Primary Depressive Disorder Research Articles

Prevalence of co-occurring conditions among youths receiving treatment with primary anxiety, ADHD, or depressive disorder diagnoses

IntroductionAnxiety disorders, depressive disorders, and attention-deficit/hyperactivity disorder (ADHD) are some of the most common conditions that youths (<18 years old) receive mental health treatment for. These conditions are associated with high-risk substance use or substance use disorders (SUDs). This study sought to identify the proportion of youths (<18 years old) with anxiety disorders, depressive disorders, or ADHD as a primary diagnosis in community mental health centers (CMHCs) having co-occurring high-risk substance use or a SUD.MethodsAnalysis included binary logistic regression models using the Mental Health Client-Level Data 2017–2019 datasets which contains annual cross-sectional administrative data from mental health treatment facilities. The final sample included n = 458,888 youths with an anxiety disorder as a primary diagnosis, n = 570,388 youths with a depressive disorder as a primary diagnosis, and n = 945,277 youths with ADHD as a primary diagnosis.ResultsIn the subsample with anxiety as a primary diagnosis, approximately 5% of youth had high-risk substance use or a SUD. Approximately 10% of youth with depression as a primary diagnosis had high-risk substance use or a SUD. Among youth with ADHD as a primary diagnosis, 5% had high-risk substance use or a SUD. Odds of having a co-occurring high-risk substance use or SUD differed based on the youth’s age, race and ethnicity, gender, and other mental health diagnoses.ConclusionsEffective care for this high-need youth population at CMHCs will require mental health clinicians to possess knowledge and skills related to substance use treatment.

Long-Term Trends in Psychiatric Day Hospitalization: A Retrospective Study in Algarve, Portugal

IntroductionCurrent healthcare policies encourage the investment in transition units between hospitalization and outpatient care. Psychiatry day hospitals (DH) serve as partial hospitalization structures that facilitate this transition. The DH at the Faro Unit of the Centro Hospitalar Universitário do Algarve (CHUA), began its activity in 2008, is situated in southern Portugal and provides support to the entire eastern Algarve region (approximately 300,000 people). Its focus is on rehabilitating individuals with severe mental illnesses necessitating multidisciplinary care, with personalized therapeutic plans.ObjectivesWe aimed to categorize patients based on diagnoses (primary psychotic disorder, depressive disorder, and others) according to the International Classification of Diseases (ICD-11) and to characterize and compare sociodemographic and clinical data among these three groups.MethodsA retrospective study spanning from May 2008 to June 2023 was conducted. We assessed sociodemographic, clinical, and epidemiological data of patients undergoing treatment at CHUA Faro Unit’s DH.ResultsOver this period, 541 treatment cycles were carried out to 433 distinct patients, between 18 and 78 years old. Of the total treatments, 38% were for Primary Psychotic Disorder (PPD), 24% for Depressive Disorder (DD) and among the others (39%) the diagnosis of Bipolar Affective Disorder and Personality Disorder predominated . Statistically significant differences were identified among these three groups. The PPD group exhibited a male predominance, whereas DD and others were largely female. Patients in the PPD group were significantly younger (average age of 36 in PPD, 40 in others, and 48 in DD), more likely to be single, and a majority were unemployed (with several patients retired due to disability). No significant differences were noted regarding dropouts, expulsions, or the duration of DH treatment. These results are preliminary, and additional relevant data are being collected and processed.ConclusionsThe diagnostic group’s consideration revealed differences in the social, demographic, and clinical characteristics of patients. These findings offer insights into patient details, enabling the future adaptation of intervention strategies in a more personalized manner.Disclosure of InterestNone Declared

Emotional and cognitive processes in psychotherapy are associated with different aspects of the therapeutic relationship.

