Search

Background. Electroconvulsive therapy (ECT) is an established treatment for depression, but more data on effectiveness and safety in clinical practice is needed. The aim of this register-based study was to investigate short-term effectiveness and cognitive safety after ECT, evaluated by clinicians and patients. Secondary, we investigated predictors for remission and cognitive decline. Methods. The study included 392 patients from the Regional Register for Neurostimulation Treatment in Western Norway. Depressive symptoms and cognitive function were assessed with Montgomery-Åsberg Depression Rating Scale and Mini-Mental State Examination (clinicianrated) and Beck Depression Inventory and Everyday Memory Questionnaire (patient-rated). Assessments were done prior to ECT-series and a mean of 1.7 days after (range 6 days before and 12 days after) end of ECT-series. Paired samples t-tests were extended by detailed, clinically relevant subgroups. Predictors were examined using logistic regression. Results. Clinician- and patient-rated remission rates were 49.5 and 41.0%, respectively. There was a large reduction in depressive symptoms and a small improvement in cognition after ECT, but we also identified subgroups with non-response of ECT in combination with cognitive decline (4.6% clinician-rated, 15.7% patient-rated). Positive predictors for patient- and clinicianrated remission were increasing age, shorter duration of depressive episode, and psychotic features. Antipsychotic medication at the commencement of treatment and previous ECTtreatment gave higher odds of clinician-rated remission, whereas higher pretreatment subjective depression level was associated with lower odds for patient-rated remission. Clinician-rated cognitive decline was predicted by higher pretreatment MMSE scores, whereas psychotic features, increasing age, and greater pretreatment subjective memory concerns were associated with lower odds for patient-rated cognitive decline. Conclusions. Our study supports ECT as an effective and safe treatment, although subgroups have a less favorable outcome. ECT should be considered at an early stage for older patients suffering from depression with psychotic features. Providing comprehensive and balanced information from clinicians and patients perspectives on effects and side effects, may assist in a joint consent process. [ABSTRACT FROM AUTHOR]

Background. Suicidal ideation (SI) is an important risk factor of death by suicide. Recent data suggest that suicidal depression (i.e., moderate to severe depression with SI) could be a specific depression subtype with worse clinical outcomes than nonsuicidal depression (i.e., without SI). Methods. Among 898 French adult inpatients (67% women, mean age: 41.23 [SD: 14.33]) with unipolar depression, 71.94% had moderate to severe depression (defined using the cut-offs of validated scales: beck depression inventory, clinician-rated 30-item inventory depression symptomatology, and quick inventory of depressive symptomatology) and among them, 63.6% had SI according to the suicidal item (score ≥ 2) of the depression scale they filled in. Clinical features (anxiety, psychological pain, and hopelessness) were assessed at baseline. The occurrence of a suicide attempt (SA) or a suicide event (SE) (i.e., actual, aborted or interrupted SA, or hospitalization for SI) was recorded during the 1-year follow-up. The risk of actual SA and SE was compared between groups with adjusted Cox regression models. Results. The risk of actual SA and SE during the follow-up was 2- and 1.8-fold higher, respectively, in patients with suicidal depression, independently of potential cofounders such as history of lifetime SA, age, sex, and baseline depression severity. Conclusions. Suicidal depression is associated with poorer prognosis in terms of actual SA/SE, despite optimal care (i.e., care in a hospital department specialized in the management of suicidal crisis). Specific therapeutic strategies might be needed for these patients. [ABSTRACT FROM AUTHOR]

Background. Psychopathological network model has received attention recently in the traditional debate about the continuity of depression. However, there is little evidence for comparing the network structure of depressive symptoms in several depressive states at different clinical stages. Through this study of a broad sample of patients with nonclinical to clinical depression, we examined differences in the network structure of depressive symptoms. Methods. Four groups of participants, including cohorts of clinical depression (current depression, n = 294; remitted depression, n = 118) and nonclinical depression (subthreshold depression, N = 184; healthy control, n = 257), responded to Beck Depression Inventory-II (BDI-II). After adjusting for age and sex, the residual scores of the 21 BDI-II items were input into a regularized partial correlation network for each group. Then, the estimated edge strengths/densities and node characteristics were compared. Results. Current depression has a discontinuous structure with a stronger and denser network of symptoms compared with nonclinical groups. Interestingly, remitted depression had improved to the level in healthy controls; however, it retained the same network structure as current depression, which indicates a trace of depression. Conclusions. We found the traces of depression that remained even after the symptoms disappeared. This study might provide a novel framework for elucidating the development and formation of depression. [ABSTRACT FROM AUTHOR]

Background. Personality traits have been associated with long-term suicide risk but their relationship with short-term risk is still unknown. Therefore, to address this gap, we explored the moderating effect of personality traits on the relationship between the Suicide Crisis Syndrome (SCS) and short-term suicidal behaviors (SB). Sampling and Methods. Adult participants (N = 459) were administered the Suicide Crisis Inventory (SCI), a validated self-report questionnaire designed to measure the intensity of the Suicidal Crisis Syndrome, the Big Five Inventory for personality traits, and the Columbia Suicide Severity Rating Scale for SB at intake and at a 1-month follow-up. The PROCESS macro in SPSS was used to test the moderation model. Covariates hypothesized to influence the results were added: age, gender, ethnicity, years of education, and depressive symptomatology on the Beck Depression Inventory. This study was a secondary analysis drawn from a larger study on the SCS. Results. SCI total score had a significant positive relationship with SB at the 1-month follow-up for patients with lower levels of extraversion, agreeableness, conscientiousness, and openness, respectively. Hence, these four traits were protective against SB. There was an association between SCI and SB for patients with high levels of neuroticism at the 1-month follow-up. Conclusions. High levels of neuroticism served as a risk factor, whereas high levels of the other Big Five traits were protective factors against short-term SB in the context of elevated SCS symptoms. Thus, personality traits play a role in moderating the relationship between the SCS and imminent SB. [ABSTRACT FROM AUTHOR]

