Self-reported Depression Scores Research Articles

A National Survey on the Relationship of Youth Sport Specialization Behaviors to Self-Reported Anxiety and Depression in Youth Softball Players.

There are little to no data on whether any associations exist between sport specialization and mental health in youth softball athletes. Highly specialized youth softball athletes will have worse self-reported depression and anxiety symptom scores compared with low and moderate specialized athletes. Cross-sectional survey. Level 4. An online cross-sectional survey was distributed in the fall of 2021 to a national sample of female youth softball athletes between the ages of 12 and 18 years. Sport specialization status was determined using a 3-point specialization scale that classifies either low, moderate, or high. The patient health questionnaire-9 (PHQ-9) and the 7-item general anxiety disorder scale (GAD-7) were used to assess self-reported symptoms of depression and anxiety. Comparison also included sports participation and specialization behaviors between specialization groups. A total of 1283 subjects (mean age, 15.1 ± 1.7 years) fully completed the survey. After adjusting for covariates, lower scores were reported on both the PHQ-9 and GAD-7 by highly specialized athletes compared with moderate or low specialization athletes (PHQ-9, high = 8.6 ± 0.4; moderate = 11.2 ± 0.3; low = 10.9 ± 0.5; P < 0.01; GAD-7, high = 6.5 ± 0.4; moderate = 8.6 ± 0.3; low = 8.4 ± 0.4, P < 0.01). Conversely, higher scores were reported on both scales for athletes who received private softball coaching compared with those who did not (PHQ-9, 11.5 ± 0.3 vs 9.0 ± 0.3; P < 0.01; GAD-7, 8.8 ± 0.3 vs 6.9 ± 0.3, P < 0.01). Finally, athletes who reported an arm overuse injury in the previous year reported higher PHQ-9 scores (10.8 ± 0.3 vs 9.8 ± 0.3; P < 0.01). While sport specialization, as measured by the validated 3-point scale, was not associated with increased anxiety and depression symptom scores, other aspects of specialization behavior such as private coaching or overuse injury history were associated with worse scores on these scales, indicating potential concern for anxiety and depression. However, although the differences we observed were statistically significant, they did not exceed the minimal clinically important difference values that have been established for the PHQ-9 (5 points) or GAD-7 (4 points). This project is a first step toward understanding the sport specialization behaviors and their influence on the mental health of youth softball athletes. Focusing on investigating specialization behaviors further may reveal to be a better indicator of risk of developing anxiety and depression symptoms compared with utilizing the 3-point specialization scale.

Risk tolerance in youth with emerging mood disorders

Reward-seeking behavior drives adolescents toward risky decision-making. As compared to their older and younger peers, adolescents experience higher rates of anxiety and depressive disorders, leading to impaired decision-making with negative consequences. At two time points, separated by 6–8 weeks, we measured risky and ambiguous choices concurrently with levels of dysregulated emotion for youth aged 16–25 (N = 30, mean age 19.22 years, 19 males) attending a youth mental health clinic. The Kessler Psychological Distress Scale (10 items) (K10), the Quick Inventory of Depressive Symptomatology Adolescent (17 items) (QIDS-A17) specifically designed for youth, and the Somatic and Psychological Health Report (12 items) (SPHERE-12) questionnaires were used to evaluate participant’s self-reported anxiety and depression scores. Risk and ambiguity tolerance was calculated at the individual and group level. At baseline, 25 (83%) participants were rated as experiencing a mental health condition, and 15 (50%) rated high on all three psychological questionnaires combined, scoring “severely” depressed and “severely” anxious. At follow-up, 25 returning participants, 80% (N = 20) remained distressed, with 11 continuing to rate high on all psychological scores. In Session 1, participants had a mean of approximately 14 risky choices (SD = 4.6), and 11 ambiguous choices (SD = 7.6), whilst in Session 2, participants’ mean equated to approximately 13 ambiguous choices (SD = 8.5), but their risk increased to 15 choices (SD = 6.5). Applying a multiple regression analysis at the group level, the data suggests that participants were risk averse (α = 0.55, SE = 0.05), and preferred making ambiguous choices (β = 0.25, SE = 0.04). These results suggest that high trait-like anxiety in youth is associated with risk intolerance. These findings may have implications for screening young people with emerging mood disorders.

