Reduction In Depressive Symptoms Research Articles

Engaging husbands in a digital mental health intervention to provide tailored counseling for women experiencing postpartum depression: A mixed methods study in Nepal

BackgroundPostpartum depression (PPD) is a common experience among mothers worldwide. Family members, especially husbands, can play an integral role in supporting and helping mothers recover from PPD. However, husbands are typically not included in interventions to address postpartum depression among women. This study explored husbands’ perspectives on engaging in a counseling intervention augmented with a digital health component for the treatment of PPD. MethodsA convergent mixed methods design was used to evaluate husbands’ attitudes and involvement in a counseling and digital intervention for mothers in a semi-urban region of Nepal.Thematic analysis of semi-structured interviews was used to derive emergent themes. A joint display examined differences in themes for husbands whose wives experienced a significant decline in PPD symptoms as measured by the Patient Health Questionnaire-9 pre and post intervention, as compared to husbands of women whose symptoms stayed the same or worsened. ResultsThirteen husbands were interviewed. Three primary themes emerged: the impact of gender norms and attitudes on engagement in the intervention, involvement and support in the intervention, and suggestions for future interventions for PPD. Among wives who experienced a reduction in depression symptoms, their husbands were more likely to endorse gender-equitable norms and attitudes and the husbands provided emotional support, as well as participating in household chores and childcare. ConclusionWhen husbands are living in the same household, providing support and being involved in their wives’ PPD treatment can help them recover. Husbands describe time at home and work as barriers to being able to help their wives. PPD interventions that involve husbands might need to educate husbands about how they can provide emotional support to their partner.

The impact of preventive behaviors on self-rated health, depression symptoms, and daily functioning among middle-aged and elderly Chinese: An empirical study.

With the intensifying issue of an aging population, the health of middle-aged and elderly individuals garners increased attention. Preventive behaviors are pivotal in enhancing life quality and extending healthy living. This study examines the effects of preventive behaviors on self-rated health, depression, and daily functioning among these populations. Drawing on data from the China Health and Retirement Longitudinal Study (CHARLS), this research applies a panel ordered probability model to scrutinize the influence of preventive behaviors on health outcomes among middle-aged and elderly populations. It utilizes self-rated health, depression, and daily functioning as pivotal health indicators to assess the effects. Preventive behaviors exert a significant impact on self-assessed health and daily functioning among middle-aged and elderly populations. Engagement in social activities effectively reduces depression symptoms. Primary preventive measures, including physical and social activities, enhance health outcomes through medical consultations. Conversely, secondary preventive actions, such as undergoing physical examinations, facilitate early detection of diseases, enabling timely intervention and health advisories. It is noteworthy that individuals with higher incomes derive lesser benefits from these physical or social endeavors. Sociodemographic determinants such as age, income, and educational attainment significantly modulate the efficacy of preventive behaviors on the health outcomes of middle-aged and elderly populations. This research underscores the pivotal role of physical examination services within primary healthcare frameworks and advocates for the tailoring of health promotion strategies to the accessible social needs and engagements of economically and educationally disadvantaged seniors.

The effect of the US Child Tax Credit advance payments in 2021 on adolescent mental health: Changes in depression symptoms and suicidality

