ObjectivesTo systematically review the detection rate of depression in Chinese individuals with type 2 diabetes mellitus (T2DM).MethodsPubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data and VIP databases were electronically searched to collect observational studies on the detection rate of depression in Chinese with T2DM from inception to January, 2019. Two reviewers independently screened literature, extracted data and evaluated the quality of included studies. Meta-analysis was performed by R 3.6.1 software.ResultsA total of 29 studies involving 96 557 cases were included. Meta-analysis results showed that the total detection rate of depression in Chinese with T2DM was 27% (95%CI 24% to 30%). Subgroup analysis showed that the detection rate of depression in female was 32% (95%CI 20% to 45%), and in male was 26% (95%CI 18% to 37%). The detection rate of depression in rural areas was 36% (95%CI 18% to 54%), and in urban areas was 30% (95%CI 16% to 43%). The detection rate of depression in individuals aged 60 and above was 31% (95%CI 24% to 39%), and in individuals aged less than 60 was 23% (95%CI 10% to 36%). Individuals with a primary school education and below, a middle or high school education and college degree and above education had detection rate of 31%, 23% and 22%, respectively. Individuals with diabetes duration less than 5 years, 5 to 10 years and more than 10 years had detection rates of 23%, 25% and 30%, respectively. Individuals with and without complications had detection rates of 43% and 26%, respectively. The detection rates of mild and moderate to major depression were 20% and 10%, respectively.ConclusionsThe detection rate of depression in Chinese with T2DM is high. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusion.
ObjectiveTo investigate the psychological states and their influencing factors in parents of congenital defect neonates admitted to Intensive Care Unit (ICU).
MethodsThe self-designed general information questionnaire was used to collect the demographic data, and self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate the states of anxiety and depression of the parents of congenital defect neonates admitted to ICU between June 1 and November 29, 2013.
ResultsA total of 152 parents were included in this investigation. The average score of SAS was 39.45±8.53. The average score of SDS was 43.28±10.76. Univariate analysis found that parents with lower educational level, poorer family income, positive family history and countryside residence might have higher score of SAS, while parents with Han nationality, poorer family income and family history would have higher score of SDS. Multivariate analysis discovered that living condition and family history were related to anxiety status. However, depression state was influenced by nationality, family income and family history.
ConclusionA considerable number of parents of congenital defect neonates admitted to ICU have anxiety or depression. And nationality, family income, family history and living condition are the major risk factors.
Objectives
To analyze the prevalence and clinical features of depression, anxiety, depression and anxiety in Tibetan patients with epilepsy and to improve the diagnosis and treatment.
Methods
102 patients with epilepsy, who had been admitted to the Department of Neurology of the People's Hospital of Tibet Autonomous Region from January 2017 to December 2017, were diagnosed according to the Chinese Standard Classification and Diagnostic Criteria for Mental Disorders (3rd Edition) (CCMD-3). The Hamilton depression scale (HAMD 24 items) and the Hamilton anxiety scale (HAMA 14 items) were used to measure depression and anxiety. Different genders, ages, durations, frequency of attacks, and seizures types were analyzed for depression, anxiety, depression and anxiety. Univariate analysis was used to screen the factors that may cause depression, anxiety, depression and anxiety in patients with epilepsy. Logistic regression was used to analyze the risk factors of depression, anxiety, depression and anxiety in patients with epilepsy.
Results
Among the 102 patients with epilepsy, 35 (34.31%) comorbid depression, 10 (9.80%) comorbid anxiety, and 54 (52.94%) comorbid depression and anxiety. Univariate analysis showed that there was a significantly statistical difference in the duration of the disease and the frequency of seizures in local patients with epilepsy (P<0.05). There was a statistically significant difference in the frequency of epileptic seizures and anxiety (P<0.05). Multivariate logistic regression analysis showed that the probability of anxiety in patients with a disease duration of ≤2 years was only 10.1% of those with a course >2 years [OR=0.101, 95%CI (0.012, 0.915), P<0.05]; and the frequency of seizures was not an risk factors for epileptic comorbid with anxiety (P>0.05). The rate of depression and anxiety in patients with seizure frequency >2 times per month was 4.853 times higher than that of patients with seizure frequency ≤2 times per month [OR=4.853, 95%CI (2.024, 11.634), P<0.05].
Conclusions
Tibetan patients with epilepsy have a high prevalence of depression, anxiety, depression and anxiety. In the diagnosis and treatment, we should strengthen the understanding and provide the appropriate prevention and treatment to improve the diagnosis and treatment level.