Long Term Antidepressant Effects of Deep Brain Stimulation for Treatment Resistant Depression – A Research Protocol

Introduction: Individuals with treatment resistant depression (TRD) are those with severe major depressive disorder who fail to respond to conventional pharmacological treatment. As a result, novel technologies in the field of neuromodulation have been investigated to alleviate depressive symptoms in this population. One such neuromodulation therapy is deep brain stimulation (DBS), in which electrodes are neurosurgically implanted into target regions of the brain associated with depression, such as the subgenual anterior cingulate cortex (sgACC). While previous studies have explored the use of DBS as a therapy for TRD, few studies with adequate statistical power have explored the sustained antidepressant effects of DBS when targeting the sgACC of the brain. Methods: This study aims to explore the long-term effects in DBS patients for TRD by measuring changes in cerebral blood flow and cerebral metabolic rate in the sgACC, and its correlation to changes in self-reported depressive symptoms. Forty-five participants will be enlisted into this study. Psychometric evaluation and positron-emission topography imaging will be conducted prior to neurosurgery. Electrodes will be implanted into the sgACC, with extension wires attaching the electrodes to the internal pulse generator. In the six-week blinded phase, progressive increases in stimulation will be administered within the blinded group and sham stimulation in controls. The three-month open label phase will administer the same degree of high-frequency biphasic stimulation to the control and blinded groups and assess depression scores, neuroimaging, and adverse events. After cessation of active stimulation, a one-year, three-year, seven-year, and ten-year follow-up will monitor changes in antidepressant effects of DBS using simple linear contrasts and paired-sample t-tests. Expected Results: This study expects to find a sustained antidepressant response marked by decreases in sgACC metabolism and cerebral blood flow, and a reduction in self-report depression scores. Discussion: The use of DBS shows promise as a successful treatment intervention with sustained long-term effects for individuals with TRD. Additional secondary outcomes to be expected are improved quality of life and health behaviours. Conclusion: Though minor fluctuations are expected due to the presence of comorbidities, this study expects to showcase the long-term efficacy of deep brain stimulation for treatment resistant depression.

Mental Health Impact of COVID-19 Infection on Postpartum Women from Lower and Middle-income Backgrounds in India and its Effects on Early Mother-infant Bonding: An Observational Study.

The study was designed to examine the mental health impact of COVID-19 infection in postpartum women and its effects on mother-infant bonding during the first eight weeks postpartum. Fifty-seven consenting eligible postpartum women were recruited for the study. They were assessed at two time points using standardized rating scales to measure distress and uniquely designed scales assessing COVID-19-specific outcome fears and bonding. Almost half [42%] of postpartum women with COVID-19 suffered from a probable anxiety disorder, and one-third [33.3%] suffered from probable depression. The overwhelming majority [91.2%] experienced COVID-19-specific fear. There was an inverse relationship between one dimension of maternal caregiving and self-report depression and anxiety scores, respectively. Additionally, despite discharge, 25% of the mothers had not breastfed the infants till the 8th-week postpartum period, which is in discordance with the World Health Organization (WHO) recommendation of exclusive breastfeeding up to 6 months of age that is widely practiced in India. The novel COVID-19 pandemic was associated with anxiety and depression, impacting mother-infant bonding. Therefore, there is a need for specialized mental health services and individualized breastfeeding interventions for this vulnerable population to ensure positive outcomes.

Sleep Quality and Self-Reported Symptoms of Anxiety and Depression Are Associated with Physical Activity in Patients with Severe COPD.