Background. Aberrant activity of the subcallosal cingulate (SCC) is a common theme across pharmacologic treatment efficacy prediction studies. The functioning of the SCC in psychotherapeutic interventions is relatively understudied, as are functional differences among SCC subdivisions. We conducted functional connectivity analyses (rsFC) on resting-state functional magnetic resonance imaging (fMRI) data, collected before and after a course of cognitive behavioral therapy (CBT) in patients withmajor depressive disorder (MDD), using seeds from three SCC subdivisions. Methods. Resting-state data were collected from unmedicated patients with current MDD (Hamilton Depression Rating Scale-17 > 16) before and after 14-sessions of CBT monotherapy. Treatment outcome was assessed using the Beck Depression Inventory (BDI). Rostral anterior cingulate (rACC), anterior subcallosal cingulate (aSCC), and Brodmann's area 25 (BA25) masks were used as seeds in connectivity analyses that assessed baseline rsFC and symptom severity, changes in connectivity related to symptom improvement after CBT, and prediction of treatment outcomes using whole-brain baseline connectivity. Results. Pretreatment BDI negatively correlated with pretreatment rACC ~ dorsolateral prefrontal cortex and aSCC ~ lateral prefrontal cortex rsFC. In a region-of-interest longitudinal analysis, rsFC between these regions increased post-treatment (p < 0.05FDR). In whole-brain analyses, BA25 ~ paracentral lobule and rACC ~ paracentral lobule connectivities decreased post-treatment. Whole-brain baseline rsFC with SCC did not predict clinical improvement. Conclusions. rsFC features of rACC and aSCC, but not BA25, correlated inversely with baseline depression severity, and increased following CBT. Subdivisions of SCC involved in top-down emotion regulation may be more involved in cognitive interventions, while BA25 may be more informative for interventions targeting bottom-up processing. Results emphasize the importance of subdividing the SCC in connectivity analyses. [ABSTRACT FROM AUTHOR]

In observational studies, vitamin D deficiency is associated with depressive symptoms. However, randomised controlled trials (RCT) with vitamin D supplementation have not been conclusive. In the present study 206 subjects were randomised to vitamin D (100 000 IU (2500 µg) as a bolus dose followed by 20 000 IU (500 µg) per week) and 202 to placebo. The Beck Depression Inventory-II (BDI-II) was filled in at baseline and after 4 months at the end of the study. At baseline the mean age was 51·4 and 52·5 years and mean serum 25-hydroxyvitamin D (25(OH)D) 32·5 and 35·1 nmol/l in the vitamin D and placebo groups, respectively. Among the 408 subjects, 193 had a BDI-II score >4, and forty-five had a score >13. Twenty-three subjects were using antidepressant or mood-stabilising drugs. At the end of the study, there were no significant differences in Δ BDI-II score (score at the end of the study minus score at baseline), regardless of analysing all subjects, subjects with or without psycopharmaca, or if performing subgroup analyses based on baseline and final serum 25(OH)D levels combined with categories of baseline BDI-II scores >4 or >13. In conclusion, we have not been able to demonstrate any significant effect of vitamin D supplementation on depressive symptoms. However, few of our subjects were clinically depressed. Future RCT should include subjects with more severe vitamin D deficiency as well as more depressed subjects than in our study. In such a setting vitamin D may probably be more relevant as an augmenter of standard antidepressant medication/treatment. [ABSTRACT FROM AUTHOR]

Introduction: It is common knowledge that depressive disorders are prevalent in cardiac patients. The fact of a prospective heart surgery can have a negative effect on depressive manifestations in cardiac patients. Objectives: To describe representation and structure of depression in preoperative cardiac surgery patients and its correlation with the patients' personal time perspective Methods: We used the Beck Depression Inventory to estimate the level and structure of depression in 60 cardiac surgery patients of both sexes and the Zimbardo Time Perspective Inventory to identify the patients' personal time perspective. Results: We revealed depression of various manifestations in 53.4% of preoperative cardiac patients; 3.3% of them had severe depression, 11.7% - moderate depression, 8.3% - mild depression, 30.0% - minimal depression. The patients' average level of depression was certainly higher than the standard one (t=3.295; ?=.000). According to degree, the structure of depressive manifestations included asthenia, irritability, sleeping disorders, low sex drive, weight loss, pessimism, tearfulness, difficulty working, and difficulty taking decision. Two patients showed suicidal thoughts. We revealed a positive correlation between the depression level and a Negative-Past time perspective (r=.39) and a negative correlation with the Positive Past time perspective (r=-.27). Conclusions: We identified depressive manifestations in every second preoperative cardiac patient. Every sixth one has moderate or severe depression, which calls for special attention. Research in personal time perspective has good prospects for psychological interventions. [ABSTRACT FROM AUTHOR]

Introduction: The available literature indicates a possible association between metabolic syndrome (MS) which is highly prevalent among patients with bipolar disorder (BD), and functioning. Objectives:Wesought to compare differences in functional areas of patients with Bipolar Disorder Type 1 (BPD-1)with and without MS in euthymic period. Methods: This study included 69 euthymic BPD-1 patients without MS and 46 age- and sex-matched BPD-1 patients with MS. All participants completed a sociodemographic form; took the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Young Mania Rating Scale score, and Bipolar Disorder Functioning Questionnaire. MS was diagnosed according to the International Diabetes Federation (IDF) criteria. Results: All of the functioning areas were significantly lower in the BPD-1 with MS group than in the without MS group (p < 0.05). Moreover age at onset of disease was significantly lower in BPD-1 groupwithMS thanwithoutMS(p < 0.05). Number of suicide attempts was significantly higher in BPD-1 group withMSthan withoutMS (p < 0.05). Catatonic and melancholic depression were significantly more prevalent in the BPD-1 with MS than withoutMS (p < 0.05). Conclusions: Our findings suggest that MS might have an effect on functioning in BD patients even in euthymic period. [ABSTRACT FROM AUTHOR]