In this naturalistic study we aimed to investigate the relationships between two central change processes (affective and cognitive) and two common relationship factors ("Confidence in the therapist" and "Confidence in the treatment"), which have been shown to impact outcomes in a clinical context. We also investigated whether these interrelationships varied across treatment orientations (i.e., cognitive or psychodynamic focused). The sample consisted of 631 patients with a primary anxiety or depressive disorder who were admitted to an inpatient program and treated with psychotherapy. The data consisted of weekly measures of cognitive (i.e., "rumination") and affective (i.e., "problems with emotional clarity") change processes as well as scores on Confidence in the therapist and Confidence in the treatment and symptom distress. A multivariate version of the latent curve model with structured residuals was used to investigate the within-patient effects of week-to-week changes in all variables. Initial analyses established that both problems with emotional clarity and rumination predicted symptom distress. Further, we found that higher Confidence in the therapist predicted higher emotional clarity (but not lower rumination) whereas higher Confidence in the treatment predicted lower rumination (but did not affect emotional clarity). Post hoc analyses found that these interrelationships varied across treatment orientation (i.e., cognitive vs. psychodynamic). The results indicate that patients' experience of the therapist is associated with emotional change processes, and that patients' experience of the coherence and meaningfulness of treatment, on the other hand, is associated with cognitive change processes. Implications for clinical practice are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Predicting non-improvement of symptoms in daily mental healthcare practice using routinely collected patient-level data: a machine learning approach.

Anxiety and mood disorders greatly affect the quality of life for individuals worldwide. A substantial proportion of patients do not sufficiently improve during evidence-based treatments in mental healthcare. It remains challenging to predict which patients will or will not benefit. Moreover, the limited research available on predictors of treatment outcomes comes from efficacy RCTs with strict selection criteria which may limit generalizability to a real-world context. The current study evaluates the performance of different machine learning (ML) models in predicting non-improvement in an observational sample of patients treated in routine specialized mental healthcare. In the current longitudinal exploratory prediction study diagnosis-related, sociodemographic, clinical and routinely collected patient-reported quantitative outcome measures were acquired during treatment as usual of 755 patients with a primary anxiety, depressive, obsessive compulsive or trauma-related disorder in a specialized outpatient mental healthcare center. ML algorithms were trained to predict non-response (< 0.5 standard deviation improvement) in symptomatic distress 6 months after baseline. Different models were trained, including models with and without early change scores in psychopathology and well-being and models with a trimmed set of predictor variables. Performance of trained models was evaluated in a hold-out sample (30%) as a proxy for unseen data. ML models without early change scores performed poorly in predicting six-month non-response in the hold-out sample with Area Under the Curves (AUCs) < 0.63. Including early change scores slightly improved the models' performance (AUC range: 0.68-0.73). Computationally-intensive ML models did not significantly outperform logistic regression (AUC: 0.69). Reduced prediction models performed similar to the full prediction models in both the models without (AUC: 0.58-0.62 vs. 0.58-0.63) and models with early change scores (AUC: 0.69-0.73 vs. 0.68-0.71). Across different ML algorithms, early change scores in psychopathology and well-being consistently emerged as important predictors for non-improvement. Accurately predicting treatment outcomes in a mental healthcare context remains challenging. While advanced ML algorithms offer flexibility, they showed limited additional value compared to traditional logistic regression in this study. The current study confirmed the importance of taking early change scores in both psychopathology and well-being into account for predicting longer-term outcomes in symptomatic distress.

Suicidal thoughts and behaviors in youth seeking mental health treatment in Texas: Youth Depression and Suicide Network research registry.

Suicidality in youth is a serious public health problem. The Texas Youth Depression and Suicide Research Network (TX-YDSRN) was initiated in 2020 to create a research registry for youth with depression and/or suicidality in Texas. This report presents baseline clinical/demographic characteristics of the first 1000 participants, focusing on suicidal thoughts and behaviors. The registry includes 8-20-year-old youth receiving treatment for depression, or who screen positive for depression and/or suicidal ideation/behavior. Baseline data include diagnosis, depression/anxiety severity, suicidal ideation/behavior, trauma history, and measures of resilience. We present baseline data on the first 1000 participants. Most (79.6%) of the sample had a primary depressive disorder. The sample had moderate to severe depression (Patient Health Questionnaire for Adolescents, PHQ-A; 12.9 ± 6.4) and anxiety (Generalized Anxiety Disorder, GAD-7; 11.3 ± 5.9). Nearly half reported ≥1 lifetime suicide attempts and 90% reported lifetime or current suicidal ideation. Participants with past/current suicidality (attempts and/or ideation) had greater illness severity (depression, anxiety, and suicidal thoughts/behaviors), lower resilience, and higher rates of trauma exposure than those without suicidality. Baseline data indicate moderate levels of depression, anxiety, and suicidality and their correlates in this cohort. Future reports will determine trajectories of outcomes and predictors, moderators, and social determinants related to these outcomes.