Sleep quantity, quality and symptoms of depression or anxiety potentially affect the level of daily physical activity (PAL) and plausibly counteracts benefits from pulmonary rehabilitation programs. Their collective impact on PAL is sparsely investigated, particularly in patients with severely progressed chronic obstructive pulmonary disease (COPD). Aim: To investigate if sleep quantity, quality and symptoms from self-reported hospital anxiety and depression scores (HADS) are associated with PAL. Methods: In this exploratory cross-sectional study data were analysed from 148 participants with COPD; GOLD grade II-IV; GOLD group B to D (52% female, mean 69.7 ± SD of 8.4 years, FEV1% predicted 33.6 ± 10.9, 6MWD 327 ± 122 m, CAT 20 ± 7 points), eligible for conventional outpatient hospital-based pulmonary rehabilitation. Participants had sleep and PAL measured 24 h per day for five consecutive days with an activPAL monitor. Adjusted negative binomial regression was applied to investigate the associations with PAL. Results: Participants walked median (25th, 75th percentile) of 2358 (1325.75; 3822.25) steps per day and 14% walked >5000 steps per day on average. Time in bed (TIB) were a median (25th, 75th percentile) of 8.3 (7.1; 9.7) hours and numbers of nocturnal sleeping bouts (NSB) were 1.5 (0.8; 3), Anxiety (HADS-A) and depression (HADS-D) scores were median (25th, 75th percentile) of 5 (3; 8) points and 3 (2; 6) points, respectively, whereof 29% (HADS-A) and 15% (HADS-D) reported scores ≥8 points indicating significant symptoms. The fully adjusted rate ratio (RR) for steps per day for TIB (hours) [RR 0.97 (95% CI: 0.92; 1.02)], NSB (numbers) [RR 1.02 (95% CI: 0.97; 1.07)] were not significantly associated with number of steps per day, while there was a significantly association with number of steps per day for HADS-A [RR 1.04 (95% CI: 1.01; 1.07)] and HADS-D [RR 0.95 (95% CI: 0.91; 0.99)]. Conclusion: This exploratory cross-sectional study found a statistically significant association between HADS-A and HADS-D with numbers of steps per day in patients with severe COPD.

[Remote psychological intervention for the treatment of depression heart failure].

Cardiovascular disease and depression are considered public health problems, depression is a risk factor for patients with heart failure (HF) for its clinical implications. The objective of this study was to describe two modalities of psychotherapeutic interventions in the approach to depression in patients with HF. We searched the specialized databases MEDLINE, PubMed, PsycINFO, Web of Science, CINAHL and Cochrane Library from 2010 to 2020. Selection criteria. Articles were selected by title and abstract., published in the last 10 years, written in Spanish or English and repeated registrations were deleted. Three authors collected information from the studies being documented. We included 4 clinical studies with 911 patients, were conducted in 4 countries in the last 10 years and implemented different methods of digital interventions and home visits, the effects of these treatments have been statistically significant to reduce self-reported depression scores in patients with HF who received psychotherapeutic intervention in any of these modalities compared to those patients who only received a treatment. Due to the limited number of studies and different methods of intervention, a standard treatment of HF depression in these care formats is not identified, so more research in this field of study is recommended.

Online guided meditation training (Isha Kriya) improves self-reported symptoms of anxiety and depression within 2 weeks of practice—An observational study

IntroductionAnxiety and depression have increased dramatically 2–3-fold with the COVID-19 pandemic. There is an urgent need for safe, cost-effective, and scalable approaches to alleviate this parallel mental health pandemic. Meditation has previously been shown to reduce stress, anxiety, and depression symptoms. Furthermore, online delivery of mind-body interventions will be impactful in addressing disparities in access to mental healthcare. In this observational pilot study, we investigate the impact of a digitally delivered guided meditation followed by daily practice on symptoms of anxiety and depression.MethodsInitially, 57 male and 202 female subjects enrolled in this study. Participants attended a webinar where they learned the Isha Kriya meditation practice. They were subsequently requested to perform the intervention daily for 6 weeks. Subjects were given scales to assess anxiety and depression at baseline, 2, 4, and 6 weeks following the training. The changes in the self-reported anxiety and depression scores were examined by the linear mixed effect models.ResultsParticipants completed survey responses for the following time points: baseline (n = 82), week 2 (n = 58), week 4 (n = 37), and week 6 (n = 28). During the 6 weeks of the study over 68% of subjects were compliant with their daily practice. When comparing baseline with week 2, the mean anxiety scores decreased from 25.4 to 16.8 (p < 0.01, d = 1.31). Similarly, mean depression scores decreased from 15 to 8.81 (p < 0.01, d = 0.9). The reduced scores for both anxiety and depression were maintained at weeks 4 and 6.ConclusionThis preliminary study assesses the effectiveness of online meditation training on self-reported symptoms of anxiety and depression. After 2 weeks of practice, those with baseline anxiety and depression showed significant improvement with a large effect size. The results from weeks 4 and 6 show sustained reduced anxiety and depression symptoms. These findings suggest that daily Isha Kriya practice could alleviate symptoms of these conditions. Future studies utilizing randomized control trials should be conducted to rigorously evaluate the benefits of this meditation practice on anxiety and depression.Trials registrationClinicalTrials.gov, identifier: NCT05065476.