Introduction: Adherence to antiretroviral therapy is a key factor in predicting the success or failure of treatment. Data suggest that the status of mental health and especially depression of people living with HIV can affect adherence to antiretroviral therapy. Objectives: The purpose of this study was to assess the mental health status of people living with HIV, to record adherence to antiretroviral therapy and to investigate whether mental health affects adherence to antiretroviral therapy. Methods: A cross-sectional mixed observational correlation study in a sample of 112 HIV-positive individuals was conducted. The Simplified Medication Adherence Questionnaire (SMAQ) was used to assess adherence to antiretroviral therapy, the Beck Depression Inventory (BDI) was used to assess depression, and the WHOQOL - BREF tool was used to assess mental health. Results: The results of the study showed that 58.93% of patients were found to be non-adherent to antiretroviral therapy. Furthermore, according to the BDI scale, 10.7% of patients experienced marginal clinical depression, 10.7% experienced moderate levels of depression and 2.7% experienced severe or very severe levels of depression. Further, people living with HIV had a moderate level of mental health (M = 3.40, SD = 0.58). Conclusions: Our study showed that a high percentage of people living with HIV are non-adherent to antiretroviral therapy. Factors that are possibly associated with decreased adherence are mental health and especially depression. Psychological support for people living with HIV and anti-depressant prevention programs could increase adherence to antiretroviral therapy. [ABSTRACT FROM AUTHOR]

Introduction: The effects of bullying can be both physical and emotional, and they can last for many years. Children that experience verbal and physical bullying are at a greater risk of developing depression later on in life, compared with children who did not. Objectives: This study aims to look into the relationship between bullying, depressive symptomatology and suicidal thoughts in adolescents of high schools in Lushnje. Methods: Three questionaires (the Beck Depression Inventory; the Bully/victim Behavior / Victim Behavior Questionnaire by Olweus; the Suicide Questionnaire) were circulated online and were completed by 400 adolescents from 2 high schools in a small city in Albania between September-November 2019. Data has been analysed using the Software Package for Social Sciences for Windows v. 22.0 (SPSS Inc. Chicago, IL). Results: We found significant positive correlation between bullying (victimization) and the level of depression (r (n = 400) =. 300, p≤.05), and significant positive correlation of bullying (cause) with level of depression (r (n = 400) =. 160, p≤.05) but lower than in victimes. The victims of bullying have higher levels of depression and vice versa. We found higher rate of depression in female adolescents with the average (M = 14.710, ds = 11.263) compared to boys with the average (M = 9.609, ds = 10.723). There is an important positive correlation of suicidal ideation with the level of depression (r (n = 400) =. 616, p≤.05). Conclusions: Being either a bully or a victim of bullying seems to increase the chances of being affected by depression and suicidal thoughts. [ABSTRACT FROM AUTHOR]

Introduction: Novel, evidence-based treatments are required for treatment-resistant post-traumatic stress disorder (PTSD). 3,4-Methylenedioxymethamphetamine (MDMA) has beneficially augmented psychotherapy in several small clinical trials. Objectives: To review the use of MDMA-assisted psychotherapy in treatment-resistant PTSD. Methods: Systematic searches of four databaseswere conducted from inception to February 2020. A meta-analysis was performed on trials which were double-blinded, randomised, and compared MDMAassisted psychotherapy to psychotherapy and placebo. The primary outcomes were the differences in Clinician Administered PTSDScale (CAPS-IV) score and Beck's Depression Inventory (BDI). Secondary outcome measures included neurocognitive and physical adverse effects, at the time, and within seven days of intervention. Results: Four randomised controlled trials (RCTs) met inclusion criteria. When compared to active placebo, intervention groups taking 75mg (MD -46.90; 95% CI -58.78, -35.02), 125mg (MD -20.98; 95% CI -34.35, -7.61) but not 100mg (MD -12.90; 95% CI -36.09, 10.29) of MDMA with psychotherapy, had significant decreases in CAPS-IV scores, as did the inactive placebo arm (MD -33.20; 95% CI -40.53, -25.87). A significant decrease in BDI when compared to active placebo (MD -10.80; 95% CI -20.39, -1.21) was only observed at 75mg. Compared to placebo, participants reported significantly more episodes of low mood, nausea and jaw-clenching during sessions and lack of appetite after seven days. Conclusions: These results demonstrate potential therapeutic benefit with minimal physical and neurocognitive risk for the use of MDMA-assisted psychotherapy in TR-PTSD, despite little effect on Beck's Depression Inventory. Better powered RCTs are required to investigate further. [ABSTRACT FROM AUTHOR]

Introduction: Studies have associated students from Medicine and other healthcare degrees with high levels of stress and depression. This puts at risk both their mental health and the quality of physician-patient relationship. Mindfulness-Based Stress Reduction (MBSR) program has been shown to improve psychological wellbeing and to reduce rumination; however, it seems unclear if digital programs have the same effect. Objectives: To compare the effectiveness of a mindfulness smartphone app versus an adapted version of the MBSR program among healthcare students. Methods: A parallel-group, single-blind, randomised (1:1:1), controlled trial was designed. 140 students of Medicine, Nursing, Psychology and Nutrition were allocated to either the app program, the in-person program, or a waitlist. The assessment of depressive symptoms was included though the Beck Depression Inventory at baseline and post-intervention (8 weeks). Results: 86 participants completed BDI at both times and an intention-to-treat analysis was performed. Depressive levels changed from 7.21 (SD 6.08) to 4.07 (SD 4.44) in the app group, and from 7.11 (SD 6.62) to 5.26 (SD 5.21) in the in-person group. ANOVA test did not find a significant difference for depression among the three arms. Conclusions: Only a tendency to significance was found for both the app and the in-person program for the reduction of depressive symptoms. Most participants presented minimum levels of depression at baseline, so a floor effect might be considered as an explanation. Future studies are needed to determine the effect of mindfulnessbased programs on the depression levels of healthcare students. [ABSTRACT FROM AUTHOR]

Introduction: Identifying the predictors of response to psychiatric and psychotherapeutic treatment may be useful for increasing treatment efficacy in pharmacoresistant depressive patients. Objectives: The goal of this study was to examine the influence of dissociation, hope, personality trait and selected demographic factors in treatment response of this group of patients. Methods: Pharmacoresistant depressive inpatients were enrolled in the study. All patients completed Clinical Global Impression - both objective and subjective form (CGI), Beck Depression Inventory (BDI-II), and Beck Anxiety Inventory (BAI) at baseline and after six weeks of combined pharmacotherapy and psychotherapy treatment as outcome measures. Internalized Stigma Of Mental Illness Scale (ISMI), Dissociative Experience Scale (DES), Adult Dispositional Hope Scale (ADHS), and Temperament and Character Inventory (TCI-R) were completed at start of treatment with intention to find predictors of treatment efficacy. Results: The study included 72 patients hospitalized for the pharmacoresistant major depression, 63 of them finished the study. Mean scores of BDI-II, BAI, subjCGI, and objCGI significantly decreased during the treatment. BDI-II relative change statistically significantly correlated with the total ISMI score, Discrimination Experience, and Harm Avoidance. Strongest factors connected to BDI-II relative change were duration of disorder and Discrimination Experience. The strongest factor connected to objCGI relative change was Discrimination Experience. The existence of comorbid personality disorder did not influence the treatment response Conclusions: According to our results, the patients with pharmacoresistant depressive disorders, who have had more experience with discrimination because of their mental struggles, showed a poorer response to treatment. [ABSTRACT FROM AUTHOR]

