Prevalence and characteristics of depressive disorders in type 1 diabetes

PubMed Central

2013-01-01

Background Persons with diabetes and depression have increased risk of complications and increased mortality. We aimed to investigate the prevalence, clinical characteristics and impact with regard to glycosylated haemoglobin (HbA1c) of depressive disorders in persons with type 1 diabetes at an outpatient specialist diabetes clinic. Findings A total of 51 persons with type 1 diabetes were diagnosed according to Mini International Neuropsychiatric Interview (M.I.N.I) with regard to dysthymia and previous or ongoing depressive episodes during spring 2005. HbA1c was measured at the day of the interview, and self-reported information on family history of depressive disorders was obtained. Eight persons (16%; 95% CI: 7%, 29%) were in the midst of a major depressive episode, 4 of these also reported a previous episode of depression. Seven of the 8 persons with an ongoing major depressive episode met the criteria for melancholia. Three persons (6%) met the criteria for dysthymia, and 6 persons (12%) had previous episode(s) of depression, without being currently depressed. The 17 (33%; 95% CI: 21%, 48%) persons with ongoing and/or previous depressive disorder had increased HbA1c (8.5%; 95% CI: 7.6%, 9.4%) compared to those without depressive disorders (7.9%; 95% CI: 7.5%, 8.3%), although the difference did not reach statistical significance. Conclusions Persons with type 1 diabetes had a high prevalence of depressive disorders, mainly depressive episodes that also met the criteria for melancholia, a subtype often considered a more serious and “biologic” form of depression. We were not able to demonstrate that persons with depressive disorders had poorer regulated diabetes compared to those without depressive disorders. PMID:24354794

Contributors to depressive symptoms among Korean immigrants with type 2 diabetes.

PubMed

Choi, Sarah E; Reed, Preston L

2013-01-01

Patients with diabetes have a higher prevalence of depression than the general population. Korean immigrants with type 2 diabetes are understudied. The aim of this study was to identify the prevalence and correlates of depressive symptoms in Korean immigrants. In this cross-sectional descriptive study, a community sample of 164 Korean immigrant adults with type 2 diabetes were assessed for depressive symptoms using the Center for Epidemiological Studies Depression scale. Predictors of depression were grouped into three categories: demographic (age, gender, education, English proficiency), clinical (duration of diabetes, comorbidities, insulin use), and psychosocial (general health, diabetes-related quality of life [QOL], family support). Approximately 56% of participants had Center for Epidemiological Studies Depression Scale scores of ≥16. Higher levels of depression were associated with greater impact of diabetes on QOL (b = 5.68, p = .001), worse overall health (b = -0.09, p = .012), and less family support (b = -4.02, p = .042). The relationship between depression and diabetes impact on QOL was stronger for men than women (b = 6.67, p = .020). Depressive symptoms are common among Korean immigrants with type 2 diabetes. Assessing diabetes-related QOL, general health, and family support may be of value in better understanding depressive symptoms among this population. Among Korean immigrant men with type 2 diabetes, specific attention should be paid to diabetes-related QOL.

Beyond METs: types of physical activity and depression among older adults.

PubMed

Joshi, Spruha; Mooney, Stephen J; Kennedy, Gary J; Benjamin, Ebele O; Ompad, Danielle; Rundle, Andrew G; Beard, John R; Cerdá, Magdalena

2016-01-01

physical activity may be beneficial in reducing depression incidence among the elderly. A key unanswered question is whether certain types of physical activity are particularly associated with decreased depression incidence. We examined the relationship between quantity and type of physical activity and subsequent depression using longitudinal data from elderly adults in New York City (NYC). we followed 3,497 adults aged 65-75 living in NYC for three years. Total physical activity was measured using the Physical Activity Scale for the Elderly (PASE) and type of physical activity was measured using a latent class analysis of PASE item responses. We used generalised estimating equations to measure the relationship between quantity and latent class of physical activity at waves 1-2 and depression at waves 2-3, controlling for wave-1 depression. individuals in the second highest quartile (50-75%) (odds ratio (OR) = 0.45; 95% confidence interval (CI) = 0.23, 0.88) and highest quartile of activity (OR = 0.31; 95% CI = 0.16, 0.63) had lower odds of depression. Among all subjects, athletic types (OR = 0.25; 95% CI = 0.12, 0.51) and walker types (OR = 0.58; 95% CI = 0.34, 0.99) had lower odds of depression. Among non-disabled participants, walkers (OR = 0.36; 95% CI = 0.18, 0.73), athletic types (OR = 0.14; 95% CI = 0.06, 0.32), domestic/gardening types (OR = 0.29; 95% CI = 0.12, 0.73) and domestic/gardening athletic types (OR = 0.13; 95% CI = 0.02, 0.75) had lower odds of depression. respondents who practised the highest levels of physical activity and who performed athletic activities were at lower risk for depression. Interventions aimed at promoting athletic physical activity among older adults may generate benefits for mental health. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

[TYPE 2 DIABETES MELLITUS AND DEPRESSION].

PubMed

Kravchenko, A Ya; Esaulenko, I E; Sahnenko, V V; Budnevskyj, A V; Podvygyn, S N

2016-01-01

The clinical significance of type 2 diabetes mellitus is not confined to metabolic disorders. A serious problem is also affective pathology that occurs in the majority (30-70%) of patients. However, diagnostics and correction of anxiety and depressive disorders associated with diabetes are often given insufficient attention. Many studies showed relationship between affective disorders and low adherence to the prescribed treatment resulting in general deterioration of clinical prognosis of diabetes. This review article describes the basic mechanisms behind the interrelation of affective disorders and diabetes. The role of persistent subclinical inflammation in diabetes and depression is discussed. The influence of emotional stress on the activation of the hypothalamic-pituitary-adrenal axis on the overproduction of cortisol is emphasized. The similarity of some structural changes in the brain tissue in diabetes and depression is discussed. Effect of endocrine disruption in the emotional sphere is demonstrated. Mechanisms responsible for the development of diabetes and its complications provoked by depression are considered.

Assessment of type 1 and type 3 deiodinase expression levels in depressive disorders.

PubMed

Gałecka, Elżbieta; Kumor-Kisielewska, Anna; Orzechowska, Agata; Maes, Michael; Górski, Paweł; Szemraj, Janusz

2017-01-01

A depressive disorder is a disease characterized by a heterogenous background. The important processes observed and diagnosed in depressed patients indicate that the etiology of depression may include disturbances in thyroid hormone (TH) levels and the occurrence of immune-inflammatory activation. Type 1 (DIO1) and type 3 (DIO3) iodothyronine deiodinases are the enzymes which determine the peripheral and tissue levels of TH, but also interfere with immunological cells and inflammatory processes. We aimed to investigate the levels of DIO1 and DIO3 in the patients suffering from recurrent depressive disorders (rDD). Data collected from 91 rDD patients and 105 healthy controls were analyzed. The diagnoses were made based on the ICD-10 criteria (F33.0-F33.8). The expression levels of DIO1 and DIO3 were estimated using the polymerase chain reaction method and the enzyme-linked immunosorbent assay (ELISA). The expression of DIO1 on mRNA/protein levels in the rDD patients was reduced in comparison to the control subjects, while the expression of DIO3 was higher in the patients suffering from depression. No significant relationship was found between the investigated DIOs and other clinical parameters. Our results indicate and suggest a role of DIO1 and DIO3-related pathways in the pathophysiology of depression. The results represent a promising way to investigate the biological markers of depression.

Bidirectional Association between Depression and Type 2 Diabetes in Women

PubMed Central

Pan, An; Lucas, Michel; Sun, Qi; van Dam, Rob M.; Franco, Oscar H.; Manson, JoAnn E.; Willett, Walter C.; Ascherio, Alberto; Hu, Frank B.

2011-01-01

Background Although it has been hypothesized that the diabetes-depression relation is bidirectional, few studies have addressed this hypothesis in a prospective setting. Methods A total of 65381 women aged 50–75 years in 1996 were followed until 2006. Clinical depression was defined as having diagnosed depression or using antidepressants, and depressed mood was defined as having clinical depression or severe depressive symptomatology, i.e., a Mental Health Index (MHI-5) score ≤52. Self-reported type 2 diabetes was confirmed using a supplementary questionnaire validated by medical record review. Results During 10-year follow-up (531097 person-years), 2844 incident cases of type 2 diabetes were documented. Compared to referents (MHI-5 score 86–100) who had the least depressive symptomatology, participants with increased severity of symptoms (MHI-5 score 76–85, 53–75, depressed mood) showed a monotonic elevated risk of developing type 2 diabetes (P for trend = 0.002). The relative risk (RR) for individuals with depressed mood was 1.17 (95% confidence interval [CI], 1.05–1.30) after adjustment for various covariates, and participants using antidepressants were at a particularly higher risk (RR, 1.25; 95% CI, 1.10–1.41). In a parallel analysis, 7415 incident clinical depression were documented (474722 person-years). Compared to non-diabetics, the RRs of developing clinical depression after controlling for all covariates were 1.29 (95% CI, 1.18–1.40) for diabetic patients, and 1.25, 1.24, 1.53 in diabetics without medications, with oral hypoglycemic agents, and insulin therapy, respectively (all P<0.01). These associations remained significant after adjustment for diabetes-related comorbidities. Conclusions Our results provide compelling evidence that the diabetes-depression association is bidirectional. PMID:21098346

Evaluation of pipe-type cable joint restraint systems

DOE Office of Scientific and Technical Information (OSTI.GOV)

Silver, D.A.; Seman, G.W.

1990-03-01

the purpose of this project was to evaluate two systems for restraining the movement of 345kV high-pressure oil-filled (HPOF) cable joints during load cycling. Problems with joints and adjacent cables due to thermomechanical bending (TMB) experienced by the Consolidated Edison Company of New York and Public Service Electric Gas Company of New Jersey are reviewed. Some approaches to reducing or preventing TMB induced damage to HPOF pipe type cable joints are discussed. The design and operation of a special test apparatus for simulating TMB effects under laboratory conditions is described. One of the two joint restraint systems evaluated under thismore » project was developed by PSE G and employed wedging devices, which could be retrofitted into existing installations, that limited the longitudinal movement of the joints during load cycling. The other system developed by Pirelli Cable Corporation applied the restraining force to the cylindrical portion of the hand applied joint insulation by means of support spiders and steel rods attached to the reducer faces. The test results show that the PSE G restraint system can effectively limit joint longitudinal movement while causing a minimal amount of mechanical disturbance to the joint stress cones. The test results obtained with the PCC system are inconclusive and indicate that further refinement and testing are required to demonstrate the effectiveness of this promising joint restraint system.« less

[The effects of hand acupuncture therapy on pain, ROM, ADL and depression among elders with low back pain and knee joint pain].

PubMed

Yang, Jin-Hyang

2009-02-01

The purpose of this study was to identify the effects of hand acupuncture therapy on pain, ROM, ADL, and depression among older people with low back pain and knee joint pain. The research was a quasi-experimental design using a non-equivalent control group pre-post test. The participants were 40 patients, 18 in the experimental group and 22 in the control group. A pretest and 2 posttest were conducted to measure the main variables. For the experimental group, hand acupuncture therapy, consisting of hand acupuncture and press-pellets based on corresponding points, was given. There were statistically significant differences in pain, ROM in knee joint, and ADL in the experimental group but not in depression compared to the control group over two different times. The hand acupuncture therapy was effective for low back pain, knee joint pain, ROM in knee joint and ADL among the elders in this study. Therefore, the hand acupuncture therapy can be utilized in the field of geriatric nursing as a nursing intervention for older people with low back pain and knee joint pain.

Depression, automatic thoughts, alexithymia, and assertiveness in patients with tension-type headache.

PubMed

Yücel, Basak; Kora, Kaan; Ozyalçín, Süleyman; Alçalar, Nilüfer; Ozdemir, Ozay; Yücel, Aysen

2002-03-01

The role of psychological factors related to headache has long been a focus of investigation. The aim of this study was to evaluate depression, automatic thoughts, alexithymia, and assertiveness in persons with tension-type headache and to compare the results with those from healthy controls. One hundred five subjects with tension-type headache (according to the criteria of the International Headache Society classification) and 70 controls were studied. The Beck Depression Inventory, Automatic Thoughts Scale, Toronto Alexithymia Scale, and Rathus Assertiveness Schedule were administered to both groups. Sociodemographic variables and headache features were evaluated via a semistructured scale. Compared with healthy controls, the subjects with headache had significantly higher scores on measures of depression, automatic thoughts, and alexithymia and lower scores on assertiveness. Subjects with chronic tension-type headache had higher depression and automatic thoughts scores than those with episodic tension-type headache. These findings suggested that persons with tension-type headache have high depression scores and also may have difficulty with expression of their emotions. Headache frequency appears to influence the likelihood of coexisting depression.

Cotton-type and joint invariants for linear elliptic systems.

PubMed

Aslam, A; Mahomed, F M

2013-01-01

Cotton-type invariants for a subclass of a system of two linear elliptic equations, obtainable from a complex base linear elliptic equation, are derived both by spliting of the corresponding complex Cotton invariants of the base complex equation and from the Laplace-type invariants of the system of linear hyperbolic equations equivalent to the system of linear elliptic equations via linear complex transformations of the independent variables. It is shown that Cotton-type invariants derived from these two approaches are identical. Furthermore, Cotton-type and joint invariants for a general system of two linear elliptic equations are also obtained from the Laplace-type and joint invariants for a system of two linear hyperbolic equations equivalent to the system of linear elliptic equations by complex changes of the independent variables. Examples are presented to illustrate the results.

Cotton-Type and Joint Invariants for Linear Elliptic Systems

PubMed Central

Aslam, A.; Mahomed, F. M.

2013-01-01

Cotton-type invariants for a subclass of a system of two linear elliptic equations, obtainable from a complex base linear elliptic equation, are derived both by spliting of the corresponding complex Cotton invariants of the base complex equation and from the Laplace-type invariants of the system of linear hyperbolic equations equivalent to the system of linear elliptic equations via linear complex transformations of the independent variables. It is shown that Cotton-type invariants derived from these two approaches are identical. Furthermore, Cotton-type and joint invariants for a general system of two linear elliptic equations are also obtained from the Laplace-type and joint invariants for a system of two linear hyperbolic equations equivalent to the system of linear elliptic equations by complex changes of the independent variables. Examples are presented to illustrate the results. PMID:24453871

Depressive Symptoms in Youth With Type 1 or Type 2 Diabetes: Results of the Pediatric Diabetes Consortium Screening Assessment of Depression in Diabetes Study.

PubMed

Silverstein, Janet; Cheng, Peiyao; Ruedy, Katrina J; Kollman, Craig; Beck, Roy W; Klingensmith, Georgeanna J; Wood, Jamie R; Willi, Steven; Bacha, Fida; Lee, Joyce; Cengiz, Eda; Redondo, Maria J; Tamborlane, William V

2015-12-01

To evaluate the frequency of depressive symptoms and the diagnosis and management of depression in youth with type 1 diabetes (T1D) and type 2 diabetes (T2D) enrolled in the Pediatric Diabetes Consortium T1D and T2D registries. The Children's Depression Inventory (CDI) 2 Self-Report (Short) version was completed by 261 T1D and 339 T2D youth aged 10-17 years. Symptoms of depression were identified in 13% of T1D and 22% of T2D (P = 0.007) participants; of these, only 4% of T1D and 9% of T2D youth were treated by a therapist within the prior 12 months. Depressive symptoms were associated with lower family income (P = 0.006) and obesity (P = 0.002) in T1D but not T2D youth. Depressive symptoms are more frequent than diagnosed depression in youth with T1D or T2D. These results underscore the need for regular depression screening and appropriate referral for youth with diabetes. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

State of the Science: Depression and Type 2 Diabetes

PubMed Central

Penckofer, Sue; Doyle, Todd; Byrn, Mary; Lustman, Patrick J.

2014-01-01

Depression is a significant comorbid condition in diabetes. Individuals with type 2 diabetes (T2DM) are 2 times more likely to experience depression or elevated depressive symptoms compared to those without T2DM. The aims of this state of the science review were to summarize the putative links between diabetes and depression and review empirically supported treatments of depression in diabetes. Findings suggest that a bidirectional association between depression and T2DM exists and that several biological and psychosocial mediators underlie these conditions. Available data indicate that conventional treatments (antidepressant medication, cognitive behavioral therapy, and collaborative care) reduce depression and symptoms of depression; however more controlled studies and development of novel therapies are needed. Glycemic outcomes have most frequently been examined, but findings have been mixed. Self-care and adherence outcomes have been less well studied. Emerging evidence suggests that these outcomes may be important targets for future depression research in T2DM. PMID:24577866

Anxiety and depression among patients with different types of vestibular peripheral vertigo.

PubMed

Yuan, Qing; Yu, Lisheng; Shi, Dongmei; Ke, Xingxing; Zhang, Hua

2015-02-01

Numerous studies have been published on comorbid anxiety and depression in patients with vertigo. However, very few studies have separately described and analyzed anxiety or depression in patients with different types of vestibular peripheral vertigo. The present study investigated anxiety and depression among patients with 4 different types of peripheral vertigo. A total of 129 patients with 4 types of peripheral vertigo, namely, benign paroxysmal positional vertigo (BPPV, n = 49), migrainous vertigo (MV, n = 37), Menière disease (MD, n = 28), and vestibular neuritis (VN, n = 15), were included in the present study. Otological and neurootological examinations were carefully performed, and self-rating anxiety scale and self-rating depression scale were used to evaluate anxiety and depression. Patients were divided into 2 groups, according to the vestibular function: normal and abnormal vestibular function. There was no significant difference in the risk of anxiety/depression between these 2 groups. However, for patients with the 4 different vertigo types, the prevalence of anxiety (MV = 45.9%, MD = 50%) and depression (MV = 27%, MD = 28.6%) was significantly higher in the patients with MV or MD than those with BPPV or VN (P < 0.05). Vestibular function is not significantly associated with the risk of anxiety/depression. Anxiety/depression is more common in patients with MV or MD than those with BPPV or VN. This may be due to the different mechanisms involved in these 4 types of vertigo, as well as differences in the prevention and self-control of the patients against the vertigo.

Cognitive Emotion Regulation Strategies in Anxiety and Depression Understood as Types of Personality.

PubMed

Domaradzka, Ewa; Fajkowska, Małgorzata

2018-01-01

The identification of distinctive and overlapping features of anxiety and depression remains an important scientific problem. Currently, the literature does not allow to determine stable similarities and differences in the use of cognitive emotion regulation strategies (CERS) in anxiety and depression, especially concerning the adaptive strategies. Consequently, the aim of this study was to identify the overlapping and distinctive patterns of CERS use in the recently proposed types of anxiety and depression in a general population. In this dimensional approach, types of anxiety and depression are considered as personality types and distinguished based on their specific structural composition and functional role (reactive or regulative) in stimulation processing. 1,632 participants from a representative sample completed the Anxiety and Depression Questionnaire (measuring the Arousal and Apprehension Types of anxiety and the Valence and Anhedonic Types of depression) and the Cognitive Emotion Regulation Questionnaire. Regression analyses were conducted with the affective types as predictors. The co-occurrence of the types was accounted for in order to examine their independent relationships with the CERS. We found that reactive arousal anxiety was not related to any strategies, while regulative apprehension anxiety primarily predicted the use of rumination, which is presumably related to the type's cognitive structural components. The strategy specific to reactive valence depression was other-blame (as predicted by the high negative affect in its structure), and the regulative, most structurally complex anhedonic depression predicted the use of the largest number of strategies, including the adaptive ones. The relationships between the types of depression and self-blame and refocus on planning were moderated by sex but the effects were small. These findings fit into the current trend of exploring the shared and specific features of anxiety and depression, which might

The relationship between parental depressive symptoms, family type, and adolescent functioning.

PubMed

Sieh, Dominik Sebastian; Sieh, Dominik Sebstian; Visser-Meily, Johanna Maria Augusta; Meijer, Anne Marie

2013-01-01

It is evident that parental depressive symptoms negatively influence adolescent behavior and various psychosocial outcomes. Certain family types like families with a chronically ill parent and single parent families are more vulnerable to parental depressive symptoms. However, the relationship between these symptoms, family type, and adolescent functioning remains largely unclear. This study examined relations between self-report of parental depressive symptoms and adolescent functioning in 86 two-parent families including a parent with a chronic medical condition, 94 families with healthy single parents, and 69 families with 2 healthy parents (comparison group). Parents completed the Beck Depression Inventory. Adolescents filled in the Youth Self-Report measuring problem behavior, and other instruments measuring psychosocial outcomes (stress, grade point average, school problems, and self-esteem). Multilevel analyses were used to examine the effects of family type, parental depressive symptoms, adolescents' gender and age, and interaction effects on adolescent functioning. The results indicated that adolescents with chronically ill and single parents had a lower grade point average (p<.01) than the comparison group. Adolescents of single parents reported more internalizing problems (p<.01) and externalizing problems (p<.05) than children from the other family types. Parental depressive symptoms were strongly related to child report of stress (p<.001). Adolescents of depressed chronically ill parents were particularly vulnerable to internalizing problems (interaction effect, p<.05). Older children and girls, and especially older girls, displayed more internalizing problems and stress. It can be concluded that growing up with a chronically ill parent in a family with 2 parents may have less impact on adolescent problem behavior than growing up in a single parent family. Health practitioners are encouraged to be attentive to the unique and combined influence of

The Relationship between Parental Depressive Symptoms, Family Type, and Adolescent Functioning

PubMed Central

Sieh, Dominik Sebstian; Visser-Meily, Johanna Maria Augusta; Meijer, Anne Marie

2013-01-01

It is evident that parental depressive symptoms negatively influence adolescent behavior and various psychosocial outcomes. Certain family types like families with a chronically ill parent and single parent families are more vulnerable to parental depressive symptoms. However, the relationship between these symptoms, family type, and adolescent functioning remains largely unclear. This study examined relations between self-report of parental depressive symptoms and adolescent functioning in 86 two-parent families including a parent with a chronic medical condition, 94 families with healthy single parents, and 69 families with 2 healthy parents (comparison group). Parents completed the Beck Depression Inventory. Adolescents filled in the Youth Self-Report measuring problem behavior, and other instruments measuring psychosocial outcomes (stress, grade point average, school problems, and self-esteem). Multilevel analyses were used to examine the effects of family type, parental depressive symptoms, adolescents' gender and age, and interaction effects on adolescent functioning. The results indicated that adolescents with chronically ill and single parents had a lower grade point average (p<.01) than the comparison group. Adolescents of single parents reported more internalizing problems (p<.01) and externalizing problems (p<.05) than children from the other family types. Parental depressive symptoms were strongly related to child report of stress (p<.001). Adolescents of depressed chronically ill parents were particularly vulnerable to internalizing problems (interaction effect, p<.05). Older children and girls, and especially older girls, displayed more internalizing problems and stress. It can be concluded that growing up with a chronically ill parent in a family with 2 parents may have less impact on adolescent problem behavior than growing up in a single parent family. Health practitioners are encouraged to be attentive to the unique and combined influence of

Depression and Associated Factors in Patients with Type 2 Diabetes Mellitus.

PubMed

Hashim, N A; Ariaratnam, S; Salleh, M R; Said, M A; Sulaiman, A H

2016-06-01

To determine the prevalence of major depressive disorder and its association with socio-demographic and clinical factors in patients with type 2 diabetes mellitus. This was a cross-sectional study of patients with type 2 diabetes mellitus who attended the hospital-based primary care clinics at the University Malaya Medical Centre, Kuala Lumpur, Malaysia. The patients were interviewed using the Mini-International Neuropsychiatric Interview to diagnose depression based on the DSM-IV criteria. The socio-demographic and clinical data were obtained by interviewing the patients and subsequently verified against their respective case notes. A total of 204 patients were recruited. The prevalence of major depressive disorder was 15.7%. Major depressive disorder was significantly associated with younger age of patients (mean ± standard deviation, 57.8 ± 15.1 years, p = 0.04), younger age at diagnosis of diabetes mellitus (46.2 ± 13.0 years, p = 0.01), having secondary education (p = 0.02), and having a history of depression (p = 0.002). Multivariate analysis showed that current age (p = 0.04), duration of diabetes mellitus (p = 0.04), age at diagnosis of diabetes mellitus (p = 0.01), and secondary education (p = 0.01) were significant factors. The prevalence of major depressive disorder was high among patients with type 2 diabetes mellitus. Screening of patients with type 2 diabetes mellitus for depression should be performed periodically or routinely, especially in the primary care setting.

Anxiety and Depression Among Patients With Different Types of Vestibular Peripheral Vertigo

PubMed Central

Yuan, Qing; Yu, Lisheng; Shi, Dongmei; Ke, Xingxing; Zhang, Hua

2015-01-01

Abstract Numerous studies have been published on comorbid anxiety and depression in patients with vertigo. However, very few studies have separately described and analyzed anxiety or depression in patients with different types of vestibular peripheral vertigo. The present study investigated anxiety and depression among patients with 4 different types of peripheral vertigo. A total of 129 patients with 4 types of peripheral vertigo, namely, benign paroxysmal positional vertigo (BPPV, n = 49), migrainous vertigo (MV, n = 37), Menière disease (MD, n = 28), and vestibular neuritis (VN, n = 15), were included in the present study. Otological and neurootological examinations were carefully performed, and self-rating anxiety scale and self-rating depression scale were used to evaluate anxiety and depression. Patients were divided into 2 groups, according to the vestibular function: normal and abnormal vestibular function. There was no significant difference in the risk of anxiety/depression between these 2 groups. However, for patients with the 4 different vertigo types, the prevalence of anxiety (MV = 45.9%, MD = 50%) and depression (MV = 27%, MD = 28.6%) was significantly higher in the patients with MV or MD than those with BPPV or VN (P < 0.05). Vestibular function is not significantly associated with the risk of anxiety/depression. Anxiety/depression is more common in patients with MV or MD than those with BPPV or VN. This may be due to the different mechanisms involved in these 4 types of vertigo, as well as differences in the prevention and self-control of the patients against the vertigo. PMID:25654382

A novel multi-item joint replenishment problem considering multiple type discounts.

PubMed

Cui, Ligang; Zhang, Yajun; Deng, Jie; Xu, Maozeng

2018-01-01

In business replenishment, discount offers of multi-item may either provide different discount schedules with a single discount type, or provide schedules with multiple discount types. The paper investigates the joint effects of multiple discount schemes on the decisions of multi-item joint replenishment. In this paper, a joint replenishment problem (JRP) model, considering three discount (all-unit discount, incremental discount, total volume discount) offers simultaneously, is constructed to determine the basic cycle time and joint replenishment frequencies of multi-item. To solve the proposed problem, a heuristic algorithm is proposed to find the optimal solutions and the corresponding total cost of the JRP model. Numerical experiment is performed to test the algorithm and the computational results of JRPs under different discount combinations show different significance in the replenishment cost reduction.

Depression symptoms are persistent in Type 2 diabetes: risk factors and outcomes of 5-year depression trajectories using latent class growth analysis.