Texas Youth Depression and Suicide Research Network (TX-YDSRN) research registry and learning healthcare network: Rationale, design, and baseline characteristics

BackgroundAmerican youth are seriously impacted by depression and suicide. The Texas Youth Depression and Suicide Research Network (TX-YDSRN) Participant Registry Study was initiated in 2020 to develop predictive models for treatment outcomes in youth with depression and/or suicidality. This report presents the study rationale, design and baseline characteristics of the first 1000 participants. MethodsTX-YDSRN consists of the Network Hub (coordinating center), 12 medical school “Nodes” (manage/implement study), each with 1–5 primary care, inpatient, and/or outpatient Sub-Sites (recruitment, data collection). Participants are 8–20-year-olds who receive treatment or screen positive for depression and/or suicidality. Baseline data include mood and suicidality symptoms, associated comorbidities, treatment history, services used, and social determinants of health. Subsequent assessments occur every two months for 24 months. ResultsAmong 1000 participants, 68.7 % were 12–17 years, 24.6 % were ≥ 18 years, and 6.7 % were < 12. Overall, 36.8 % were non-Hispanic Caucasian, 73.4 % were female, and 79.9 % had a primary depressive disorder. Nearly half of the sample reported ≥1 suicide attempt, with rates similar in youth 12–17 years old (49.9 %) and those 18 years and older (45.5 %); 29.9 % of children <12 reported at least one suicide attempt. Depression and anxiety scores were in the moderate-severe range for all age groups (Patient Health Questionnaire for Adolescents [PHQ-A]: 12.9 ± 6.4; Generalized Anxiety Disorder [GAD-7]: 11.3 ± 5.9). LimitationsThe sample includes youth who are receiving depression care at enrollment and may not be representative of non-diagnosed, non-treatment seeking youth. ConclusionsThe TX-YDSRN is one of the largest prospective longitudinal cohort registries designed to develop predictive models for outcome trajectories based on disorder heterogeneity, social determinants of health, and treatment availability.

Depressive disorder comorbid with problematic alcohol use

IntroductionAlcohol use disorder is a real public health problem in the world, it consists of a pathological mode of consumption which is characterized by a loss of control and craving. Depressive disorder and alcohol use disorder are among the most frequent mental pathologies and are often associated.The links between these two disorders can be of several types: Alcohol Induced Depressive Disorders, Primary Depressive Disorders and Secondary Alcohol Dependence. They can also have two-way relationships or be favored by common factors.ObjectivesThe objective of our work is to analyze the causal links between alcohol use disorder and depression.Methodsprovide an update via two clinical vignettes and a review of the literature the relationship between alcohol use disorder and depressionResults The causal relationships between alcohol dependence and psychiatric disorders can be of several types which are not mutually exclusive: primary alcohol dependence, secondary psychiatric disorders, induced by alcohol. This is the case for the majority of depressive disorders encountered in alcohol-dependent patients; primary psychiatric disorders and secondary alcohol dependence; alcohol dependence and anxiety and/or depressive disorders are favored by common factors, in particular personality disorders, encountered in approximately 40% of alcohol-dependent patients. Whatever the direction of causation, alcohol dependence and psychiatric disorders worsen each other over time.Depression and alcohol use disorder are among the most frequent mental pathologies and are often associated.The optimal management of patients with dual diagnosis is so-called “integrated” management, simultaneously combining alcohol and psychiatric therapeutic approaches.ConclusionsAlcohol consumption impairs the prognosis of depression, increases the risk of suicide, impairs social functioning and increases recourse to the healthcare system.The optimal management of patients with dual diagnosis is so-called “integrated” management. Psychotherapeutic (individual and systemic), drug and psychosocial approaches would be necessary to maximize therapeutic success.Disclosure of InterestNone Declared