Introduction: The Interpersonal and Social Rhythm Therapy (IPSRT) has shown to be effective in reducing symptoms' severity and regularizing circadian rhythms of patients with bipolar disorder (BD). Few studies assessed the efficacy of this approach in a group format. Objectives: The aims of this study are to assess the efficacy of a group IPSRT (IPSRT-G) in terms of improvement of symptoms, quality of life and adherence to treatments and reduction of levels of stigma. Methods: Patients with BD were recruited according to the following inclusion criteria: 1) age between 18 and 65 years; 2) diagnosis of BDtype I or II; 3) absence of psychiatric comorbidities and of serious physical diseases. The IPSRT-G consisted of eight 90-minute sessions (two individual and six group sessions). Patients have been assessed at baseline (T0), at the end of the intervention (T1) and after 3 months (T2). Results: 16 patients have been recruited; 62.5% of them were females, with a mean age of 48.19±11.3 years and with a mean age at onset of 25.47±7.07 years. Patients reported a significant reduction at the Beck Depression Inventory (BDI) (p<0.05) and Internalized Stigma of Mental Illness Inventory (ISMI) total scores (p<0.01). In particular, a significant reduction was reported at the "Social Retreat" subscale (p<0.02), and an improvement at the "Stigma Resistance" subscale (p<0.05). Conclusions: Our data show that the IPRST-G can be effective in reducing depressive symptoms and stigma, in particular by increasing coping strategies to stigma and reducing social withdrawal, also when provided in the group format. [ABSTRACT FROM AUTHOR]

Introduction: Dissociation is imporant feature of the patients wiht anxiety disorders and depressive disorders. Objectives: Goal of the study was to analyze the impact of dissociation on the treatment of the patients with anxiety/neurotic spectrum and depressive disorders, and with or without personality disorders. Methods: The sample consisted of inpatients with neurotic spectrum disorders and depressive disorder. The participants completed Beck Depression Inventory, Beck Anxiety Inventory, subjective version of Clinical Global Impression-Severity, Sheehan Patient-Related Anxiety Scale, and Dissociative Experience Scale, at the start and the end of the therapeutic program Results: The total of 840 patients with anxiety or depressive spectrum disorders, who were resistant to pharmacological treatment were referred for hospitalization for the six-week complex therapeutic program, were enrolled in this study. 606 of them were statistically analyzed. The patients' ratings significantly reduced during the treatment. Patients without comorbid personality disorder improved significantly more than patients with comorbid personality disorder in the reduction of depressive symptoms. However, there were no significant differences in change of anxiety and severity of disorder between the patients with and without personality disorders. The higher degree of dissociation at the beginning of the treatment predicted minor improvement. Conclusions: Dissociation presents an important factor influencing treatment effectiveness in the treatmentresistant patients with anxiety/depression with or without personality disorders. [ABSTRACT FROM AUTHOR]

Introduction: The severity of psychological disturbances and mental disorders in adults who grew up in alcoholic families make it extremely urgent to develop effective psychotherapeutic programs for them. Besides, the topic of maintaining women's health is one of the priorities of modern Medicine and psychology. Objectives: This study aims to assess the psychological effects of the program «Adult children of alcoholics» (Twelve-step program) for Russian women who grew up in alcoholic families. Methods: The study involved 80 women who grew up in alcoholic families aged 18 to 44. Participants performed the following assessment: "Purpose-in-Life Test" (Leontiev, 2000), "The Coping Strategy Indicator" (Amirkhan, 1990), The Reflexivity Test (Karpov, 2003), The Test of the Personal Self-conception (Stolin, Panteleev, 1998), State-Trait Anxiety Inventory (Spielberger, et al., 1983), Beck Depression Inventory. Results: Women attend the twelve-step program for more than 2.5 years differ from women attended less than 6 sessions of the program as well as women grew up in prosperous families by higher rates of «Problem Solving» coping strategy (23,91±3,28 vs 19,34±5,67 vs 19,26±6,48; P=0,001); coping strategy «Seeking Social Support» (24,64±3,44 vs 19,41±5,76 vs 20,70±8,09; P=0,006); meaningfulness of life (Purpose-in-Life Test) (27,83±5,17 vs 21,24±7,53 vs 24,04±7,22; P=0,009). They are less likely to use such coping strategy as «Avoidance» (16,55±3,53 vs 21,86±5,29 vs 19,04±6,24; P=0.001). They have low anxiety (48,42±5,65 vs 54,07±7,12 vs 52,81±9,01; p=0,006) and low depression (10,92±5,52 vs 25,90±16,70 vs 16,33±12,35; P=0,003). Conclusions: The results convincingly prove the effectiveness of f twelve-step program in Russia. [ABSTRACT FROM AUTHOR]

Introduction: The electroconvulsive therapy is an ancient therapeutic technique used in the traitment of certain psychiatric diseases. Objectives: discuss the technical aspects, indications, therapeutic response and tolerance of ECT Methods: This was a descriptive retrospective study that interested all patients who were hospitalized in the psychiatric department of the Mahdia University Hospital in 2017 and 2018 and were benefited from ECT sessions Results: The number of patients who received ECT was 34, representing 4.33% of patients, 25 men and 9 women with an average age of 39, the number of ECT sessions was 785. The major diagnosis was bipolar disorder in 47,1% of patients, followed by schizophrenia in 35,3% and major depressive disorder in 14,7 %. Resistance to treatment and major suicidal risk were the main indications. All sessions were performed in a bilateral temporal mode. the initial energy delivered varied between 50 and 101 millicoulombs. The duration of the crise obtained was predominantly between 21 and 30 seconds. The average number of sessions during the attack phase was 13.88, whereas it was 2.5 sessions during the consolidation phase. The mean scores of the psychometric evaluations showed a marked improvement, especially in the mania scores (65.89%) and the beck depression inventory (63.55%). Only four incidents were reported in all patients. Only five patients (14,7%) had side effects and the most marked effect was anterograde amnesia. Conclusions: Mental health programs in Tunisia should promote the generalization of this method throughout the Tunisian territory, given the efficacy demonstrated in mood disorder, several psychoses and other psychiatric pathologie. [ABSTRACT FROM AUTHOR]