ObjectiveChild poverty is associated with poor adolescent mental health. Changes to the Child Tax Credit (CTC) in 2021 in the U.S. were historic and introduced a new model of distributing the credit in advance of tax filing, providing families with stable, supplemental monthly income. This policy shift offers a unique opportunity to examine the mental health effects for adolescents. MethodsWe use electronic health record data from a large pediatric primary care network in Columbus, Ohio, which collected adolescent depression screening scores in real time as the CTC advance payments were introduced. We utilized differences in age of eligibility for the CTC to examine the changes in the probability of depression screening outcomes (positive depression screen, any depression symptom, any suicidal ideation), for adolescents eligible for the credit (turned 18 first quarter of 2022), relative to those not eligible (turned 18 last quarter of 2021) (n = 1,423). ResultsWe did not observe a significant association between the policy change and study outcomes in the overall sample. However, the percentage of adolescents with a positive depression screen significantly declined for Non-Hispanic Black (13.4 percentage point reduction, p = 0.01) and publicly insured (9.7 percentage point reduction, p = 0.04) adolescents. ConclusionsOur findings suggest reductions in depression symptoms for subgroups of adolescents who were age-eligible for the CTC compared to their counterparts who were not eligible. The CTC advance payments were a brief experiment in universal basic income and may offer a policy solution for addressing both poverty and a growing adolescent mental health crisis.

The effects of a telenursing scheduled intervention of brief behavioral activation therapy on depression and anxiety symptoms of patients with mixed depression and anxiety disorder: A randomized controlled trial

BackgroundAlthough many studies have been conducted on the efficacy of behavioral activation in depression, few studies have evaluated the efficacy of this treatment in patients with mixed depression and anxiety through telecare. AimTo determine the effects of a telenursing scheduled intervention of brief behavioral activation therapy on depression and anxiety symptoms of patients with mixed anxiety and depression disorder (MADD). DesignA randomized controlled trial. MethodsThirty subjects with MADD were randomly assigned to an intervention group and a control group. The eight-session person-centered behavioral activation intervention was delivered twice weekly via tele-nursing. Depression and anxiety symptom severity were assessed using the Hamilton Anxiety Rating Scale and the Hamilton Depression Rating Scale at baseline, at the end, and one month after the intervention. Data were analyzed by independent t-tests, chi-square tests, and repeated-measures tests using SPSS version 24. ResultsThe results showed that after the implementation of the intervention, the depression score in the intervention group decreased from 19.86 (±8.56) to 17.21 (±6.71). In contrast, depression scores increased from 18.67 (±9.72) to 19.47 (±7.33) in the control group. For anxiety symptoms, there was a clinically significant decrease after the intervention only in the intervention group. ConclusionThe results showed the effects of brief behavioral activation tele-nursing on a non-significant reduction in depression symptoms and a significant clinical reduction in anxiety symptoms after the intervention in MADD.

The effect of a digital intervention on symptoms of depression in pregnant women exposed to Intimate partner violence in Denmark and Spain (STOP study)

Introduction and objectiveIntimate Partner Violence (IPV) during pregnancy is a significant public health concern associated with adverse maternal and fetal health outcomes, including increased risk of depression. This study aimed to assess the effectiveness of a digital empowerment-based intervention in reducing symptoms of depression among IPV-exposed pregnant women. Study designThis intervention study was nested within a cohort study conducted in Denmark and Spain. Pregnant women attending antenatal care were digital screened for IPV using the Abuse Assessment Screen (AAS) and the Women’s Abuse Screening Tool (WAST). Those screening positive were offered a digital intervention comprising 3–6 video consultations with trained IPV counsellors and access to a safety planning app. Changes in depression scores from baseline to follow-up were evaluated using mixed model regression. ResultsFrom February 2021-October 2022, 1,545 pregnant women (9.6 %) screened positive for IPV within our population (8.5 % in Denmark and 17.0 % in Spain) with 485 (31.4 %) meeting the criteria for the intervention. Of those eligible, 104 (21.4 %) accepted the intervention, and 55 completed it (13.1 %). Post-intervention, a significant reduction in Edinburgh Postnatal Depression Scale (EPDS) was found, with a mean difference of −3.9 (95 % CI: −5.3; −2.4), compared to the average pre-intervention score of 11.3. Stratifying the analyses across sociodemographic variables did not alter the overall result, indicating a reduction in EPDS scores irrespective of setting or sociodemographic factors. Notably, the intervention was most effective for women initially presenting with EPDS scores above the depression cut-off. ConclusionThe findings suggest that a brief digital intervention is associated with a reduction in depression symptoms among pregnant women exposed to IPV, particularly among those with high depressive scores. This highlights the potential of digital interventions in delivering counseling and shows efficacy when administered by both midwives and psychologists in diverse settings. However, the absence of a control group underscores the need for caution in interpreting the results.