Assessment of learning and memory impairments in adults with predominately inattentive versus combined presentation attention-deficit/hyperactivity disorder

This cross-sectional study compared adults diagnosed with Attention-Deficit/Hyperactivity Disorder-Inattentive (ADHD-I) and ADHD-Combined (ADHD-C) presentations with a non-ADHD group on verbal and visual learning and delayed recall using the Rey Auditory Verbal Learning Test (RAVLT) and Brief Visuospatial Memory Test-Revised (BVMT-R), respectively. Data from 380 predominately college student adult outpatients were used, with 155 who met criteria for ADHD-I, 165 who met criteria for ADHD-C, and 60 who did not meet criteria for ADHD but were diagnosed with a primary depressive or anxiety disorder or received no diagnosis. Each patient was administered the RAVLT and BVMT-R as part of a comprehensive neuropsychological evaluation. Significant main effects of study group were found, such that patients with ADHD-C demonstrated worse learning and delayed recall of both verbal and visual information than patients with ADHD-I and the non-ADHD group. Patients with ADHD-I performed comparably to the non-ADHD group, apart from visual learning and delayed recall. Notably, more patients in the ADHD groups had possible or probable learning and memory impairment compared to the non-ADHD group. Findings were consistent with previous research indicating that those with ADHD exhibit poorer verbal and visual learning and delayed recall than those without ADHD.

Ekbom Syndrome: A Case Report

AimsEkbom's syndrome (ES), also called delusional parasitosis, is a condition where the patient has an unshakable belief and a perception of being infested with parasites. ES is thought to mainly affect postmenopausal females and because patients are usually mono-symptomatic, they usually seek care from dermatologists. It is advocated to form a liaison between dermatology and psychiatry to ensure a full range of differential diagnoses, in order to form the most suitable management plan.MethodsCase reportResultsAn 87-year-old widow was referred to the outpatient psychiatric clinic of King Abdullah University Hospital by a dermatologist because of generalized chronic pruritus that she believes is caused by a bug infestation. The symptoms started one year prior to presentation (soon after an ischemic stroke) with the perception that macroscopic parasites were crawling over her body, biting her face, head, and hands, and entering her eyes. She tried various strategies to eradicate the parasites with no benefit. Psychiatric examination findings included hypochondriac delusional ideas and dysphoria. When her general medical condition and her medications were reviewed, it was found that she had been diagnosed with hypertension and ischemic heart disease. She was taking anti-hypertensive drugs and blood thinners. After haloperidol 5 mg daily was added, she had a progressive clinical improvement.ConclusionES is a neuropsychiatric syndrome that can follow primary psychotic or depressive disorders, dementia, or other organic diseases. Consultation-liaison by psychiatrists and dermatologists will be useful to assure timely referral. Better awareness of such an illness by general physicians, early recognition, good rapport, and empathic treatment are the cornerstones of management in such cases.