ObjectiveTo systematically review the efficacy of different stimulation modalities of repetitive transcranial magnetic stimulation (rTMS) combined with SSRI in improving depressed mood after stroke using network meta-analysis. MethodsThe PubMed, EMbase, Cochrane Library, Web of Science, CNKI, VIP, CBM and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) related to the objectives from inception to October 1, 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Network meta-analysis was then performed by using R 4.2.1software. ResultsA total of 25 RCTs involving 2 152 patients were included. Four types of rTMS stimulation combined with SSRIs were included: high-frequency stimulation of the left dorsolateral prefrontal (l-DLPFC), low-frequency stimulation of l-DLPFC, low-frequency stimulation of the right dorsolateral prefrontal (r-DLPFC), and low-frequency stimulation of the bilateral DLPFC. The results of the network meta-analysis showed that the effect of combining four stimulation methods with SSRI in treating depression was better than that of SSRI alone (P<0.05). Probability sorting results showed that low-frequency stimulated bilateral DLPFC (88.9%) > low-frequency stimulated l-DLPFC (63.1%) > high-frequency stimulation l-DLPFC (57.1%) > low-frequency stimulation r-DLPFC (40.4%). There was no statistically significant difference in the incidence of adverse reactions between the four stimulation methods combined with SSRI and the use of SSRI alone (P>0.05). Conclusion?rTMS combined with SSRIs is better than SSRIs alone in improving depressed mood after stroke. Low-frequency rTMS stimulation of bilateral DLPFC may be the best. Meanwhile, the safety of different stimulation methods is good.
ObjectiveTo investigate prevalence of anxiety and depression in chronic obstructive pulmonary disease (COPD) in order to increase the awareness of physicians on this comorbidity.MethodsPatients were from a multicenter prospective cohort study and 13 institutions or hospitals participated in the study. Four hundred and ten patients with a prior diagnosis of COPD were prospectively recruited from January 2017 to January 2019, and baseline date were analyzed. Hospital Anxiety and Depression Scale was used to identify anxiety and depression.ResultsThe cohort had a mean age of (60.7±10.0) years with 76.8% males and 74.3% smokers. Seventy-nine patients (19.3%) had anxiety or depression. Among them, 36 subjects (8.8%) had anxiety, and 64 patients (15.6%) were with depression, and 21 patients (5.1%) with anxiety and depression. The prevalence of severe anxiety (2.7%) and severe depression (2.4%) was low. Compared to patients without anxiety or depression, patients with anxiety or depression had significantly higher CAT scores (17.8±9.3 with anxiety, 17.4±8.4 with depression, 12.5±7.3 without anxiety or depression, P 0.002 and 0.000 respectively). The risk of acute exacerbations was higher in patients with depression (37.5% vs. 22.7%, P=0.016). Proportion of patients categorized into GOLD group D was higher in patients with depression (P=0.001).ConclusionsAbout 20% COPD patients has anxiety or depression. Prevalence of depression is two times that of anxiety. The prevalence of severe anxiety or severe depression is low. Patients with depression have lower quality of life, higher risk of acute exacerbations, and higher proportion of patients categorized into GOLD group D.
Objective To investigate the effect of music therapy plus selective serotonin reuptake inhibitors （SSRIs） on emotion and bum wound healing in bum patients. Methods Moderate and severe bum inpatient.s, aged 12-60 years were selected. Emotional problems were then measured by the Hamilton Rating Scale for Depression and Hamilton Rating Scale for Anxiety within three days after bum injury. Bum patients with depression and anxiety were randomly allocated into the trial group （28 patients） and the control group （27 patients）. Music therapy and SSRIs plus conventional burn care Were applied to the trial group, and conventional bum care to the control group, both for 30 days. The scores of anxiety, depression and the degree of bum wound healing were assessed. Results The differences of depression score and anxiety score before and after treatment were 13. 7 ±6.43 and 6.43 ±2.72 respectively in the trial group, and 4. 74 ±6.75 and 4.44 ±3.36 respectively in the control group. This showed both scores significantly improved compared with the control group （P 〈0. 05）. The time for burn wound healing was shortened in the treatment group （P 〈0. 05）. The anxiety score was positively correlated with bum index, and so was the depression score （P 〈 0.05 ）. Conclusions The anxiety and depression scores are positively correlated with the burn index. Music therapy plus SSrIs can ameliorate the emotional problems （ depression and anxiety）, and shorten the time for burn wound heating.