Non-specialist delivered psycho-social interventions for women with perinatal depression living in rural communities: A systematic review.

Evidence from low- and middle-income countries suggests that non-specialist-delivered interventions effectively improve access to perinatal mental health care. However, there have been no systematic attempts to synthesize the evidence on effectiveness, relevance, and application of this strategy to resource-limited settings such as rural areas. The aim of this review is to synthesize the evidence about the effectiveness of non-specialist delivered interventions in improving depression and related outcomes in women with perinatal depression living in rural communities. Seven electronic databases were searched using the following search concepts: perinatal depression (e.g., puerperal depression, antenatal depression), rural areas (e.g., remote, nonmetropolitan, underserved), and non-specialist workers (e.g., lay worker, volunteer aide, informal caretaker. The risk of bias was assessed using RoB-2 and ROBINS-I tools. A narrative synthesis was performed as the high degree of study heterogeneity precluded a meta-analysis. Nine unique studies were eligible for inclusion. Psychoeducation and problem-solving techniques were the most used intervention elements. Two interventions significantly reduced the prevalence of perinatal depression compared to usual care, and three interventions reported effectiveness in reducing depression symptom severity. There was little to no consistent evidence for other outcomes, including but not limited to maternal health care utilization, breastfeeding behaviors, and child health. This review provides limited evidence to suggest that non-specialist delivered interventions effectively improved outcomes among women with perinatal depression living in rural communities. The paucity of high-quality studies included in this review demonstrates that this rural demographic is frequently neglected in the context of maternal mental health research.

Associations Between Reductions in Depressive Symptoms and Reductions in Pain and Anxiety Symptoms and Substance Use: Emulation of a Randomized Trial

Depressive symptoms are linked with pain, anxiety, and substance use. Research estimating whether a reduction in depressive symptoms is linked to subsequent reductions in pain and anxiety symptoms and substance use is limited. Using data from the Veterans Aging Cohort Study, a multisite observational study of U.S. veterans, the authors used a target trial emulation framework to compare individuals with elevated depressive symptoms (Patient Health Questionnaire-9 score ≥ 10) who experienced reductions in depressive symptoms (Patient Health Questionnaire-9 score < 10) with those whose symptoms persisted (Patient Health Questionnaire-9 score ≥ 10) at the next follow-up visit (on average, 1 year later). Using inverse probability of treatment weighting, the authors estimated ORs and 95% CIs for associations between depressive symptom reduction status and improvement on the following: anxiety symptoms, pain symptoms, unhealthy alcohol use, and use of tobacco, cannabis, cocaine, and/or illicit opioids. Reductions in depressive symptoms were associated with reductions in pain symptoms (OR=1.43, 95% CI=1.01, 2.02), anxiety symptoms (OR=2.50, 95% CI=1.63, 3.83), and illicit opioid use (OR=2.07, 95% CI=1.13, 3.81). Depressive symptom reductions were not associated with reductions in unhealthy alcohol use (OR=0.85, 95% CI=0.48, 1.52) or use of tobacco (OR=1.49, 95% CI=0.89, 2.48), cannabis (OR=1.07, 95% CI=0.63, 1.83), or cocaine (OR=1.28, 95% CI=0.73, 2.24). Reducing depressive symptoms may potentially reduce pain and anxiety symptoms and illicit opioid use. Future work should determine whether reductions achieved through antidepressant medications, behavioral therapy, or other means have comparable impact.

Docosahexaenoic Acid (DHA) and Eicosapentaenoic Acid (EPA)-Should They Be Mandatory Supplements in Pregnancy?

Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are essential fatty acids for the human body. Seafood and microalgae are the most important sources of omega-3 fatty acids. Supplementation with 200 mg/day of DHA during pregnancy and breastfeeding has been suggested for women and infants in countries with low seafood consumption. Maternal concentration of DHA and EPA was associated with concentration in cord blood and breast milk. High concentrations of DHA and EPA were identified at the level of retinal photoreceptors and neuronal cell membranes. It was observed that supplementation with DHA and EPA during pregnancy had beneficial effects on the neurological development of the fetus and infant by improving language, memory, attention, and hand coordination, affecting sleep patterns, and improving visual acuity. Beneficial effects on the development of the infant were also associated with the maternal intake of omega-3 fatty acids during breastfeeding. Supplementation with DHA and EPA may reduce the risk of preterm birth but also of preeclampsia in low-risk pregnancies. Women of childbearing age should have an intake of 250 mg/day of DHA + EPA from their diet or supplements. To reduce the risk of premature birth, pregnant women must additionally receive at least 100-200 mg of DHA every day. It is recommended that supplementation with omega-3 fatty acids starts before 20 weeks of pregnancy. Beneficial effects on the mother have been identified, such as the reduction of postpartum depression symptoms, the decrease of cardiovascular risk, and the anti-inflammatory role.

Online mindfulness-based cognitive therapy for treatment-resistant depression: a parallel-arm randomized controlled feasibility trial.

Treatment-resistant depression (TRD) presents a significant challenge, affecting approximately 30% of individuals diagnosed with major depressive disorder and leading to poor treatment responses. Innovations in digital mental health, especially online mindfulness-based cognitive therapy (eMBCT), offer promising avenues for enhancing access to effective mental health care for individuals with TRD in a clinical setting. The aim of this study was to examine the feasibility of eMBCT in an individual clinical context to decrease depressive symptoms for TRD. Conducted at the Institute of Psychiatry of the Federal University of Rio de Janeiro, Brazil, this parallel-arm, randomized controlled feasibility trial involved outpatients diagnosed with TRD, aged 18 and above. Of the 39 outpatients invited, 28 were randomized into two groups: an intervention group receiving the eMBCT program (n = 15) and a control group (n = 13). The intervention, consisting of an 8-week course, was delivered via live video sessions. Following the assessment period, participants in the control group were offered the eMBCT intervention. Assessments using standardized questionnaires were conducted at the start and end of the study. Within the eMBCT group, improvements were observed in depression symptoms (Z = -3.423; p = 0.001; effect size r = 0.78), anxiety symptoms (Z = -3.361; p = 0.001; effect size r = 0.77), with no significant changes in the control group. Comparatively, the eMBCT group showed significant reductions in depression symptoms and improvements in clinical global impressions over the control group (BDI2: U = 30.5; p = 0.015; effect size r = 0.47, CGI1: U = 21.0; p = 0.004; effect size r = 0.56). eMBCT in an individual format combined with medication, appears to be a feasible treatment for TRD, decreasing symptoms of depression. In a future trial the control group may have a manualized intervention. The Brazilian Clinical Trials Registry: (https://ensaiosclinicos.gov.br/rg/RBR-6zndpbv) and RBR-6zndpbv.

Taking ACTion for anxiety and depression: A pilot study of a brief virtual Acceptance and commitment therapy group in primary care

Brief Acceptance and Commitment Therapy (ACT) interventions are well-suited to facilitate timely access to effective treatment for patients experiencing common mental health concerns. This study piloted a 4-session virtual ACT group for primary care patients experiencing symptoms of depression and anxiety (n = 21). Changes in symptoms of depression and anxiety, psychological flexibility, and quality of life (QoL) were examined at post-treatment and at 1- and 3-month follow-up. At a group level, there were significant reductions in symptoms of depression for all time points and symptoms of anxiety were significantly reduced at 1- and 3-month follow-up. Measures of psychological flexibility and QoL were significantly improved at 1- and 3-month follow-up. Reliable change index scores revealed high proportions of individual improvement for depression and anxiety symptoms (56–83% across time points). Proportions of reliable change ranged from 25 to 50% for measures of psychological flexibility and QoL at 1- and 3-month follow-up. Overall, these results are comparable with previously reported rates of improvement for empirically supported treatments and provide preliminary evidence for the effectiveness of this brief ACT intervention delivered in a community setting.