Treatment Engagement Following a Positive Mental Health Screening Questionnaire

Less than half of U.S. adolescents with major depressive disorder receive treatment. Despite the U.S. Preventive Services Task Force 2016 statement supporting primary care major depressive disorder screening, there is limited data examining whether positive screens prompt treatment engagement. This study evaluated treatment engagement following a positive Patient Health Questionnaire-Adolescent Version screen and assessed the impact of demographics, clinical variables, and provider recommendations on treatment engagement. This was a retrospective cohort study (analysis November 2021) of adolescents aged 11-18 years seen at a primary care clinic of an academic medical center from July 2017 to December 2018 and identified with a positive Patient Health Questionnaire-Adolescent Version (broadest definition score ≥10; ≥1 for Item 9 regarding suicidal thoughts; yes for unscored Items 1, 3, or 4; or very or extremely difficult for unscored Item 2). Positive screen by score ≥10 alone was also considered. The primary outcome was treatment engagement, defined as initiation of a psychotropic medication, or a behavioral health treatment session within 1 year of symptom identification. Of the 1,315 eligible adolescents, 23.0% had a positive Patient Health Questionnaire-Adolescent Version (n=302) by the broadest criteria; 92/302 (30.5%) engaged in treatment. Patients whose providers recommended treatment had 7.32 times the odds (95% CI=3.76, 14.2, p<0.001) of treatment engagement. For those positive by Patient Health Questionnaire-Adolescent Version ≥10 (85/302, 28.1%), 37/85 (43.5%) engaged in treatment. The influence of provider recommendations was comparable (OR=6.96, 95% CI=3.56, 13.6, p<0.001). Less than half of adolescents with a positive Patient Health Questionnaire-Adolescent Version at an academic primary care clinic engaged with treatment. Provider recommendation was an impactful intervention to improve mental healthcare treatment engagement.

Cognitive behavioral therapy for depressive disorders: Outcomes from a multi-state, multi-site primary care practice

BackgroundIndividuals with depressive disorders often present to and seek treatment in primary care. Integrated behavioral health services within this setting can improve access to evidence-based cognitive behavioral therapy (CBT). However, limited information exists on the effectiveness of CBT for depression in primary care. MethodsOf the 1,302 participants with a primary depressive disorder referred by their primary care provider, 435 endorsed moderate to severe depression at baseline and engaged in at least one CBT session. A psychotherapy tracking database was used to collect relevant data, which included demographics, clinical characteristics, treatment outcomes, and CBT intervention use. ResultsParticipants with moderate to severe depression who participated in CBT reported a significant decrease in depression and anxiety symptoms at the end of treatment (p ≤ .001, d = 0.52–0.78). Rates of reliable change, response, and remission and types of CBT interventions used differed between major and persistent depressive disorders. LimitationsMultiple limitations must be noted, which are related to the naturalistic study design, inclusion and exclusion criteria, sample operationalization, symptomatic measurement, time-limited and focused assessment, data collection strategies, and psychological services. Together, these temper the conclusions that can be drawn. ConclusionSignificant reductions in depression and anxiety symptoms were reported by participants with depressive disorders who engaged in short-term CBT within primary care. This study indicates that CBT can be implemented within primary care and suggests that primary care patients with depression can benefit from integrated psychological services, supporting population-based models of care.

Reward-Related Neural Circuitry in Depressed and Anxious Adolescents: A Human Connectome Project

Although depression and anxiety often have distinct etiologies, they frequently co-occur in adolescence. Recent initiatives have underscored the importance of developing new ways of classifying mental illness based on underlying neural dimensions that cut across traditional diagnostic boundaries. Accordingly, the aim of the study was to clarify reward-related neural circuitry that may characterize depressed-anxious youth. The Boston Adolescent Neuroimaging of Depression and Anxiety Human Connectome Project tested group differences regarding subcortical volume and nucleus accumbens activation during an incentive processing task among 14- to 17-year-old adolescents presenting with a primary depressive and/or anxiety disorder (n= 129) or no lifetime history of mental disorders (n= 64). In addition, multimodal modeling examined predictors of depression and anxiety symptom change over a 6-month follow-up period. Our findings highlighted considerable convergence. Relative to healthy youth, depressed-anxious adolescents exhibited reduced nucleus accumbens volume and activation following reward receipt. These findings remained when removing all medicated participants (∼59% of depressed-anxious youth). Subgroup analyses comparing anxious-only, depressed-anxious, and healthy youth also were largely consistent. Multimodal modeling showed that only structural alterations predicted depressive symptoms over time. Multimodal findings highlight alterations within nucleus accumbens structure and function that characterize depressed-anxious adolescents. In the current hypothesis-driven analyses, however, only reduced nucleus accumbens volume predicted depressive symptoms over time. An important next step will be to clarify why structural alterations have an impact on reward-related processes and associated symptoms.