PubMed

Whitworth, S R; Bruce, D G; Starkstein, S E; Davis, W A; Davis, T M E; Skinner, T C; Bucks, R S

2017-08-01

To describe the long-term trajectories of depression symptom severity in people with Type 2 diabetes, and to identify predictors and associates of these trajectories. A community-dwelling cohort of 1201 individuals with Type 2 diabetes from the Fremantle Diabetes Study Phase II was followed for 5 years. The nine-item version of the Patient Health Questionnaire was administered annually to assess depression symptoms, and biomedical and psychosocial measures were assessed at baseline and biennially. Latent class growth analysis was used to identify classes of depression severity trajectories and associated outcomes, and logistic regression models were used to determine predictors of class membership. Three trajectories of depression symptoms were identified: continuously low depression symptoms (85.2%); gradually worsening symptoms that then began to improve (persistent depression - low-start; 7.3%); and gradually improving symptoms which later worsened (persistent depression - high-start; 7.5%). Younger age, being a woman, and a lifetime history of major depressive disorder, were associated with greater risk of persistent depression symptoms. Persistent depression was associated with consistently higher BMI over time, but not with changes in HbA 1c or self-monitoring of blood glucose. A subset of individuals with Type 2 diabetes is at risk of depression symptoms that remain elevated over time. Younger, overweight individuals with a history of depression may benefit from early and intensive depression management and ongoing follow-up as part of routine Type 2 diabetes care. © 2017 Diabetes UK.

Neighborhood settings, types of social capital and depression among immigrants in Toronto.

PubMed

Daoud, Nihaya; Haque, Nasim; Gao, Meiyin; Nisenbaum, Rosane; Muntaner, Carles; O'Campo, Patricia

2016-04-01

Few studies consider the associations between neighborhood social capital and immigrant's mental health. We examined associations between bonding, bridging and linking social capital and depression among immigrants in Toronto neighborhoods. We used data on immigrants from the neighborhood effects on health and well-being (NEHW) study, conducted in 47 randomly selected greater Toronto area neighborhoods (sample = 916), and a study of one low-income, immigrant receiving neighborhood (IRN) (sample = 600). We conducted logistic regression models for depression (Epidemiologic Studies Depression Scale, CES-D) and social capital types: bonding (social cohesion and informal social control), bridging (group membership) and linking (engagement in political activities), while adjusting for different covariates. The prevalence of depression was 22.9 % in IRN and 21.4 % in NEHW. The associations between social capital types and depression differed in each sample. Lower social cohesion (bonding) was associated with higher depression in NEHW only. Lower linking social capital (never participated in political activities) was associated with lower depression in IRN only. These associations were consistent after adjustment for different covariates. Results suggest that social cohesion might have a protective effect from depression among immigrants in NEHW. In IRN, lower linking social capital associated with lower depression might reflect opposite direction association. Bridging social capital was not associated with depression in either sample, indicating that current community building might be insufficient to impact depression. Different pathways might explain how depression among immigrants is impacted by social capital types operating in different neighborhood settings; this could be examined in future longitudinal studies.

46 CFR 154.528 - Piping joints: Flange type.

Code of Federal Regulations, 2010 CFR

2010-10-01

... and Process Piping Systems § 154.528 Piping joints: Flange type. (a) A flange must be one of the following types: (1) Welding neck. (2) Slip-on. (3) Socket weld. (b) If the piping is designed for a... less; or (3) Welding neck. (c) If the piping is designed for a temperature lower than −55 °C (−67 °F...

Use of Interpersonal Counseling for Modern Type Depression.

PubMed

Ono, Hisae; Yamamoto, Ami; Taketani, Reiko; Tsujimoto, Emi

2017-01-01

A novel form of depression, called "modern type depression" (MTD), has been increasing in prevalence in Japan. Patients with MTD present with an overt appeal of depressive mood and a desire to be excused from their work duties; as such, this can cause considerable trouble in the workplace. Psychosocial interventions should be primarily considered for the treatment of MTD. Interpersonal counseling (IPC), which has proven effective for treating subthreshold depression, may be effective for MTD. However, IPC is rarely done in Japan. Herein, we report on a successful case of IPC for a woman in her thirties who was about to quit her job due to MTD (diagnosed by the criteria for research use). After IPC, the patient enjoyed good communication with her boss and continued her job without succumbing to her depression. This case suggests that IPC may be effective for MTD in workers and further highlights the benefits of teaching interpersonal communication methods in the workplace.

Prevalence of depression in type 2 diabetes mellitus.

PubMed

Rodríguez Calvín, J L; Zapatero Gaviria, A; Martín Ríos, M D

2015-04-01

The relationship between depression and diabetes has been widely documented but there have been methodological limitations such as the failure to conduct a diagnostic interview of the depressive condition. We have estimated the prevalence of depression in patients with type 2 diabetes mellitus (DM2) and its relationship with sociodemographic, lifestyle and clinical variables. This was a cross-sectional, randomized study (stratified by sex and age) of patients with DM2 treated in a healthcare area with approximately 3000 eligible patients. The depressive symptoms were assessed using the Beck Depression Inventory (depression defined as a BDI score>16) and a psychiatric interview. We used a multivariate logistic regression model to evaluate the association between depression and DM2, after adjusting for known risk factors. We examined 275 patients with DM2 (mean age, 64.5 years; men, 56.4%). The prevalence of depression was calculated at 32.7% (95% CI 27.4-38.5) and increased with age. A greater prevalence of depression was found in women, widowers, patients with obesity, those with poor compliance with the prescription, those with poor glycemic control and those who developed complications from diabetes. Thirty-five percent (95% CI 26.4-45.8) of the patients who scored>16 on the BDI scale had not been diagnosed with depression. Depression is highly prevalent in patients with DM2, especially in women. For approximately one-third of the patients, a diagnosis of depression had not been reached. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

The association between type D personality, and depression and anxiety ten years after PCI.

PubMed

Al-Qezweny, M N A; Utens, E M W J; Dulfer, K; Hazemeijer, B A F; van Geuns, R-J; Daemen, J; van Domburg, R

2016-09-01

There are indications that type D personality and depression are associated in patients treated with percutaneous coronary intervention (PCI). However, at present it is unclear whether this relationship holds in the long term. This study's aim was to investigate the association between type D personality at 6 months post-PCI (baseline), and depression at 10-year follow-up. A secondary aim was to test the association between type D personality at baseline and anxiety at 10-year follow-up. A cohort of surviving consecutive patients (N = 534) who underwent PCI between October 2001 and October 2002. Patients completed the type D personality scale (DS14) measuring type D personality at baseline, and the Hospital Anxiety and Depression Scale (HADS) measuring anxiety and depression at baseline and at 10 years post-PCI. At baseline, the prevalence of type D personality was 25 % (135/534). Type D personality patients were more often depressed (42 %) than non-type D personality patients (9 %). Response rate of anxiety and depression questionnaires at 10 years was 75 %. At 10-year follow-up, 31 % of type D personality patients were depressed versus 13 % of non-type D personality patients. After adjustments, baseline type D personality remained independently associated with depression at 10 years (OR = 3.69; 95 % CI [1.89-7.19]). Type D showed a similar association with anxiety at 10 years, albeit somewhat lower (OR = 2.72; 95 % CI [1.31-5.63]). PCI patients with type D personality had a 3.69-fold increased risk for depression and a 2.72-fold increased risk for anxiety at 10 years of follow-up.

Prevalence of depression in Type 1 diabetes and the problem of over-diagnosis.

PubMed

Fisher, L; Hessler, D M; Polonsky, W H; Masharani, U; Peters, A L; Blumer, I; Strycker, L A

2016-11-01

To determine the prevalence of depression and diabetes distress in adults with Type 1 diabetes and the rate of false-positives when compared with rates of major depressive disorder. The sample consisted of 368 individuals with Type 1 diabetes, aged > 19 years. Individuals completed: the eight-item Patient Health Questionnaire depression scale (PHQ8), which was coded using four scoring criteria (scores > 10, >12 and >15, and Diagnostic and Statistical Manual of Mental Disorders 5 (DSM) algorithm scores); the Type 1 Diabetes Distress Scale; and the Structured Clinical Interview for DSM Disorders (SCID) to assess major depressive disorder. The prevalence rates of depression according to the eight-item Patient Health Questionnaire were: score >10, 11.4%; score >12, 7.1%; score >15, 3.8%; and positive algorithm result, 4.6%. The prevalence of major depressive disorder was 3.5%; and the prevalence of at least moderate diabetes distress was 42.1%. Depending on the criterion used, the false-positive rate when using the Patient Health Questionnaire compared with the results when using the SCID varied from 52 to 71%. Of those classified as depressed on the PHQ-8 or Structured Clinical Interview for DSM Disorders, between 92.3 and 96.2% also reported elevated diabetes distress. No significant association was found between any group classed as having depression according to the PHQ8 or the SCID and HbA 1c concentration. Depression was significantly associated with more other life stress, more complications and a lower level of education. We found an unexpectedly low rate of current depression and major depressive disorder in this diverse sample of adults with Type 1 diabetes, and a very high rate of false-positive results using the Patient Health Questionnaire. Considering the high prevalence of diabetes distress, much of what has been considered depression in adults with Type 1 diabetes may be attributed to the emotional distress associated with managing a demanding chronic

Prevalence of restless legs symptoms according to depressive symptoms and depression type: a cross-sectional study.

PubMed

Auvinen, Piritta; Mäntyselkä, Pekka; Koponen, Hannu; Kautiainen, Hannu; Korniloff, Katariina; Ahonen, Tiina; Vanhala, Mauno

2018-01-01

Restless legs syndrome is a sensorimotor disorder and it is associated with several other diseases especially mental illnesses. To analyze the relationship between the symptoms of restless legs syndrome and the severity of depressive symptoms and the prevalence of restless legs symptoms in depression subtypes. A cross-sectional study of primary care patients in the Central Finland Hospital District. The prevalence of restless legs symptoms was studied in 706 patients with increased depressive symptoms and 426 controls without a psychiatric diagnosis by using a structured questionnaire. The depressive symptoms were evaluated with the Beck Depression Inventory (BDI) and the psychiatric diagnosis was confirmed by means of a diagnostic interview (Mini-International Neuropsychiatric Interview). The subjects with increased depressive symptoms were divided into three groups (subjects with depressive symptoms without a depression diagnosis, melancholic depression and non-melancholic depression). In the whole study population, the prevalence of restless legs symptoms increased with the severity of depressive symptoms. The prevalence of restless legs symptoms was highest in the melancholic and non-melancholic depressive patients (52 and 46%, respectively) and then in subjects with depressive symptoms without a depression diagnosis (43.4%), but the prevalence was also substantial (24.6%) in subjects without a psychiatric diagnosis. Restless legs symptoms are very common in primary care among subjects with depression, regardless of the depression type. The prevalence of restless legs symptoms increased with increasing severity of depressive symptoms, regardless of the diagnosis. These findings should be considered in clinical evaluation and treatment of patients visiting their physician due to restless legs or depressive symptoms.

JOINT AND INDIVIDUAL VARIATION EXPLAINED (JIVE) FOR INTEGRATED ANALYSIS OF MULTIPLE DATA TYPES.

PubMed

Lock, Eric F; Hoadley, Katherine A; Marron, J S; Nobel, Andrew B

2013-03-01

Research in several fields now requires the analysis of datasets in which multiple high-dimensional types of data are available for a common set of objects. In particular, The Cancer Genome Atlas (TCGA) includes data from several diverse genomic technologies on the same cancerous tumor samples. In this paper we introduce Joint and Individual Variation Explained (JIVE), a general decomposition of variation for the integrated analysis of such datasets. The decomposition consists of three terms: a low-rank approximation capturing joint variation across data types, low-rank approximations for structured variation individual to each data type, and residual noise. JIVE quantifies the amount of joint variation between data types, reduces the dimensionality of the data, and provides new directions for the visual exploration of joint and individual structure. The proposed method represents an extension of Principal Component Analysis and has clear advantages over popular two-block methods such as Canonical Correlation Analysis and Partial Least Squares. A JIVE analysis of gene expression and miRNA data on Glioblastoma Multiforme tumor samples reveals gene-miRNA associations and provides better characterization of tumor types.

Correlates of depression in type 2 diabetic elderly patients: a correlational study.

PubMed

Bai, Yu-Ling; Chiou, Chou-Ping; Chang, Yong-Yuan; Lam, Hing-Chung

2008-04-01

This aim of this study was to investigate depression and related factors in elderly patients (65 years) with type 2 diabetics. The study utilized a descriptive-correlational design. Convenience sampling was applied to enroll 156 subjects, aged >or= 65 years from diabetic outpatient clinics at three hospitals in Kaohsiung. This study applied the Personal Resource Questionnaire 2000 (PRQ 2000), Taiwan Geriatric Depression Scale (TGDS), and a form for demographic data. (1) The mean index score for depression level was 26, indicating that study subjects had a low level of depression. The social support index score was 76. (2) Significant differences in TGDS scores existed for diabetes duration, diabetes complications, and treatment type. (3) Social support and regular exercise were significantly and negatively correlated with depression. (4) Social support and diabetes complications were significant correlates of depression and accounted for 25.9% of variance in depression. Analytical results may assist nurses in understanding depression and related factors for diabetic patients aged >or= 65. Therefore, this study could form a basis for caring older people with diabetes, and provide a reference for further research.

Intra-articular calcaneal fractures: effect of open reduction and internal fixation on the contact characteristics of the subtalar joint.

PubMed

Mulcahy, D M; McCormack, D M; Stephens, M M

1998-12-01

Intra-articular calcaneal fractures are associated with significant long-term morbidity, and considerable controversy exists regarding the optimum method of treating them. The contact characteristics in the intact subtalar joint were determined at known loads and for different positions of the ankle and subtalar joint, using pressure-sensitive film (Super Low; Fuji, Itochu Canada Ltd, Montreal, Quebec). We measured the contact area to joint area ratio (pressure > 5 kg force/cm2 [kgf/cm2]) which normalizes for differences in joint size and the ratio of high pressure zone (>20 kgf/cm2) as a reflection of overall increase in joint pressure. Three simulated fracture patterns were then created and stabilized with either 1 or 2 mm of articular incongruity. Eight specimens were prepared with a primary fracture line through the posterior facet, eight with a joint depression-type fracture, and six with a central joint depression fracture. A measure of 1 to 2 mm of incongruity in the posterior facet for all three fracture patterns produced significant unloading of the depressed fragment, with a redistribution of the overall pattern of pressure distribution to parts of the facet that were previously unloaded.

Prevalence of depression in patients with type 2 diabetes mellitus in Irish primary care and the impact of depression on the control of diabetes.

PubMed

Foran, E; Hannigan, A; Glynn, L

2015-06-01

As the Irish population ages, the management of chronic conditions in primary care is emerging as a challenge. The presence of co-morbid depression is common among such patients and may affect their response to treatment. This study sought to determine whether the prevalence of depression is higher in patients with type 2 diabetes mellitus than in the population aged >50 in the West of Ireland, and whether depression is an independent predictor of diabetes control. We used a cross-sectional design to examine an anonymized database of 9,698 patients aged >50 years whose medical data were collected as part of NUI Galway's CLARITY study. Glycosylated HbA1c levels were used to estimate type 2 DM control; depression was assessed using the Hospital Anxiety and Depression Scale. We found that while there is a higher prevalence of severe depression in patients with type 2 DM, there is no association between their diabetes control and depression after controlling for age, gender, comorbidity and GMS status. Multimorbidity is a significant predictor of depression in both diabetic and non-diabetic populations, with the odds of depression increasing as the number of co-morbidities increased. Patients with type 2 DM are more likely to suffer from severe depression than those without. Depression itself is not an independent predictor of diabetes control. However, it may be that the increased rates of depression observed in patients with type 2 DM are at least partially attributable to the burden of additional illnesses seen in these patients.

[Frequency of depression in patients with diabetes mellitus type 2].

PubMed

Garduño-Espinosa, J; Téllez-Zenteno, J F; Hernández-Ronquillo, L

1998-01-01

To determine the prevalence of depression in Mexican adult diabetics and to identify factors associated to the depression. Prolective survey. Four Mexico City hospitals (Clinica San Pedro de los Pinos IMSS, Centro Medico Nacional Siglo XXI IMSS, Hospital Gea González SSa and Centro de Salud Margarita Chorne SSa). 79 patients with diabetes mellitus type 2. The Beck Depression Inventory was used as a measure of depression. We used sociodemographic variables (age, gender, marital status, religion, education, occupation, socioeconomic status) and disease variables (years of diagnosis, other chronic medical conditions and compliance with therapeutic regimens) as the independent variables of depression. Mean age was 59 +/- 11 years (SD) and 58 (73%) were females. The frequency of depression was 46%. Factors associated to depression were: females (OR = 3.67, CI = 1.07-13.3, p = 0.03) and years of diagnosis above 15 (OR = 3.08, CI = 0.91-10.8, p = 0.07). Frequency of depression was high (46%). Gender and years of diabetes diagnosis were factors associated to depression.

Investigating Factors Associated with Depression of Type 2 Diabetic Retinopathy Patients in China

PubMed Central

Qian, Duo; Dong, Qing; Gu, Zhifeng

2015-01-01

Aims and objectives To assess the depression status of type 2 diabetic retinopathy patients in Nantong China and to identify factors associated with depression. Methods Two hundred and ninety-four patients with type 2 diabetic retinopathy were recruited from the Affiliated Hospital of Nantong University. The severity of DR was measured in the worse eye. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale (CES-D); the quality of life was measured with the Medical Outcomes Study Short Form 36 (SF-36). The logistic regression analyses were used to identify the independent factors of depression. Results The mean age of the study subjects was 57.77 years (SD: 9.64). Approximately 35.7% of subjects reported depressive symptoms (n = 105).Multiple logistic regression analyses showed that female gender (p = 0.014), low monthly income (p = 0.01), poor vision in the better eye (P = 0.002), laser treatment history (p = 0.01) were significant risk factors for depression. The quality of life of individuals with CES-D score<16 was significantly better compared with individuals with CES-D score≥16. Conclusion The reported depressive symptoms among type 2 diabetic retinopathy population is higher in Nantong China. Gender, salary, vision acuity and treatment history were important risk factors linked to this disorder in the Chinese type 2 diabetic retinopathy population from Nantong. More attention by medical care personnel needs to be paid to the psychological health of this population. PMID:26151365

Microalbuminuria is associated with limited joint mobility in type I diabetes mellitus.

PubMed Central

Montaña, E; Rozadilla, A; Nolla, J M; Gomez, N; Escofet, D R; Soler, J

1995-01-01

OBJECTIVE--To determine whether limited joint mobility (LJM) is associated with microalbuminuria in type I diabetes mellitus. METHODS--Joint mobility was measured in a control group of 63 healthy subjects and in 63 type I diabetic patients, older than 18 years (mean 31.7 years, range 18-57), recruited from the outpatient clinic of the Endocrine Unit. Patients with established diabetic nephropathy (proteinuria or increased creatinine) were excluded. Joint mobility was assessed qualitatively with the prayer manoeuvre and quantitatively by measuring the angles of maximal flexion and extension of the fifth and third metacarpophalangeal (MCP) joints and wrist. Diabetic retinopathy was assessed by direct ophthalmoscopy. Urinary albumin excretion (UAE) was determined in at least two 24 hour urine samples. RESULTS--Joint mobility was limited in diabetic patients compared with control subjects. Diabetic patients with LJM had longer duration of diabetes (12.1 (SD 6.4) years compared with 6.9 (5.7) years; p < 0.001). Joint mobility was limited in patients with retinopathy: prayer manoeuvre was positive in 96.4% of patients with retinopathy, but in only 40.0% of patients with no retinopathy (p < 0.001); mobility of MCP joints and wrist was limited in diabetic patients with retinopathy even when the longer duration of their diabetes was taken into consideration. Microalbuminuria, present in 11 patients (17.5%), was associated with LJM: prayer manoeuvre was positive in 90.9% of patients with microalbuminuria, but in only 57.4% of patients with normal UAE (p < 0.05). Maximal flexion of MCP joints was reduced in patients with microalbuminuria. Microalbuminuria, but not LJM, was associated with risk factors of cardiovascular disease. CONCLUSION--LJM is associated with microalbuminuria and retinopathy in type I diabetes. The association is independent of age and duration of diabetes. PMID:7668902

Selective depression behavior of guar gum on talc-type scheelite flotation

NASA Astrophysics Data System (ADS)

Zhang, Yong-zhong; Gu, Guo-hua; Wu, Xiang-bin; Zhao, Kai-le

2017-08-01

The depression behavior and mechanism of guar gum on talc-type scheelite flotation were systematically investigated by flotation experiments, adsorption tests, zeta-potential measurements, and infrared spectroscopic analyses. The flotation results for monominerals, mixed minerals, and actual mineral samples indicated that guar gum exhibited much higher selective depression for talc than for scheelite. Bench-scale closed-circuit tests showed that a tungsten concentrate with a WO3 grade of 51.43% and a WO3 recovery of 76.18% was obtained. Adsorption tests, zeta-potential measurements, and infrared spectral analyses confirmed that guar gum absorbed more strongly onto the talc surface than onto the scheelite surface because of chemisorption between guar gum and talc. This chemisorption is responsible for the guar gum's highly selective depression for talc and small depression for scheelite. The flotation results provide technical support for talc-type scheelite flotation.

Correlations among social support, depression, and anxiety in patients with type-2 diabetes.

PubMed

Wu, Shu-Fang Vivienne; Young, Li-Sei; Yeh, Fang-Chih; Jian, Yu-Mei; Cheng, Kuei-Chen; Lee, Mei-Chen

2013-06-01

Social support is related to patient self-care and health status. Patients' psychosocial issues play an important role in diabetes care. This study investigates correlations among social support, depression, and anxiety in patients with diabetes. A cross-sectional study design and purposive sampling were used. One hundred eleven patients with type-2 diabetes were recruited from three regional teaching hospitals in northern, central, and southern Taiwan, respectively. Questionnaires used included the social support and psychological referral inventory, Beck depression inventory, and Beck anxiety inventory. Approximately 12.6% of the study population had depression, and 27.0% had anxiety. Depression and anxiety were positively correlated (r = .65, p < .01), whereas depression was negatively correlated with the sum of disease control types (r = -0.26, p < .01) and social support (r = -0.27, p <.01). The sum of disease control types and social support were the most important explanatory factors for depression in patients, explaining 45.5% of variance. Anxiety was correlated positively with age (r = .26, p < .01), total number of complications (r = .31, p < .01), and depression (r = .65, p < .01). Anxiety correlated negatively with weight (r = -0.20, p < .05) and sum of disease control types (r = -0.25, p < .05). The above variables were important explanatory factors for anxiety, accounting for 15.2% of variance. Psychological factors, such as depression and anxiety, are common symptoms in patients with diabetes. If social support can be strengthened in these patients, then psychological factors can be improved. Professional care providers should focus on reducing the patient depression and anxiety levels, strengthening social support, and providing referrals to psychology-related professionals.

Diabetes Distress and Depression in South Asian Canadians with Type 2 Diabetes.

PubMed

Sidhu, Rawel; Tang, Tricia S

2017-02-01

South Asians are disproportionately affected by diabetes compared to some other ethnic groups in Canada. Although depression and diabetes distress are psychological issues well studied in the general population of those with diabetes, they have not been investigated in South Asian Canadians with type 2 diabetes. We sought to identify the rates of depression and diabetes distress in South Asian adults with type 2 diabetes and to explore the relationship among glycemic control, depression and diabetes distress. We recruited 41 South Asian adults with type 2 diabetes for this study. Glycated hemoglobin (A1C) levels were collected via venous puncture. We utilized the Diabetes Distress Scale to assess total diabetes distress and its subscales (emotional distress, interpersonal distress, regimen-related distress and physician distress) and the Personal Health Questionnaire-9 to assess depressive symptoms. The rate of depression was 15%, and the rate of total diabetes distress was 52.5%. Although neither measure was found to be correlated with A1C levels, depression had a moderate positive correlation with total diabetes distress (r=0.696; p<0.001); subscales of regimen distress and emotional burden emerged as the strongest correlates. This is the first study to report that diabetes distress is a serious concern for South Asian Canadians with type 2 diabetes. Given that depression and diabetes distress are linked, studies recruiting a larger and more diverse sample of South Asian Canadians should be conducted to better understand the psychological issues that may impact diabetes self-management in this community. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Joint trajectories of cigarette smoking and depressive symptoms from the mid-twenties to the mid-thirties predicting generalized anxiety disorder

PubMed Central

Lee, Jung Yeon; Brook, Judith S.; Finch, Stephen J.; De La Rosa, Mario; Brook, David W.

2017-01-01

The current study examines the longitudinal patterns of both cigarette smoking and depressive symptoms as predictors of generalized anxiety disorder (GAD) using data from the Harlem Longitudinal Development Study. There were 674 African American (53%) and Puerto Rican (47%) participants. Among the 674 participants, 60% were females. In the logistic regression analyses, the indicator variables of membership in each of the joint trajectories of cigarette smoking and depressive symptoms from the mid 20s to the mid 30s were used as the independent variables, and the diagnosis of GAD in the mid 30s was used as the dependent variable. The high cigarette smoking with high depressive symptoms group and the low cigarette smoking with high depressive symptoms group were associated with an increased likelihood of having GAD as compared to the no cigarette smoking with low depressive symptoms group. The findings shed light on the prevention and treatment of GAD. PMID:28281938

Frequency of depression in type 2 diabetes mellitus and an analysis of predictive factors.

PubMed

Arshad, Abdul Rehman; Alvi, Kamran Yousaf

2016-04-01

To determine frequency of depression in patients with diabetes mellitus type 2 and to identify predictive factors. The observational study was carried out at 1 Mountain Medical Battalion, Bagh, Azad Kashmir, Pakistan, from June 2013 to May 2014, and comprised type 2 diabetic patients who were not using anti-depressants and did not have history of other psychiatric illnesses. Demographic data, duration of diabetes, presence of hypertension and type of treatment were recorded and body mass index was calculated. Patient Health Questionnaire-9, translated into Urdu, was administered during face-to-face interviews. Scores >5 indicated depression, which was classified into different grades of severity using standard cut-off values. Of the 133 patients, 51(38.35%) were depressed. Depression was mild in 34(26%), moderate in 12(9.6%), moderately severe in 4(2.9%) and severe in 1(0.7%) patient. On univariate binary logistic regression, female gender (odds ratio=3.07; 95% confidence interval = 1.43, 6.59), lesser education (odds ratio = 0.90; 95% confidence interval 0.84, 0.97) shorter duration of diabetes (odds ratio=0.87; 95% confidence interval = 0.80, 0.96) and higher body mass index (odds ratio=1.41; 95% confidence interval = 1.05, 1.25) were significantly associated with depression. Only shorter duration of diabetes (odds ratio=0.90; 95% confidence interval = 0.82, 0.99) remained significant after adjustment for confounders. Age, level of education, glycaemic control and type of treatment did not predict depression. A significant proportion of type 2 diabetics were depressed. Shorter duration of diabetes reliably predicted depression in these patients.

Optimal Joint Detection and Estimation That Maximizes ROC-Type Curves.