Increased Dietary Carotenoid Intake and Reduced Depression Symptoms in Hispanic/Latino Midlife Adults

Increased Dietary Carotenoid Intake and Reduced Depression Symptoms in Hispanic/Latino Midlife Adults

Psychological Interventions for PTSD, Depression, and Anxiety in Child, Adolescent and Adult Forced Migrants: A Systematic Review and Frequentist and Bayesian Meta-Analyses.

The number of forced migrants has been rising for years. Many forced migrants suffer from post-traumatic stress disorder (PTSD), depression, and/or anxiety and need treatment. Here, we evaluate the effectiveness of psychological interventions (CBT, EMDR, expressive/art, mindfulness, mixed elements, NET and psychoeducation) in reducing symptoms of PTSD, depression, and anxiety in forced migrants. Systematic searches in PubMed and Web of Science and searches of preprint servers and grey literature were performed (final search date: 1 September 2023). Random-effects frequentist and Bayesian meta-analyses were used for data synthesis. We included 84 studies on treatment effects in adults (pooled N = 6302) and 32 on children and adolescents (pooled N = 1097). Our data show a reduction in symptoms of PTSD, depression and anxiety symptoms in both adults and child/adolescent forced migrants. Pooled pre- to post-treatment effects (effect size Cohen's d) ranged from -1.03 to -0.26 for PTSD, from -0.91 to -0.11 for depression and from -0.91 to -0.60 for anxiety, without there being differences in outcome per study design (i.e., RCT comparison vs. non-RCT comparison vs. single arm treatment study). Treatment effects remained evident over follow-up, and not a single type of treatment stood out as being superior to other treatment types. Structural differences in populations (e.g., regarding country of origin) over studies, however, could have hampered the validity of the comparisons between study characteristics such as treatment type. Our findings support the effectiveness of psychological treatment in adult and child/adolescent forced migrants.

Implementation of caring contacts using patient feedback to reduce suicide-related outcomes following psychiatric hospitalization.

Suicide risk is substantially elevated following discharge from a psychiatric hospitalization. Caring Contacts (CCs) are brief communications delivered post-discharge that can help to improve mental health outcomes. This three-phase, mixed-method quality-improvement study revised an existing CC intervention using iterative patient and community feedback. Inpatients (n = 2) and community members (n = 13) participated in focus groups to improve existing CC messages (phases 1 and 2). We piloted these messages among individuals with a suicide-related concern following discharge from an inpatient psychiatric hospitalization (n = 27), sending CCs on days 2 and 7 post-discharge (phase 3). Phase 3 participants completed mental health symptom measures at baseline and day 7, and provided feedback on these messages. Phase 1 and 2 focus group participants indicated preferences for shorter, more visually appealing messages that featured personalized, recovery-focused content. Phase 3 participants demonstrated reductions in depressive symptoms at day-7 post-discharge (-6.4% mean score on Hopkins-Symptom-Checklist, -9.0% mean score on Entrapment-Scale). Most participants agreed that CC messages helped them feel more connected to the hospital and encouraged help-seeking behavior post-discharge. This study supports the use of an iterative process, including patient feedback, to improve CC messages and provides further pilot evidence that CC can have beneficial effects.