Phase II study of ketogenic diets in relapsing multiple sclerosis: safety, tolerability and potential clinical benefits

BackgroundDietary changes impact human physiology and immune function and have potential as therapeutic strategies.ObjectiveAssess the tolerability of a ketogenic diet (KD) in patients with relapsing multiple sclerosis (MS) and define...

Internet use, depression, and cognitive outcomes among Chinese adolescents.

This study provides new evidence on how the growingly significant digital life shapes Chinese adolescents' cognitive and mental health outcomes based on their gender, parental education, and geographical location. Using the China Education Panel Survey, a nationally representative survey following 12-15-year-old students in 2013 and 2014, and individual fixed-effect models, we find that more time spent on the Internet is associated with higher self-reported depression scores. This negative impact on mental health is more substantial for girls, those with less-educated parents, and those living outside the city center. The link between Internet use and cognitive development is almost null. Time spent online negatively affects Chinese young adolescents' subjective well-being but has little impact on their cognitive development. The link between Internet use time and subjective well-being also depends on gender, parental education, and the geographical location of those adolescents. The heterogeneous impacts of Internet use time offer crucial new evidence to the multiple dimensions of the digital divide among adolescents in China.

Living with a child who has a life-limiting condition: The functioning of well-siblings and parents.

Living with a child who has a life-limiting condition (LLC) is likely to have a major impact on all family members. There is a need to have a clearer understanding of the nature and extent of this impact on parents and well-siblings. The current study aimed to investigate the psychosocial functioning of well-siblings and parents living with a child with an LLC. Further, the study aimed to assess the resilience resources of both well-siblings and parents, giving consideration to how these relate to psychosocial functioning. Participants included 48 well-siblings (6-21 years) and 42 parents of children with LLCs. Parents and well-siblings independently completed validated measures of child and adult functioning and personal resilience. Parents provided demographic information about the patient and family. The emotional, social and school functioning of well-siblings in the current study was found to be significantly poorer than published norms (all p's < .01). Parental self-reported depression, anxiety and stress scores were also all significantly poorer than published norms (all p's < .01). There was negligible agreement between well-sibling self-reported functioning and parental proxy-report of the well-siblings functioning (all r's < .126, all p's > .464). Sibling self-reported resilience was positively correlated with each of the measures of psychosocial functioning (all r's > .318, p's < .05). Parental resilience was significantly negatively correlated with depressive symptoms (r = -.369, p < .05) and anxiety symptoms (r = -.473, p < .01) but not stress scores (r = -.074, p = .644). Family members living with a child who has an LLC were found to have significantly poorer psychosocial functioning than published norms. Although one cannot infer a causal direction from the current study, greater self-reported well-sibling and parental resilience were associated with aspects of better self-reported psychosocial functioning. Future studies should assess the impact of psychosocial interventions aimed at enhancing the resilience and functioning of both well-siblings and parents.