PubMed

Wunderlich, Adam; Goossens, Bart; Abbey, Craig K

2016-09-01

Combined detection-estimation tasks are frequently encountered in medical imaging. Optimal methods for joint detection and estimation are of interest because they provide upper bounds on observer performance, and can potentially be utilized for imaging system optimization, evaluation of observer efficiency, and development of image formation algorithms. We present a unified Bayesian framework for decision rules that maximize receiver operating characteristic (ROC)-type summary curves, including ROC, localization ROC (LROC), estimation ROC (EROC), free-response ROC (FROC), alternative free-response ROC (AFROC), and exponentially-transformed FROC (EFROC) curves, succinctly summarizing previous results. The approach relies on an interpretation of ROC-type summary curves as plots of an expected utility versus an expected disutility (or penalty) for signal-present decisions. We propose a general utility structure that is flexible enough to encompass many ROC variants and yet sufficiently constrained to allow derivation of a linear expected utility equation that is similar to that for simple binary detection. We illustrate our theory with an example comparing decision strategies for joint detection-estimation of a known signal with unknown amplitude. In addition, building on insights from our utility framework, we propose new ROC-type summary curves and associated optimal decision rules for joint detection-estimation tasks with an unknown, potentially-multiple, number of signals in each observation.

[A new type sternoclavicular hook plate for unstable sternoclavicular joint dislocation and fracture].

PubMed

Zhang, Chuan-Yi; Lin, Lie; Liang, Jun-Bo; Wang, Bin; Chen, Guo-Fu; Chen, Hai-Xiao

2016-11-25

To evaluate the therapeutic effect of a new type sternoclavicular hook plate fixation in treating unstable sternoclavicular joint dislocation and fracture. From June 2011 to December 2013, 32 patients with sternoclavicular joint dislocation and fracture were treated with a new type sternoclavicular hook plate fixation, including 24 males and 8 females with an average age of 42 years ranging from 25 to 76 years;12 patients were anterior dislocation, 5 pations were posterior dislocation, 10 patients were internal extremity of clavicle fracture and 5 patients were sternoclavicular joint dislocation combined with fracture. The anterior fracture dislocation of the sternoclavicular joint adopted standard sternoclavicular joint hook plate, and the posterior dislocation was at the distal end of the hook of the steel plate, that is, the front part of the handle of the breast was added with a nut and a gasket to prevent the re-dislocation after operation. The results were evaluated according to Rockwood score. No complication happened in all patients. X-ray and CT showed that the dislocation and fracture of the sternoclavicular joint was well reduced and the plate was on right position. All patients were followed up for 6 to 24 months with an average of 10 months. At 6 to 3 months after operation, the fracture was healing without re-dislocation of the sternoclavicular joint, the medial end of the clavicle anatomical structure were restored, functional satisfaction, in which 9 patients with the swelling around sternoclavicular joint, but no pain and other symptoms. The total Rockwood score was 12.78±1.43; the results were excellent in 24 cases, good in 8 cases. The use of the new type of locking hook plate for the treatment of unstable fracture of the sternoclavicular joint, internal fixation is reliable, high security, easy to operate, to provide a reliable method for the treatment of such trauma.

[Prevalence of type 2 diabetes and factors associated in depression].

PubMed

Sebbani, M; Dali Sahi, M; Amine, M; Aouar, A

2014-02-01

The aim of our study was to estimate the prevalence of type 2 diabetes in patients with depression and to describe its associated factors. A cross-sectional descriptive study was conducted over a period of three months (from May to August 2012) in a hospital in Tlemcen, Algeria. The sample study had included 73 consecutive depressed patients who had attended the unit for assessment, education or treatment of depression or its complications. Data collection was conducted using a questionnaire. Blood sampling was performed in all patients to measure glycemic levels. Data analysis was performed using the spss version 10 software. P-value was considered significant when ≤ 0.05. Means age was 53 ± 15 years. Sex-ratio female/male was 1.35. The prevalence of type 2 diabetes was 69.9% with 95% CI [57.9; 79.8]. Heredity and collective lifestyle were significantly associated with diabetes (P<0.0001). We have not found an association of diabetes with the factors studied: gender, presence of remaining associated diseases, smoking, and treatment regime. In the absence of national epidemiological data, the results of our study provide the frequency of type 2 diabetes during depression. This requires planning strategies for diagnosis and appropriate care for this population. Copyright © 2013 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Longitudinal Analysis of Depressive Symptoms and Glycemic Control in Type 2 Diabetes

PubMed Central

Aikens, James E.; Perkins, Denise White; Lipton, Bonnie; Piette, John D.

2009-01-01

OBJECTIVE To compare whether depressive symptoms are more strongly related to subsequent or prior glycemic control in type 2 diabetes and to test whether patient characteristics modify these longitudinal associations. RESEARCH DESIGN AND METHODS On two occasions separated by 6 months, depressive symptoms and glycemic control were assessed in 253 adults with type 2 diabetes. Regression analyses examined depressive symptoms as both a predictor and outcome of glycemic control and tested whether medication regimen (e.g., insulin versus oral drugs) was an effect modifier before and after adjusting for baseline levels of the outcome being predicted. RESULTS Depressive symptom severity predicted poor glycemic control 6 months later (P = 0.018) but not after baseline glycemic control was taken into account (P = 0.361). Although baseline glycemic control did not generally predict depressive symptoms 6 months later (P = 0.558), it significantly interacted with regimen (P = 0.008). Specifically, glycemic control predicted depressive symptoms among patients prescribed insulin (β = 0.31, P = 0.002) but not among those prescribed oral medication alone (β = −0.10, P = 0.210). Classifying depression dichotomously produced similar but weaker findings. CONCLUSIONS Depressive symptoms do not necessarily lead to worsened glycemic control. In contrast, insulin-treated patients in poor glycemic control are at moderate risk for worsening of depressive symptoms. These patients should be carefully monitored to determine whether depression treatment should be initiated or intensified. PMID:19389814

Evaluation of anticollagen type I antibody titers in synovial fluid of both stifle joints and the left shoulder joint of dogs with unilateral cranial cruciate disease.

PubMed

de Bruin, Tanya; de Rooster, Hilde; van Bree, Henri; Cox, Eric

2007-03-01

To evaluate anticollagen type I antibodies in synovial fluid of the affected stifle joint, the contralateral stifle joint, and the left shoulder joint of dogs with unilateral cranial cruciate ligament (CrCL) rupture during an extended period of 12 to 18 months. 13 client-owned dogs with CrCL rupture and 2 sham-operated dogs. All dogs were examined and arthrocentesis of all 3 joints was performed every 6 months after surgery. Synovial fluid samples were tested for anticollagen type I antibodies by use of an ELISA. Dogs with partial CrCL rupture had higher antibody titers than dogs with complete rupture. Six of 13 dogs ruptured the contralateral CrCL during the study, whereby higher antibody titers were found for the stifle joints than for the shoulder joint. Seronegative dogs or dogs with extremely low antibody titers and 2 dogs with high antibody titers did not sustain a CrCL rupture in the contralateral stifle joint. In most dogs that had a CrCL rupture of the contralateral stifle joint, a distinct antibody titer gradient toward the stifle joints was detected, suggesting that there was a local inflammatory process in these joints. However, only a small number of sham-operated dogs were used to calculate the cutoff values used to determine the anticollagen type I antibody titers in these patients. Synovial fluid antibodies against collagen type I alone do not initiate CrCL rupture because not all dogs with high antibody titers sustained a CrCL rupture in the contralateral stifle joint.

Prevalence of diagnosed depression in South Asian and white European people with type 1 and type 2 diabetes mellitus in a UK secondary care population.

PubMed

Ali, S; Davies, M J; Taub, N A; Stone, M A; Khunti, K

2009-05-01

To examine the prevalence and correlates of diagnosed depression among South Asians and white Europeans with type 1 and type 2 diabetes mellitus, attending a specialist diabetes clinic in the UK. A cross-sectional study was conducted using the hospital clinic's computerised database. Medical and demographic data were extracted for 6230 people with diabetes attending the clinic between 2003 and 2005. Multiple logistic regression was used to model ethnic differences in the probability of diagnosed depression after controlling for demographic and diabetes related factors. Analyses were conducted separately for type 1 and type 2 diabetes. The unadjusted prevalence of depression in people with type 1 and type 2 diabetes was 8.0% and 9.3%, respectively. Risk factors for depression in type 1 diabetes included female gender, diabetes related complications, and comorbidities. In people with type 2 diabetes the risk factors for depression included younger age, diabetes related complications, comorbidities, insulin use and deprivation. In addition, white Europeans were significantly more likely to be diagnosed with depression compared to South Asians (odds ratio (OR) 1.59, 95% confidence interval (CI) 1.21 to 2.08; p<0.001). Further interaction analyses revealed no evidence that the association between ethnicity and depression differed according to any of the other factors examined in this study. The findings add to the limited body of knowledge regarding ethnic differences in depression and diabetes. Among those with type 2 diabetes, white Europeans had nearly 60% higher adjusted odds of diagnosed depression compared to South Asians. Disparities may be due to differences in presentation or identification of depression between these two ethnic groups.

Effects of type of exercise on depression in recovering substance abusers.

PubMed

Palmer, J A; Palmer, L K; Michiels, K; Thigpen, B

1995-04-01

This experiment investigated the effects of three types of structured exercise (aerobics, bodybuilding, and circuit training) on depressive symptoms of 45 clients undergoing a 4-wk., inpatient rehabilitation program for substance abuse. Pre- and posttest measures included the Center of Epidemiological Studies--Depression, resting pulse rate, blood pressure, maximum strength on incline bench press, and estimates of aerobic fitness and body fat. The bodybuilding program produced a significant decrease in depressive symptoms. Physiological and psychological explanations are discussed.

Prevalence and Predictors of Depression among Type 2 Diabetes Mellitus Outpatients in Eastern Province, Saudi Arabia.

PubMed

El Mahalli, A A

2015-04-01

Diabetes Mellitus is frequently accompanied by serious complications. Less known is the increased risk for depression. Undiagnosed depression prevents initiation of treatment, thereby contributing to poor clinical outcomes. Study aimed to determine prevalence and predictors of depression among type 2 diabetes mellitus patients. Study was cross-sectional. It was conducted in the outpatient clinics of diabetes mellitus in a governmental hospital in Eastern Province, Saudi Arabia in 2013. Patients with type 2 diabetes mellitus (260 participants) were selected using systematic random sampling technique. One interview questionnaire was designed to collect demographic and health factors. Two self- administered instruments were used to assess perceived social support and depression. Assessment of the relationship between depression and its predictors was done using Univariate analysis. Multivariable analysis was used to evaluate the combined effect of several factors associated with depression among type 2 diabetes mellitus patients after adjusting for confounding variables. Almost fifty percent of diabetics were depressed (49.6%). Patients with poor diabetes mellitus control (OR 3.221, P.000) and unmarried (OR 3.206, P .025) were more risky for developing depression and difference was significant. Prevalence of depression among Type 2 diabetes mellitus patients was almost fifty percent. So, diabetics should be regularly examined for signs and symptoms of depression.

Psychopathological manifestations of joint hypermobility and joint hypermobility syndrome/ Ehlers-Danlos syndrome, hypermobility type: The link between connective tissue and psychological distress revised.

PubMed

Sinibaldi, Lorenzo; Ursini, Gianluca; Castori, Marco

2015-03-01

Psychological distress is a known feature of generalized joint hypermobility (gJHM), as well as of its most common syndromic presentation, namely Ehlers-Danlos syndrome, hypermobility type (a.k.a. joint hypermobility syndrome - JHS/EDS-HT), and significantly contributes to the quality of life of affected individuals. Most published articles dealt with the link between gJHM (or JHS/EDS-HT) and anxiety-related conditions, and a novel generation of studies is emerging aimed at investigating the psychopathologic background of such an association. In this paper, literature review was carried out with a semi-systematic approach spanning the entire spectrum of psychopathological findings in gJHM and JHS/EDS-HT. Interestingly, in addition to the confirmation of a tight link between anxiety and gJHM, preliminary connections with depression, attention deficit (and hyperactivity) disorder, autism spectrum disorders, and obsessive-compulsive personality disorder were also found. Few papers investigated the relationship with schizophrenia with contrasting results. The mind-body connections hypothesized on the basis of available data were discussed with focus on somatotype, presumed psychopathology, and involvement of the extracellular matrix in the central nervous system. The hypothesis of positive Beighton score and alteration of interoceptive/proprioceptive/body awareness as possible endophenotypes in families with symptomatic gJHM or JHS/EDS-HT is also suggested. Concluding remarks addressed the implications of the psychopathological features of gJHM and JHS/EDS-HT in clinical practice. © 2015 Wiley Periodicals, Inc.

Optimal joint detection and estimation that maximizes ROC-type curves

PubMed Central

Wunderlich, Adam; Goossens, Bart; Abbey, Craig K.

2017-01-01

Combined detection-estimation tasks are frequently encountered in medical imaging. Optimal methods for joint detection and estimation are of interest because they provide upper bounds on observer performance, and can potentially be utilized for imaging system optimization, evaluation of observer efficiency, and development of image formation algorithms. We present a unified Bayesian framework for decision rules that maximize receiver operating characteristic (ROC)-type summary curves, including ROC, localization ROC (LROC), estimation ROC (EROC), free-response ROC (FROC), alternative free-response ROC (AFROC), and exponentially-transformed FROC (EFROC) curves, succinctly summarizing previous results. The approach relies on an interpretation of ROC-type summary curves as plots of an expected utility versus an expected disutility (or penalty) for signal-present decisions. We propose a general utility structure that is flexible enough to encompass many ROC variants and yet sufficiently constrained to allow derivation of a linear expected utility equation that is similar to that for simple binary detection. We illustrate our theory with an example comparing decision strategies for joint detection-estimation of a known signal with unknown amplitude. In addition, building on insights from our utility framework, we propose new ROC-type summary curves and associated optimal decision rules for joint detection-estimation tasks with an unknown, potentially-multiple, number of signals in each observation. PMID:27093544

[Association between depression and hearing loss in patients with type 2 diabetes].

PubMed

Zamora-Vega, Omar; Gómez-Díaz, Rita Angélica; Delgado-Solís, Margarita; Vázquez-Estupiñán, Felipe; Vargas-Aguayo, Alejandro Martín; Wacher-Rodarte, Niels H

2016-01-01

The association between diabetes, hearing loss and depression is unknown, and needs to be understood clearly and precisely. Our objective was to estimate the association between depression and hearing loss in patients with type 2 diabetes. Cross-sectional analytical study. Patients of 40 years or older with type 2 diabetes were studied. Anthropometric measurements and biochemical parameters were recorded. The Beck Depression Inventory and a pure tone audiometry were applied. Groups were compared with chi squared test and logistic regression for confounders. 150 patients were included (76 % women). Average age was 56 ± 9.3 years, with 12.4 ± 6.5 years of progression of diabetes, weight 67.4 ± 11.6 kg; 31 % were obese; 25.5 % hypertensive (126.3 ± 19.3 / 79.4 ± 19.7 mm Hg) and 80.7 % had poor metabolic control (HbA1c ≥ 7 %). Of all the patients, 45.3 % presented hearing loss and 32.4 % depression. Diagnosis of depression in patients with hearing loss remained significant after adjusting for confounders (odds ratio [OR] = 2.3; 95 % confidence interval [CI] = 1.051-5.333, p = 0.037). Women had greater risk of depression, difference that remained significant (OR = 3.2; 95 % CI = 1.268-8.584, p = 0.014) after adjustment. Almost half of the patients with diabetes presented hearing loss and more than three times the risk of depression. Subjects with depression and diabetes presented more hearing loss (> 20 dB) than those without diabetes and/or without depression.

Joint Newspaper Operating Agreements.

ERIC Educational Resources Information Center

Parsons, Marie

The number of competing daily newspapers in American cities has dwindled until only about 50 cities boast two papers. Of the newspapers in those cities, 23 now maintain separate editorial operations but have joint printing, advertising, and circulation departments. The concept of joint operation is 50 years old, dating from the Depression years…

Depression is associated with the metabolic syndrome among patients with type 1 diabetes.

PubMed

Ahola, Aila J; Thorn, Lena M; Saraheimo, Markku; Forsblom, Carol; Groop, Per-Henrik

2010-10-01

Both depression and the metabolic syndrome are frequently found among patients with type 1 diabetes, but their potential association has not yet been investigated. In this paper the relationship between depression and the metabolic syndrome among patients with type 1 diabetes was evaluated. A total of 1226 patients participating in the Finnish Diabetic Nephropathy Study between 2003 and 2009 were included. Depression was defined as use of antidepressive medication or Beck Depression Inventory (BDI) score ≥16. The metabolic syndrome was defined using the criteria established by the International Diabetes Federation Task Force on Epidemiology and Prevention (IDF); National Heart, Lung, and Blood Institute (NHLBI); American Heart Association (AHA); World Heart Federation (WHF); International Atherosclerosis Society (IAS); and International Association for the Study of Obesity (IASO). The metabolic syndrome was more frequently observed among depressed patients (57% versus 46%, P = 0.008). Of the individual components of the metabolic syndrome, waist, triglyceride, and HDL components were more frequently fulfilled among patients with depression. The BDI score increased with the number of components of the metabolic syndrome present. The BDI score was independently associated with the waist component (odds ratio 1.03, 95% confidence interval 1.01-1.05) when adjusted for gender, age, socio-economic status, smoking, nephropathy, and HbA(1c). The metabolic syndrome is frequently found among depressed patients with type 1 diabetes. Whether this association influences the development of diabetic complications is not known.

Comorbidity of Depression and Anxiety: Association with Poor Quality of Life in Type 1 and 2 Diabetic Patients

PubMed Central

de Ornelas Maia, Ana Claudia C.; Braga, Arthur de Azevedo; Paes, Flávia; Machado, Sergio; Carta, Mauro Giovanni; Nardi, Antonio Egidio; Silva, Adriana Cardoso

2013-01-01

Background: Diabetes is associates with depression and impairment in Quality of Life (QoL). Objective: The objective is to define the frequencies of depressive and anxiety symptoms in a sample of patients diagnosed with type 1 and 2 diabetes, the amount of impairment of QoL and the weight of depression and anxiety in determining the QoL in such of patients. Methods: A total of 210 patients were divided into two groups (type 1 and type 2). Patients completed the HADS and WHOQoL-bref. Results: Groups showed a high prevalence of anxiety (type 1 = 60%, type 2 = 43.8%) and depression (type 1 = 52.4%, type 2 = 38.1%), both measures were significantly higher (p < 0.05) in diabetes type 1 patients. Type 1 patients also showed a QoL in the overall assessment and the physical, psychological and social relations domains. In both Type 1 and 2 diabetes poor QoL was found associated by anxiety and depression comorbidity. Conclusion: In overall diabetes patients depression and anxiety seems to be a determinant of poor QoL. PMID:23935696

Depression and poverty among African American women at risk for type 2 diabetes.

PubMed

de Groot, Mary; Auslander, Wendy; Williams, James Herbert; Sherraden, Michael; Haire-Joshu, Debra

2003-01-01

Poverty is associated with negative health outcomes, including depression. Little is known about the specific elements of poverty that contribute to depression, particularly among African American women at risk for type 2 diabetes. This study examined the relationships of economic and social resources to depression among African American women at high risk for the development of type 2 diabetes (N = 181) using the Conservation of Resources theory as a conceptual framework. Women were assessed at 3 time points in conjunction with a dietary change intervention. At baseline, 40% of women reported clinically significant depression, and 43.3% were below the poverty line. Depressed women reported fewer economic assets and greater economic distress than nondepressed peers. Multivariate logistic regression analyses indicated that nonwork status, lack of home ownership, low appraisal of one's economic situation, low self-esteem, and increased life events were significantly associated with depression at baseline. Longitudinal multivariate logistic regression models indicated that income, home ownership, future economic appraisal, life events, and self-esteem predicted depression trajectories at Time 3. These results speak to the multifaceted sources of stress in the lives of poor African American women. Interventions that address the economic and social factors associated with depression are needed.

Association between obesity and depression in patients with diabetes mellitus type 2; a study protocol.

PubMed

De la Cruz-Cano, Eduardo; Tovilla-Zarate, Carlos Alfonso; Reyes-Ramos, Emilio; Gonzalez-Castro, Thelma Beatriz; Juarez-Castro, Isela; López-Narváez, Maria Lilia; Fresan, Ana

2015-01-01

Diabetes mellitus and depression are highly prevalent conditions throughout the world and have significant impact on health outcomes. It has been estimated that diabetes mellitus type 2 affects about 246 million people in the world; nevertheless, incidence varies among countries. There is evidence that depression is associated with a poor metabolic control in patients with type 2 diabetes mellitus that present other health problems (such as hypertension and obesity). The aim of this study protocol is to determine if obesity increases the risk for depression in patient with diabetes type 2. The analysis will be reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).The studies suitable for inclusion will be assessed by the Newcastle-Ottawa Scale (NOS) to determine their methodological quality. To identify the studies of interest, we will search on PubMed and EBSCO databases. We will use the following keyword combinations: "Diabetes Mellitus type 2 AND obesity AND depression", "depression AND Diabetes Mellitus type 2", "Diabetes Mellitus type 2 AND body mass index cross sectional study", "depression AND obesity cross-sectional study". Causes for exclusion will be publications that studied patients diagnosed with diabetes mellitus type 1; articles that focused on the treatment and complications of diabetes mellitus type 2; publications that have studied other clinical or psychiatric conditions (for instance, seizure disorder or history of schizophrenia, bipolar disorder, psychotic symptoms or dementia). The results of this study will form the basis for a better understanding of the association between obesity and depression in patients with diabetes mellitus type 2, and will allow development of prediction tools and better interventions. It is evident that several modifiable and non-modifiable risk factors play an important role in the pathogenesis of diabetes among population. Currently, evidence for the deleterious effects

Clinical variables associated with depression in patients with type 2 diabetes.

PubMed

Ferreira, Mari Cassol; Piaia, Camila; Cadore, Ana Carolina; Antoniolli, Marinez Amabile; Gamborgi, Geni Portela; Oliveira, Patrícia Pereira de

2015-08-01

the aim of the study was to evaluate the relationship between type 2 diabetes (T2DM), depression and depressive symptoms and their clinical impact on T2DM. the authors evaluated 214 outpatients, 105 with diabetes (T2DM group) and 109 non-diabetics (control group), with ages ranging between 50 and 75 years (T2DM group 65.1 ± 5.6 years, control group 63.4 ± 5.8 years). Use of antidepressant treatment or score ≥ 16 on the Beck depression inventory (BDI) was considered depression. Complications of diabetes and total symptom score (TSS) for peripheral neuropathy were reported by patients. diabetes group had a higher frequency of depression (35.2%) compared to controls (21.1%) (p=0,021), with 2.4 times increased risk of depression. The presence of depressive symptoms was also higher in T2DM group (mean BDI 9.5 ± 8.8 versus 6.9 ± 6.2; p=0.039). Symptoms of diabetic neuropathy were higher in depressed subjects. The metabolic control and presence of complications in T2DM group were not associated with depression. T2DM led to an increased risk of depression, but this did not influence the metabolic control or the presence of other complications.

Depression in type 2 diabetes mellitus: prevalence, impact, and treatment.

PubMed

Semenkovich, Katherine; Brown, Miriam E; Svrakic, Dragan M; Lustman, Patrick J

2015-04-01

Clinically significant depression is present in one of every four people with type 2 diabetes mellitus (T2DM). Depression increases the risk of the development of T2DM and the subsequent risks of hyperglycemia, insulin resistance, and micro- and macrovascular complications. Conversely, a diagnosis of T2DM increases the risk of incident depression and can contribute to a more severe course of depression. This linkage reflects a shared etiology consisting of complex bidirectional interactions among multiple variables, a process that may include autonomic and neurohormonal dysregulation, weight gain, inflammation, and hippocampal structural alterations. Two recent meta-analyses of randomized controlled depression treatment trials in patients with T2DM concluded that psychotherapy and antidepressant medication (ADM) were each moderately effective for depression and that cognitive behavior therapy (CBT) had beneficial effects on glycemic control. However, the number of studies (and patients exposed to randomized treatment) included in these analyses is extremely small and limits the certainty of conclusions that can be drawn from the data. Ultimately, there is no escaping the paucity of the evidence base and the need for additional controlled trials that specifically address depression management in T2DM. Future trials should determine both the effects of treatment and the change in depression during treatment on measures of mood, glycemic control, and medical outcome.

Joint trajectories of cigarette smoking and depressive symptoms from the mid-20s to the mid-30s predicting generalized anxiety disorder.

PubMed

Lee, Jung Yeon; Brook, Judith S; Finch, Stephen J; De La Rosa, Mario; Brook, David W

2017-01-01

The current study examines longitudinal patterns of cigarette smoking and depressive symptoms as predictors of generalized anxiety disorder using data from the Harlem Longitudinal Development Study. There were 674 African American (53%) and Puerto Rican (47%) participants. Among the 674 participants, 60% were females. In the logistic regression analyses, the indicators of membership in each of the joint trajectories of cigarette smoking and depressive symptoms from the mid-20s to the mid-30s were used as the independent variables, and the diagnosis of generalized anxiety disorder in the mid-30s was used as the dependent variable. The high cigarette smoking with high depressive symptoms group and the low cigarette smoking with high depressive symptoms group were associated with an increased likelihood of having generalized anxiety disorder as compared to the no cigarette smoking with low depressive symptoms group. The findings shed light on the prevention and treatment of generalized anxiety disorder.

Cortisol dysregulation: the bidirectional link between stress, depression, and type 2 diabetes mellitus

PubMed Central

Joseph, Joshua J.; Golden, Sherita H.

2016-01-01

Controversy exists over the role of stress and depression in the pathophysiology of type 2 diabetes mellitus. Depression has been shown to increase the risk for progressive insulin resistance and incident type 2 diabetes mellitus in multiple studies, whereas the association of stress with diabetes is less clear, owing to differences in study designs and in forms and ascertainment of stress. The biological systems involved in adaptation that mediate the link between stress and physiological functions include the hypothalamic–pituitary–adrenal axis and the autonomic nervous and immune systems. The hypothalamic–pituitary–adrenal axis is a tightly regulated system that represents one of the body’s mechanisms for responding to acute and chronic stress. Depression is associated with cross-sectional and longitudinal alterations in the diurnal cortisol curve, including a blunted cortisol awakening response and flattening of the diurnal cortisol curve. Flattening of the diurnal cortisol curve is also associated with insulin resistance and type 2 diabetes mellitus. In this article, we review and summarize the evidence supporting hypothalamic–pituitary–adrenal axis dysregulation as an important biological link between stress, depression, and type 2 diabetes mellitus. PMID:27750377

Cortisol dysregulation: the bidirectional link between stress, depression, and type 2 diabetes mellitus.

PubMed

Joseph, Joshua J; Golden, Sherita H

2017-03-01

Controversy exists over the role of stress and depression in the pathophysiology of type 2 diabetes mellitus. Depression has been shown to increase the risk for progressive insulin resistance and incident type 2 diabetes mellitus in multiple studies, whereas the association of stress with diabetes is less clear, owing to differences in study designs and in forms and ascertainment of stress. The biological systems involved in adaptation that mediate the link between stress and physiological functions include the hypothalamic-pituitary-adrenal (HPA) axis and the autonomic nervous and immune systems. The HPA axis is a tightly regulated system that represents one of the body's mechanisms for responding to acute and chronic stress. Depression is associated with cross-sectional and longitudinal alterations in the diurnal cortisol curve, including a blunted cortisol awakening response and flattening of the diurnal cortisol curve. Flattening of the diurnal cortisol curve is also associated with insulin resistance and type 2 diabetes mellitus. In this article, we review and summarize the evidence supporting HPA axis dysregulation as an important biological link between stress, depression, and type 2 diabetes mellitus. © 2016 New York Academy of Sciences.