Multilevel associations of daily skill use and effectiveness with anxiety, depression, and stress in a transdiagnostic sample undergoing dialectical behavior therapy skills training

ABSTRACT Dialectical Behavior Therapy (DBT) is effective at treating disorders of emotion dysregulation. However, it is unclear which mechanisms contribute to these effects. The aim of this study was to characterize the within-person associations of two theoretically relevant mechanisims of change, skill use and skill effectiveness, with anxiety, stress, and depression. Participants (n = 19, M age = 31.8, 68% female) with a primary anxiety or depressive disorder completed daily reports (N = 1344) of DBT skill use, perceived effectiveness, anxiety, stress, and depression during a 16-session DBT skills training group. DBT skill use increased across treatment, p < .01, but effectiveness did not, p = .64. Within persons, participants used more skills on days with greater stress and anxiety, p < .01, which predicted next-day decreases in stress and anxiety, p = .03. On days when participants reported higher effectiveness, they used more skills than their personal average when experiencing more intense negative affect, p < .01. These results suggest using more skills, especially when used more effectively, is a mechanism by which DBT skills groups address emotional dysfunction for those with transdiagnostic emotional disorders.

The reliability and validity of the Florida Obsessive-Compulsive Inventory in a Chinese clinical sample

BackgroundThe Florida Obsessive-Compulsive Inventory (FOCI) is a self-report measure designed to assess obsessive-compulsive symptom presence and severity. This study evaluated the reliability and validity of the Chinese version of the FOCI and its optimal cut-off score. MethodsA systematic translation process was used to translate the English FOCI into Chinese. Four hundred and fifty-three adults participated in the study including 153 individuals with OCD, 150 case-controls with a primary anxiety or depressive disorder, and 150 healthy controls. All three groups were evaluated by a set of measures including the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the FOCI, the Obsessive-Compulsive Inventory-Revised (OCI-R), the Beck Depression Inventory-Second Edition (BDI-Ⅱ), the Beck Anxiety Inventory (BAI), and the Short Form Health Survey (SF-36). Among the OCD patients, a subset of 47 participants were evaluated over a two-week interval to assess test-retest reliability of the FOCI. ResultsThe internal consistency of the FOCI Symptom Checklist and Severity Scale in the OCD group were0.813 and 0.840. Two-week test-retest reliability were 0.934 and 0.935. Convergent validity of the FOCI Symptom Checklist and Severity Scale were both strong. Correlations with diverging constructs were modest overall. Factor analysis of the FOCI Severity Scale was conducted, identifying a single factor solution explaining 62.3% of the variance. FOCI scores among those in the OCD group were higher than those from the case-control and healthy control groups. A cut-off score of 8 was optimal in predicting caseness. ConclusionsThe Chinese version of the FOCI demonstrated good psychometric properties including internal consistency, test-retest reliability, a stable factor structure, and convergent and divergent validity. A cut-off score of 8 was optimal in predicting caseness.

Sarcopenic Obesity and Depression: A Systematic Review.

Sarcopenic obesity (SO) is a condition combining two important public health issues commonly seen amongst older individuals, obesity and sarcopenia. Depressive symptoms are common among older people, whose population is increasing worldwide. Obesity and sarcopenia alone, are clearly associated with depression while the coexistence of these two conditions (SO) upon depressive disorders is currently unclear. We aimed to systematically review the association between primary SO and depressive disorders. Searches were run on MEDLINE, EMBASE, PsycINFO, and CINAHL (inception to June 2019). One reviewer screened titles, abstracts, and full-texts, with 10% checked independently by a second reviewer. Cohort and cross-sectional studies were included. Two reviewers independently assessed risk of bias using the Mixed Methods Appraisal Tool. Results were narratively synthesised. Out of the 7 studies eligible for inclusion, evidence of sarcopenic obesity as a predictor of depressive symptoms was found in two studies. The main observed trend was that diagnosing sarcopenia using muscle strength led to significant associations between sarcopenic obesity and depressive symptoms. Two cross-sectional studies found a significant association between SO and depressive symptoms, whilst three others found no statistically significant associations. All possessed some methodological limitations. This is the first review to systematically examine a potential relationship between sarcopenic obesity and depressive disorders. Currently, the results are heterogeneous due to the large variability in assessment methods and outcome measurements. Future longitudinal studies would achieve greater confidence in the provisional conclusion that sarcopenic obesity, when measured using muscle strength, is associated with depressive symptoms.