Introduction: Shame and guilt are often discussed in their association with depression. However, there is a need in deeper understanding of relationship between these emotions and depressive symptoms in personality disorders, where affective patterns do not reach the level of clinical depression. Objectives: To examine the differences in shame and guilt levels in normal subjects and patients with personality disorders and their association with depressive symptoms. Methods: In total, 28 patients (M=36.07, SD=11.87) diagnosed with personality disorders and 76 (M=29.67, SD=8.87) healthy individuals were recruited to take part in this study. Patients and healthy controls had equivalent educational level. Participants were given two standardized tests: Beck Depression Inventory and Test of Self-Conscious Affect (TOSCA) - 3. Results: There were significant differences in levels of guilt between patients with personality disorders (M=64.79, SD=6.78) and healthy individuals (M = 59.92, SD = 11.86), t (102) = 2.603, p = .011. Patients also demonstrated higher levels of shame (M=47.86, SD=9.70) than the participants without diagnoses (M = 43.38, SD = 14.96), however, these differences were not significant t (102) = 1.47, p > .05. It was found that depressive symptoms in normal population but not in patients significantly correlated with levels of guilt (r(76) = .124, p <.01) and shame (r(76)=.188, p<.01). Conclusions: It might be assumed that shame and guilt play different roles in emotional sphere of healthy individuals and patients with personality disorders, being associated with depressive symptoms in norm and unrelated to depressive symptoms in personality disorders. [ABSTRACT FROM AUTHOR]

Introduction: Cognitive impairment is frequently observed in patients suffering from depression. Cognitive dysfunction play a critical role in increasing the individual's vulnerability for the first onset, maintenance and future recurrence of depressive episodes. Objectives: The objectiv was to assess the cognitive impairment in patient with depressive episode. Methods: A cross sectional, hospital based study was conducted among 100 patients with depressive episodes diagnosed by International Classification of Diseases - 10 visiting outpatient and inpatient in Department of Psychiatry of Manipal Teaching Hospital, Pokhara, Nepal. The subjects were interviewed with Beck's depression inventory, Perceived deficient questionnaire, Frontal assessment battery, Trail making test A and B and Forward and Backward Digit Span test. For the assessment of correlates, regression analyses were done using SPSS v 20.0. Results: The mean age of the participants was 32.47 years (SD±12.25), majority were female, married, Hindu and from urban population. Higher number of respondent were student. Most of them were educated till intermediate level and belonged to middle socioeconomic class family. Different domain of cognitive function according to severity of depression was found to be statistically significant (p<0.05). This study also found that age, sex, education, medication use and Becks depression inventory score predicted the cognitive function. Conclusions: Cognitive impairment is not ucommon among patient with depressive episodes. The impairment is not only seen in severe cases but also in mild to moderate cases. The assessment of cognitive deficits should be the regular part of the assessment in depressive patients. [ABSTRACT FROM AUTHOR]

Introduction: The environment at medical colleges is competitive and typically generates higher stress levels. Both academic and psychosocial stresses appear to play a role, and the resourceful students who are able to employ effective coping strategies to deal with their stress are shown to outperform their peers in the academic settings. Objectives: Objective: To determine the Association of Perceived Stress and Coping Strategies with Depressive symptoms in students at a private medical college in Islamabad Methods: Fourth and Final year medical students of Foundation university medical college were enrolled in the study. Beck's Depression Inventory was used to assess the depressive symptoms, Perceived Stress Scale (PSS) was the tool used to look for the perceived stress and the coping strategies were assessed using the Brief COPE Inventory. Association of Perceived Stress and Coping Strategies with Depressive symptoms and other sociodemographic factors was established. Results: Out of 262 medical students studied, 211 (80.5%) had no or mild depressive symptoms while 51 (19.5%) had moderate to severe depressive symptoms. 66 (25.2%) had low stress, 127 (48.4%) had moderate stress while 69 (26.3%) had high stress. Chi-square test revealed that perceived stress, self-distraction, active coping, denial, substance use, behavioral disengagement, positive reframing, acceptance, religion/spirituality and self-blaming had statistically significant relationship with presence of depressive symptoms among the target population. Conclusions: Considerable number of medical students had presence of moderate to severe depressive symptoms in our study. Perceived stress and some specific kinds of coping strategies had significant association with presence of depressive symptoms among target population. [ABSTRACT FROM AUTHOR]