Parental Depression and Anxiety and Early Childhood Behavior Problems across Family Types

ERIC Educational Resources Information Center

Meadows, Sarah O.; McLanahan, Sara S.; Brooks-Gunn, Jeanne

2007-01-01

Using the Fragile Families and Child Wellbeing Study, we examine the association between parental major depressive and generalized anxiety disorders and child behavior problems across family types: married, cohabiting, involved nonresident father, and noninvolved nonresident father. Among 3-year-olds in all families, maternal anxiety/depression is…

Role of tissue-type plasminogen activator and plasminogen activator inhibitor-1 in psychological stress and depression.

PubMed

Tsai, Shih-Jen

2017-12-22

Major depressive disorder is a common illness worldwide, but the pathogenesis of the disorder remains incompletely understood. The tissue-type plasminogen activator-plasminogen proteolytic cascade is highly expressed in the brain regions involved in mood regulation and neuroplasticity. Accumulating evidence from animal and human studies suggests that tissue-type plasminogen activator and its chief inhibitor, plasminogen activator inhibitor-1, are related to stress reaction and depression. Furthermore, the neurotrophic hypothesis of depression postulates that compromised neurotrophin brain-derived neurotrophic factor (BDNF) function is directly involved in the pathophysiology of depression. In the brain, the proteolytic cleavage of proBDNF, a BDNF precursor, to mature BDNF through plasmin represents one mechanism that can change the direction of BDNF action. We also discuss the implications of tissue-type plasminogen activator and plasminogen activator inhibitor-1 alterations as biomarkers for major depressive disorder. Using drugs that increase tissue-type plasminogen activator or decrease plasminogen activator inhibitor-1 levels may open new avenues to develop conceptually novel therapeutic strategies for depression treatment.

Joint torques in a freely walking insect reveal distinct functions of leg joints in propulsion and posture control

PubMed Central

2016-01-01

Determining the mechanical output of limb joints is critical for understanding the control of complex motor behaviours such as walking. In the case of insect walking, the neural infrastructure for single-joint control is well described. However, a detailed description of the motor output in form of time-varying joint torques is lacking. Here, we determine joint torques in the stick insect to identify leg joint function in the control of body height and propulsion. Torques were determined by measuring whole-body kinematics and ground reaction forces in freely walking animals. We demonstrate that despite strong differences in morphology and posture, stick insects show a functional division of joints similar to other insect model systems. Propulsion was generated by strong depression torques about the coxa–trochanter joint, not by retraction or flexion/extension torques. Torques about the respective thorax–coxa and femur–tibia joints were often directed opposite to fore–aft forces and joint movements. This suggests a posture-dependent mechanism that counteracts collapse of the leg under body load and directs the resultant force vector such that strong depression torques can control both body height and propulsion. Our findings parallel propulsive mechanisms described in other walking, jumping and flying insects, and challenge current control models of insect walking. PMID:26791608

Jointly characterizing epigenetic dynamics across multiple human cell types

PubMed Central

An, Lin; Yue, Feng; Hardison, Ross C

2016-01-01

Advanced sequencing technologies have generated a plethora of data for many chromatin marks in multiple tissues and cell types, yet there is lack of a generalized tool for optimal utility of those data. A major challenge is to quantitatively model the epigenetic dynamics across both the genome and many cell types for understanding their impacts on differential gene regulation and disease. We introduce IDEAS, an integrative and discriminative epigenome annotation system, for jointly characterizing epigenetic landscapes in many cell types and detecting differential regulatory regions. A key distinction between our method and existing state-of-the-art algorithms is that IDEAS integrates epigenomes of many cell types simultaneously in a way that preserves the position-dependent and cell type-specific information at fine scales, thereby greatly improving segmentation accuracy and producing comparable annotations across cell types. PMID:27095202

Depression, smoking, physical inactivity and season independently associated with midnight salivary cortisol in type 1 diabetes.

PubMed

Melin, Eva O; Thunander, Maria; Landin-Olsson, Mona; Hillman, Magnus; Thulesius, Hans O

2014-09-16

Disturbances of the circadian rhythm of cortisol secretion are associated with depression, coronary calcification, and higher all-cause and cardiovascular mortality.The primary aim of this study was to test the associations between midnight salivary cortisol (MSC), depression and HbA1c, and control for behavioural, environmental and intra individual factors with possible impact on cortisol secretion, like smoking, physical inactivity, season, medication, diabetes duration, severe hypoglycemia episodes, age and gender in patients with type 1 diabetes. Secondary aims were to present MSC levels for a reference group of non-depressed type 1 diabetes patients with a healthy life style (physically active and non-smoking), and to explore seasonal variations. A cross-sectional population based study of 196 patients (54% men and 46% women) aged 18-59 years that participated in a randomized controlled trial targeting depression in type 1 diabetes. Depression was assessed by the Hospital Anxiety and Depression Scale-depression subscale. MSC, HbA1c, serum-lipids, blood pressure, waist circumference and data from medical records and the Swedish National Diabetes Registry were collected. Thirty four patients (17%) had MSC ≥9.3 nmol/L, which was associated with smoking (AOR 5.5), spring season (AOR 4.3), physical inactivity (AOR 3.9), self-reported depression (AOR 3.1), and older age (per year) (AOR 1.08). HbA1c >70 mmol/mol (>8.6%) (AOR 4.2) and MSC ≥9.3 nmol/L (AOR 4.4) were independently linked to self-reported depression. Season was strongly associated with MSC levels and no other variables studied showed seasonal variations. In a reference group of 137 non-depressed patients with a healthy life style (physically active, non-smoking) the median MSC level was 4.6 nmol/L (range 1.9-23.0). In this study of patients with type 1 diabetes high MSC was linked to smoking, physical inactivity, depression, season and older age. Thus a high cortisol value identified three major

Genetic Predictors of Depressive Symptoms in the Look AHEAD Trial.

PubMed

McCaffery, Jeanne M; Papandonatos, George D; Faulconbridge, Lucy F; Erar, Bahar; Peter, Inga; Wagenknecht, Lynne E; Pajewski, Nicholas M; Anderson, Andrea; Wadden, Thomas A; Wing, Rena R

2015-01-01

Numerous studies have found elevated depressive symptoms among individuals with Type 2 diabetes, yet the mechanisms remain unclear. We examined whether genetic loci previously associated with depressive symptoms predict depressive symptoms among overweight/obese individuals with Type 2 diabetes or change in depressive symptoms during behavioral weight loss. The Illumina CARe iSelect (IBC) chip and Cardiometabochip were characterized in 2118 overweight or obese participants with Type 2 diabetes from Look AHEAD (Action for Health in Diabetes), a randomized trial to determine the effects of intensive life-style intervention and diabetes support and education on cardiovascular morbidity and mortality. Primary analyses focused on baseline Beck Depression Inventory (BDI) scores and depressive symptom change at 1 year. Of eight single nucleotide polymorphisms (SNPs) in six loci, three a priori SNPs in two loci (chromosome 5: rs60271; LBR: rs2230419, rs1011319) were associated with baseline BDI scores, but in the opposite direction of prior research. In joint analysis of 90,003 IBC and Cardiometabochip SNPs, rs1543654 in the region of KCNE1 predicted change in BDI scores at Year 1 in diabetes support and education (β = -1.05, standard error [SE] = 0.21, p = 6.9 × 10(-7)) at the level of chip-wide significance, while also showing a nominal association with baseline BDI (β = 0.35, SE = 0.16, p = .026). Adjustment for antidepressant medication and/or limiting analyses to non-Hispanic white individuals did not meaningfully alter results. Previously reported genetic associations with depressive symptoms did not replicate in this cohort of overweight/obese individuals with Type 2 diabetes. We identified KCNE1 as a potential novel locus associated with depressive symptoms.

Antidepressant medication use and glycaemic control in co-morbid type 2 diabetes and depression.

PubMed

Brieler, Jay A; Lustman, Patrick J; Scherrer, Jeffrey F; Salas, Joanne; Schneider, F David

2016-02-01

Depression is prevalent in diabetes and is associated with increased risks of hyperglycaemia, morbidity and mortality. The effect of antidepressant medication (ADM) on glycaemic control is uncertain owing to a paucity of relevant data. We sought to determine whether the use of ADM is associated with glycaemic control in depressed patients with type 2 diabetes. A retrospective cohort study (n = 1399) was conducted using electronic medical record registry data of ambulatory primary care visits from 2008 to 2013. Depression and type 2 diabetes were identified from ICD-9-CM codes; ADM use was determined from prescription orders; and glycaemic control was determined from measures of glycated haemoglobin (A1c). Good glycaemic control was defined as A1c < 7.0% (53 mmol/mol). Generalized estimating equations were used to determine the effect of depression and ADM use on glycaemic control. Good glycaemic control was achieved by 50.9% of depressed subjects receiving ADM versus 34.6% of depressed subjects without ADM. After adjusting for covariates, depressed patients receiving ADM were twice as likely as those not receiving ADM to achieve good glycaemic control (odds ratio = 1.95; 95% confidence interval: 1.02-3.71). In this retrospective cohort study of a large sample of primary care patients with type 2 diabetes, ADM use was associated with improved glycaemic control. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

[Selective serotonin reuptake inhibitors in the therapy of various types of endogenous depressions].

PubMed

Panteleeva, G P; Abramova, L I; Korenev, A N

2000-01-01

In order to specify differential indications for the use of selective serotonin reuptake inhibitors (SSRI) their therapeutic effect was investigated in apathic-adynamic, melancholic and anxious depressions. Group of 151 patients received monotherapy with one of SSRI-drugs: citalopram--22 patients (mean daily dosage--27.4 mg), paroxetine--47 patients (23 mg), sertraline--19 patients (107 mg), fluvoxamine--28 patients (162 mg), fluoxetine--35 patients (20 mg). The state of the patients was estimated 5 times during 42 days of therapy by clinical estimations and according to Hamilton Depression Scale (HAM-D). Therapeutic effects of the drugs were determined according to the degree of reduction of the total HAM-D scores and they were considered as "significant" (a reduction of the scores by 50% and more), "moderate" (by 21-49%), and "insignificant" (by 1-20%). Positive antidepressive effect, including "significant" was obtained in the case of the use of all the drugs studied. Differential evaluation of the three components of antidepressive activity (thymoleptic, sedative-anxiolytic, and stimulative) according to the degrees and data of expression of drugs' therapeutic effect has allowed to determine indications for the therapy of endogenous depressions by each of SSRI: to recommend cytalopram for the treatment of various types of depressive states mainly, for anxious and apatho-adynamic types; paroxetin--for treatment of melancholic depressions as well as for anxious and apatho-dynamic ones; sertralin++--for depression with anxiety and fobic disorders; fluvoxamine--for melancholic and anxious depression; fluoxetine--for apatho-adynamic depressions.

Combined effects of sleep quality and depression on quality of life in patients with type 2 diabetes.

PubMed

Zhang, Pan; Lou, Peian; Chang, Guiqiu; Chen, Peipei; Zhang, Lei; Li, Ting; Qiao, Cheng

2016-04-05

Poor sleep quality and depression negatively impact the health-related quality of life of patients with type 2 diabetes, but the combined effect of the two factors is unknown. This study aimed to assess the interactive effects of poor sleep quality and depression on the quality of life in patients with type 2 diabetes. Patients with type 2 diabetes (n = 944) completed the Diabetes Specificity Quality of Life scale (DSQL) and questionnaires on sleep quality and depression. The products of poor sleep quality and depression were added to the logistic regression model to evaluate their multiplicative interactions, which were expressed as the relative excess risk of interaction (RERI), the attributable proportion (AP) of interaction, and the synergy index (S). Poor sleep quality and depressive symptoms both increased DSQL scores. The co-presence of poor sleep quality and depressive symptoms significantly reduced DSQL scores by a factor of 3.96 on biological interaction measures. The relative excess risk of interaction was 1.08. The combined effect of poor sleep quality and depressive symptoms was observed only in women. Patients with both depressive symptoms and poor sleep quality are at an increased risk of reduction in diabetes-related quality of life, and this risk is particularly high for women due to the interaction effect. Clinicians should screen for and treat sleep difficulties and depressive symptoms in patients with type 2 diabetes.

Association of psychiatric history and type D personality with symptoms of anxiety, depression, and health status prior to ICD implantation.

PubMed

Starrenburg, Annemieke H; Kraaier, Karin; Pedersen, Susanne S; van Hout, Moniek; Scholten, Marcoen; van der Palen, Job

2013-09-01

Personality factors and psychiatric history may help explain individual differences in risk of psychological morbidity and poor health outcomes in patients with an implantable cardioverter defibrillator (ICD). We examined associations between previous anxiety and depressive disorder, type D personality, anxiety or depressive symptoms, and health status in ICD patients prior to ICD implantation. Patients (N = 278; 83 % men; mean age = 62.2 years ±11) receiving a first ICD from September 2007 through April 2010 at the Medisch Spectrum Twente, The Netherlands completed validated questionnaires before implantation assessing type D personality (14-item Type D Scale), anxiety and depressive symptoms (Hospital Anxiety and Depression Scale), and health status (36-item Short Form Health Survey). History of anxiety or depressive disorder was assessed with the Mini International Neuropsychiatric Interview structural interview. Previous anxiety or depressive disorder was prevalent in 8 and 19 % of patients, respectively. Type D personality was present in 21 %, depressive symptoms in 15 %, and anxiety in 24 %. In adjusted analyses, type D personality was a dominant correlate of previous depressive disorder (odds ratio (OR) 6.2, p < 0.001) and previous anxiety disorder (OR 3.9, p = 0.004). Type D personality (OR 4.0, p < 0.001), age (OR 1.03, p = 0.043), and gender (OR 2.5, p = 0.013) were associated with anxiety symptoms at baseline. Type D personality (OR 5.9. p < 0.001) was also associated with increased depressive symptoms at baseline. Heart failure and type D personality were related to poorer health status. In ICD patients, prior to ICD implantation, a previous anxiety or depressive disorder, type D personality, and anxiety and depressive symptoms were associated with poorer health status. Type D personality was also independently associated with increased anxiety and depression symptoms.

The joint association of depression and cognitive function with severe disability among community-dwelling older adults in Finland, Poland and Spain.

PubMed

Olaya, Beatriz; Moneta, Maria Victoria; Koyanagi, Ai; Lara, Elvira; Miret, Marta; Ayuso-Mateos, José Luis; Chatterji, Somnath; Leonardi, Matilde; Koskinen, Seppo; Tobiasz-Adamczyk, Beata; Lobo, Antonio; Haro, Josep Maria

2016-04-01

To explore the joint association of depression and cognitive function with severe disability in nationally-representative samples of community-dwelling adults aged 50 years and older from Finland, Poland and Spain. Cross-sectional. Community-based. Population-based sample of 7987 non-institutionalized adults aged 50 and older. The outcome was severe disability, defined as ≥ 90th percentile of the 12-item version of the World Health Organization Disability Assessment Schedule (WHODAS 2.0). Past 12-month DSM-IV major depressive disorder was assessed with the depression module of the WHO Composite International Diagnostic Interview (CIDI). A global cognitive function score was obtained through neuropsychological tests. Product terms between depression and cognition were introduced in multivariable logistic regression models to test for interaction. Lower cognitive function and depression were both significantly associated with severe disability in all countries. A significant interaction was only found in Finland where the ORs (95% CIs) of depression for severe disability at the 25th (worse), 50th, and 75th (better) percentiles of cognitive function were 7.26 (4.28-12.32), 11.1 (6.7-18.38), and 17.56 (9.29-33.2), respectively. People with depression and cognitive decline are likely to benefit from the usual evidence-based treatments to reduce the burden of disability. However, in Finland, those with better cognitive function may benefit from more aggressive depression treatment. Future research is warranted to assess whether our results may be replicated.

Types of childhood trauma and spirituality in adult patients with depressive disorders.

PubMed

Song, Jun-Mi; Min, Jung-Ah; Huh, Hyu-Jung; Chae, Jeong-Ho

2016-08-01

The aim of this study was to investigate the differences in spirituality among adult patients with depressive disorders, who had suffered various types of abuse or neglect in childhood. A total of 305 outpatients diagnosed with depressive disorders completed questionnaires on socio-demographic variables, childhood trauma history, and spirituality. We used the Childhood Trauma Questionnaire-Short Form (CTQ-SF) to measure five different types of childhood trauma (emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect) and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale (FACIT-Sp-12) to assess spirituality. Depressive symptoms and total CTQ-SF scores showed a negative correlation with spirituality. In the regression model, being older and belonging to a religion significantly predicted greater spirituality. Depressive symptoms significantly predicted lower spirituality. From among the five types of childhood trauma assessed by the CTQ-SF, only emotional neglect significantly predicted lower spirituality. A history of childhood emotional neglect was significantly related to lower spirituality, especially in the case of the Meaning aspect of spirituality. This finding suggests the potential harmful influence of childhood emotional neglect on the development of spirituality in psychiatric patients. Investigating different aspects of childhood trauma might be important in order to develop a more comprehensive psychiatric intervention that aids in the development of spirituality. Copyright © 2016 Elsevier Inc. All rights reserved.

Depression and risk of type 2 diabetes: the potential role of metabolic factors.

PubMed

Schmitz, N; Deschênes, S S; Burns, R J; Smith, K J; Lesage, A; Strychar, I; Rabasa-Lhoret, R; Freitas, C; Graham, E; Awadalla, P; Wang, J L

2016-12-01

The aim of the present study was to evaluate the interaction between depressive symptoms and metabolic dysregulations as risk factors for type 2 diabetes. The sample comprised of 2525 adults who participated in a baseline and a follow-up assessment over a 4.5-year period in the Emotional Health and Wellbeing Study (EMHS) in Quebec, Canada. A two-way stratified sampling design was used, on the basis of the presence of depressive symptoms and metabolic dysregulation (obesity, elevated blood sugar, high blood pressure, high levels of triglycerides and decreased high-density lipoprotein). A total of 87 (3.5%) individuals developed diabetes. Participants with both depressive symptoms and metabolic dysregulation had the highest risk of diabetes (adjusted odds ratio=6.61, 95% confidence interval (CI): 4.86-9.01), compared with those without depressive symptoms and metabolic dysregulation (reference group). The risk of diabetes in individuals with depressive symptoms and without metabolic dysregulation did not differ from the reference group (adjusted odds ratio=1.28, 95% CI: 0.81-2.03), whereas the adjusted odds ratio for those with metabolic dysregulation and without depressive symptoms was 4.40 (95% CI: 3.42-5.67). The Synergy Index (SI=1.52; 95% CI: 1.07-2.17) suggested that the combined effect of depressive symptoms and metabolic dysregulation was greater than the sum of individual effects. An interaction between depression and metabolic dysregulation was also suggested by a structural equation model. Our study highlights the interaction between depressive symptoms and metabolic dysregulation as a risk factor for type 2 diabetes. Early identification, monitoring and a comprehensive management approach of both conditions might be an important diabetes prevention strategy.

Types of prayer and depressive symptoms among cancer patients: the mediating role of rumination and social support.

PubMed

Pérez, John E; Rex Smith, Amy; Norris, Rebecca L; Canenguez, Katia M; Tracey, Elizabeth F; Decristofaro, Susan B

2011-12-01

We examined the association between different types of prayer and depressive symptoms--with rumination and social support as potential mediators--in a sample of predominantly White, Christian, and female ambulatory cancer patients. In a cross-sectional design, 179 adult cancer outpatients completed measures of prayer, rumination, social support, depressive symptoms, and demographic variables. Type and stage of cancer were collected from electronic medical charts. Depressive symptoms were negatively correlated with adoration prayer (r = -.15), reception prayer (r = -.17), thanksgiving prayer (r = -.29), and prayer for the well-being of others (r = -.26). In the path analysis, rumination fully mediated the link between thanksgiving prayer and depressive symptoms (β for indirect effect = -.05), whereas social support partially mediated the link between prayer for others and depressive symptoms (β for indirect effect = -.05). These findings suggest that unique mechanisms may link different prayer types to lower depressive symptoms among cancer patients.

Depression, smoking, physical inactivity and season independently associated with midnight salivary cortisol in type 1 diabetes

PubMed Central

2014-01-01

Background Disturbances of the circadian rhythm of cortisol secretion are associated with depression, coronary calcification, and higher all-cause and cardiovascular mortality. The primary aim of this study was to test the associations between midnight salivary cortisol (MSC), depression and HbA1c, and control for behavioural, environmental and intra individual factors with possible impact on cortisol secretion, like smoking, physical inactivity, season, medication, diabetes duration, severe hypoglycemia episodes, age and gender in patients with type 1 diabetes. Secondary aims were to present MSC levels for a reference group of non-depressed type 1 diabetes patients with a healthy life style (physically active and non-smoking), and to explore seasonal variations. Methods A cross-sectional population based study of 196 patients (54% men and 46% women) aged 18–59 years that participated in a randomized controlled trial targeting depression in type 1 diabetes. Depression was assessed by the Hospital Anxiety and Depression Scale-depression subscale. MSC, HbA1c, serum-lipids, blood pressure, waist circumference and data from medical records and the Swedish National Diabetes Registry were collected. Results Thirty four patients (17%) had MSC ≥9.3 nmol/L, which was associated with smoking (AOR 5.5), spring season (AOR 4.3), physical inactivity (AOR 3.9), self-reported depression (AOR 3.1), and older age (per year) (AOR 1.08). HbA1c >70 mmol/mol (>8.6%) (AOR 4.2) and MSC ≥9.3 nmol/L (AOR 4.4) were independently linked to self-reported depression. Season was strongly associated with MSC levels and no other variables studied showed seasonal variations. In a reference group of 137 non-depressed patients with a healthy life style (physically active, non-smoking) the median MSC level was 4.6 nmol/L (range 1.9–23.0). Conclusions In this study of patients with type 1 diabetes high MSC was linked to smoking, physical inactivity, depression, season and older age. Thus a

Diabetes-Related Distress, Depression and Distress-Depression among Adults with Type 2 Diabetes Mellitus in Malaysia.

PubMed

Chew, Boon-How; Vos, Rimke; Mohd-Sidik, Sherina; Rutten, Guy E H M

2016-01-01

Type 2 diabetes mellitus (T2DM) brings about an increasing psychosocial problem in adult patients. Prevalence data on and associated factors of diabetes related distress (DRD) and depression have been lacking in Asia. This study aimed to examine the prevalence of DRD and depression, and their associated factors in Asian adult T2DM patients. This study was conducted in three public health clinics measuring DRD (Diabetes Distress Scale, DDS), and depression (Patient Health Questionnaire, PHQ). Patients who were at least 30 years of age, had T2DM for more than one year, with regular follow-up and recent laboratory results (< 3 months) were consecutively recruited. Associations between DRD, depression and the combination DRD-depression with demographic and clinical characteristics were analysed using generalized linear models. From 752 invited people, 700 participated (mean age 56.9 years, 52.8% female, 52.9% Malay, 79.1% married). Prevalence of DRD and depression were 49.2% and 41.7%, respectively. Distress and depression were correlated, spearman's r = 0.50. Patients with higher DRD were younger (OR 0.995, 95% CI 0.996 to 0.991), Chinese (OR 1.2, 95% CI 1.04 to 1.29), attending Dengkil health clinic (OR 1.1, 95% CI 1.00 to 1.22) and had higher scores on the PHQ (OR 1.1, 95% CI 1.04 to 1.06). Depression was less likely in the unmarried compared to divorced/separately living and those attending Dengkil health clinic, but more likely in patients with microvascular complications (OR 1.4, 95% CI 1.06 to 1.73) and higher DDS (OR 1.03, 95% CI 1.02 to 1.03). For the combination of DRD and depression, unemployment (OR 4.7, 95% CI 1.02 to 21.20) had positive association, whereas those under medical care at the Salak health clinics (OR 0.28, 95% CI 0.12 to 0.63), and those with a blood pressure > 130/80 mmHg (OR 0.53, 95% CI 0.32 to 0.89) were less likely to experience both DRD and depression. DRD and depression were common and correlated in Asian adults with T2DM at primary

Diabetes-Related Distress, Depression and Distress-Depression among Adults with Type 2 Diabetes Mellitus in Malaysia

PubMed Central

Chew, Boon-How; Vos, Rimke; Mohd-Sidik, Sherina; Rutten, Guy E. H. M.

2016-01-01

Type 2 diabetes mellitus (T2DM) brings about an increasing psychosocial problem in adult patients. Prevalence data on and associated factors of diabetes related distress (DRD) and depression have been lacking in Asia. This study aimed to examine the prevalence of DRD and depression, and their associated factors in Asian adult T2DM patients. This study was conducted in three public health clinics measuring DRD (Diabetes Distress Scale, DDS), and depression (Patient Health Questionnaire, PHQ). Patients who were at least 30 years of age, had T2DM for more than one year, with regular follow-up and recent laboratory results (< 3 months) were consecutively recruited. Associations between DRD, depression and the combination DRD-depression with demographic and clinical characteristics were analysed using generalized linear models. From 752 invited people, 700 participated (mean age 56.9 years, 52.8% female, 52.9% Malay, 79.1% married). Prevalence of DRD and depression were 49.2% and 41.7%, respectively. Distress and depression were correlated, spearman’s r = 0.50. Patients with higher DRD were younger (OR 0.995, 95% CI 0.996 to 0.991), Chinese (OR 1.2, 95% CI 1.04 to 1.29), attending Dengkil health clinic (OR 1.1, 95% CI 1.00 to 1.22) and had higher scores on the PHQ (OR 1.1, 95% CI 1.04 to 1.06). Depression was less likely in the unmarried compared to divorced/separately living and those attending Dengkil health clinic, but more likely in patients with microvascular complications (OR 1.4, 95% CI 1.06 to 1.73) and higher DDS (OR 1.03, 95% CI 1.02 to 1.03). For the combination of DRD and depression, unemployment (OR 4.7, 95% CI 1.02 to 21.20) had positive association, whereas those under medical care at the Salak health clinics (OR 0.28, 95% CI 0.12 to 0.63), and those with a blood pressure > 130/80 mmHg (OR 0.53, 95% CI 0.32 to 0.89) were less likely to experience both DRD and depression. DRD and depression were common and correlated in Asian adults with T2DM at primary

Depression treatment decreases healthcare expenditures among working age patients with comorbid conditions and type 2 diabetes mellitus along with newly-diagnosed depression.

PubMed

Bhattacharya, Rituparna; Shen, Chan; Wachholtz, Amy B; Dwibedi, Nilanjana; Sambamoorthi, Usha

2016-07-19

There are many studies in the literature on the association between depression treatment and health expenditures. However, there is a knowledge gap in examining this relationship taking into account coexisting chronic conditions among patients with diabetes. We aim to analyze the association between depression treatment and healthcare expenditures among adults with Type 2 Diabetes Mellitus (T2DM) and newly-diagnosed depression, with consideration of coexisting chronic physical conditions. We used multi-state Medicaid data (2000-2008) and adopted a retrospective longitudinal cohort design. Medical conditions were identified using diagnosis codes (ICD-9-CM and CPT systems). Healthcare expenditures were aggregated for each month for 12 months. Types of coexisting chronic physical conditions were hierarchically grouped into: dominant, concordant, discordant, and both concordant and discordant. Depression treatment categories were as follows: antidepressants or psychotherapy, both antidepressants and psychotherapy, and no treatment. We used linear mixed-effects models on log-transformed expenditures (total and T2DM-related) to examine the relationship between depression treatment and health expenditures. The analyses were conducted on the overall study population and also on subgroups that had coexisting chronic physical conditions. Total healthcare expenditures were reduced by treatment with antidepressants (16 % reduction), psychotherapy (22 %), and both therapy types in combination (28 %) compared to no depression treatment. Treatment with both antidepressants and psychotherapy was associated with reductions in total healthcare expenditures among all groups that had a coexisting chronic physical condition. Among adults with T2DM and chronic conditions, treatment with both antidepressants and psychotherapy may result in economic benefits.