A mixed methods exploration of the role of multi-family groups in community treatment of patients with depression and anxiety in Pakistan

BackgroundAn open, non-controlled trial was conducted to explore the feasibility, experiences and outcomes of multi-family groups in community mental health care of patients with depression and anxiety.MethodsThe study was conducted in community settings within the catchment area of a free of cost primary care center in Karachi, Pakistan. 30 patients with symptoms of depression and anxiety, their caregivers and 3 lay counsellors were recruited enrolled in the study between May–September 2019. Patients were enrolled for monthly multi-family group meetings conducted over 6 months in groups of 5–6 patients and 1–2 nominated caregivers each. Meetings were facilitated by the non-specialist trained counsellors. The primary outcome was quality of life (assessed using Manchester Short Assessment of Quality of Life) and secondary outcomes were symptoms of depression and anxiety (assessed on Aga Khan University Depression and Anxiety Scale), social outcomes (Social Outcome Index), and caregiver burden (Burden Assessment Scale). Change in all measures was assessed pre and 6-month post intervention using t-test. In-depth interviews were conducted with 7 patients, 7 caregivers and the 3 lay counsellors.ResultsA total of 36 family intervention meetings were conducted with six groups with a total of 30 patients, 34 caregivers and 3 counsellors. Between baseline and the end of the intervention, subjective quality of life increased significantly from 3.34 to 4.58 (p < 0.001, 95% CI 0.93–1.54). Self-reported depression and anxiety scores reduced from 34.7 to 19.5 (p < 0.001, 95% CI 10.8–19.8) and the Social Outcome Index improved from 3.63 to 4.52 (p < 0.001, 95% CI 0.39–1.39). There was no change in family burden. Participants reported that the group meetings were seen as a safe space for shared learning, and that the experience helped improve self-regulation of emotions and behaviors and instilled a sense of belonging.ConclusionMulti-family groups in community treatment of common mental health disorders facilitated by non-specialist mental health service providers is feasible, experienced positively and has the potential for large and positive effects on subjective quality of life, self-reported depression and anxiety, and objective social outcomes.Trial Registration: ISRCTN, ISRCTN12299326. Registered 05 June 2019. Retrospectively registered, https://doi.org/10.1186/ISRCTN12299326.

Fusing Location Data for Depression Prediction.

Recent studies have demonstrated that geographic location features collected using smartphones can be a powerful predictor for depression. While location information can be conveniently gathered by GPS, typical datasets suffer from significant periods of missing data due to various factors (e.g., phone power dynamics, limitations of GPS). A common approach is to remove the time periods with significant missing data before data analysis. In this paper, we develop an approach that fuses location data collected from two sources: GPS and WiFi association records, on smartphones, and evaluate its performance using a dataset collected from 79 college students. Our evaluation demonstrates that our data fusion approach leads to significantly more complete data. In addition, the features extracted from the more complete data present stronger correlation with self-report depression scores, and lead to depression prediction with much higher F 1 scores (up to 0.76 compared to 0.5 before data fusion). We further investigate the scenerio when including an additional data source, i.e., the data collected from a WiFi network infrastructure. Our results show that, while the additional data source leads to even more complete data, the resultant F 1 scores are similar to those when only using the location data (i.e., GPS and WiFi association records) from the phones.

Exploring the psychological well-being of postgraduate accounting students at a South African university

The challenges associated with higher education studies can impact significantly on the psychological well-being of students and can influence their academic success, even leading to anxiety, stress and depression. Factors influencing academic success in postgraduate accounting students have been well researched, but a dearth of literature exists on their psychological well-being. This knowledge gap necessitated an investigation into the psychological well-being of postgraduate accounting students at a South African university. In this descriptive study, a self-compiled demographic questionnaire, the Multidimensional Scale of Perceived Social Support, the Utrecht Work Engagement Scale, and the Zung Self-rating Anxiety and Depression Scales were used for data collection. A total of 115 postgraduate accounting students participated in this study. Students reported a high level of support from family and friends, but their vigour and absorption regarding their full-time studies were merely average. Self-reported anxiety and depression scores indicated mild to moderate anxiety (28.7%), marked to severe anxiety (7.4%), mild to moderate depression (42.4%) and severe depression (17.2%) amongst participants. Study-related issues led to 10% of participants receiving psychological and/or psychiatric treatment and 5% using psychiatric medication. This study creates awareness of and proposes practical measures to enhance the psychological well-being of postgraduate accounting students to ultimately support academic success.