Introduction: Immigration entails uprooting and this is always a destabilizing event. It includes disorders in family life and a radical break with culture, values, among others. These events create a situation of uncertainty that exacerbates stress and anxiety. Objectives: Within this framework, we wanted to inquire about the state of mental health, and more specifically, about depression, in migrants. Methods: A cross-sectional study was carried out that includes 272 migrants from different countries of the world, during the months of August and September 2020, through an anonymous, voluntary and multiple response type online survey which included questions about sociodemographic aspects and the Beck Depression Inventory. The survey was published through social networks (Facebook and Whatapp) in migrant forums around the world, mostly Spanish-speaking, because the survey was published in Spanish. Results: Of the 276 immigrants surveyed, an average age of 36.63 is seen. The 30% are single. The 30.79% are unemployed. 0.72% attended an immigrant reception centre. 99.63% have Spanish as mother tongue. 33.33% emigrated alone. The results of Beck's questionnaire, 28.98% have moderate/severe depression. Of the total respondents, 49.63% have been an immigrant for 1 to 5 years. The 85,14% were in a regular legal-inmigration situation. Conclusions: The immigrant population can be a group at risk for developing anxiety or depressive symptoms, especially when there is a situation of vulnerability and the necessary adaptation mechanisms for a satisfactory migration process cannot be guaranteed. [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of depression differs between groups, such as race, gender, and age group. According to the World Health Organization (WHO), depression is one of the leading causes of death in the age group of 15-29 years-old. During the COVID-19 pandemic, some countries, including Indonesia, ordered a nationwide physical distancing and limited public activities. Indonesia also restricts the public mobilities, leaving the college students, studying in different regions, isolated and confined to their flats, boarding houses, and apartments. Objectives: To find out the prevalence of Depression in College Students, living alone, in Pandemic 2020. Methods: College students aged 18 to 28 years old, were assessed using Beck's Depression Inventory (BDI-II), through Google Form, and shared using social media. We also grouped the participants to age, gender, religion, and types of housing, and did themultivariate analysis using median comparison and multinomial logistic regression. Results: A total of 84 college students, who are living alone during the Pandemic 2020, participated in this study. We found that 33.3%of the population suffered from depression. The median score for the group of females, prefer not to say their religion, and living in the owned house have a higher median. While multinomial logistic regression study does not have any significant odd risks in the variables. Conclusions: The results indicate that in time of nationwide physical distancing and limited public activities due to COVID-19 Pandemic, the prevalence of depression among college students living alone in Pandemic 2020 is 33%. One-fourth of them are with severe depression. [ABSTRACT FROM AUTHOR]

Introduction: International Classification of Diseases 11th Revision (ICD-11) has inserted complex post-traumatic stress disorder (cPTSD) as a clinically distinct disorder, different from PTSD. The diagnosis of cPTSD has the same requirements for the one of PTSD, in addition to disturbances of self-organization (DSO - e.g., disturbances in relationships, affect dysregulation, and negative selfconcept). Objectives: This study aimed to explore suicidality in PTSD and cPTSD. We examined also the association between clinical dimensions of hopelessness (feelings, loss of motivation, future expectations) and other symptomatologic variables. Methods: The sample, recruited at the Fondazione Policlinico Tor Vergata, Rome, Italy, consisted of 189 subjects, 132 diagnosed with PTSD, and 57 with cPTSD, according to the ICD-11 criteria. Participants underwent the following clinical assessments: Clinician-Administered PTSD Scale (CAPS), Impact of Event Scale-Revised (IES), Beck Depression Inventory (BDI), Symptom Checklist-90-Revised (SCL-90), Dissociative Experience Scale (DES), Beck Hopelessness Scale (BHS). Results: cPTSD showed significantly higher BHS-total (p = 0.01) and BHS-loss of motivation subscale (p <0.001) scores than PTSD. Besides, cPTSD showed significantly higher scores in all clinical variables except for the IES-intrusive subscale. By controlling for the confounding factor "depression", suicidality in cPTSD (and in particular the BHS-total) appears to be correlated with IES-total score (p = 0.042) and with DES-Absorption (p = 0.02). Differently, no such correlations are found in PTSD. Conclusions: Our study shows significant symptomatologic differences between PTSD and cPTSD, including suicidality. Indeed, suicidality in cPTSD appears to be correlated with the "loss of motivation" dimension, which fits well within the ICD-11 criteria of DSO. [ABSTRACT FROM AUTHOR]

Introduction: Neuropsychological disturbances are shown in studies about eating disorders (ED). On the other hand, attention impairment is related with cronic depression and anxiety, with poor improvement with pharmachological treatment. Important comorbility between ED and other psychiatric diseases is described, specially with depression and anxiety. Objectives: The aim of this study was to evaluate the influence of depression in neuropsychological variables in eating disordered patients. Methods: A descriptive analyse was performed with 81 female patients with ED between 18-50 years old. Socio-demographical, Clinical and neuropsychological variables were collected. Depression was measured by Beck Depression Inventory (BDI). Results: A relationship between depression (dicotomic variable) and Symbol Digit Modalities Test (SDMT) was found (p<0.05, Z -1.69, average range without depression 32.64 vs average range with depression 23.49). Attending to cuantitative result of BDI, relationships with Letter and Number Sequencing (total score: p<0.05, rho -0.29; SpanLN: p<0.05, rho -0.28) and SDMT (p<0.05, ? Pearson -0.28) were found. Conclusions: In ED impairment of attention and working memory have been related to executive function or stimuli distortion. In our sample the scores are similar to normal population but they're related to severity of depression. [ABSTRACT FROM AUTHOR]

Introduction: Although the inflammatory hypothesis in depression is more than two decades old, only some aspects are well researched. Transforming growth factor beta (TGF-β), which has a role as an anti-inflammatory and regulatory cytokine, is very poorly investigated in patients with major depressive disorder (MDD) who experienced childhood trauma. Objectives: Aim of our study was to analyze differences in serum concentrations of TGF-β between patients with MDD (with and without previous history of childhood abuse) and healthy controls, as well as to investigate possible predictors of TGF-β levels. Methods: Blood samples were obtained from 55 patients who fulfilled DSM-IV-R criteria for a current MDD episode without psychotic symptoms and 45 healthy controls, matched for age and gender. Participants were administered the Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HDRS) and the Childhood Trauma Questionnaire (CTQ). Serum TGF-β concentration was determined by enzyme-linked immunosorbent assay. Results: Concentration of TGF-β was significantly higher in patients compared to healthy controls and in those who reported experience of childhood abuse or neglect. Multiple logistic regressions showed a strong effect of CTQ total scores and duration of symptoms as predictors of TGF-β levels in patients. Conclusions: Conclusions: Childhood abuse as a predictor of TGF-β concentration in MDD patients could be an important missing puzzle in understanding immunological pathways and the role of cytokines in depression. ! [ABSTRACT FROM AUTHOR]