Symptoms of depression and anxiety in youth with type 1 diabetes: A systematic review and meta-analysis.

PubMed

Buchberger, Barbara; Huppertz, Hendrik; Krabbe, Laura; Lux, Beate; Mattivi, Jessica T; Siafarikas, Aris

2016-08-01

The interaction between psychosocial factors and type 1 diabetes is complex and screening for psychosocial risk factors from diagnosis of type 1 diabetes has been recommended. This is a systematic review and meta-analysis to address the following questions: (1) How prevalent are symptoms of depression and anxiety in children and adolescents with type 1 diabetes? (2) Is there an association of symptoms of depression and anxiety with diabetes management and glycemic control? We searched EMBASE, MEDLINE, The Cochrane Library, and PsycINFO in April 2014 with an update in May 2015. When possible, data were pooled to estimate summary effects. 14 studies investigated symptoms of depression and anxiety in children and adolescents with type 1 diabetes. The pooled prevalence of depressive symptoms was 30.04%, 95% CI [16.33; 43.74]. There were correlations between symptom levels and glycemic control as well as three-way interactions between HbA1c, blood glucose monitoring frequency or diabetes-specific stress and depression. Symptoms of anxiety were reported for up to 32% of patients. A negative impact on glycemic control was demonstrated. Our analyses confirmed a high prevalence of symptoms of depression and anxiety in youth with type 1 diabetes that potentially compromise diabetes management and glycemic control. In our opinion these findings support recommendations for early screening for psychological comorbidity and regular psychosocial assessment from diagnosis. Future prospective studies are warranted to further explore the interaction of symptoms of depression and anxiety with type 1 diabetes and develop evidence-based treatment models. Copyright © 2016 Elsevier Ltd. All rights reserved.

Types of prayer and depressive symptoms among cancer patients: the mediating role of rumination and social support

PubMed Central

Smith, Amy Rex; Norris, Rebecca L.; Canenguez, Katia M.; Tracey, Elizabeth F.; DeCristofaro, Susan B.

2014-01-01

We examined the association between different types of prayer and depressive symptoms—with rumination and social support as potential mediators—in a sample of predominantly White, Christian, and female ambulatory cancer patients. In a cross-sectional design, 179 adult cancer outpatients completed measures of prayer, rumination, social support, depressive symptoms, and demographic variables. Type and stage of cancer were collected from electronic medical charts. Depressive symptoms were negatively correlated with adoration prayer (r = −.15), reception prayer (r = −.17), thanksgiving prayer (r = −.29), and prayer for the well-being of others (r = −.26). In the path analysis, rumination fully mediated the link between thanksgiving prayer and depressive symptoms (β for indirect effect = −.05), whereas social support partially mediated the link between prayer for others and depressive symptoms (β for indirect effect = −.05). These findings suggest that unique mechanisms may link different prayer types to lower depressive symptoms among cancer patients. PMID:21487725

A descriptive and comparative study from China on patients with type-2 diabetes with and without depressive symptoms.

PubMed

Liu, Yu; Maier, Manfred; Wu, Jihong; Li, Wei; Chen, Yan; Qin, Yuelan; Hao, Yufang; Jin, Rongchen

2013-01-01

The aim of this study was to assess the prevalence of depressive symptoms for patients with type-2 diabetes at the population level in China and explore differences in demographic, socioeconomic, and disease-specific parameters between diabetic patients with and without depression. Self-rating depression scale was used to screen for depressive symptoms in 667 patients with type-2 diabetes from 4 communities in Beijing; their quality of life and social support was assessed using appropriate and validated tools. The results indicate that 44.23% of diabetic patients report depressive symptoms; patients with depressive symptoms had a significantly higher rate of diabetic complications, a lower quality of life and less social support than patients without depressive symptoms.

Bidirectional Connections between Depression and Ataxia Severity in Spinocerebellar Ataxia Type 3 Patients.

PubMed

Lin, Min-Ting; Yang, Jin-Shan; Chen, Ping-Ping; Qian, Mei-Zhen; Lin, Hui-Xia; Chen, Xiao-Ping; Shang, Xian-Jin; Wang, Dan-Ni; Chen, Yu-Chao; Jiang, Bin; Chen, Yi-Jun; Chen, Wan-Jin; Wang, Ning; Gan, Shi-Rui

2018-05-15

Spinocerebellar ataxia type 3 (SCA3), which is the most common subtype of SCA worldwide, exhibits common neuropsychological symptoms such as depression. However, the contribution of depression to the severity of SCA3 has not yet been thoroughly investigated. The present study investigated the prevalence of depression using Beck depression inventory in 104 molecularly confirmed SCA3 patients from China. The putative risk factors for depression and whether the depression could affect the severity of ataxia were established by multivariable linear regression models. The frequency of depression in the study subjects was 57.69% (60/104), which was higher than that in SCA3 patients from a subset of other populations. The gender (p = 0.03) and severity (p < 0.01) of ataxia were those risk factors that could affect depression. Conversely, depression (p < 0.01) together with the duration (p < 0.01) of SCA3 could also play a positive role in the severity of ataxia. The extremely common depression results from motor disability caused by ataxia; it also affects the disease severity of SCA3. These findings suggested that depression was a part of neurodegeneration in SCA3 and necessitated intensive focus and interventions while caring for SCA3 patients. © 2018 S. Karger AG, Basel.

Depression and type 2 diabetes in low- and middle-income countries: a systematic review.

PubMed

Mendenhall, Emily; Norris, Shane A; Shidhaye, Rahul; Prabhakaran, Dorairaj

2014-02-01

Eighty percent of people with type 2 diabetes reside in low- and middle-income countries (LMICs). Yet much of the research around depression among people with diabetes has been conducted in high-income countries (HICs). In this systematic review we searched Ovid Medline, PubMed, and PsychINFO for studies that assessed depression among people with type 2 diabetes in LMICs. Our focus on quantitative studies provided a prevalence of comorbid depression among those with diabetes. We reviewed 48 studies from 1,091 references. We found that this research has been conducted primarily in middle-income countries, including India (n = 8), Mexico (n = 8), Brazil (n = 5), and China (n = 5). There was variation in prevalence of comorbid depression across studies, but these differences did not reveal regional differences and seemed to result from study sample (e.g., urban vs rural and clinical vs population-based samples). Fifteen depression inventories were administered across the studies. We concluded that despite substantial diabetes burden in LMICs, few studies have reviewed comorbid depression and diabetes. Our review suggests depression among people with diabetes in LMICs may be higher than in HICs. Evidence from these 48 studies underscores the need for comprehensive mental health care that can be integrated into diabetes care within LMIC health systems. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Prevalence of co-morbid depression in out-patients with type 2 diabetes mellitus in Bangladesh.

PubMed

Roy, Tapash; Lloyd, Cathy E; Parvin, Masuma; Mohiuddin, Khondker Galib B; Rahman, Mosiur

2012-08-22

Little is known about the prevalence of depression in people with diabetes in Bangladesh. This study examined the prevalence and factors associated with depression in out-patients with Type 2 diabetes in Bangladesh. In this cross-sectional study a random sample of 483 diabetes out-patients from three diabetes clinics in Bangladesh was invited to participate. Of them 417 patients took part. Depressive symptoms were measured using previously developed and culturally standardized Bengali and Sylheti versions of the World HealthOrganization-5 Well Being Index (WHO-5) and the Patient Health Questionairre-9 (PHQ-9) with predefined cut-off scores. Data was collected using two different modes; e.g. standard assisted collection and audio questionnaire methods. Associations between depression and patient characteristics were explored using regression analysis. The prevalence of depressive symptoms was 34% (PHQ-9 score ≥ 5) and 36% (WHO-5 score < 52) with audio questionnaire delivery method. The prevalence rates were similar regardless of the type (PHQ-9 vs. WHO-5) and language (Sylheti vs. Bengali) of the questionnaires, and methods of delivery (standard assisted vs. audio methods). The significant predictors of depressive symptoms using either the PHQ-9 or WHO-5 questionnaires were; age, income, gender, treatment intensity, and co-morbid cardiovascular disease. Further, depression was strongly associated with poor glycaemic control and number of co-morbid conditions. This study demonstrated that depression prevalence is common in out-patients with type 2 diabetes in Bangladesh. In a setting where recognition, screening and treatment levels remain low, health care providers need to focus their efforts on diagnosing, referring and effectively treating this important disease in order to improve service delivery.

Elevated depressive symptoms and adolescent injury: examining associations by injury frequency, injury type, and gender

PubMed Central

2014-01-01

Background Key risk factors for adolescent injury have been well documented, and include structural, behavioural, and psychosocial indicators. While psychiatric distress has been associated with suicidal behaviour and related self-harm, very little research has examined the role of depression in shaping adolescent injury. This study examines the association of elevated depressive symptoms with injury, including total number of injuries and injury type. Gender differences are also considered. Methods Data were drawn in 2010–11 from a representative sample of 2,989 high school students (14 to18 years of age) from Nova Scotia, Canada. Self-reported injury outcomes were examined using the 17-item Adolescent Injury Checklist, which captures past six-month injuries. Elevated depressive symptoms were assessed using the Centers for Epidemiological Studies Depression scale. Associations of elevated depressive symptoms with total number of injuries were estimated with negative binomial regression, while associations with specific injury types were estimated with logistic regression. Analyses were conducted in 2012. Results Adolescents with elevated depressive symptoms experienced a 40% increase in the total number of injury events occurring in the past six months. The association of elevated depressive symptoms with injury was consistent across injury type; violence-related (OR 2.21, 95% CI 1.61 to 3.03), transport-related (OR 1.53, 95% CI 1.10 to 2.13), and unintentional injuries (OR 1.65, 95% CI 1.20 to 2.27). Gender differences were also observed. Conclusion Elevated depressive symptoms play a role in shaping adolescent injury. Interventions aimed at reducing adolescent injury should look to minimize psychosocial antecedents, such as poor mental health, that put adolescents at an elevated risk. PMID:24555802

Depression differed by midnight cortisol secretion, alexithymia and anxiety between diabetes types: a cross sectional comparison.

PubMed

Melin, Eva O; Thunander, Maria; Landin-Olsson, Mona; Hillman, Magnus; Thulesius, Hans O

2017-09-20

Increased prevalence of depression is found in both type 2 diabetes (T2D) and type 1 diabetes (T1D). Melancholia and atypical depression differ by cortisol secretion and clinical features. The aim was to compare the clinical presentation of T1D and T2D patients in relation to self-reported depression, self-reported anxiety, alexithymia, obesity, and midnight salivary cortisol (MSC). Comparative cross-sectional design. The participants were consecutively recruited from one hospital diabetes outpatient clinic: 24 T2D patients (31-59 years) and 148 T1D patients (32-59 years). Self-reported depression, anxiety and alexithymia were assessed by Hospital Anxiety and Depression scale and Toronto Alexithymia Scale-20. MSC, HbA1c, anthropometrics and data from medical records were collected. Multiple logistic regression analyses were performed. Comparisons of prevalence between diabetes types showed for T2D/T1D: depression 25%/12% (P = 0.10); high MSC (≥9.3 nmol/L) 38%/22% (P = 0.13); alexithymia 25%/13% (P = 0.12); anxiety 38%/35% (P = 0.82). The prevalence of high MSC did not differ between depressed and non-depressed T2D patients (17% vs. 44%, P = 0.35), but differed between depressed and non-depressed T1D patients (53% vs. 18%, P = 0.003). The alexithymia prevalence differed between depressed and non-depressed T2D patients (67% vs.11%, P = 0.018), and between depressed and non-depressed T1D patients (47% vs. 11%, P < 0.001). The anxiety prevalence did not differ between depressed and non-depressed T2D patients (67% vs. 28%, P = 0.15), but differed between depressed and non-depressed T1D patients (76% vs. 30%, P < 0.001). The obesity prevalence (BMI ≥30 kg/m 2 ) was 83% for depressed T2D patients and 6% for depressed T1D patients. In the T2D patients, depression was associated with alexithymia (Adjusted odds ratio (AOR) 15.0). In the T1D patients, depression was associated with anxiety (AOR 11.0), foot complications (AOR 8.5), HbA1C >70�

The efficiency of botulinum toxin type A for the treatment of masseter muscle pain in patients with temporomandibular joint dysfunction and tension-type headache.

PubMed

Pihut, Malgorzata; Ferendiuk, Ewa; Szewczyk, Michal; Kasprzyk, Katarzyna; Wieckiewicz, Mieszko

2016-01-01

Temporomandibular joint dysfunction are often accompanied by symptoms of headache such as tension-type headache which is the most frequent spontaneous primary headache. Masseter muscle pain is commonly reported in this group. The purpose of the study was to assess the efficiency of intramuscular botulinum toxin type A injections for treating masseter muscle pain in patients with temporomandibular joint dysfunction and tension-type headache. This prospective outcome study consisted of 42 subjects of both genders aged 19-48 years diagnosed with masseter muscle pain related to temporomandibular joint dysfunction and tension-type headache. The subjects were treated by the intramuscular injection of 21 U (mice units) of botulinum toxin type A (Botox, Allergan) in the area of the greatest cross-section surface of both masseter bellies. Pain intensity was evaluated using visual analogue scale (VAS) and verbal numerical rating scale (VNRS) 1 week before the treatment and 24 weeks after the treatment. The obtained data were analyzed using the Wilcoxon matched pairs test (p ≤ 0,005). The results of this study showed a decrease in the number of referred pain episodes including a decrease in pain in the temporal region bilaterally, a reduction of analgesic drugs intake as well as a decrease in reported values of VAS and VNRS after injections (p = 0,000). The intramuscular botulinum toxin type A injections have been an efficient method of treatment for masseter muscle pain in patients with temporomandibular joint dysfunction and tension-type headache.

Nocturia and Prevalence of Depressive Symptoms in Japanese Adult Patients With Type 2 Diabetes Mellitus: The Dogo Study.

PubMed

Furukawa, Shinya; Sakai, Takenori; Niiya, Tetsuji; Miyaoka, Hiroaki; Miyake, Teruki; Yamamoto, Shin; Kanzaki, Sayaka; Maruyama, Koutatsu; Tanaka, Keiko; Ueda, Teruhisa; Senba, Hidenori; Torisu, Masamoto; Minami, Hisaka; Tanigawa, Takeshi; Matsuura, Bunzo; Hiasa, Yoichi; Miyake, Yoshihiro

2018-02-01

No studies have investigated the association between nocturia and depressive symptoms in patients with type 2 diabetes mellitus. Because nocturia and depressive symptoms are common in patients with type 2 diabetes, we examined this association in Japanese patients with type 2 diabetes. We studied 762 Japanese patients with type 2 diabetes. A self-administered questionnaire was used to collect information about the variables under study. The subjects were divided into 3 groups according to their nocturnal micturition: 1) no nocturia; 2) mild nocturia (1 void per night) and 3) moderate to severe nocturia (2 or more voids per night). Depressive symptoms were defined as being present when a subject had a Self-Rating Depression Scale score higher than 49. The prevalence values of mild nocturia, moderate to severe nocturia and depressive symptoms were 39.5%, 41.9% and 16.8%, respectively. Both mild nocturia and moderate to severe nocturia were independently positively associated with depressive symptoms in all patients; the adjusted ORs were 1.96 (95% CI 1.06 to 3.77) and 2.58 (95% CI 1.38 to 5.04). In female patients, both mild nocturia and moderate to severe nocturia were independently associated with depressive symptoms; the adjusted ORs were 5.26 (95% CI 1.73 to 20.61) and 6.91 (95% CI 2.15 to 28.54), respectively. In male patients, neither mild nocturia nor moderate to severe nocturia was significantly related to depressive symptoms. In Japanese female patients with type 2 diabetes, nocturia may be positively associated with depressive symptoms. Copyright © 2017 Diabetes Canada. Published by Elsevier Inc. All rights reserved.

Optimal joint remote state preparation in the presence of various types of noises

NASA Astrophysics Data System (ADS)

Hop Nguyen, Van; Bich Cao, Thi; Nguyen, Ba An

2017-03-01

A main obstacle faced by any quantum information processing protocol is the noise that degrades the desired coherence/entanglement. In this work we study by means of Kraus operators the effect of four typical types of noises on the quality of joint remote state preparation of a single-qubit state using a three-qubit Greenberger-Horne-Zeilinger-type state as the initial quantum channel. Assuming that two of the three involved qubits independently suffer a type of noise, we derive analytical expressions not only for the optimal averaged fidelities but also for the boundaries in phase space of the domains in which the joint remote state preparation protocol outperforms the classical one. Detailed discussion is given for each of the total 16 noisy scenarios. We also provide physical interpretation for the obtained results and outline possible future topics.

Whole-body patterns of the range of joint motion in young adults: masculine type and feminine type.

PubMed

Moromizato, Keiichi; Kimura, Ryosuke; Fukase, Hitoshi; Yamaguchi, Kyoko; Ishida, Hajime

2016-10-01

Understanding the whole-body patterns of joint flexibility and their related biological and physical factors contributes not only to clinical assessments but also to the fields of human factors and ergonomics. In this study, ranges of motion (ROMs) at limb and trunk joints of young adults were analysed to understand covariation patterns of different joint motions and to identify factors associated with the variation in ROM. Seventy-eight healthy volunteers (42 males and 36 females) living on Okinawa Island, Japan, were recruited. Passive ROM was measured at multiple joints through the whole body (31 measurements) including the left and right side limbs and trunk. Comparisons between males and females, dominant and non-dominant sides, and antagonistic motions indicated that body structures influence ROMs. In principal component analysis (PCA) on the ROM data, the first principal component (PC1) represented the sex difference and a similar covariation pattern appeared in the analysis within each sex. Multiple regression analysis showed that this component was associated with sex, age, body fat %, iliospinale height, and leg extension strength. The present study identified that there is a spectrum of "masculine" and "feminine" types in the whole-body patterns of joint flexibility. This study also suggested that body proportion and composition, muscle mass and strength, and possibly skeletal structures partly explain such patterns. These results would be important to understand individual variation in susceptibility to joint injuries and diseases and in one's suitable and effective postures and motions.

A stochastic Iwan-type model for joint behavior variability modeling

NASA Astrophysics Data System (ADS)

Mignolet, Marc P.; Song, Pengchao; Wang, X. Q.

2015-08-01

This paper focuses overall on the development and validation of a stochastic model to describe the dissipation and stiffness properties of a bolted joint for which experimental data is available and exhibits a large scatter. An extension of the deterministic parallel-series Iwan model for the characterization of the force-displacement behavior of joints is first carried out. This new model involves dynamic and static coefficients of friction differing from each other and a broadly defined distribution of Jenkins elements. Its applicability is next investigated using the experimental data, i.e. stiffness and dissipation measurements obtained in harmonic testing of 9 nominally identical bolted joints. The model is found to provide a very good fit of the experimental data for each bolted joint notwithstanding the significant variability of their behavior. This finding suggests that this variability can be simulated through the randomization of only the parameters of the proposed Iwan-type model. The distribution of these parameters is next selected based on maximum entropy concepts and their corresponding parameters, i.e. the hyperparameters of the model, are identified using a maximum likelihood strategy. Proceeding with a Monte Carlo simulation of this stochastic Iwan model demonstrates that the experimental data fits well within the uncertainty band corresponding to the 5th and 95th percentiles of the model predictions which well supports the adequacy of the modeling effort.

Brief report: depression and history of suicide attempts in adults with new-onset Type 2 Diabetes.

PubMed

Myers, Alyson K; Grannemann, Bruce D; Lingvay, Ildiko; Trivedi, Madhukar H

2013-11-01

To assess past suicide attempts in a cohort of adults with Type 2 Diabetes diagnosed within the prior 24 months. Outpatients were recruited from diabetes education classes or diabetes shared medical appointment. Participants aged 18 or over with a self-reported diagnosis of Type 2 Diabetes (T2DM) in the prior 24 months completed questionnaires about medical (including diabetes), psychiatric, and social history. Participants also completed two screening questionnaires for depression: Patient Health Questionnaire 9 and the Questionnaire Inventory for Depressive Symptoms-Self Report. Those who screened positive for depression had confirmatory testing with a clinician administered Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) checklist. In this convenience sample of 145 patients with Type 2 Diabetes, 9.7% of patients had history of a suicide attempt and 38.2% met diagnosis for major depressive disorder (MDD). Patients with MDD were more likely to have a history of suicide attempts than those without MDD (p=0.0002). Of the patients with prior suicide attempts, 50% screened positive for MDD at the time of the survey. In patients with newly-diagnosed Type 2 Diabetes the rate of past suicide attempts was nearly 10%, which is twice the rate seen in the general population. The rate of past suicide attempts in currently depressed patients with diabetes is 21.8%. These findings suggest the need for monitoring patients with diabetes and depression for future suicide risk. Copyright © 2013 Elsevier Ltd. All rights reserved.

Lifetime Duration of Depressive Disorders in Patients With Type 2 Diabetes

PubMed Central

Crick, Kent A.; Long, Molly; Saha, Chandan; Shubrook, Jay H.

2016-01-01

OBJECTIVE Depression in patients with type 2 diabetes (T2D) is associated with long-term complications, disability, and early mortality. No studies have systematically examined the length of episodes and remission in adults with major depressive disorder (MDD) and T2D. This study examined the course of depressive disorders in patients with T2D and MDD. RESEARCH DESIGN AND METHODS Participants (N = 50) enrolled in a behavioral intervention for adults with T2D and MDD were interviewed using the Structured Clinical Interview for DSM-IV-TR to assess history of depressive disorders at baseline (lifetime history), postintervention, and 3-month follow-up. Onset and remission dates were recorded for all Axis I depressive disorders from birth to final interview. RESULTS Average number of MDD episodes was 1.8 with a mean duration of 23.4 months (SD 31.9; range 0.5–231.3). Over the life course, mean exposure to MDD was 43.1 months (SD 46.5; range 0.5–231.3). Kaplan-Meier survival curve analysis indicated median episode duration decreased with subsequent episodes (14 months, first episode; 9 months, second episode; P < 0.002). In patients with multiple depressive episodes, recovery time was shorter with each subsequent episode (P = 0.002). No differences in length of episode or remission were observed based on chronology of T2D diagnosis. CONCLUSIONS The overall exposure to depression in this sample of adults with T2D represents a substantial period of time that can contribute to negative medical and psychiatric outcomes. Recurrent episodes decrease in duration as do recovery periods, resulting in a waxing and waning pattern. Findings from this study underscore the need to effectively diagnose and treat depression in patients with T2D to minimize risk of future depressive episodes. PMID:27729427

Association of Types of Life Events with Depressive Symptoms among Puerto Rican Youth

PubMed Central

2016-01-01

The main objective of this study was to examine the association between four types of adverse life events (family environment, separation, social adversity, and death) and the development of depressive symptoms among Puerto Rican youth. This was a secondary analysis using three waves (2000–2004) of interview data from the Boricua Youth Study of 10–13 year old Puerto Rican youth residing in New York and Puerto Rico with no depressive symptoms at baseline (n = 977). Depressive symptoms increased with an increase in social adversity, separation, death, and death events. Youth support from parents was a significant protective factor for all adverse events and parent coping was a protective factor in social adversity events. Relying on standard diagnostic tools is ideal to identify youth meeting the criteria for a diagnosis of depression but not useful to detect youth who present with subclinical levels of depression. Youth with sub-clinical levels of depression will not get treated and are at increased risk of developing depression later in life. Adverse life events are potentially relevant to use in conjunction with other screening tools to identify Puerto Rican youth who have subclinical depression and are at risk of developing depression in later adolescence. PMID:27788173

Female Gender and Acne Disease Are Jointly and Independently Associated with the Risk of Major Depression and Suicide: A National Population-Based Study

PubMed Central

Yang, Yi-Chien; Tu, Hung-Pin; Chang, Wei-Chao; Fu, Hung-Chun; Ho, Ji-Chen; Chang, Wei-Pin; Chuang, Hung-Yi; Lee, Chih-Hung

2014-01-01

Acne is a common disease in adolescence with female preponderance. It could cause poor self-esteem and social phobia. Previous studies based on questionnaires from several thousands of adolescents showed that acne is associated with major depression and suicide. However, the gender- and age-specific risk of depression and suicide in patients with acne remain largely unknown. Using a database from the National Health Insurance, which included 98% of the population of Taiwan in 2006, we identified patients of acne, major depression, and suicide based on ICD-9-CM codes. Totally 47111 patients with acne were identified (16568 males and 30543 females) from 1 million subjects. The youths of 7–12 years had the highest prevalence of acne (14.39%). Major depression was more common in those with acne (0.77%) than controls (0.56% , P < 0.0001) regardless of gender. Multiple logistic regression showed an increased risk of major depression in women without acne (OR = 1.85, 95% CI 1.75–1.96). The risk is additive in women with acne (OR = 2.78, 95% CI 2.43–3.17). Similar additive risk of suicide was noticed in women with acne. In conclusion, acne and gender, independently and jointly, are associated with major depression and suicide. Special medical support should be warranted in females with acne for the risk of major depression and suicide. PMID:24678508

Female gender and acne disease are jointly and independently associated with the risk of major depression and suicide: a national population-based study.

PubMed

Yang, Yi-Chien; Tu, Hung-Pin; Hong, Chien-Hui; Chang, Wei-Chao; Fu, Hung-Chun; Ho, Ji-Chen; Chang, Wei-Pin; Chuang, Hung-Yi; Lee, Chih-Hung

2014-01-01

Acne is a common disease in adolescence with female preponderance. It could cause poor self-esteem and social phobia. Previous studies based on questionnaires from several thousands of adolescents showed that acne is associated with major depression and suicide. However, the gender- and age-specific risk of depression and suicide in patients with acne remain largely unknown. Using a database from the National Health Insurance, which included 98% of the population of Taiwan in 2006, we identified patients of acne, major depression, and suicide based on ICD-9-CM codes. Totally 47111 patients with acne were identified (16568 males and 30543 females) from 1 million subjects. The youths of 7-12 years had the highest prevalence of acne (14.39%). Major depression was more common in those with acne (0.77%) than controls (0.56% , P < 0.0001) regardless of gender. Multiple logistic regression showed an increased risk of major depression in women without acne (OR = 1.85, 95% CI 1.75-1.96). The risk is additive in women with acne (OR = 2.78, 95% CI 2.43-3.17). Similar additive risk of suicide was noticed in women with acne. In conclusion, acne and gender, independently and jointly, are associated with major depression and suicide. Special medical support should be warranted in females with acne for the risk of major depression and suicide.

Effects of depression and antidepressant use on goal setting and barrier identification among patients with type 2 diabetes.