P098 Higher self-reported depression, anxiety and MSK scores in patients with non-inflammatory compared to inflammatory rheumatic diseases irrespective of age and gender

Abstract Background/Aims  It is recognised that chronic musculo-skeletal (MSK) conditions have a significant impact on patients’ quality of life and level of functioning, as well as mood. In order to explore holistic therapeutic approaches and multidisciplinary support for this patient group, the differential impact of a diagnosis of an inflammatory versus non-inflammatory rheumatic condition on anxiety, depression and MSK general health was assessed. The objectives of this pilot study were to determine the level of anxiety and depression in patients with inflammatory versus non-inflammatory rheumatic conditions and explore some of their determinants. Methods  A questionnaire comprising the GAD-7 (anxiety), PHQ-9 (depression) and MSKHQ instruments was disseminated to 165 randomly selected patients attending outpatient clinics. Preliminary results from this questionnaire were analysed using descriptive statistics, Mann-Whitney tests and a multiple linear regression. Patients were stratified according to diagnosis classified as categorical variable, inflammatory and non-inflammatory rheumatic conditions. Results  Differences between patients’ age and gender, as well anxiety, depression and MSK outcomes between the inflammatory and non-inflammatory groups are presented in the table below: Linear regression showed that the strongest determinant of anxiety and depression was the category of diagnosis, i.e. inflammatory or non-inflammatory (p = 0.002, R2 = 0.060; p = 0.001, R2 = 0.072, respectively). Anxiety, depression or MSKHQ outcomes were not affected by gender or age, and MSKHQ was not predicted by diagnosis category either, when we accounted for gender and age. P098 Table 1:InflammatoryNon-inflammatoryp-valuen11946% Female65.871.70.467Age mean (range)54.1 (24-85)53.1 (26-81)0.689Anxietymedian (IQR)5 (1-11)9.5 (5-15.3)0.001n (%) clinically significant anxiety44 (37.0)25 (54.4)0.042Depressionmedian (IQR)8 (4-13)13 (7-19.3)0.002n (%) clinically significant depression54 (45.4)30 (65.2)0.022MSKHQ median (IQR)26 (16-35)33 (22-42.5)0.004 Conclusion  The preliminary analysis of our study showed that patient-reported anxiety, depression and MSK outcomes were significantly higher in patients with non-inflammatory compared to those with inflammatory rheumatic conditions, and that the diagnosis category was the strongest determinant for anxiety and depression. Disclosure  J.R. Henty: None. C. Ciurtin: None. E. Stefanova: None. B. Ellis: None. A. Kocsis: None.

Socioeconomic Deprivation Index Is Associated With Psychiatric Disorders: An Observational and Genome-wide Gene-by-Environment Interaction Analysis in the UK Biobank Cohort

BackgroundPsychiatric disorders are among the largest and fastest-growing categories of the global disease burden. However, limited effort has been made to further elucidate associations between socioeconomic factors and psychiatric disorders from a genetic perspective. MethodsWe randomly divided 501,882 participants in the UK Biobank cohort with socioeconomic Townsend deprivation index (TDI) data into a discovery cohort and a replication cohort. For both cohorts, we first conducted regression analyses to evaluate the associations between the TDI and common psychiatric disorders or traits, including anxiety, bipolar disorder, self-harm, and depression (based on self-reported depression and Patient Health Questionnaire scores). We then performed a genome-wide gene-by-environment interaction study using PLINK 2.0 with the TDI as an environmental factor to explore interaction effects. ResultsIn the discovery cohort, significant associations were observed between the TDI and psychiatric disorders (p < 4.00 × 10−16), including anxiety (odds ratio [OR] = 1.08, 95% confidence interval [CI] = 1.07–1.10), bipolar disorder (OR = 1.42, 95% CI = 1.36–1.48), self-harm (OR = 1.21, 95% CI = 1.19–1.23), self-reported depression (OR = 1.22, 95% CI = 1.20–1.24), and Patient Health Questionnaire scores (β = .07, SE = 0.004). We observed similar significant associations in the replication cohort. In addition, multiple candidate loci were identified by the genome-wide gene-by-environment interaction study, including rs10886438 at 10q26.11 (GRK5) (p = 5.72 × 10−11) for Patient Health Questionnaire scores and rs162553 at 2p22.2 (CYP1B1) (p = 2.25 × 10−9) for self-harm. ConclusionsOur findings suggest the relevance of the TDI to psychiatric disorders. The genome-wide gene-by-environment interaction study identified several candidate genes interacting with the TDI, providing novel clues for understanding the biological mechanism of associations between the TDI and psychiatric disorders.