Influence of Hostility on 24-Hour Diastolic Blood Pressure Load in Hypertension Patients with Depressive Disorders.

BackgroundHostility in hypertension patients combined with depressive disorders indicates a worse outcome for hypertension management. This study was designed to explore the influence of hostility on 24-h diastolic blood pressure in hypertension patients who also had depressive disorders.Material/MethodsA total of 130 people with primary hypertension and depressive disorders were collected through unstructured psychiatric interview by a professional psychiatrist and ambulatory blood pressure monitor in this cross-sectional study. During the study, dynamic blood pressure was examined for 24 h by ambulatory blood pressure monitoring. Patients were divided into 3 groups according to the hostility level. Hostility was defined by hostile factors of the Symptom Checklist 90. The association between hostility and 24-h dynamic blood pressure was analyzed by multivariable logistic regression.Results30.8% (40 of 130) patients had a high level of 24-h dynamic blood pressure load (>30%), in which 14.6% was for male and 16.2% for female respectively. In male, the proportion of high 24 h DBP load (>30%) in highest hostility group was greater than that of low hostility group and median hostility group significantly (p=0.03). No significant differences were revealed among 3 groups in female. The age-adjusted odds-ratio (OR) 95% confidence interval of diastolic blood pressure across the categories of hostility were: in males, 1.44 (0.60, 3.47) (1 for reference), and in females, 5.86 (0.58, 59.06) (P for trend=0.04).ConclusionsOur results showed that hostility may be a risk factor for increased 24-h diastolic blood pressure in hypertension patients who also have depressive disorders, especially in males. The clinical meaning of the study is that hypertension management should contain psychological interventions for better effects.

Relationship of affect intolerance with anxiety, depressive, and obsessive-compulsive symptoms in youth

BackgroundStructural research on the construct of affect intolerance (an overarching latent construct indicated by distress tolerance and anxiety sensitivity) has only been conducted in adults. Given that a self-report measure of distress tolerance was recently validated for youth and affect intolerance may be a core mechanism of transdiagnostic interventions for internalizing disorders, we examined how affect intolerance relates to internalizing symptoms in youth. We predicted that a latent affect intolerance factor (indicated by distress tolerance and anxiety sensitivity) would be associated with self and parent-reports of youth anxiety, depressive, and obsessive-compulsive symptoms, controlling for age and gender. MethodsAt a pre-treatment evaluation, youth with a primary depressive, anxiety, or obsessive-compulsive spectrum disorder (N=277) aged 8-17, and their parent, completed questionnaires. ResultsGreater levels of the affect intolerance factor predicted greater youth- and parent-reported youth anxiety, depression, and obsessive-compulsive symptoms, controlling for age. LimitationsFuture research should replicate findings in a sample with a greater proportion of depressed youth and utilize experimental or longitudinal methods. ConclusionsImportantly, distress tolerance and anxiety sensitivity are core transdiagnostic processes that can be targeted in cognitive-behavioral interventions. Future research should examine how transdiagnostic interventions for youth with internalizing disorders can target these cross-cutting emotional vulnerabilities.

التقییم النفسی المُستند إلى القوى الإنسانیة لدى عینات من المرضى النفسیین مقارنة بالعادیین Strength-Based Assessment among samples of psychological disorders patients compared with normal people