PubMed

Chen, Hsiang-Yu; Ruppert, Kristine; Charron-Prochownik, Denise; Noullet, William V; Zgibor, Janice C

2011-01-01

The purpose of this study was to examine the effects of depression and antidepressant use on goal setting and barrier identification in patients with type 2 diabetes. In a large diabetes education network, 778 patients with type 2 diabetes were enrolled in the American Association of Diabetes Educators (AADE) Outcomes System as part of their routine diabetes education between 2005 and 2008. Self-reported depression, 7 self-identified behavior change goals, and 13 barriers to diabetes self-care were collected from the Diabetes Self-Management Assessment Report Tool (D-SMART(®)); antidepressant use was documented from the Diabetes Educator Tool (D-ET(®)). Multiple linear regression was used to evaluate the effects of depression or antidepressant use on the number of goals or the number of barriers while controlling for relevant covariates. Among 778 patients (507 nondepressed, 181 depressed with antidepressant use, 90 depressed without antidepressant use), median age was 58, 60.9% were female, and 85.9% were Caucasian. Patients with and without depression had a similar number of self-identified behavior change goals, whereas patients with depression had 1 additional barrier to diabetes self-care compared with those without depression. In the depressed subgroup, antidepressant use had no association with the number of goals that the subjects set or the number of barriers they identified. Among patients with type 2 diabetes, depression was associated with a slightly greater number of barriers, which may support the importance of depression screening and depression treatment in patients with diabetes.

Correlates of anxiety and depression among patients with type 2 diabetes mellitus.

PubMed

Balhara, Yatan Pal Singh; Sagar, Rajesh

2011-07-01

Research has established the relation between diabetes and depression. Both diabetes and anxiety/depression are independently associated with increased morbidity and mortality. The present study aims at assessing the prevalence of anxiety/depression among outpatients receiving treatment for type 2 diabetes. The study was conducted in the endocrinology outpatient department of an urban tertiary care center. The instruments used included a semi-structured questionnaire, HbA1c levels, fasting blood glucose and postprandial blood glucose, Brief Patient Health Questionnaire, and Hospital Anxiety and Depression Scale (HADS). Analysis was carried out using the SPSS version 16.0. Pearson's correlation coefficient was calculated to find out the correlations. ANOVA was carried out for the in between group comparisons. There was a significant correlation between the HADS-Anxiety scale and Body Mass Index (BMI) with a correlation coefficient of 0.34 (P = 0.008). Also, a significant correlation existed between HADS-Depression scale and BMI (correlation coefficient, 0.36; P = 0.004). Significant correlation were observed between the duration of daily physical exercise and HADS-Anxiety (coefficient of correlation, -0.25; P = 0.04) scores. HADS-Anxiety scores were found to be related to HbA1c levels (correlation-coefficient, 0.41; P = 0.03) and postprandial blood glucose levels (correlation-coefficient, 0.51; P = 0.02). Monitoring of biochemical parameters like HbA1c and postprandial blood glucose levels and BMI could be a guide to development of anxiety in these patients. Also, physical exercise seems to have a protective effect on anxiety in those with type 2 diabetes mellitus.

Integrated management of type 2 diabetes mellitus and depression treatment to improve medication adherence: a randomized controlled trial.

PubMed

Bogner, Hillary R; Morales, Knashawn H; de Vries, Heather F; Cappola, Anne R

2012-01-01

Depression commonly accompanies diabetes, resulting in reduced adherence to medications and increased risk for morbidity and mortality. The objective of this study was to examine whether a simple, brief integrated approach to depression and type 2 diabetes mellitus (type 2 diabetes) treatment improved adherence to oral hypoglycemic agents and antidepressant medications, glycemic control, and depression among primary care patients. We undertook a randomized controlled trial conducted from April 2010 through April 2011 of 180 patients prescribed pharmacotherapy for type 2 diabetes and depression in primary care. Patients were randomly assigned to an integrated care intervention or usual care. Integrated care managers collaborated with physicians to offer education and guideline-based treatment recommendations and to monitor adherence and clinical status. Adherence was assessed using the Medication Event Monitoring System (MEMS). We used glycated hemoglobin (HbA(1c)) assays to measure glycemic control and the 9-item Patient Health Questionnaire (PHQ-9) to assess depression. Intervention and usual care groups did not differ statistically on baseline measures. Patients who received the intervention were more likely to achieve HbA(1c) levels of less than 7% (intervention 60.9% vs. usual care 35.7%; P < .001) and remission of depression (PHQ-9 score of less than 5: intervention 58.7% vs. usual care 30.7%; P < .001) in comparison with patients in the usual care group at 12 weeks. A randomized controlled trial of a simple, brief intervention integrating treatment of type 2 diabetes and depression was successful in improving outcomes in primary care. An integrated approach to depression and type 2 diabetes treatment may facilitate its deployment in real-world practices with competing demands for limited resources.

Prevalence of Depressive Disorder in Persons With Type 2 Diabetes: A National Population-Based Cohort Study 2000-2010.

PubMed

Tu, Hung-Pin; Hsieh, Hui-Min; Liu, Tai-Ling; Jiang, He-Jiun; Wang, Peng-Wei; Huang, Chun-Jen

Diabetes mellitus, a chronic and disabling disease, is epidemic worldwide. Depressive disorder affects the productivity of workers and leads to disability. This study investigated the prevalence of depressive disorder among persons with type 2 diabetes in Taiwan. We extracted service claims data for subjects who had at least 2 ambulatory care service claims or 1 inpatient service claim with a principal diagnosis of type 2 diabetes and at least 1 ambulatory or inpatient service claim with a principal diagnosis of depressive disorder from Taiwan's National Health Insurance Database. From 2000-2010, the prevalence of depressive disorder increased from 3.50-4.07% in people with type 2 diabetes, and from 1.05-2.27% in the general population. The higher prevalence of depressive disorder in persons with type 2 diabetes was associated with being female; residence in central, southern, and eastern Taiwan; residence in urban areas; the comorbidities of hemiplegia or paraplegia, cerebrovascular disease, and anxiety disorder; Charlson Comorbidity Index scores ≥1; diabetes duration >9 years; and the use of rapid-acting insulin injection therapy. The prevalence of depressive disorder is higher among persons with type 2 diabetes than the general population. Consequently, more public health attention should be devoted to the prevention and treatment of this debilitating disease in persons with type 2 diabetes, especially those with the earlier mentioned risk factors. Copyright © 2017 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

[Main types of depression with the prevalence of overvalued ideas within the pubertal decompensation of personality disorders].

PubMed

Krylova, E S; Beburishvili, A A

2009-01-01

Authors observed 96 patients (81 males and 15 females) with overvalued depressions within the pubertal decompensation of personality disorders. Past medical history and prospective observation showed that those conditions develop over the long period of distimia and pose a high risk of suicide. Such conditions differ mildly in content - metaphysical, dysmorphophobical or hypohondriacal, but far more significantly in a parity of structural components of overvalued symptoms, which consist of an ideational cultivation, an affective filling and a component of inclination. According to prevalence of one of the components three main types of such depressions were described: classical, obsessive and type of overvalued inclination. There was established a correlation between type of depression and patient's personality structure and it influenced on the clinical course of depression, the choice of therapy and on prognosis on personality disorders compensation probability in adulthood.

Research Program on Type 1 Diabetes and Youth Depression in Puerto Rico

PubMed Central

Cumba-Avilés, Eduardo; Sáez-Santiago, Emily

2016-01-01

This work reviews the progress and current state of a research program on Diabetes and youth depression in Puerto Rico. Given the high depression rate, its impact in youth with Type 1 Diabetes (T1D), and the lack of interventions to target this link in an integrative way, the manual titled Cognitive-Behavioral Treatment for Depression in Adolescents with T1D was developed. After its first use in an Open Trial, we currently assess the initial efficacy of its revised version to reduce depression and improve glycemic control, self-care, and quality of life. We present its approach, and initial data on its feasibility, acceptability and potential to reduce emotional problems in T1D youth. We discuss implications of this line of research for health psychology, and its utility to model the development of interventions alike focused on other chronic illnesses. PMID:27818725

Research Program on Type 1 Diabetes and Youth Depression in Puerto Rico.

PubMed

Cumba-Avilés, Eduardo; Sáez-Santiago, Emily

2016-01-01

This work reviews the progress and current state of a research program on Diabetes and youth depression in Puerto Rico. Given the high depression rate, its impact in youth with Type 1 Diabetes (T1D), and the lack of interventions to target this link in an integrative way, the manual titled Cognitive-Behavioral Treatment for Depression in Adolescents with T1D was developed. After its first use in an Open Trial, we currently assess the initial efficacy of its revised version to reduce depression and improve glycemic control, self-care, and quality of life. We present its approach, and initial data on its feasibility, acceptability and potential to reduce emotional problems in T1D youth. We discuss implications of this line of research for health psychology, and its utility to model the development of interventions alike focused on other chronic illnesses.

Temporal alteration of spreading depression by the glycine transporter type-1 inhibitors NFPS and Org-24461 in chicken retina.

PubMed

Kertesz, Szabolcs; Szabo, Geza; Udvari, Szabolcs; Levay, Gyorgy; Matyus, Peter; Harsing, Laszlo G

2013-01-25

We used isolated chicken retina to induce spreading depression by the glutamate receptor agonist N-methyl-d-aspartate. The N-methyl-d-aspartate-induced latency time of spreading depression was extended by the glycine(B) binding site competitive antagonist 7-chlorokynurenic acid. Addition of the glycine transporter type-1 inhibitors NFPS and Org-24461 reversed the inhibitory effect of 7-chlorokynurenic acid on N-methyl-d-aspartate-evoked spreading depression. The glycine uptake inhibitory activity of Org-24461, NFPS, and some newly synthesized analogs of NFPS was determined in CHO cells stably expressing human glycine transporter type-1b isoform. Compounds, which failed to inhibit glycine transporter type-1, also did not have effect on retinal spreading depression. These experiments indicate that the spreading depression model in chicken retina is a useful in vitro test to determine activity of glycine transporter type-1 inhibitors. In addition, our data serve further evidence for the role of glycine transporter type-1 in retinal neurotransmission and light processing. Copyright © 2012 Elsevier B.V. All rights reserved.

[Classification and Treatment of Sacroiliac Joint Dislocation].

PubMed

Tan, Zhen; Huang, Zhong; Li, Liang; Meng, Wei-Kun; Liu, Lei; Zhang, Hui; Wang, Guang-Lin; Huang, Fu-Guo

2017-09-01

To develop a renewed classification and treatment regimen for sacroiliac joint dislocation. According to the direction of dislocation of sacroiliac joint,combined iliac,sacral fractures,and fracture morphology,sacroiliac joint dislocation was classified into 4 types. Type Ⅰ (sacroiliac anterior dislocation): main fracture fragments of posterior iliac wing dislocated in front of sacroiliac joint. Type Ⅱ (sacroiliac posterior dislocation): main fracture fragments of posterior iliac wing dislocated in posterior of sacroiliac joint. Type Ⅲ (Crescent fracturedislocation of the sacroiliac joint): upward dislocation of posterior iliac wing with oblique fracture through posterior iliac wing. Type ⅢA: a large crescent fragment and dislocation comprises no more than onethird of sacroiliac joint,which is typically inferior. Type ⅢB: intermediatesize crescent fragment and dislocation comprises between one and twothirds of joint. Type ⅢC: a small crescent fragment where dislocation comprises most,but not the entire joint. Different treatment regimens were selected for different types of fractures. Treatment for type Ⅰ sacroiliac joint dislocation: anterior iliac fossa approach pry stripping reset; sacroiliac joint fixed with sacroiliac screw through percutaneous. Treatment for type Ⅱ sacroiliac joint dislocation: posterior sacroiliac joint posterior approach; sacroiliac joint fixed with sacroiliac screw under computer guidance. Treatment for type ⅢA and ⅢB sacroiliac joint dislocation: posterior sacroiliac joint approach; sacroiliac joint fixed with reconstruction plate. Treatment for type ⅢC sacroiliac joint dislocation: sacroiliac joint closed reduction; sacroiliac joint fixed with sacroiliac screw through percutaneous. Treatment for type Ⅳ sacroiliac joint dislocation: posterior approach; sacroiliac joint fixed with spinal pelvic fixation. Results of 24 to 72 months patient follow-up (mean 34.5 months): 100% survival,100% wound healing,and 100

Depression, anxiety disorders and Type D personality as risk factors for delirium after cardiac surgery.

PubMed

Tully, Phillip J; Baker, Robert A; Winefield, Helen R; Turnbull, Deborah A

2010-11-01

To determine the prognostic risk of incident delirium after cardiac surgery attributable to preoperative affective disorders and Type D personality. Patients awaiting elective coronary revascularization surgery (N = 158; 20.9% female; 11.4% concomitant valve surgery; age M = 64.7, SD = 10.6) underwent the structured MINI International Neuropsychiatric Interview and completed a measure of Type D personality. Postoperative incident delirium was established prior to discharge from the index hospitalization with structured psychiatric interview. The prevalence of psychiatric disorders before cardiac surgery was 17.1% for major depression, 7.6% for panic disorder, 10.1% for generalized anxiety disorder, and 13.3% for Type D personality, while there were 49 (31% of total) cases of delirium after surgery. After adjustment for sex, older age, cross-clamp time, haemoglobin (Hb) and psychotropic drug use, major depression was significantly associated with delirium, odds ratio (OR) = 3.86 (95% confidence interval (CI) 1.42 to 10.52, p = 0.001). Adjustment for clinical covariates suggested that Type D personality was not significantly associated with delirium, OR = 2.85 (95%CI 0.97 to 8.38, p = 0.06). Major depression was significantly associated with incident delirium after cardiac surgery. These findings suggest that the risk of incident delirium attributable to major depression was not merely a reflection of common diagnostic features in prospectively examined cardiac surgery patients.

Effects of cognitive behavioral coaching on depressive symptoms in a sample of type 2 diabetic inpatients in Nigeria.

PubMed

Onyechi, Kay Chinonyelum Nwamaka; Eseadi, Chiedu; Okere, Anthony U; Onuigbo, Liziana N; Umoke, Prince C I; Anyaegbunam, Ngozi Joannes; Otu, Mkpoikanke Sunday; Ugorji, Ngozi Juliet

2016-08-01

Depression is one of the mental health problems confronting those with diabetes mellitus and may result from self-defeating thoughts and lifestyles. Therefore, the aim of this study was to investigate the effects of cognitive behavioral coaching (CBC) program on depressive symptoms in a sample of the Type 2 diabetic inpatients in Onitsha metropolis of Anambra State, Nigeria. The design of the study was pretest-post-test randomized control group design. The participants were 80 Type 2 diabetic inpatients randomly assigned to the treatment and control groups. The primary outcome measures were Beck's Depression Inventory-II and a Diabetic Inpatient's Depressive Symptoms Observation Checklist. Mean, standard deviation, repeated measures analysis of covariance, and partial eta squared were used for data analysis. The results revealed that the baseline of depressive symptoms was similar between the control and treatment groups of the Type 2 diabetic inpatients. But, exposing the Type 2 diabetic inpatients to a cognitive behavioral coaching program significantly reduced the depressive symptoms in the treatment group compared to those in the control group at the end of the intervention. The effects of cognitive behavioral coaching program on the depressive symptoms of those in the treatment group remained consistent at a 6 month follow-up meetings compared to the control group. Given the potential benefits of a cognitive behavioral coaching program, clinicians and mental health professionals are urged to support and implement evidence-based cognitive-behavioral coaching interventions aimed at promoting diabetic inpatients' wellbeing in the Nigerian hospitals.

Features that exacerbate fatigue severity in joint hypermobility syndrome/Ehlers-Danlos syndrome - hypermobility type.

PubMed

Krahe, Anne Maree; Adams, Roger David; Nicholson, Leslie Lorenda

2018-08-01

To assess the prevalence, severity and impact of fatigue on individuals with joint hypermobility syndrome (JHS)/Ehlers-Danlos syndrome - hypermobility type (EDS-HT) and establish potential determinants of fatigue severity in this population. Questionnaires on symptoms and signs related to fatigue, quality of life, mental health, physical activity participation and sleep quality were completed by people with JHS/EDS-HT recruited through two social media sites. Multiple regression analysis was performed to identify predictors of fatigue in this population. Significant fatigue was reported by 79.5% of the 117 participants. Multiple regression analysis identified five predictors of fatigue severity, four being potentially modifiable, accounting for 52.3% of the variance in reported fatigue scores. Predictors of fatigue severity were: the self-perceived extent of joint hypermobility, orthostatic dizziness related to heat and exercise, levels of participation in personal relationships and community, current levels of physical activity and dissatisfaction with the diagnostic process and management options provided for their condition. Fatigue is a significant symptom associated with JHS/EDS-HT. Assessment of individuals with this condition should include measures of fatigue severity to enable targeted management of potentially modifiable factors associated with fatigue severity. Implications for rehabilitation Fatigue is a significant symptom reported by individuals affected by joint hypermobility syndrome/Ehlers-Danlos syndrome - hypermobility type. Potentially modifiable features that contribute to fatigue severity in this population have been identified. Targeted management of these features may decrease the severity and impact of fatigue in joint hypermobility syndrome/Ehlers-Danlos syndrome - hypermobility type.

Type D Personality, Social Support, and Depression Among Ethnic Chinese Coronary Artery Disease Patients Undergoing a Percutaneous Coronary Intervention: An Exploratory Study.

PubMed

Su, Shu-Fen; He, Chung-Ping

2018-01-01

This study investigated the relationships between Type D personality, depression, and social support among ethnic Chinese coronary artery disease (CAD) patients undergoing percutaneous coronary interventions. Type D personality is associated with CAD, and may increase patients' depression and mortality rate. However, very few studies have explored the relationships between depression and social support among ethnic Chinese Type D CAD patients. A longitudinal, repeated-measures design was used; 105 Taiwanese CAD patients undergoing a percutaneous coronary intervention were recruited between January and December 2015. A demographic questionnaire, Type D Scale, ENRICHD Social Support Inventory, and Patient Health Questionnaire-9 were completed by 102 participants (mean age = 64.42, SD = 13.67 years) at hospitalization, and at the second week and third month after discharge. Data were analyzed using t tests and a generalized estimating equation. Results indicated that 46.7% of participants who had Type D personality had lower social support and higher depression than did the remaining (non-Type D) participants. At two weeks after discharge, the improvement in social support was higher among Type D patients than non-Type D participants; the same was true for depression at two weeks and three months after discharge each. Type D Taiwanese CAD patients showed lower perceived social support and higher depression during hospitalization than did non-Type D participants. Furthermore, the more social support patients received at home, the lower was their depression. Health-care providers should provide continuous mental health care, conduct early screening of mental health issues, and ensure that patients receive sufficient social support to reduce depression.

Pure Varus Injury to the Knee Joint.

PubMed

Yoo, Jae Ho; Lee, Jung Ha; Chang, Chong Bum

2015-06-01

A 30-year-old male was involved in a car accident. Radiographs revealed a depressed marginal fracture of the medial tibial plateau and an avulsion fracture of the fibular head. Magnetic resonance imaging showed avulsion fracture of Gerdy's tubercle, injury to the posterior cruciate ligament (PCL), posterior horn of the medial meniscus, and the attachments of the lateral collateral ligament and the biceps femoris tendon. The depressed fracture of the medial tibial plateau was elevated and stabilized using a cannulated screw and washer. The injured lateral and posterolateral corner (PLC) structures were repaired and augmented by PLC reconstruction. However, the avulsion fracture of Gerdy's tubercle was not fixed because it was minimally displaced and the torn PCL was also not repaired or reconstructed. We present a unique case of pure varus injury to the knee joint. This case contributes to our understanding of the mechanism of knee injury and provides insight regarding appropriate treatment plans for this type of injury.

Biological interaction between sleep quality and depression in type 2 diabetes.

PubMed

Zhao, J; Li, X-L; Han, K; Tao, Z-Q; Wu, Z-M

2016-07-01

To explore the interaction of sleep quality and depression among patients with type 2 diabetes mellitus (T2DM). With multistage cluster sampling, the living quality of all participants was investigated. The indicator of interaction was calculated according to the delta method and non-conditional logistic regression model. There were 944 residents involved in the final analysis including 365 males and 579 females. The average age was (64 ± 10.2) years. The rate of poor sleep quality and poor sleep quality combined depression were 33.6% and 40.1%, respectively. Due to poor sleep quality and depression in patients with T2DM, the combined interaction index was 2.48 (95% CI 1.44-4.29), the relative excess risk was 3.42 (95% CI 2.16-4.67), and the attributable proportion was 0.51 (95% CI 0.32-0.70). An additive interaction rather than a multiplicative interaction of poor sleep quality and depression in affecting the quality of life was found in T2DM patients. When both factors existed at the same time, the interaction effect of these 2 factors was greater than the sum of the two factors.

Mechanisms of degradation in adhesive joint strength: Glassy polymer thermoset bond in a humid environment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kropka, Jamie Michael; Adolf, Douglas Brian; Spangler, Scott Wilmer

The degradation in the strength of napkin-ring (NR) joints bonded with an epoxy thermoset is evaluated in a humid environment. While adherend composition (stainless steel and aluminum) and surface preparation (polished, grit blasted, primed, coupling agent coated) do not affect virgin (time=0) joint strength, they can significantly affect the role of moisture on the strength of the joint. Adherend surface abrasion and corrosion processes are found to be key factors in determining the reliability of joint strength in humid environments. In cases where surface specific joint strength degradation processes are not active, decreases in joint strength can be accounted formore » by the glass transition temperature, T g, depression of the adhesive associated with water sorption. Under these conditions, joint strength can be rejuvenated to virgin strength by drying. In addition, the decrease in joint strength associated with water sorption can be predicted by the Simplified Potential Energy Clock (SPEC) model by shifting the adhesive reference temperature, T ref, by the same amount as the T g depression. When surface specific degradation mechanisms are active, they can reduce joint strength below that associated with adhesive T g depression, and joint strength is not recoverable by drying. Furthermore, a critical relative humidity (or, potentially, critical water sorption concentration), below which the surface specific degradation does not occur, appears to exist for the polished stainless steel joints.« less

Mechanisms of degradation in adhesive joint strength: Glassy polymer thermoset bond in a humid environment

DOE PAGES

Kropka, Jamie Michael; Adolf, Douglas Brian; Spangler, Scott Wilmer; ...

2015-08-06

The degradation in the strength of napkin-ring (NR) joints bonded with an epoxy thermoset is evaluated in a humid environment. While adherend composition (stainless steel and aluminum) and surface preparation (polished, grit blasted, primed, coupling agent coated) do not affect virgin (time=0) joint strength, they can significantly affect the role of moisture on the strength of the joint. Adherend surface abrasion and corrosion processes are found to be key factors in determining the reliability of joint strength in humid environments. In cases where surface specific joint strength degradation processes are not active, decreases in joint strength can be accounted formore » by the glass transition temperature, T g, depression of the adhesive associated with water sorption. Under these conditions, joint strength can be rejuvenated to virgin strength by drying. In addition, the decrease in joint strength associated with water sorption can be predicted by the Simplified Potential Energy Clock (SPEC) model by shifting the adhesive reference temperature, T ref, by the same amount as the T g depression. When surface specific degradation mechanisms are active, they can reduce joint strength below that associated with adhesive T g depression, and joint strength is not recoverable by drying. Furthermore, a critical relative humidity (or, potentially, critical water sorption concentration), below which the surface specific degradation does not occur, appears to exist for the polished stainless steel joints.« less

Depression in Chinese patients with type 2 diabetes: associations with hyperglycemia, hypoglycemia, and poor treatment adherence

PubMed Central

Zhang, Yuying; Ting, Rose ZW; Yang, Wenying; Jia, Weiping; Li, Wenhui; Ji, Linong; Guo, Xiaohui; Kong, Alice PS; Wing, Yun‐Kwok; Luk, Andrea OY; Sartorius, Norman; Morisky, Donald E; Oldenburg, Brian; Weng, Jianping

2015-01-01

Abstract Background We hypothesize that depression in type 2 diabetes might be associated with poor glycemic control, in part due to suboptimal self‐care. We tested this hypothesis by examining the associations of depression with clinical and laboratory findings in a multicenter survey of Chinese type 2 diabetic patients. Method 2538 patients aged 18–75 years attending hospital‐based clinics in four cities in China underwent detailed clinical‐psychological‐behavioral assessment during a 12‐month period between 2011 and 2012. Depression was diagnosed if Patient Health Questionnaire‐9 (PHQ‐9) score ≥10. Diabetes self‐care and medication adherence were assessed using the Summary of Diabetes Self‐care Activities and the 4‐item Morisky medication adherence scale respectively. Results In this cross‐sectional study (mean age: 56.4 ± 10.5[SD] years, 53% men), 6.1% (n = 155) had depression. After controlling for study sites, patients with depression had higher HbA 1c (7.9 ± 2.0 vs. 7.7 ± 2.0%, P = 0.008) and were less likely to achieve HbA 1c goal of <7.0% (36.2% vs 45.6%, P = 0.004) than those without depression. They were more likely to report hypoglycemia and to have fewer days of being adherent to their recommended diet, exercise, foot care and medication. In logistic regression, apart from young age, poor education, long disease duration, tobacco use, high body mass index, use of insulin, depression was independently associated with failure to attain HbA 1c target (Odds Ratio [OR] = 1.56, 95%CI:1.05–2.32, P = 0.028). The association between depression and glycemic control became non‐significant after inclusion of adherence to diet, exercise and medication (OR = 1.48, 95% CI 0.99–2.21, P = 0.058). Conclusion Depression in type 2 diabetes was closely associated with hyperglycemia and hypoglycemia, which might be partly mediated through poor treatment adherence. PMID:25349949

[The development of research in tribology of artificial joints].

PubMed

Dai, Zhendong; Gong, Juanqing

2006-06-01

Aseptic loosening of the prosthesis is a major form for the failure of artificial joints, which results in the conglomeration of wear particles at the bone-implant interface. This paper briefly reviews the recent development of tribology of artificial joints preserving good lubrication, enhancing the wear resistance of materials for the joints, reducing the generation of sensitive-size particles and depressing the debris-tissue reactions. Suggestion for improvement in the design of artificial joints is presented.

Place and health in diabetes: the neighbourhood environment and risk of depression in adults with type 2 diabetes.

PubMed

Gariepy, G; Kaufman, J S; Blair, A; Kestens, Y; Schmitz, N

2015-07-01

Depression is a common co-illness in people with diabetes. Evidence suggests that the neighbourhood environment impacts the risk of depression, but few studies have investigated this effect in those with diabetes. We examined the effect of a range of neighbourhood characteristics on depression in people with Type 2 diabetes. This cohort study used five waves of data from 1298 participants with Type 2 diabetes from the Diabetes Health Study (2008-2013). We assessed depression using the Patient Health Questionnaire. We measured neighbourhood deprivation using census data; density of services using geospatial data; level of greenness using satellite imagery; and perceived neighbourhood characteristics using survey data. The effect of neighbourhood factors on risk of depression was estimated using survival analysis, adjusting for sociodemographic variables. We tested effect modification by age, sex and socio-economic characteristics using interaction terms. More physical activity facilities, cultural services and a greater level of greenness in the neighbourhood were associated with a lower risk of depression in our sample, even after adjusting for confounders. Material deprivation was associated with increased risk of depression, particularly in participants who were older or retired. Characteristics of neighbourhoods were associated with the risk of depression in people with Type 2 diabetes and there were vulnerable subgroups within this association. Clinicians are encouraged to consider the neighbourhood environment of their patients when assessing the risk of depression. Future intervention research is need for health policy recommendations. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

Depressive Symptoms, Emotion Dysregulation, and Bulimic Symptoms in Youth With Type 1 Diabetes

PubMed Central

Young-Hyman, Deborah L.; Peterson, Claire M.; Fischer, Sarah; Markowitz, Jessica T.; Muir, Andrew B.; Laffel, Lori M.