A network meta-analysis of psychological interventions for children and adolescents after natural and man-made disasters

IntroductionChildren and adolescents, after natural and man-made disasters, often exhibit various psychological, emotional, and behavioral issues, showing a range of clinical symptoms related to post-traumatic stress disorder (PTSD) and depression. This review used a network meta-analysis (NMA) approach to compare and rank psychological interventions for PTSD and depression in children and adolescents after exposure to natural and man-made disasters.MethodsRandomized studies of psychosocial interventions for PTSD and depression in children and adolescents exposed to natural and man-made disasters were identified. PTSD and depression symptoms at postintervention and 1–12 month follow-up are the outcomes. The standardized mean differences (SMDs) between pairs of interventions at postintervention and follow-up were pooled. Mean effect sizes with 95% credible intervals (CI) were calculated, and the ranking probabilities for all interventions were estimated using the surface under the cumulative ranking curve. Study quality was assessed with version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2).ResultsIn total, 26 studies with 4331 participants were included in this NMA. Eye movement desensitization and reprocessing therapy (EMDR) (SMD = − 0.67; 95% CI − 1.17 to − 0.17), exposure therapy (ET) (SMD = − 0.66; 95% CI − 1.11 to − 0.22), and cognitive behavioral therapy (CBT) (SMD = − 0.62; 95% CI − 0.90 to − 0.34) were significantly more effective for PTSD at postintervention than inactive intervention. EMDR (SMD = − 0.72; 95% CI − 1.11 to − 0.33) and ET (SMD = − 0.62; 95% CI − 0.97 to − 0.27) were associated with a higher reduction in PTSD symptoms at follow-up than inactive intervention. EMDR (SMD = − 0.40; 95% CI − 0.78 to − 0.03) and play therapy (PT) (SMD = − 0.37; 95% CI − 0.62 to − 0.12) were significantly more effective for depression at postintervention than inactive intervention. For all psychological interventions in reducing depression symptoms at follow-up compared with inactive intervention, the differences were not significant.ConclusionEMDR appears to be most effective in reducing PTSD and depression in children and adolescents exposed to natural and man-made disasters. In addition, ET and CBT are potentially effective in reducing PTSD symptoms at postintervention, while PT is beneficial in managing depression symptoms at the treatment endpoint.

Electroconvulsive Therapy Changes Immunological Markers in Patients With Major Depressive Disorder: A Scoping Review.

Major depressive disorder (MDD) is a highly prevalent and disabling condition. As such, understanding the causes of and treatment options for MDD is critical. Electroconvulsive therapy (ECT) remains the gold standard depression treatment, but the molecular mechanisms that underlie its effects are still largely unknown. One such explanation hinges on the immuno-inflammatory correlates of ECT treatment, given mounting evidence supporting the inflammatory hypothesis of depression. This review aims to provide an overview of the suggested immunomodulatory effects of ECT and the predictive value of immune biomarkers in relation to treatment outcomes and side effects. We conducted a preregistered, systematic literature search utilizing MEDLINE (PubMed), Embase (Elsevier), and PsycINFO (EBSCO) databases. We employed keywords related to MDD, ECT, gut microbiome, and the immune system. We only included human subjects research published between 1985 and January 13, 2021. Twenty-six unique studies were included in our analyses. Findings indicate a proinflammatory profile associated with MDD, with immune biomarkers exhibiting acute and chronic changes following ECT. Consistently, lower baseline interleukin 6 levels and higher C-reactive protein levels are correlated with a greater reduction in depressive symptoms following ECT. Furthermore, included studies emphasize the predictive value of peripheral immune changes, specifically interleukin 6 and tumor necrosis factor α, on cognitive outcomes following ECT. Given these results, further exploration of the potential roles of immunomodulatory effects on ECT treatment outcomes, as well as adverse cognitive side effects, is indicated.

A brief reappraisal intervention leads to durable affective benefits.