Objective To assess the efficacy and safety of mirtazapine and fluoxetine on depression. Methods We searched The Cochrane Library (Issue 2, 2009), MEDLINE (1980 to Dec.2008), EMbase (1980 to Dec.2008), CBM (1980 to Dec.2008), VIP (1980 to Dec.2008), CNKI (1980 to Dec.2008) and Wanfang database (1980 to Dec.2008) to search randomized controlled trials (RCTs) comparing mirtazapine with fluoxetine for depression. The quality of the included trials was assessed and meta-analysis was conducted by RevMan 5.0 software. Results Five RCTs involving 695 patients were included. The results of meta-analyses showed that: (1) After one-week treatment and two-week treatment, effectiveness of the mirtazapine group was significantly higher than that of the fluoxetine group [one-week treatment: RR=2.00, 95%CI (1.30, 3.10), P=0.002; two-week treatment: RR=1.49, 95%CI (1.08, 2.06), P=0.02]. But after six-week treatment, there was no significant difference of the efficacy between the mirtazapine and the fluoxetine groups with RR=1.21 and 95%CI 0.89 to 1.63 (P=0.23), and the cure rate of the mirtazapine group was a little higher than that of the fluoxetine group with RR=1.40 and 95%CI 1.09 to 1.80 (P=0.009). (2) Side reaction: The somnolence and weight gain rates of the mirtazapine group was higher than those of the fluoxetine group with RR=1.78 and 95%CI 1.18 to 2.70 (P=0.006) and RR=5.91 and 95%CI 2.21 to 15.83 (P=0.000 4). But fluoxetine more easily induced nausea and insomnia with RR=0.47 and 95%CI 0.31 to 0.71 (P=0.000 3); RR=0.39 and 95%CI 0.17 to 0.89 (P=0.03) than mirtazapine. And the other common side reactions were all not significantly different between the two groups (Pgt;0.05). Conclusion Mirtazapine is more effective than fluoxetine and works faster. Mirtazapine could more easily induce somnolence and weight gain, and is with lower nausea or insomnia rate when compared with fluoxetine. And there is no significant difference in comparison of other common side reactions.
Rapid and accurate identification and effective non-drug intervention are the worldwide challenges in the field of depression. Electroencephalogram (EEG) signals contain rich quantitative markers of depression, but whole-brain EEG signals acquisition process is too complicated to be applied on a large-scale population. Based on the wearable frontal lobe EEG monitoring device developed by the authors’ laboratory, this study discussed the application of wearable EEG signal in depression recognition and intervention. The technical principle of wearable EEG signals monitoring device and the commonly used wearable EEG devices were introduced. Key technologies for wearable EEG signals-based depression recognition and the existing technical limitations were reviewed and discussed. Finally, a closed-loop brain-computer music interface system for personalized depression intervention was proposed, and the technical challenges were further discussed. This review paper may contribute to the transformation of relevant theories and technologies from basic research to application, and further advance the process of depression screening and personalized intervention.
Based on literatures on Meta-analysis and randomized controlled trial, drug use and some geriatrics syndromes such as cognitive impairment and depression, in elderly diabetic patients were reviewed. Insulin plus oral hypoglycemic drugs was more rational therapy for insulin resistance and islet dysfunction in type 2 diabetes mellitus. We should pay more attention to cognitive impairment and depression in elderly type 2 diabetic patients.
ObjectivesTo evaluate the efficacy and safety of newer-generation antidepressants for patients with myocardial infarction (MI) and depression.MethodsPubMed, The Cochrane Library, EMbase, Web of Science, CBM, CNKI, WanFang Data, and VIP databases were searched from inception to December 2017 to collect randomized controlled trials (RCT) on newer-generation antidepressants for patients with MI and depression. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software.ResultsTen RCTs involving 552 participants were included. The results showed that the antidepressant group was superior to the placebo or treatment group in terms of the improvement of depressive symptoms (SMD=–1.38, 95%CI –1.93 to –0.82, P<0.000 01), and incidence of angina (RR=0.42, 95%CI 0.25 to 0.71,P=0.001), recurrent MI (RR=0.43, 95%CI 0.22 to 0.83, P=0.01), and re-hospitalization for cardiac reasons (RR=0.51, 95%CI 0.28 to 0.92, P=0.03). However, there were no significant differences between two groups on all-cause mortality (RR=0.45, 95%CI 0.18 to 1.11, P=0.08), cardiovascular mortality (RR=0.53, 95%CI 0.16 to 1.73, P=0.29) and incidence of heart failure (RR=0.75, 95%CI 0.39 to 1.43, P=0.38). Subgroup analysis revealed that the type of antidepressants could affect the improvement of depression outcome. Citalopram and fluoxetine might be the most effective drugs for patients with MI and depression.ConclusionsNewer-generation antidepressants are effective for treatment of depressive symptoms in patients with MI and depression, with no significant impact on all-cause mortality and cardiovascular mortality. Moreover, antidepressants can reduce the incidence of angina, recurrent MI, and re-hospitalization for cardiac reasons in patients suffering from MI and depression. Due to limited quantity and quality of included studies, more high quality studies are required to verify above conclusions.