2016-01-01

This study evaluated the associations between depressive symptoms, emotion dysregulation and bulimic symptoms in youth with type 1 diabetes (T1D) in the context of the diagnosis and treatment of T1D. Study participants were 103 youth in 2 distinct groups: newly diagnosed (New) or transitioning to pump therapy (continuous subcutaneous insulin infusion [CSII]; “Pump”), who completed questionnaires regarding symptoms of depression, emotion dysregulation, and bulimia. Glycemic control (A1c), height, weight, and questionnaires were evaluated within 10 days of diagnosis (n = 58) or at education/clinic visit before starting insulin utilizing CSII (n = 45). In the newly diagnosed group, only depression accounted for significant variance in bulimia scores (β = .47, P < .01). For the group with disease treatment experience (Pump), but not for the newly diagnosed group (New), greater depressive symptoms and emotion dysregulation were associated with greater bulimic symptoms. Depressive symptoms and emotion dysregulation, an indicator of poor coping/behavioral control, could help explain adoption of disordered eating behaviors in youth with T1D who are transitioning to pump therapy. PMID:27137457

Vascular access type, health-related quality of life, and depression in hemodialysis patients: a preliminary report.

PubMed

Afsar, Baris; Elsurer, Rengin; Covic, Adrian; Kanbay, Mehmet

2012-01-01

Arteriovenous fistulas (AVF) are the vascular access of choice for hemodialysis (HD) compared with arteriovenous grafts (AVG) and central venous catheters (CVC). In spite of increasing recognition of importance of a patient's perception of health-related quality of life (HRQOL) and depression, few studies have assessed the association of vascular access type with HRQOL and depression. The purpose of our study was to examine HRQOL and depression among patients with different vascular access. Severity of symptoms of depression and HRQOL were assessed by Beck Depression Inventory (BDI) and Short Form-36 (SF-36), respectively. Vascular access was reported as one of three options; AVF, AVG, and CVC. In total, 136 patients were included; 104 had AVF, 15 had AVG, and 17 had CVC. BDI and HRQOL parameters differed among patients with different vascular access types. In post hoc analysis, BDI and HRQOL subscales were not different between patients with AVF and AVG. Patients with CVC had lower physical functioning (P:.001), role-physical limitation (P:.015), general health perception (P:.017), vitality (P:.010), social functioning (P:.004), role-emotional (P:.008), mental health (P:.001), physical component summary score (P:.017), and mental component summary score (P:.006) when compared to patients with AVF. Patients with CVC had lower physical functioning (P:.044), role-emotional (P:.044) and mental health scores (P:.04) when compared to patients with AVG. Having a CVC may negatively influence HRQOL in HD patients. Vascular access type does not seem to be related to depressed mood in HD.

Statistical inferences with jointly type-II censored samples from two Pareto distributions

NASA Astrophysics Data System (ADS)

Abu-Zinadah, Hanaa H.

2017-08-01

In the several fields of industries the product comes from more than one production line, which is required to work the comparative life tests. This problem requires sampling of the different production lines, then the joint censoring scheme is appeared. In this article we consider the life time Pareto distribution with jointly type-II censoring scheme. The maximum likelihood estimators (MLE) and the corresponding approximate confidence intervals as well as the bootstrap confidence intervals of the model parameters are obtained. Also Bayesian point and credible intervals of the model parameters are presented. The life time data set is analyzed for illustrative purposes. Monte Carlo results from simulation studies are presented to assess the performance of our proposed method.

Temporomandibular joint and muscle disorder-type pain and comorbid pains in a national US sample.

PubMed

Plesh, Octavia; Adams, Sally H; Gansky, Stuart A

2011-01-01

To compare prevalences of self-reported comorbid headache, neck, back, and joint pains in respondents with temporomandibular joint and muscle disorder (TMJMD)-type pain in the 2000-2005 US National Health Interview Survey (NHIS), and to analyze these self-reported pains by gender and age for Non-Hispanic (NH) Whites (Caucasians), Hispanics, and NH Blacks (African Americans). Data from the 2000-2005 NHIS included information on gender, age, race, ethnicity, education, different common types of pain (specifically TMJMD-type, severe headache/migraine, neck, and low back pains), changes in health status, and health care utilization. Estimates and test statistics (ie, Pearson correlations, regressions, and logistic models) were conducted using SAS survey analysis and SUDAAN software that take into account the complex sample design. A total of 189,977 people (52% female and 48% males, 73% NH Whites, 12% Hispanic, 11% NH Blacks, and 4% "Other") were included. A total of 4.6% reported TMJMD-type pain, and only 0.77% overall reported it without any comorbid headache/migraine, neck, or low back pains; also 59% of the TMJMD-type pain (n = 8,964) reported ⋝ two comorbid pains. Females reported more comorbid pain than males (odds ratio [OR] = 1.41, P < .001); Hispanic and NH Blacks reported more than NH Whites (OR = 1.56, P <.001; OR= 1.38, P <.001, respectively). In addition, 53% of those with TMJMD-type pain had severe headache/migraines, 54% had neck pain, 64% low back pain, and 62% joint pain. Differences in gender and race by age patterns were detected. For females, headache/migraine pain with TMJMD-type pain peaked around age 40 and decreased thereafter regardless of race/ethnicity. Neck pain continued to increase up to about age 60, with a higher prevalence for Hispanic women at younger ages, and more pronounced in males, being the highest in the non-Whites. Low back pain was higher in Black and Hispanic females across the age span, and higher among non-White males

Trajectories of depression in adults with newly diagnosed type 1 diabetes: results from the German Multicenter Diabetes Cohort Study.

PubMed

Kampling, Hanna; Petrak, Frank; Farin, Erik; Kulzer, Bernd; Herpertz, Stephan; Mittag, Oskar

2017-01-01

There is a paucity of longitudinal data on type 1 diabetes and depression, especially in adults. The present study prospectively analysed trajectories of depressive symptoms in adults during the first 5 years of living with type 1 diabetes. We aimed to identify distinct trajectories of depressive symptoms and to examine how they affect diabetes outcome. We reanalysed data from a prospective multicentre observational cohort study including 313 adults with newly diagnosed type 1 diabetes. At baseline and in annual postal surveys over 5 consecutive years, we gathered patient characteristics and behavioural and psychosocial data (e.g. Symptom Checklist-90-R [SCL-90-R]). Medical data (e.g. HbA 1c levels) was obtained from the treating physicians. We applied growth mixture modelling (GMM) to identify distinct trajectories of depression over time. Five years after diagnosis, 7.8% (n = 20) of patients were moderately depressed and 10.2% (n = 26) were severely depressed. GMM statistics identified three possible models of trajectories (class 1, 'no depressive symptoms'; class 2, 'worsening depressive symptoms that improve after 2 years'; class 3, 'worsening depressive symptoms'). Severity of depression symptoms at baseline (subscale of the SCL-90-R questionnaire) significantly predicted membership of classes 2 and 3 vs class 1. After 5 years, higher HbA 1c values were detected in class 3 patients (mean = 8.2%, 66 mmol/mol) compared with class 1 and class 2 (both: mean = 7.2%, 55 mmol/mol). We identified distinct trajectories of depressive symptoms that are also relevant for diabetes outcome. Patients with worsening depressive symptoms over time exhibited poor glycaemic control after the first 5 years of living with diabetes. They also exhibited a reduced quality of life and increased diabetes-related distress.

Comorbid Anxiety and Depression and Their Impact on Cardiovascular Disease in Type 2 Diabetes: The Fremantle Diabetes Study Phase II.

PubMed

Bruce, David G; Davis, Wendy A; Dragovic, Milan; Davis, Timothy M E; Starkstein, Sergio E

2016-10-01

The aims were to determine whether anxious depression, defined by latent class analysis (LCA), predicts cardiovascular outcomes in type 2 diabetes and to compare the predictive power of anxious depression with Diagnostic & Statistical Manual Versions IV and 5 (DSM-IV/5) categories of depression and generalized anxiety disorder (GAD). Prospective observational study of 1,337 type 2 participants. Baseline assessment with the 9-item Patient Health Questionnaire and the GAD Scale; LCA-defined groups with minor or major anxious depression based on anxiety and depression symptoms. Cox modeling used to compare the independent impact of: (1) LCA anxious depression, (2) DSM-IV/5 depression, (3) GAD on incident cardiovascular events and deaths after 4 years. LCA minor and major anxious depression was present in 21.9 and 7.8% of participants, respectively, DSM-IV/5 minor and major depression in 6.2 and 6.1%, respectively, and GAD in 4.8%. There were 110 deaths, 31 cardiovascular deaths, and 199 participants had incident cardiovascular events. In adjusted models, minor anxious depression (Hazard ratio (95% confidence intervals): 1.70 (1.15-2.50)) and major anxious depression (1.90 (1.11-3.25)) predicted incident cardiovascular events and major anxious depression also predicted cardiovascular mortality (4.32 (1.35-13.86)). By comparison, incident cardiovascular events were predicted by DSM-IV/5 major depression (2.10 (1.22-3.62)) only and cardiovascular mortality was predicted by both DSM-IV/5 major depression (3.56 (1.03-12.35)) and GAD (5.92 (1.84-19.08)). LCA-defined anxious depression is more common than DSM-IV/5 categories and is a strong predictor of cardiovascular outcomes in type 2 diabetes. These data suggest that this diagnostic scheme has predictive validity and clinical relevance. © 2016 Wiley Periodicals, Inc.

[Type 2 Diabetes Mellitus, Depression and Eating Disorders in Patients Submitted to Bariatric Surgery].

PubMed

Brandão, Isabel; Marques Pinho, Ana; Arrojado, Filipa; Pinto-Bastos, Ana; Maia da Costa, José; Coelho, Rui; Calhau, Conceição; Conceição, Eva

2016-03-01

Obesity is associated with a great number of complications, including type 2 diabetes mellitus and psychiatric pathology. Bariatric surgery is the best solution to weight loss and improvement of complications in morbid obese patients. This study aims to analyze the evolution of type 2 diabetes mellitus and psychopathologic variables before and after bariatric surgery and assess the importance of different variables in weight loss. This is a longitudinal study, which evaluates 75 patients before and after bariatric surgery (47 - LAGB - laparoscopic adjustable gastric band; 19 - RYGB - Roux-en-Y gastric bypass; 9 - sleeve) with a follow-up time between 18 and 46 months. A clinical interview and self report questionnaires were applied - Eating Disorder Examination questionnaire - EDE-Q and Beck Depression Inventory - BDI. Results show an improvement in type 2 diabetes mellitus after surgery (X2 (1) = 26.132, p < 0.001). There was not a significant improvement among psychiatric pathology when we controlled the analysis for the type of surgery. It was verified that type 2 diabetes mellitus, depression and eating disorders in post-operative period are associated with less weight loss. This model explains 27% of weight variance after surgery (R2 = 0.265) and it is significant F (3.33) = 2.981, p = 0.038. Type 2 diabetes mellitus, psychiatric pathology and eating disorders after surgery influenced weight loss. It was not clear in what way this relation was verified, neither the relation that these metabolic and psychological variables may have during the postoperative period. Type 2 diabetes mellitus improved after surgery. Type 2 diabetes mellitus, depression and eating disorders influenced weight loss in the postoperative period. These variables did not influence weight loss in the preoperative period.

Prevalence of comorbid depression is high in out-patients with Type 1 or Type 2 diabetes mellitus. Results from three out-patient clinics in the Netherlands.

PubMed

Pouwer, F; Geelhoed-Duijvestijn, P H L M; Tack, C J; Bazelmans, E; Beekman, A-J; Heine, R J; Snoek, F J

2010-02-01

Depression is common in diabetes, but the scope of the problem and associated correlates are not well established in specialist diabetes care. We aimed to determine the prevalence of depression among adult outpatients with Type 1 (T1DM) or Type 2 diabetes (T2DM) using both self-report measures and a diagnostic interview, and to establish demographic and clinical characteristics associated with depressive affect. A random sample of 2055 diabetes out-patients from three diabetes clinics was invited to participate. Depressive affect was assessed using the World Health Organization-5 Well Being Index (WHO-5), the Centre for Epidemiologic Studies-Depression scale (CESD) using predefined cut-off scores, and depressive disorder with the Composite International Diagnostic Interview (CIDI). Associations between depression and patient characteristics were explored using regression analyses. Seven hundred and seventy-two patients completed the depression questionnaires. About one-third of T1DM patients and 37-43% of T2DM patients reported depressive affect (WHO-5). The prevalence of depressive affect (CESD) was 25% and 30% for men and women with T1DM, and 35% and 38% for men and women with T2DM, respectively. Based on the CIDI, 8% of T1DM patients (no gender difference) and 2% of men and 21% of women with T2DM suffered from a depressive disorder. Depressive affect was associated with poor glycaemic control and proliferative retinopathy in T1DM, while non-Dutch descent, obesity and neuropathy were correlates in T2DM. Depressive symptoms and major depressive disorder constitute a common comorbid problem among Dutch out-patients with T1DM or T2DM and appear particularly common in migrants and women with T2DM.

Prevalence of depression in adults with type 2 diabetes in the Basque Country: relationship with glycaemic control and health care costs.

PubMed

Alonso-Morán, Edurne; Satylganova, Altynai; Orueta, Juan F; Nuño-Solinis, Roberto

2014-07-30

The aim of the study was to estimate the prevalence of depression in the population diagnosed with diabetes type 2 and to test the hypothesis that the presence of depression in such cases was associated with a) worse glycaemic control, and b) higher healthcare costs. We conducted a cross-sectional analysis, from 1st September 2010 to 31st August 2011, among patients with type 2 diabetes aged 35 years and over in the Basque Country. It was identified how many of them had also depression. The database included administrative individual level information on age, sex, healthcare costs, other comorbidities, and values of glycaemic control (HbA1c). Deprivation index variable was used as socioeconomic measure and, to observe the coexistent pathologies, all the patients diagnoses were categorized by Adjusted Clinical Groups. We used a measure of association, a logistic and a linear regression for analysis. 12.392 (9.8%) of type 2 diabetes patients were diagnosed with depression, being the prevalence 5.2% for males and 15.1% for females. This comorbidity was higher among the most deprived population. There was no association between the presence of depression and glycaemic control. We estimated that the comorbidity average cost per patient/year was 516€ higher than in patients with just type 2 diabetes (P < 0.001) adjusted by the other covariates. We did not find any relationship between depression and glycaemic control in patients with type 2 diabetes. However, the comorbidity was associated with significantly high healthcare costs compared to that of type 2 diabetes occurring alone, after adjusting by other illness. Thus, there is a need of more precise recognition, screening and monitoring of depression among diabetic population. Evidence-based treatment for depression should be included in type 2 diabetes clinical guidelines.

Differential effects of anxiety and depressive symptoms on working memory components in children and adolescents with ADHD combined type and ADHD inattentive type.

PubMed

Ferrin, Maite; Vance, Alasdair

2014-12-01

Working memory (WM) deficits have been shown to be associated with core ADHD symptoms, worse academic achievement and peer-relationship problems. Internalizing symptoms, such as anxiety and depression, have also been associated with impaired WM performance. However, the association of anxiety and depression and WM performance remains unclear for children and adolescents with ADHD. Further, it is unknown how these comorbid conditions might affect WM performance in the two main ADHD subtypes. The association of anxiety and depression and the specific components of spatial (SWM) and verbal working memory (VWM) were examined in 303 children and adolescents with ADHD, combined type (ADHD-CT) and 77 ADHD, inattentive type (ADHD-IA) compared to 128 age- and gender-matched typically developing participants. The relationship between anxiety and depression and WM was assessed using multiple linear regression analyses and separate simple regression analyses. Higher levels of anxiety/depression were associated with (1) increased between-search errors in the typically developing participants alone, (2) a better strategy performance in the ADHD-CT group, and (3) a better spatial span performance in the ADHD-IA group. VWM was equally impaired in the ADHD-CT and ADHD-IA groups, independent of the levels of anxiety and depression. The results suggest that the effects of internalizing symptoms on WM differ in typically developing children and adolescents compared to those with ADHD. Further, high levels of anxiety and depression modified WM performance differently according to the specific ADHD subtypes. This might help explain contradictory findings observed in previous studies of mixed samples of participants with ADHD-CT and ADHD-IA.

Relationship between depression and glycemic control among patients with type 2 diabetes in Medan

NASA Astrophysics Data System (ADS)

Amelia, R.; Yunanda, Y.

2018-03-01

Depression is a mental problem whichifnot handled properly will cause uncontrolled diabetes that affects the quality of life and increase the risk of complications. This study aimed to determine the relationship between depressionwith glycemic control among patients with type 2 Diabetes in Amplas Primary Health Care (PHC) Medan. The study design was a cross-sectional analytic approach. The study population was patients with Type 2 diabetes that is in the region Amplas PHC with a sample of 100 people with consecutive sampling method. We collected data by interviewing and blood analysis. Adapted CES-D questionnaire assessed the depression status. AFull Automatic Spectrophotometer Colorimeter method measured the Blood Sugar Level (BSL),and a Modified HPLC with Doronad affinity measured the HbA1c in avenous blood sample. We used Chi-square test and SPP to analyze and process the data. The results showed 57 (57%) subjects had depression, based on BSL as many as 69 subjects (69%) were not well-controlled diabetes, HbA1c levels showed that 79 subjects (79%) were uncontrolled diabetes. Chi-Square test found a significant relationship between the incidence of depression with glycemic control in diabetic patients in the Amplas PHC (p <0.05).

Depression in Chinese patients with type 2 diabetes: associations with hyperglycemia, hypoglycemia, and poor treatment adherence.

PubMed

Zhang, Yuying; Ting, Rose Zw; Yang, Wenying; Jia, Weiping; Li, Wenhui; Ji, Linong; Guo, Xiaohui; Kong, Alice Ps; Wing, Yun-Kwok; Luk, Andrea Oy; Sartorius, Norman; Morisky, Donald E; Oldenburg, Brian; Weng, Jianping; Chan, Juliana Cn

2015-11-01

We hypothesize that depression in type 2 diabetes might be associated with poor glycemic control, in part due to suboptimal self-care. We tested this hypothesis by examining the associations of depression with clinical and laboratory findings in a multicenter survey of Chinese type 2 diabetic patients. 2538 patients aged 18-75 years attending hospital-based clinics in four cities in China underwent detailed clinical-psychological-behavioral assessment during a 12-month period between 2011 and 2012. Depression was diagnosed if Patient Health Questionnaire-9 (PHQ-9) score ≥10. Diabetes self-care and medication adherence were assessed using the Summary of Diabetes Self-care Activities and the 4-item Morisky medication adherence scale respectively. In this cross-sectional study (mean age: 56.4 ± 10.5[SD] years, 53% men), 6.1% (n = 155) had depression. After controlling for study sites, patients with depression had higher HbA(1c) (7.9 ± 2.0 vs. 7.7 ± 2.0%, P = 0.008) and were less likely to achieve HbA(1c) goal of <7.0% (36.2% vs 45.6%, P = 0.004) than those without depression. They were more likely to report hypoglycemia and to have fewer days of being adherent to their recommended diet, exercise, foot care and medication. In logistic regression, apart from young age, poor education, long disease duration, tobacco use, high body mass index, use of insulin, depression was independently associated with failure to attain HbA(1c) target (Odds Ratio [OR] = 1.56, 95%CI:1.05-2.32, P = 0.028). The association between depression and glycemic control became non-significant after inclusion of adherence to diet, exercise and medication (OR = 1.48, 95% CI 0.99-2.21, P = 0.058). Depression in type 2 diabetes was closely associated with hyperglycemia and hypoglycemia, which might be partly mediated through poor treatment adherence. © 2014 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

Associations between HbA1c and depressive symptoms in young adults with early-onset type 1 diabetes.

PubMed

Bächle, Christina; Lange, Karin; Stahl-Pehe, Anna; Castillo, Katty; Holl, Reinhard W; Giani, Guido; Rosenbauer, Joachim

2015-05-01

This study sought to evaluate the associations between metabolic control and each DSM-5 (Diagnostic and Statistical Manual, fifth edition) symptom of depression among young women and men with early-onset long-duration type 1 diabetes. The data of 202 18-21-year-old patients with type 1 diabetes from a population-based, nationwide survey (40.1% male) with a mean age of 19.4 (standard deviation 0.9) years, a mean HbA1c level of 8.3% (1.6%) (i.e., 67 [17.5]mmol/mol), and a mean diabetes duration of 15.7 (1.0) years were included. The German version of the Patient Health Questionnaire (PHQ-9) was used to assess depression symptoms. For each PHQ-9 depressive symptom, the mean HbA1c values of screening-positive and screening-negative patients were compared via t-test. The associations between HbA1c levels and depressive symptoms were analyzed using multiple linear regression analyses and stepwise adjustments for individual, socioeconomic and health-related covariates. Exactly 43.0% and 33.3% of female and male participants reported at least one depressive symptom, and 5.0% and 2.5% met the DSM-5 criteria for major depressive syndrome. HbA1c levels increased with psychomotor agitation/retardation (women), overeating/poor appetite (men/women), lethargy (men), and sleep difficulty (men). Overeating/poor appetite, lethargy, and total PHQ-9 score (per score increase by one) were associated with increased HbA1c levels of 1.10, 0.96 and 0.09 units (%), respectively. The associations between depressive symptoms and HbA1c levels vary by symptom and sex. Differentiating the symptoms of depression and targeted interventions might help to improve metabolic outcomes in young adults with early-onset type 1 diabetes and depression. Copyright © 2015 Elsevier Ltd. All rights reserved.

Depression and diabetes distress in adults with type 2 diabetes: results from the Australian National Diabetes Audit (ANDA) 2016.

PubMed

Nanayakkara, Natalie; Pease, Anthony; Ranasinha, Sanjeeva; Wischer, Natalie; Andrikopoulos, Sofianos; Speight, Jane; de Courten, Barbora; Zoungas, Sophia

2018-05-18

This study explores the prevalence of, and factors associated with, likely depression and diabetes distress in adults with type 2 diabetes in a large, national sample. Australian National Diabetes Audit data were analysed from adults with type 2 diabetes attending 50 diabetes centres. The Brief Case find for Depression and Diabetes Distress Score 17 were administered to screen for likely depression and diabetes-related distress, respectively. A total of 2,552 adults with type 2 diabetes participated: (mean ± SD) age was 63 ± 13 years, diabetes duration was 12 ± 10 years, and HbA1c was 8 ± 2%. Twenty-nine percent of patients had likely depression, 7% had high diabetes distress, and 5% had both. Difficulty following dietary recommendations, smoking, forgetting medications, and diabetes distress were all associated with greater odds of depression whereas higher own health rating was associated with lower odds (all p < 0.02). Female gender, increasing HbA1c, insulin use, difficulty following dietary recommendations and depression were all associated with greater odds of diabetes distress & older age, higher own health rating and monitoring blood glucose levels as recommended were associated with lower odds (all p < 0.04). Depression was associated with sub-optimal self-care, while diabetes distress was associated with higher HbA1c and sub-optimal self-care.

Moderating effects of coping styles on anxiety and depressive symptoms caused by psychological stress in Chinese patients with Type 2 diabetes.

PubMed

Zhang, C-X; Tse, L-A; Ye, X-Q; Lin, F-Y; Chen, Y-M; Chen, W-Q

2009-12-01

This study aimed to assess possible interactive effects of coping styles and psychological stress on depression and anxiety symptoms in Chinese patients with Type 2 diabetes. Three hundred and four patients with Type 2 diabetes underwent a face-to-face interview by trained research staff according to a standardized questionnaire including information on socio-demographic characteristics, psychological stress, coping styles and anxiety and depressive symptoms. The interactive effects of coping styles and psychological stress on depression and anxiety symptoms were assessed by hierarchical multiple regression analyses. There were significant associations of the four domains of psychological stress with anxiety and depressive symptoms, except for the relationship between 'reduced economic condition' and depressive symptoms. 'Negative coping style' significantly increased the level of both anxiety and depressive symptoms; whereas, 'active coping style' and 'avoidant coping style' decreased the risk of depressive symptoms. The interactions of 'negative coping style' with 'worrying about decline in body/physical function' and 'reduced economic condition' significantly increased the risk of anxiety and depressive symptoms, and the interaction of 'social/family crisis caused by the disease' with 'avoidance coping style' and 'worrying about decline in body/physical function' with 'active coping style' significantly decreased the risk of depressive symptoms. The results of this study suggest that certain coping styles might moderate the association of psychological stress with anxiety and depressive symptoms in Chinese patients with Type 2 diabetes.

Diabetes self-management, depressive symptoms, quality of life and metabolic control in youth with type 1 diabetes in China.

PubMed

Guo, Jia; Whittemore, Robin; Grey, Margaret; Wang, Jing; Zhou, Zhi-Guang; He, Guo-Ping

2013-01-01

To assess diabetes self-management, depressive symptoms, quality of life and metabolic control in a cohort of youth with type 1 diabetes in mainland China. Predictors of self-management and depressive symptoms were also explored. Studies have shown that adaptation to childhood chronic illness is important in determining outcomes. Few studies have been reported on the behavioural, psychosocial and physiological adaptation processes and outcomes in Chinese youth with type 1 diabetes. This is a cross-sectional study as part of a multi-site longitudinal descriptive study. Data for this report were collected at baseline. A convenience sample of 136 eligible youth was recruited during follow-up visits in hospitals in 14 major cities of Hunan Province (located in central southern mainland China) from July 2009-October 2010. Data were collected on socio-demographic background, clinical characteristics, diabetes self-management, depressive symptoms, quality of life and metabolic control. Diabetes self-management was lower in Chinese youth compared with a US cohort and was associated with insulin treatment regimen, treatment location, depressive symptoms and gender. A total of 17·6% of youth reported high depressive symptoms, and depressive symptoms were correlated with family annual revenue, school attendance, peer relationship and parent-child relationship. The mean score of global satisfaction with quality of life was 17·14 ± 3·58. The mean HbA1c was 9·68%. Living with type 1 diabetes poses considerable challenges, and Chinese youth report lower self-management than US youth and high depressive symptoms. Metabolic control and quality of life were sub-optimal. More clinic visits, treatment for high depressive symptoms and an intensive insulin regimen may improve diabetes self-management for youth with type 1 diabetes in China. Culturally appropriate interventions aimed at helping them adapt to living with the disease and improving outcomes are urgently needed. © 2012

Social problem-solving, perceived stress, depression and life-satisfaction in patients suffering from tension type and migraine headaches.