People who report frequently using cognitive reappraisal to decrease the impact of potentially upsetting situations report better affective functioning than people who report using cognitive reappraisal less frequently. However, most work linking everyday reappraisal use to affective outcomes has been correlational, making causal inference difficult. In this study, we examined whether 2 weeks of daily practice of reappraising negatively valenced personally relevant events would improve affective functioning compared with a wait-list control. Data were collected between 2021 and 2022 from a sample mainly comprised of females (82%) and who identified as Asian (35%) or White/Caucasian (40%). Our planned analyses indicated that reappraisal decreased depressive symptoms and perceived stress as well as increased life satisfaction both immediately and 4 weeks postintervention. Reductions in depressive symptoms and perceived stress were mediated by increases in reappraisal self-efficacy. These findings support the causal efficacy of brief reappraisal training. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A novel approach to treating post-stroke depression: administration of Botulinum Toxin A via local facial injection.

Post-stroke depression (PSD) is a frequent complication following a stroke, characterized by prolonged feelings of sadness and loss of interest, which can significantly impede stroke rehabilitation, increase disability, and raise mortality rates. Traditional antidepressants often have significant side effects and poor patient adherence, necessitating the exploration of more suitable treatments for PSD. Previous researchers and our research team have discovered that Botulinum Toxin A (BoNT-A) exhibits antidepressant effects. Therefore, our objective was to assess the efficacy and side effects of BoNT-A treatment in patients with PSD. A total of 71 stroke patients meeting the inclusion criteria were allocated to the two group. 2 cases were excluded due to severe neurological dysfunction that prevented cooperation and 4 cases were lost follow-up. Ultimately, number of participants in the BoNT-A group (n = 32) and Sertraline group (n = 33). Treatment efficacy was evaluated 1, 2, 4, 8 and 12 weeks post-treatment. There were no significant differences in baseline characteristics between the two groups (p > 0.05). Both groups exhibited comparable treatment efficacy, with fewer side effects observed in the BoNT-A group compared to the Sertraline group. BoNT-A therapy demonstrated significant effects as early as the first week (p < 0.05), and by the 12th week, there was a notable decrease in neuropsychological scores, significantly lower than the baseline level. The analysis revealed significant differences in measurements of the Hamilton Depression Scale (HAMD) (F(770) = 12.547, p = 0.000), Hamilton Anxiety Scale (HAMA) (F(951) = 10.422, p = 0.000), Self-Rating Depression Scale (SDS) (F(1385) = 10.607, p = 0.000), and Self-Rating Anxiety Scale (SAS) (F(1482) = 11.491, p = 0.000). BoNT-A treatment effectively reduces depression symptoms in patients with PSD on a continuous basis.

Impact of Ocrelizumab on Disease Progression, Memory Improvement, and Quality of Life in Patients with Relapsing-Remitting Multiple Sclerosis: A Longitudinal MRI and Clinical Criteria Analysis.

Multiple sclerosis (MS) is a chronic, progressive neurological disorder that significantly impacts quality of life and functionality. Ocrelizumab, a monoclonal antibody targeting CD20-positive B cells, has emerged as a treatment for relapsing-remitting MS (RRMS). This study aimed to assess the impact of ocrelizumab on disease progression and quality of life over a longitudinal course, utilizing clinical criteria and magnetic resonance imaging (MRI) analyses. Conducted at the Neurology Department of Pius Brinzeu Clinical Emergency Hospital in Western Romania from 2020 to 2023, this observational study enrolled 93 patients with RRMS who commenced ocrelizumab therapy. The study employed the Expanded Disability Status Scale (EDSS) and MRI to evaluate disease progression, while quality of life was assessed using the World Health Organisation Quality of Life (WHOQOL) questionnaire, Beck Depression Index (BDI), and MOCA scales. Significant improvements were observed post-treatment. EDSS scores decreased from 4.61 to 4.08 (p = 0.038), indicating reduced disability. MRI analyses showed a substantial decrease in expansive lesions (from 67.74% to 26.88%, p < 0.001) and an increase in stationary lesions (from 32.26% to 73.12%, p < 0.001). Quality of life improvements were notable in the physical (from 58.42 to 64.84, p = 0.005) and environmental domains (from 63.21 to 68.44, p = 0.033). Cognitive functions, assessed via Montreal Cognitive Assessment (MOCA), showed a significant total score increase from 20.38 to 22.30 (p < 0.001). Subgroup analysis revealed more pronounced effects in females and younger patients, with a significant reduction in depressive symptoms measured by BDI scores (from 14.35 to 11.62, p = 0.003). Ocrelizumab significantly reduced disease activity and disability in RRMS patients, as demonstrated by improvements in EDSS scores and MRI findings. Quality of life and cognitive functions also showed considerable enhancements. These findings support ocrelizumab's efficacy in not only managing MS symptoms but also improving overall patient well-being.