Impact of cognitive behavioral therapy on depression symptoms after transcatheter aortic valve replacement: A randomized controlled trial

BackgroundDepression is a significant concern after cardiac surgery and has not been studied in patients undergoing transcatheter aortic valve replacement (TAVR). We sought to examine the prevalence of pre-procedure depression and anxiety symptoms and explore whether brief bedside cognitive behavioral therapy (CBT) could prevent post-TAVR psychological distress. MethodsWe prospectively recruited consecutive TAVR patients and randomized them to receive brief CBT or treatment as usual (TAU) during their hospitalization. Multi-level regression techniques were used to evaluate changes by treatment arm in depression, anxiety, and quality of life from baseline to 1 month post-TAVR adjusted for sex, race, DM, CHF, MMSE, and STS score. ResultsOne hundred and forty six participants were randomized. The mean age was 82 years, and 43% were female. Self-reported depression and anxiety scores meeting cutoffs for clinical level distress were 24.6% and 23.2% respectively. Both TAU and CBT groups had comparable improvements in depressive symptoms at 1-month (31% reduction for TAU and 35% reduction for CBT, p = .83). Similarly, both TAU and CBT groups had comparable improvements in anxiety symptoms at 1-month (8% reduction for TAU and 11% reduction for CBT, p = .1). Quality of life scores also improved and were not significantly different between the two groups. ConclusionsPre-procedure depression and anxiety may be common among patients undergoing TAVR. However, TAVR patients show spontaneous improvement in depression and anxiety scores at 1-month follow up, regardless of brief CBT. Further research is needed to determine whether more tailored CBT interventions may improve psychological and medical outcomes.

The relationship between mucosal inflammatory cells, specific symptoms, and psychological functioning in youth with irritable bowel syndrome

Both mucosal inflammation and psychologic dysfunction have been implicated in irritable bowel syndrome (IBS). While some relationships between inflammation (mast cells and eosinophils) and depression have been reported in adults with IBS, relationships between inflammation and psychologic function have not been studied in children and adolescents. The aims of the current study were to: (1) assess densities of colonic mast cells, eosinophils, and TH17 cells in youth with IBS; and, (2) explore relationships between these cells and specific IBS symptoms and psychologic functioning. Utilizing previously obtained biopsies from the descending and rectosigmoid colons, densities were determined for mast cells, eosinophils, and TH17 cells, respectively, in 37 youth with IBS and 10 controls. In IBS patients, densities were assessed in relation to specific IBS symptoms and in relation to self-report anxiety and depression scores. In both the descending and rectosigmoid colons, densities of mast cells, eosinophils, and TH17 cells were higher in IBS patients as compared to controls. In IBS patients, rectosigmoid mast cell density was higher in those reporting pain relief with defecation. Also, in IBS patients, rectosigmoid eosinophilia was associated with higher anxiety scores and eosinophil density correlated with depression scores. In the descending colon, eosinophil and mast cell densities both correlated with depression scores. In conclusion, mucosal inflammation (mast cells and eosinophils) is associated with pain relief with defecation and with anxiety and depression in youth with IBS.