هدف هذا البحث إلى التحقق من الاستعانة بالتقييم النفسي المستند إلى القوى الإنسانية في التشخيص النفسي الفارق والتمييز بين المرضى النفسيين والعاديين، وکذلک الفروق بين بعض فئات المرضى النفسيين في القوى الإنسانية، وذلک على عينة من المرضى النفسيين بلغ عددهم (110)، موزعين کالتالي: (27) من ذوي اضطراب کرب ما بعد الصدمة مصاحبة اکتئاب، (41) من ذوي اضطراب کرب ما بعد الصدمة، (20) من ذوي اضطراب الاکتئاب الأساسي، (22) من ذوي اضطراب الوسواس القهري، وعينة مقارنة من العاديين، بلغ عددهم (110) مشارکين. استجابوا لمسح القوى الإنسانية لبترسون وسيلجمان (VIA-IS)، المکونة من 240 بندا، وترجمه الباحث. وأشارت النتائج إلى وجود فروق بين العاديين والمرضى في جميع القوى والفضائل الإنسانية في اتجاه العاديين، بينما وجدت فروق بين عينات المرضى النفسيين، وکان الوسواسيون هم الأعلى بشکل دال إحصائيا في أغلب القوى الإنسانية. وتم تفسير النتائج في ضوء الأدبيات المتاحة والدراسات السابقة والواقع المعاش. The aim of this research is to use Strength-Based Assessmentin psychological diagnosis, the difference and the distinction between mental and normal patients, as well as the differences between some categories of mental patients in Human Strength, on a sample of mental patients (110) distributed as follows: (27) PTSD was associated with depression, (41) with post-traumatic stress disorder, (20) with primary depressive disorder, (22) with obsessive-compulsive disorder, and a comparative sample consists of 110 participants from normal people. They responded to the 240-item (VIA-IS). The results indicated that there were differences between the psychological and mental patients and normal in all the human strengths and human virtues in the direction of normal people, there were differences between mental patients in the direction of obsessive-compulsive patients. The results were explained in light of the available literature, previous studies and the reality life

Subthreshold Depression Needs A Prime Time In Old Age Psychiatry? A Narrative Review Of Current Evidence.

This study aims to carry out a narrative review, aiming to update the literature on subsyndromic depression (SD), which is the most prevalent depressive disorder in older adults, and no formal guidelines or consensus are dedicated to this topic. We carried out an electronic search for articles on SD. Relevant articles were retrieved from Pubmed, EMBASE and Web of Science using the search terms “subthreshold depression,” “prevalence,” “treatment” and “older adults” in several combinations. Original articles in English were included from inception to 1st March 2019. No clear consensus exists in the literature on its nosologic classification, diagnostic tools, causes, course, outcomes or management. SD diagnosis should base in depressive symptoms scales and DSM criteria. Treatment relies mainly on collaborative care and psychotherapy. SD is relevant in clinical practice and research in geriatric psychiatry. Given the negative outcomes and potential benefits of treatment, we recommend brief psychotherapy as first-line treatment and use of psychotropic agents in cases with greater severity and/or functional impairment in association with psychotherapy. SD can precede major depressive disorder, but it also may consist of a primary depressive disorder in older adults. Furthermore, adequate treatment of SD can prevent or reduce negative outcomes associated with depressive symptoms such as worsening of clinical comorbidities, loss of functionality, increased demand for health services, and increased mortality.

Disability, functioning, and quality of life among treatment-seeking young autistic adults and its relation to depression, anxiety, and stress.

In this study, we consecutively recruited treatment-seeking young autistic adults without intellectual impairment aged 16-30 years who presented to a mental health service and evaluated general health (distress, quality of life, and disability), functioning (work loss days and social functioning), and mood symptoms (depression, anxiety, and stress) in those diagnosed with autism spectrum disorder (n = 96). This group was compared to young adults presenting to the same service with primary mental health disorders (depression, n = 343; bipolar, n = 132; psychosis, n = 166; and anxiety, n = 303). This study also investigated the influence of mood symptoms on general health and functioning in the autism spectrum disorder group. Young autistic adults reported significant general health and functioning impairments that were of similar degree to those presenting with primary mental health disorders. Interestingly, the autistic group also reported similarly high levels of mood symptoms to those with primary depressive and anxiety disorders. In the autistic group, depressive symptoms were strongly associated with distress, quality of life, and work loss days, while stress symptoms were strongly associated with disability. This study highlights further research, and mental health services are required specifically targeting young autistic adults to address their significant unmet needs.