood, may impair psychometric test performance. For this reason many investigators have included measures of depression in their patient assessment battery to ensure that any cognitive impairment detected is not merely a manifestation of post-operative depression. The finding that the incidence of new depression following cardiac surgery is low and that postoperative cognitive impairment cannot be explained on the basis of depression alone suggests that measures of depression may not be necessary. [1] In this study we have sought to examine the influence of preoperative mood on the incidence of depression after coronary artery bypass graft (CABG) surgery. METHODS: With Institution Ethical Committee approval and informed consent, 157 patients (mean +/- SD age 59.0 +/- 8.3 years, 138 males) scheduled to undergo elective primary CABG were studied. The Beck Depression Inventory (BDI) questionnaire was administered 1 week before surgery and 1 week and 8 weeks after surgery. A BDI score of 10 or more was used as indicator of significant depression. RESULTS: A total of 155 (99%) patients completed all three assessments. Mean +/- SD BDI scores were 7.4 +/- 4.7 before surgery, and 8.2 +/- 5.4 and 5.1 +/- 4.7 at 1 week and 8 weeks, respectively, after surgery. The number of depressed patients (BDI>=10) was 41 (26.1%) before surgery, and 60 (38.7%) and 28 (18.1%) at 1 week and 8 weeks, respectively, after surgery. One week after surgery 34/116 (29.3%) patients, who were not depressed before surgery, were depressed, whereas 26/41 (63.4%) preoperatively depressed patients remained depressed. (p=0.0001, chi squared). Eight weeks after surgery only 7/116 (6.0%) patients, who were not depressed before surgery, were depressed, whereas 21/41 (51.2%) preoperatively depressed patients remained depressed. (p<0.0001, chi squared). There was a weak but statistically significant association between increasing patient age and increase in BDI score from baseline at both 1 week (rho=0.168, p=0.036) and 8 weeks (rho=0.300, p=0.0002) after surgery (Spearman). CONCLUSIONS: The incidence of new depression in this investigation was low. Of those patients who were depressed before surgery more than half remained depressed after surgery. We confirm the previous finding that new depression is uncommon after coronary artery bypass surgery and that preoperative depression is present in more than half of those patients with postoperative depression. [1]