Examining the Bioactive Elements of Urtica urens Hydroalcoholic Extract and Its Possible Antidepressant Effects in Mice

The majority of antidepressant medications reduce depression symptoms, but they also have a number of undesirable side effects. The hunt is on for medications that are both more effective and well-tolerated. In light of this, the current investigation set out to assess the hydroalcoholic extract of Urtica Urens L.'s aerial parts' (HAUU) antidepressant potential in mice. The Tail Suspension Test (TST) and the Forced Swimming Test (FST) on mice were used to assess it. For 14 days, the HAUU (250 and 500 mg/kg, po) was given orally to distinct groups of 20–25-weight Swiss albino mice in order to conduct TST and FST testing. The presence of alkaloids, glycosides, phenols, flavonoids, and tannins was discovered through phytochemical examination. The HAUU demonstrated a dose-dependent decrease in the amount of time that mice were immobile. Mice's immobility duration was considerably shortened in both the FST and TST when 500 mg/kg of HAUU was administered. The extract's effectiveness was discovered to be on par with fluoxetine (20 mg mg/kg, po). It was discovered that when given orally at a dose of 2000 mg/kg, it was toxicologically safe and did not cause any mouse deaths. The results of the current investigation indicate that the HAUU is toxicologically safe and has strong antidepressant activity, as demonstrated by the TST and FST tests. Keywords: Urtica Urens L, Depression, Tail suspension test, Forced swimming test, Fluoxetine

Online acceptance and commitment therapy (iACT) for adults with persistent physical symptoms – 3-month follow-up study of a randomized controlled trial

ObjectivePersistent physical symptoms (PPS) represent a major health problem affecting daily functioning. This RCT aimed to examine whether a guided Internet-based treatment based on acceptance and commitment therapy (ACT) provided additional benefits compared to Treatment as Usual (TAU) in reducing somatic complaints and psychological distress in adults with PPS. MethodsA total of 103 adults with PPS related to indoor environments, chronic fatigue or both conditions were assigned to receive either either a 14-week intervention (video-based case conceptualization + Internet-based ACT) combined with TAU (iACT + TAU; n = 50) or TAU alone (n = 53). Somatic symptoms, depression, anxiety, insomnia, and psychological flexibility were assessed from pre-intervention to a 3-month follow-up. Additionally, the association between changes in psychological flexibility from pre- to post-intervention and changes in symptoms from pre to 3-month follow-up was explored. Analyses were conducted using a multigroup method with full information maximum likelihood estimator. ResultsThe results revealed a significant interaction effect, indicating reductions in somatic symptoms and symptoms of depression and anxiety with moderate to large between-group effects (d = 0.71–1.09). No significant interaction effect was observed in insomnia and measures of psychological flexibility. ConclusionInternet-based ACT, when combined with Treatment as Usual, demonstrated efficacy for individuals with PPS associated with indoor environments and chronic fatigue. These findings are pertinent for primary healthcare providers, suggesting that the current treatment model could serve as a low-threshold first-line treatment option.The clinical trial registration number: NCT04532827