Introduction: The IVF-method considers to be one of the prospective methods of infertility treatment. However, the psycho-emotional states of thewomen in the IVF programremain understudied. That is why the specifics of reaction on infertility of the woman is of crucial importance. Objectives: The research aim is studying the characteristics of the emotional sphere of women in the IVF program. Methods: The research sample consists of 150 women (mean age 34.5+2), belonging to one of three groups: (1) Experimental group 1 - the women in the IVF program with their own ovum; (2) Experimental group 2 - the women in the IVF program with a donor ovum; Control group - women having pregnancy naturally. The following methods are used: Toronto Alexithymia Scale; Beck Depression Inventory; State and Trait Anxiety Inventory; SF 36 Questionnaire; Lazarus Coping Questionnaire; Leonhard Questionnaire. Results: The women in IVF-program with a donor ovum demonstrate more pronounced depressive tendencies; they have a higher level of alexithymia and anxiety comparing with the women in the group with their own ova and the control group. Women with their own ova demonstrate a direct connection of the anxiety and depression levels. Women from both experimental groups show a higher anxiety level comparing with the control group. Conclusions: It is important to consider such characteristics as a high anxiety level, depressive tendencies and a relatively pronounced alexithymia when designing intervention psychotherapeutic programs for the women in the IVF program. [ABSTRACT FROM AUTHOR]

Introduction: The efficacy of dialectical behavior therapy (DBT) in adolescents with non-suicidal self-injury (NSSI) or suicide attempts (SA) has been supported by two randomized clinical trials (RCT). These studies could not be generalizable to the daily clinical routine and self-reported measures used may be unresponsive to the change compared to the measures assessed by clinicians. Objectives: This study evaluates the effectiveness of DBT compared with treatment as usual plus group sessions (TAU + GS) in adolescents with suicidal risk in a mental health center, using selfreported measures and those evaluated by the clinician. Methods: 35 adolescents with repetitive NSSI and/or SA during the last 12 months were recruited and randomly assigned to DBT (n = 18) or TAU + GS (n = 17), to receive both group and individual sessions for 16 weeks. The Columbia Suicide Severity Rating Scale (C-SSRS); the Beck Depression Inventory (BDI-II) and the Suicidal Ideation Questionnaire (SIQ) as self-report measures and the Clinical Global Impressions (CGI) and Children's Global Assessment Scale (CGAS) evaluated by clinicians, were included pre and post-treatment. Generalized linear models were constructed. Results: The adolescents in DBT improved significantly in the CGAS (p <0.001) and in the CGI (p <0.049) compared to TAU + SG. The self-reported measures showed no significant differences. Both the CGAS and the SIQ-JR improved significantly at the end of the treatment regardless of the treatment. Conclusions: These results confirm the effectiveness of DBT in adolescents with suicidal risk in the daily routine. Clinical judgment could potentially be more sensitive than self-report measures. [ABSTRACT FROM AUTHOR]

Introduction: Differential diagnostics of the hypochondriacal and anxiety-depressive disorder still remains an issue. The symptomatic picture of somatic complaints adds more difficulties and that can lead to various medical errors and conflicts. Objectives: The research aim is the analysis of individual personality characteristics of the patients with the hypochondriacal and anxiety-depressive disorders. Methods: The research sample includes 74 patients in the age 19-45 years: (1) Experimental group A, 25 persons with the diagnosis 45.2 Hypochondriacal disorder - 12 males and 13 females; (2)Experimental group B, 23 persons with the diagnosis 41.2 Mixed anxiety and depressive disorder - 10 males and 13 females; (3) Control group - 26 persons (12 males and 14 females) with no neurological or psychiatric disorder. Research methods: Viability test in Osina &Rasskazova adaptation; Tolerance-Intolerance Scale in Kornilova's modification; Zalevskiy's Invenory of Rigidness; Beck Depression Inventory; Hamilton Depression Inventory; Spielberger State-Trait Anxiety Inventory. Results: The research shows that the patients with the depressionanxiety disorder have more pronounced depression than those with hypochondriacal disorder, who have a medium level. The patients with the mixed disorder have the high level of both state and trait anxiety whereas the hypochondriacal patients demonstrate a high level of the state anxiety and a medium one of the personal anxiety. The hypochondriacal patients also show a low level of viability which means that their relations with other people are limited, they feel fear and helplessness. Conclusions: Those data can be applied in differential diagnostics as well as when designing a program of psychotherapeutic help for those patients. [ABSTRACT FROM AUTHOR]

Introduction: There is a lack of data on the efficacy of physical exercise (PE) as a treatment method for depression in managing in-patients in the short-term treatment course. Objectives: The aim of our study was to assess the efficacy of the physical exercise program as an adjuvant therapy for depression. Methods: For our study we formed two groups of patients with major depression receiving medical care at the Republican Research and Practice Mental Health Center: (1) the ones who received PE in addition to their usual treatment (n=57, mean age 43.4 years, SD =12.5) and (2) those with only treatment as usual - the control group (n=49, mean age 43.04, SD =13.7). PE was conducted with the frequency of 3-5 times a week in a group under the supervision of a fitness instructor. The PE program included aerobic and muscle-strengthening exercises as well as elements of yoga and pilates. We used Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HAM-A), the Positive and Negative Affect Schedule (PANAS), sleep and quality of life questionnaires. Results: The mean number of sessions in the main group was 11 (7-14). There was a significant decrease of depressive and anxiety symptoms in both groups but the effect sizes were bigger in the main group on HDRS (Cohen's d=3.38 versus 2,5 in controls) and HAM-A (Cohen's d=3.7 versus 2,11 in controls). Conclusions: Our results support the idea of the efficacy of shortterm PE program as an adjuvant therapy for treating depression. [ABSTRACT FROM AUTHOR]

Introduction: Hope has a direct effect on the effectiveness of psychotherapy. Dissociation proved to be one of the important factors influencing treatment efficacy in anxiety disorders. Selfstigma complicated adherence of the patients to the treatment. Objectives: The hypothesis is that the increase of self-stigma is connected with the level of dissociation and both lead to a decrease in self-esteem and could also decrease treatment effectiveness in patients with anxiety disorders. Methods: A total of 109 patients were evaluated the start and end of therapy by the following scales: Mini International Neuropsychiatric Interview; The Internalized Stigma of Mental Illness Scale; Adult Dispositional Hope Scale; Temperament and Character Inventory - Revised Version; Clinical Global Impression (CGI; objective and subjective); Beck Anxiety Inventory; Beck Depression Inventory - Second Edition; Dissociative Experiences Scale. The therapeutic program included 25 group sessions and 5 individual therapy sessions of cognitive behavioral therapy or psychodynamic therapy in combination with pharmacotherapy. Results: Greater improvement in psychopathology, assessed by the relative change of the objective CGI, was associated with lower initial levels of dissociation, pathological dissociation, harm-avoidance, and self-stigma, and higher levels of hope and self-directedness. There were differences in the relative changes in objective CGI between the subgroups with and without a comorbid personality disorder. The patients without comorbid personality disorder improved significantly more than those with that disorder. Conclusions: Treatment effectiveness in anxiety disorders is related to self-stigma, hope, harm-avoidance, self-directedness, and dissociation. [ABSTRACT FROM AUTHOR]