Who Turns to Amazonian Medicine for Treatment of Substance Use Disorder? Patient Characteristics at the Takiwasi Addiction Treatment Center

Complementary medicines are an emergent field in the treatment of substance use disorders (SUDs) and include Amazonian medicines, such as ayahuasca. The aim of this multimodal cross-sectional study was to investigate characteristics of people who seek treatment for SUDs at an accredited healthcare facility that applies Amazonian medicines along with conventional psychotherapy. We collected clinical and sociodemographic data of consecutive admissions at the Takiwasi Addiction Treatment Center (Tarapoto, Peru) using structured questionnaires, interviews, and letters submitted upon program application describing motivation for treatment. The sample of 50 male participants admitted between 2014 and 2016 was culturally heterogeneous, including patients from Peru (42%), other Latin American countries (34%), and North America/Europe (24%). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria indicated dependencies on cannabis (72%), alcohol (52%), cocaine/base paste (48%), and others; multiple substance use was common (84%). Self-reported depression and anxiety scores showed moderate elevation. Comparison of Addiction Severity Index composite scores to a large U.S. sample suggested somewhat more severe problems in the drug and psychiatric domains. Common motives for selecting the program included interest in Amazonian medicine, the Takiwasi concept of treatment, and unfavorable experiences with past treatments. Being motivated by family, a desire for self-transformation, and spiritual/existential motives were common themes for treatment initiation. Our results suggest that the Amazonian medicine-based therapy attracts a diverse patient group not limited to regional residents and may be particularly appealing to more impaired SUD patients with a history of unsuccessful treatment. The sample's cultural diversity suggests an existing interest in such therapies among international SUD treatment-seeking patients. These findings are relevant in light of the need for improved SUD therapies and contribute to the emergent research literature on ayahuasca-based treatments.

Relaxation Therapy for Depression: An Updated Meta-analysis.

We conducted this updated meta-analysis to evaluate the effects of relaxation therapy for depression. We searched PubMed, MEDLINE, PsycINFO, the Cochrane Library, Web of Science, and CINAHL for randomized controlled trials evaluating the effects of relaxation therapy in patients with depression. Finally, 14 studies were included in this meta-analysis. The efficacy of the intervention was evaluated using depression scale scores. We found that there was no significant difference between the effects of relaxation therapy and psychotherapy on decreasing self-rated depressive symptoms (standardized mean difference [SMD] = 0.19; 95% confidence interval [CI], -0.11 to 0.48). In addition, eight trials compared relaxation therapy with no treatment, waiting list, or minimal treatment and showed that the relaxation group reported lower levels of self-reported depression scores postintervention (SMD = -0.57; 95% CI, -0.98 to -0.15). Therefore, this meta-analysis showed that relaxation might reduce depressive symptoms, and the effect is not worse than that of psychotherapy.

Longitudinal associations between depressive symptoms and clinical factors in ankylosing spondylitis patients: analysis from an observational cohort.

Although cross-sectional studies have shown that ankylosing spondylitis-specific factors correlate with depressive symptom severity, the association of these factors over time is unresolved. We examined the demographic and clinical factors associated with longitudinal depressive symptom severity in AS patients. We analyzed sociodemographic, clinical, behavioral and medication data from 991 patients from the Prospective Study of Outcomes in Ankylosing spondylitis cohort, and measured depression severity with the Center for Epidemiological Studies Depression (CES-D) Scale administered at approximately 6-month visit intervals. Multivariable longitudinal negative binomial regression models were conducted using generalized estimating equation modeling to assess the demographic, clinical, and medication-related factors associated with depression severity by CES-D scores over time. The median baseline CES-D score (possible range 0-60) was 10.0 (interquartile range = 5, 17). In longitudinal multivariable analyses, higher CES-D scores were associated with longitudinal smoking, greater functional impairment, greater disease activity, self-reported depression, and poor global health scores. Marital status (e.g., being married) was associated with lower CES-D. Adjusted mean CES-D scores in our model decreased over time, with a significant interaction between time and gender observed. This study identified longitudinal clinical factors such as greater disease activity, greater functional impairment, and poor global health to be associated with longitudinal depression severity. These factors are potentially modifiable and may help manage depressive symptoms in AS.