Introduction: Currently, suicide is a serious public health problem due to its elevated prevalence, and the lack of adequate preventive strategies implementation. Nowadays, there is intense work on the search of suicide predictors. Objectives: To evaluate the suicidal impulse (SI) score (item 9 of the Beck Depression Inventory) and the percentage of repeated attempts (RA) in a sample of patients with ideation or suicidal attempt (SA), who are followed up in an intensive intervention program (IIP). Methods: Implemented in the city of Ourense, the IIP is an assistance and preventive program for suicidal behavior. The sample is made up of patients included in the IIP due to SA or ideation. The following variables were registered during the 12-month follow-up: socio-demographic and clinical, RA and the Beck Depression Inventory (baseline, 6 months and 12 months). Results: Of the 448 patients included in the program, 319 were due to SA and 129 to ideation. RA during the program was 29 (9%) and 6 (4.65%) respectively. SI changed from a 100% of the patients with clear plans to commit suicide at the beginning of the program, to 50%, in the SA group, and 66.67%, in the ideation group, with no plans to commit suicide after a 12-month follow-up. Conclusions: The IIP shows strong effectiveness in patients with ideation or suicidal attempts. The percentage of RA is reduced parallel to the SI punctuation reduction during the intervention period. [ABSTRACT FROM AUTHOR]

Introduction: Potential involvement of immune mechanisms in the etio-pathogenesis of suicidal behaviour has been postulated. Hypotheses regarding an immune-cytokine basis have been advanced with controversial findings regarding predominance of type-1 or type-2 cytokines. Objectives: The aim of this study was to assess serum levels of IL-1, IL-4, and IFN-γ in drug-free suicide attempters and to determine potential associations between cytokine levels and clinical parameters and psychopathology. Methods: IL-1, IL-4 and IFN-γ serum levels were measured with ELISA techniques for 31 drug-free suicide attempters and 31 healthy controls matched for age, sex and body mass index. Current symptoms were assessed with Beck Depression inventory, Beck Hopelessness scale, Hamilton Anxiety Rating Scale and Barratt impulsivity scale. Results: Suicide attempters exhibited significantly lower IL-1 serum levels than controls (p<0.006). There was no significant difference between patients and controls regarding IFN-γ and IL-4 levels. Conclusions: IL-1 level was significantly decreased in the blood samples of patients with suicidal behaviour and these cytokines may help distinguish suicidal from non-suicidal patients. [ABSTRACT FROM AUTHOR]

Introduction: Suicidal behaviour is a major public health problem. Several factors have been associated with it, among which impulsivity that seems to increase the risk of suicide attempts according to some studies. Objectives: To determine the prevalence of impulsivity along with the factors associated to it, in suicidal patients. Methods: This is a cross-sectional descriptive study conducted among patients aged 16 and above, living in Sousse, who attempted suicide and were admitted in the emergency department, between November 2016 and July 2017. A standardized assessment was performed using the Beck Depression Inventory (BDI) scale, Hamilton Anxiety Scale, Beck's hopelessness Scale (BHS) and Barratt Impulsiveness Scale (BIS-11). Results: Our study was conducted among 31 suicidal patients. The average age was 26,0 ± 9.8 years old. The sex ratio was 0,4. In our population, 7 (22,6%) had a family history of suicidal behaviour, 18 (58,1%) had active suicidal thoughts before acting out and 16 (51,6%) have made at least two suicide attempts. Among our patients, 27 (87,1%) had a BDI score superior to 16 corresponding to severe depression and the prevalence of impulsivity was 100% with a mean Barratt score at 85,03 ± 13,58. The mean score was 29,58 ± 6,76 in the motor impulsiveness, 22.96 ± 4,03 in the cognitive impulsiveness and 32,48 ± 4,82 in the non-planning impulsiveness. Conclusions: Our study revealed that the majority of the suicide attempts were concomitant with depression and associated to impulsivity. This should encourage a systematic evaluation of the risk of acting out in depressed and impulsive subjects. [ABSTRACT FROM AUTHOR]

Introduction: Aberrant emotional processing is increasingly recognized as a vascular risk factor. The same time, multiple theories of emotion link emotion with interoception. Thus, it is feasible to investigate the mechanisms of cerebrovascular disorders from a broad psychosomatic perspective that includes the role of interrelated emotional and interoceptive processing in body regulation. Objectives: To identify a pattern of emotional and interoceptive processing that is associated with cerebrovascular risk. Methods: The pilot study included 30 females aged 40-65 years with no history of cardiovascular events. The participant underwent ambulatory blood pressure monitoring, classified in accordance with the ESC criteria for hypertension, structural brain MRI, rated by the Fasekas criteria for vascular lesions, functional MRI with the heartbeat detection task and psychological examination. A cluster analysis was performed on the variables describing the emotional and interoceptive processing: Mayer-Salovey-Caruso Emotional Intelligence Test (MSEIT), Toronto Alexithymia Scale (TAS), Beck Depression Inventory, Short Health Anxiety Inventory, Screening for Somatoform Symptoms (SOMS), Interoceptive Accuracy and right insular activation during the heartbeat detection task. Results: The cluster analysis identified three subgroups. Subgroup including participants with lower emotional intelligence (MSEIT 92±8), higher alexythimia (TAS 57±11), higher rate of somatization (SOMS 21±5), lower interoceptive accuracy and insular activation showed higher rate of cerebral small vascular disease (modified Fasekas score 1 or more) -- 73% vs. 31% in other participants (p=.05), along with higher rate of arterial hypertension -- 82% vs. 38% in other participants (p=.004). Conclusions: In a pilot study we identified a psychosomatic pattern associated with higher cerebrovascular risk. [ABSTRACT FROM AUTHOR]