PubMed

Eskin, Mehmet; Akyol, Ali; Çelik, Emine Yilmaz; Gültekin, Bülent Kadri

2013-08-01

This study aimed at investigating social problem solving, perceived stress, depression, and life-satisfaction in patients with tension type and migraine headaches. Forty-nine migraine and 42 tension type headache patients (n = 91) consenting to participate were compared to a total of 49 matched healthy control group. Participants filled in a questionnaire consisting self-report measures of problem solving, perceived stress, depression and life satisfaction. They were also asked about headache duration, frequency, pain severity, psychiatric treatment and sense of control in one's life. T-tests, chi-square, analysis of variance, logistic regression analysis and Pearson product moment correlation coefficient procedures were used to analyze the data. Tension type headache patients reported having had more frequent headaches than the migraine patients but migraine patients reported having had more intense pain than the tension type headache patients. Instances of psychiatric treatment were more common among tension type headache patients than the migraine and the control group. Compared to the healthy controls, headache patients displayed a deficiency in problem solving, higher levels of perceived stress and depression. Levels of problem solving skills in headache patients were related inversely to depression, perceived stress and the number of negative life events but problem solving skills of headache patients was related positively to life-satisfaction. The findings from this study suggested that cognitive behavioral problem solving therapy or training might be a viable option for reducing levels of stress and depression, and to increase life-satisfaction in patients suffering from primary headache. © 2013 The Scandinavian Psychological Associations.

Subjective health complaints and illness perception amongst adults with Joint Hypermobility Syndrome/Ehlers-Danlos Syndrome-HypermobilityType - a cross-sectional study.

PubMed

Hope, Lena; Juul-Kristensen, Birgit; Løvaas, Helene; Løvvik, Camilla; Maeland, Silje

2017-10-17

To investigate the prevalence and severity of subjective health complaints and describe illness perception in a population of Joint Hypermobility Syndrome or Ehlers-Danlos Syndrome-Hypermobile Type. This study was a postal survey with a questionnaire battery on demographic data, subjective health complaints inventory, and illness perception. A total of 110 individuals diagnosed with Joint Hypermobility Syndrome or Ehlers-Danlos Syndrome-Hypermobile Type from two specialized hospitals in Norway were offered participation. Further, 140 gender- and age-matched healthy controls from statistics Norway representing the general population were sent the questionnaire for reference. Overall response rate was 30.4% (n = 76), with 44.5% (n = 49) in Joint Hypermobility Syndrome/Ehlers-Danlos Syndrome-Hypermobile Type and 19.3% (n = 27) in controls. Subjective health complaints were significantly higher in Joint Hypermobility Syndrome/Ehlers-Danlos Syndrome-Hypermobile Type - than in the controls (32.06 vs. 11.08; p < 0.001). Further the brief illness perception questionnaire indicated that the adults with Joint Hypermobility Syndrome/Ehlers-Danlos Syndrome-Hypermobile Type had low understanding of their illness and symptoms (understanding, mean: 3.93, SD 2.88), and reported to have moderate personal and treatment control over their illness. Adults with Joint Hypermobility Syndrome/Ehlers-Danlos Syndrome-Hypermobile Type reported higher frequency and severity of subjective health complaints than the matched controls from the general adult population in Norway. Furthermore, Joint Hypermobility Syndrome/Ehlers-Danlos Syndrome-Hypermobile Type reported low understanding of their illness and associated symptoms, and moderate belief that their illness can be kept under control through self-management or treatment. This may indicate one of the reasons why prognosis for these patients is poor. Implications for rehabilitation Awareness of the complexity of the

Associations Between Physical Activity and Depressive Symptoms by Weight Status Among Adults With Type 2 Diabetes: Results From Diabetes MILES-Australia.

PubMed

Craike, Melinda J; Mosely, Kylie; Browne, Jessica L; Pouwer, Frans; Speight, Jane

2017-03-01

To examine associations between physical activity (PA) and depressive symptoms among adults with type 2 diabetes mellitus (Type 2 DM), and whether associations varied according to weight status. Diabetes MILES-Australia is a national survey of adults with diabetes, focused on behavioral and psychosocial issues. Data from 705 respondents with Type 2 DM were analyzed, including: demographic and clinical characteristics, PA (IPAQ-SF), depressive symptoms (PHQ-9), and BMI (self-reported height and weight). Data analysis was performed using ANCOVA. Respondents were aged 59 ± 8 years; 50% women. PA was negatively associated with depressive symptoms for the overall sample (η p 2 = 0.04,P < .001) and all weight categories separately: healthy (η p 2 0.11 P = .041,), overweight (η p 2 = 0.04, P = .025) and obese (η p 2 = 0.03, P = .007). For people who were healthy (BMI 18.5 to 24.9) or overweight (BMI 25 to 29.9), high amounts of PA were significantly associated with fewer depressive symptoms; for adults who were obese (BMI ≥ 30) however, both moderate and high amounts were associated with fewer depressive symptoms. PA is associated with fewer depressive symptoms among adults with Type 2DM, however the amount of PA associated with fewer depressive symptoms varies according to weight status. Lower amounts of PA might be required for people who are obese to achieve meaningful reductions in depressive symptoms compared with those who are healthy weight or overweight. Further research is needed to establish the direction of the relationship between PA and depressive symptoms.

Joint simulation of stationary grade and non-stationary rock type for quantifying geological uncertainty in a copper deposit

NASA Astrophysics Data System (ADS)

Maleki, Mohammad; Emery, Xavier

2017-12-01

In mineral resources evaluation, the joint simulation of a quantitative variable, such as a metal grade, and a categorical variable, such as a rock type, is challenging when one wants to reproduce spatial trends of the rock type domains, a feature that makes a stationarity assumption questionable. To address this problem, this work presents methodological and practical proposals for jointly simulating a grade and a rock type, when the former is represented by the transform of a stationary Gaussian random field and the latter is obtained by truncating an intrinsic random field of order k with Gaussian generalized increments. The proposals concern both the inference of the model parameters and the construction of realizations conditioned to existing data. The main difficulty is the identification of the spatial correlation structure, for which a semi-automated algorithm is designed, based on a least squares fitting of the data-to-data indicator covariances and grade-indicator cross-covariances. The proposed models and algorithms are applied to jointly simulate the copper grade and the rock type in a Chilean porphyry copper deposit. The results show their ability to reproduce the gradual transitions of the grade when crossing a rock type boundary, as well as the spatial zonation of the rock type.

Prevalence and determinants of depressive and anxiety symptoms in adults with type 2 diabetes in China: a cross-sectional study

PubMed Central

Sun, Nianquan; Lou, Peian; Shang, Yan; Zhang, Pan; Wang, Jian; Chang, Guiqiu; Shi, Chunlei

2016-01-01

Objectives To evaluate the prevalence and determinants of anxiety and depression and to assess their impact on glycaemic control in participants with type 2 diabetes mellitus. Design A cross-sectional study. Setting Community-based investigation in Xuzhou, China. Participants 893 Chinese men and women aged 18–84 years who fulfilled the inclusion criteria. Methods People with type 2 diabetes completed the Pittsburgh Sleep Quality Index and the Zung Self-Rating Anxiety and Depression Scales. Demographic and physiological characteristics were recorded. Multiple logistic regression was used to evaluate the combined effect of factors associated with anxiety and depression and to assess the effects of anxiety and depression on glycaemic control. Results The prevalence of depressive symptoms and anxiety symptoms was 56.1% and 43.6%, respectively. Multivariate logistic regression analysis indicated that anxiety symptoms were associated with being woman, low income, chronic disease, depressive symptoms and poor sleep quality. Depressive symptoms were associated with being woman, older age, low education level, being single, diabetes complications, anxiety symptoms and poor sleep quality. Glycaemic control was not related to anxiety symptoms (OR=1.31, 95% CIs 0.94 to 1.67) or depressive symptoms (OR=1.23, 95% CI 0.85 to 1.63). A combination of depressive symptoms and anxiety symptoms was associated with poor glycaemic control (relative excess risk due to interaction: 4.93, 95% CI 2.09 to 7.87; attributable proportion due to interaction: 0.27, 95% CI 0.12 to 0.45). Conclusions There was a high prevalence of depressive and anxiety symptoms in this Chinese sample of participants, although depression and anxiety were not singly associated with glycaemic control. However, a combination of depressive and anxiety symptoms was negatively correlated with glycaemic control in participants with type 2 diabetes. PMID:27531739

Joint swelling

MedlinePlus

... of arthritis caused by buildup of uric acid crystals in a joint ( gout ) Arthritis caused by wear ... osteoarthritis ) Arthritis caused by buildup of calcium-type crystals in joints ( pseudogout ) Disorder that involves arthritis and ...

Increased mortality risk in women with depression and diabetes mellitus

PubMed Central

Pan, An; Lucas, Michel; Sun, Qi; van Dam, Rob M.; Franco, Oscar H.; Willett, Walter C.; Manson, JoAnn E.; Rexrode, Kathryn M.; Ascherio, Alberto; Hu, Frank B.

2011-01-01

Context Both depression and diabetes have been associated with an increased risk of all-cause and cardiovascular diseases (CVD) mortality. However, data evaluating the joint effects of these two conditions on mortality are sparse. Objectives To evaluate the individual and joint effects of depression and diabetes on all-cause and CVD mortality in a prospective cohort study. Design, Settings and Participants A total of 78282 female participants in the Nurses' Health Study aged 54-79 years at baseline in 2000 were followed until 2006. Depression was defined as having self-reported diagnosed depression, treatment with antidepressant medications, or a score indicating severe depressive symptomatology, i.e., a five-item Mental Health Index score ≤52. Self-reported type 2 diabetes was confirmed using a supplementary questionnaire. Main outcome measures All-cause and CVD-specific mortality. Results During 6 years of follow-up (433066 person-years), 4654 deaths were documented, including 979 deaths from CVD. Compared to participants without either condition, the age-adjusted relative risks (95% confidence interval, CI) for all-cause mortality were 1.76 (1.64-1.89) for women with depression only, 1.71 (1.54-1.89) for individuals with diabetes only, and 3.11 (2.70-3.58) for those with both conditions. The corresponding age-adjusted relative risks of CVD mortality were 1.81 (1.54-2.13), 2.67 (2.20-3.23), and 5.38 (4.19-6.91), respectively. These associations were attenuated after multivariate adjustment for other demographic variables, body mass index, smoking status, alcohol intake, physical activity, and major comorbidities (including hypertension, hypercholesterolemia, heart diseases, stroke and cancer) but remained significant, with the highest relative risks for all-cause and CVD mortality found in those with both conditions (2.07 [95% CI, 1.79-2.40] and 2.72 [95% CI, 2.09-3.54], respectively). Furthermore, the combination of depression with a long duration of diabetes

Depression in type 1 diabetes was associated with high levels of circulating galectin-3

PubMed Central

Melin, Eva Olga; Dereke, Jonatan; Thunander, Maria; Hillman, Magnus

2018-01-01

Objective Neuroinflammatory responses are implicated in depression. The aim was to explore whether depression in patients with type 1 diabetes (T1D) was associated with high circulating galectin-3, controlling for metabolic variables, s-creatinine, life style factors, medication and cardiovascular complications. Design Cross-sectional. Methods Participants were T1D patients (n = 283, 56% men, age 18–59 years, diabetes duration ≥1 year). Depression was assessed by Hospital Anxiety and Depression Scale-depression subscale. Blood samples, anthropometrics and blood pressure were collected, and supplemented with data from medical records and the Swedish National Diabetes Registry. Galectin-3 ≥2.562 µg/l, corresponding to the 85th percentile, was defined as high galectin-3. Results Median (quartile1, quartile3) galectin-3 (µg/l) was 1.3 (0.8, 2.9) for the 30 depressed patients, and 0.9 (0.5, 1.6) for the 253 non-depressed, P = 0.009. Depression was associated with high galectin-3 in all the 283 patients (adjusted odds ratio (AOR) 3.5), in the 161 men (AOR 3.4), and in the 122 women (AOR 3.9). HbA1c, s-lipids, s-creatinine, blood pressure, obesity, smoking, physical inactivity, cardiovascular complications and drugs (antihypertensive, lipid lowering, oral antidiabetic drugs and antidepressants) were not associated with high galectin-3. Conclusions This is the first study to show an association between depression and galectin-3. Depression was the only explored parameter associated with high circulating galectin-3 levels in 283 T1D patients. High galectin-3 levels might contribute to the increased risk for Alzheimer’s disease, cardiovascular and all-cause mortality observed in persons with depression. Potentially, in the future, treatment targeting galactin-3 might improve the prognosis for patients with high galectin-3 levels. PMID:29760188

A Longitudinal Investigation of Anxiety and Depressive Symptomatology and Exercise Behaviour Among Adults With Type 2 Diabetes Mellitus.

PubMed

Ivanova, Elena; Burns, Rachel J; Deschênes, Sonya S; Knäuper, Bärbel; Schmitz, Norbert

2017-02-01

Evidence suggests that symptoms of depression and anxiety predict lower exercise behaviour and, inversely, that less exercise predicts higher symptomatology. The present longitudinal study examined this reciprocal association in adults with type 2 diabetes mellitus. We predicted that symptoms of anxiety or depression would intensify over time as a consequence of lower exercise frequency and, similarly, that exercise frequency would decrease as a consequence of greater symptoms of anxiety or depression. We studied 1691 adults with type 2 diabetes who provided baseline measures in 2011 and 2 subsequent annual assessments (Follow-up 1 and Follow-up 2). Symptoms of depression and anxiety were measured using the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder-7, respectively. A single item assessed exercise frequency in the past month (in days). Separate 3-wave cross-lagged path models for symptoms of anxiety and depression tested the reciprocal associations. Contrary to our hypotheses, the reciprocal associations were not supported and, by extension, the predicted secondary associations were not tested. In sum, only depressive symptoms negatively predicted subsequent exercise frequency (Follow-up 1 and Follow-up 2). Symptoms of depression were prospectively associated with lower exercise frequency, which is consistent with evidence from population-based studies that identify depressive symptoms as a barrier to exercise participation. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Multidimensional anatomy of 'modern type depression' in Japan: A proposal for a different diagnostic approach to depression beyond the DSM-5.

PubMed

Kato, Takahiro A; Hashimoto, Ryota; Hayakawa, Kohei; Kubo, Hiroaki; Watabe, Motoki; Teo, Alan R; Kanba, Shigenobu

2016-01-01

Japan's prototype of depression was traditionally a melancholic depression based on the premorbid personality known as shūchaku-kishitsu proposed by Mitsuzo Shimoda in the 1930s. However, since around 2000, a novel form of depression has emerged among Japanese youth. Called 'modern type depression (MTD)' by the mass media, the term has quickly gained popularity among the general public, though it has not been regarded as an official medical term. Likewise, lack of consensus guidelines for its diagnosis and treatment, and a dearth of scientific literature on MTD has led to confusion when dealing with it in clinical practice in Japan. In this review article, we summarize and discuss the present situation and issues regarding MTD by focusing on historical, diagnostic, psychosocial, and cultural perspectives. We also draw on international perspectives that begin to suggest that MTD is a phenomenon that may exist not only in Japan but also in many other countries with different sociocultural and historical backgrounds. It is therefore of interest to establish whether MTD is a culture-specific phenomenon in Japan or a syndrome that can be classified using international diagnostic criteria as contained in the ICD or the DSM. We propose a novel diagnostic approach for depression that addresses MTD in order to combat the current confusion about depression under the present diagnostic systems. © 2015 The Authors. Psychiatry and Clinical Neurosciences © 2015 Japanese Society of Psychiatry and Neurology.

[Tinnitus and temporomandibular joint: State of the art].

PubMed

Lina-Granade, G; Truy, E; Ionescu, E; Garnier, P; Thai Van, H

2016-12-01

Tinnitus has been described in temporomandibular joint dysfunction for a long time. Yet, other disorders, such as hearing loss, stress, anxiety and depression, play a major role in the pathophysiology of tinnitus. Temporomandibular joint dysfunctions seem to increase the risk of tinnitus in patients with other predisposing factors. Especially somatosensory tinnitus, which is characterized by sound modulations with neck or mandible movements, is frequently associated with temporomandibular joint dysfunction, but it is not pathognomonic of such a disorder. In such cases, functional therapy of the temporomandibular joint should be part of the multidisciplinary rehabilitation of patients with tinnitus. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Is Infant Initiation of Joint Attention by Pointing Affected by Type of Interaction?

ERIC Educational Resources Information Center

Franco, Fabia; Perucchini, Paola; March, Barbara

2009-01-01

This article reports the results of two experiments studying the effects of type of interaction on infant production of declarative pointing. In Experiment 1, intensity of social presence was manipulated in adult-infant interaction with 12-19-month-olds (no social presence; adult responding only; adult also initiating joint attentional bids).…

Weight cycling and depressive symptoms in diabetes: a community-based study of adults with type 2 diabetes mellitus in Quebec.

PubMed

Messier, Lyne; Elisha, Belinda; Schmitz, Norbert; Gariepy, Geneviève; Malla, Ashok; Lesage, Alain; Boyer, Richard; Wang, JianLi; Strychar, Irene

2014-12-01

The problems of obesity and depression in type 2 diabetes mellitus are well documented, yet the role of weight cycling in relation to these 2 chronic conditions has not been examined. The study objective was to determine whether weight cycling predicts the development of depressive symptoms in the course of 1 year. A cohort study of 1100 adults with type 2 diabetes participating in the Diabetes Health and Well-Being Study (telephone survey using the random-digit-dialling method) had complete data at the 1-year follow up on depressive symptoms (Patient Health Questionnaire 9) and weight cycling frequency (going on a diet and losing >10 kg). At baseline, 56.5% of subjects reported weight cycling on at least 1 occasion in their lifetime; it was found to be associated with baseline body mass index, depression, sex and age (p<0.05). Regression analyses indicated that severe weight cycling (≥4 times) was not associated with the development of major depressive symptoms; however, it was associated with maintaining major depressive symptoms (p=0.038) but significance disappeared after adjusting for body mass index, physical activity, smoking and sociodemographic characteristics. Development and maintenance of major depressive symptoms were associated with physical inactivity (p<0.05); maintenance of major depressive symptoms was also associated with higher body mass index values (p<0.05). Weight cycling is a widespread phenomenon in diabetes. It was associated with depression, but severe cycling was not an independent predictor of the development and maintenance of major depressive symptoms. Clinicians should consider physical inactivity when evaluating and addressing depression in patients with type 2 diabetes. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Factors associated with anxiety and depression among type 2 diabetes outpatients in Malaysia: a descriptive cross-sectional single-centre study.

PubMed

Ganasegeran, Kurubaran; Renganathan, Pukunan; Manaf, Rizal Abdul; Al-Dubai, Sami Abdo Radman

2014-04-23

To determine the prevalence and factors associated with anxiety and depression among type 2 diabetes outpatients in Malaysia. Descriptive, cross-sectional single-centre study with universal sampling of all patients with type 2 diabetes. Endocrinology clinic of medical outpatient department in a Malaysian public hospital. All 169 patients with type 2 diabetes (men, n=99; women, n=70) aged between 18 and 90 years who acquired follow-up treatment from the endocrinology clinic in the month of September 2013. The validated Hospital Anxiety and Depression Scale (HADS), sociodemographic characteristics and clinical health information from patient records. Of the total 169 patients surveyed, anxiety and depression were found in 53 (31.4%) and 68 (40.3%), respectively. In multivariate analysis, age, ethnicity and ischaemic heart disease were significantly associated with anxiety, while age, ethnicity and monthly household income were significantly associated with depression. Sociodemographics and clinical health factors were important correlates of anxiety and depression among patients with diabetes. Integrated psychological and medical care to boost self-determination and confidence in the management of diabetes would catalyse optimal health outcomes among patients with diabetes.

Cognitive-behavioral therapy for the treatment of depression and adherence in patients with type 1 diabetes: pilot data and feasibility.

PubMed

Markowitz, Sarah M; Carper, Matthew M; Gonzalez, Jeffrey S; Delahanty, Linda M; Safren, Steven A

2012-01-01

Depression is one of the most common psychological problems affecting individuals with type 1 diabetes, and it is associated with treatment nonadherence and worse clinical outcomes. The research on treating depression or nonadherence in adults with type 1 diabetes is limited. We adapted an evidence-supported treatment, individual cognitive-behavioral therapy for adherence and depression (CBT-AD), for type 1 diabetes and examined its feasibility, acceptability, and potential for an effect. The pilot study included 9 patients with a DSM-IV diagnosis of major depression, dysthymia, or residual depressive symptoms despite treatment with an antidepressant; a diagnosis of type 1 diabetes per patient self-report; and a glycosylated hemoglobin A1c (HbA1c) level of 8.0% or greater. Patients were referred by their diabetes care providers to a behavioral medicine specialty setting and received 10 to 12 sessions of CBT-AD. Main outcome measures included percent of eligible participants who enrolled in the study, session attendance, independently-rated Montgomery-Asberg Depression Rating Scale (MADRS) score, self-reported adherence to diabetes care activities, and adherence to self-monitoring of blood glucose levels. Data were collected from June 27, 2008, through March 31, 2010. There was a clinically meaningful decrease in depression severity (mean [SD] MADRS score decrease from 26.0 [4.73] to 12.3 [7.37], Cohen d = 2.90), demonstrated improvements in diabetes self-care (increase in blood glucose monitoring from 65.0 [26.72] to 82.7 [22.75], Cohen d = -0.66, and a difference in self-reported percent insulin doses in the past 2 weeks from 77.1 [29.84] to 87.1 [23.6], Cohen d = -0.34), and possible improvement in glycemic control (decrease in HbA1c levels from 9.6 [1.32] to 9.0 [1.04], Cohen d = 0.45). These preliminary results provide evidence for the acceptability, feasibility, and potential utility of CBT-AD for patients with type 1 diabetes and depression. clinicaltrials

Effects of joints in truss structures

NASA Technical Reports Server (NTRS)

Ikegami, R.

1988-01-01

The response of truss-type structures for future space applications, such as Large Deployable Reflector (LDR), will be directly affected by joint performance. Some of the objectives of research at BAC were to characterize structural joints, establish analytical approaches that incorporate joint characteristics, and experimentally establish the validity of the analytical approaches. The test approach to characterize joints for both erectable and deployable-type structures was based upon a Force State Mapping Technique. The approach pictorially shows how the nonlinear joint results can be used for equivalent linear analysis. Testing of the Space Station joints developed at LaRC (a hinged joint at 2 Hz and a clevis joint at 2 Hz) successfully revealed the nonlinear characteristics of the joints. The Space Station joints were effectively linear when loaded to plus or minus 500 pounds with a corresponding displacement of about plus or minus 0.0015 inch. It was indicated that good linear joints exist which are compatible with errected structures, but that difficulty may be encountered if nonlinear-type joints are incorporated in the structure.

Depression and the risk for dementia.

PubMed

Kessing, Lars Vedel

2012-11-01

Depression is associated with increased risk of subsequent development of dementia; however, the nature of the association is still poorly understood. The purpose of the review was based on recent studies to discuss whether depression is a prodromal state of dementia or an independent risk factor for dementia, as well as to discuss how the type of depression, the type of dementia, and antidepressant treatment influence the association. Findings from recent studies suggest that some forms of depressive illness, for example early-onset depression before age 65 years and recurrent depression, may constitute long-term risk factors for development of dementia, whereas the onset of more recent depressive symptoms may reflect a prodromal phase of dementia. It is not clear whether specific subtypes of depression correspond to specific types of dementia. Recent studies suggest that long-term treatment with antidepressants may decrease the risk of developing some types of dementia, depending on the type of depressive disorder. This review has shown that the type of depression and dementia, as well as the effect of drug treatment, has to be considered to improve knowledge on the association between depression and dementia.

Association between depression and glycemic control among type 2 diabetes patients in Lima, Peru.

PubMed

Crispín-Trebejo, Brenda; Robles-Cuadros, María Cristina; Bernabé-Ortiz, Antonio

2015-12-01

There is limited and controversial information regarding the potential impact of depression on glycemic control. This study aims to evaluate the association between depression and poor glycemic control. In addition, the prevalence of depression and rates of poor glycemic control were determined. Cross-sectional study performed in the endocrinology unit of two hospitals of ESSALUD in Peru. The outcome of interest was poor glycemic control, evaluated by glycated hemoglobin (HbA1c: <7% versus ≥7%), whereas the exposure of interest was depression defined as 15 or more points in the Patient Health Questionnaire-9 tool. The association of interest was evaluated using Poisson regression models with robust standard errors reporting prevalence ratios (PR) and 95% confidence intervals (95% CI) adjusting for potential confounders. A total of 277 participants, 184 (66.4%) males, mean age 59.0 (SD: 4.8), and 7.1 (SD: 6.8) years of disease were analyzed. Only 31 participants (11.2%; 95% CI: 7.5%-14.9%) had moderately severe or severe depression, whereas 70 (25.3%; 95% CI 20.3%-30.8%) had good glycemic control. Depression increased the probability of having poor glycemic control (PR=1.32; 95% CI 1.15-1.51) after adjusting for several potential confounders. There is an association between depression and poor glycemic control among type 2 diabetes patients. Our results suggest that early detection of depression might be important to facilitate appropriate glycemic control and avoid further metabolic complications. © 2015 Wiley Publishing Asia Pty Ltd.

Association between depression and glycemic control among type 2 diabetes patients in Lima, Peru

PubMed Central

Crispín‐Trebejo, Brenda; Bernabé‐Ortiz, Antonio

2015-01-01

Abstract Introduction There is limited and controversial information regarding the potential impact of depression on glycemic control. This study aims to evaluate the association between depression and poor glycemic control. In addition, the prevalence of depression and rates of poor glycemic control were determined. Methods Cross‐sectional study performed in the endocrinology unit of two hospitals of ESSALUD in Peru. The outcome of interest was poor glycemic control, evaluated by glycated hemoglobin (HbA1c: < 7% versus ≥ 7%), whereas the exposure of interest was depression defined as 15 or more points in the Patient Health Questionnaire‐9 tool. The association of interest was evaluated using Poisson regression models with robust standard errors reporting prevalence ratios (PR) and 95% confidence intervals (95% CI) adjusting for potential confounders. Results A total of 277 participants, 184 (66.4%) males, mean age 59.0 (SD: 4.8), and 7.1 (SD: 6.8) years of disease were analyzed. Only 31 participants (11.2%; 95% CI: 7.5%–14.9%) had moderately severe or severe depression, whereas 70 (25.3%; 95% CI 20.3%–30.8%) had good glycemic control. Depression increased the probability of having poor glycemic control (PR = 1.32; 95% CI 1.15–1.51) after adjusting for several potential confounders. Conclusions There is an association between depression and poor glycemic control among type 2 diabetes patients. Our results suggest that early detection of depression might be important to facilitate appropriate glycemic control and avoid further metabolic complications. PMID:26037488

Depressed patients’ perceptions of depression treatment decision‐making

PubMed Central

Simon, Daniela; Loh, Andreas; Wills, Celia E.; Härter, Martin

2006-01-01

Abstract Objective  Little is known about the feasibility and effects of patient‐clinician shared decision‐making (SDM) for depression treatment. Within a goal of informing the design of a SDM intervention, the objective of this study was to investigate depressed patients’ perceptions of the treatment decision‐making process with general practitioners (GPs). Setting and participants  Data were gathered from a convenience sample of 40 depressed patients to understand key aspects of treatment decision‐making from the patient perspective. The sample varied in depression severity and type of setting in which treatment was sought. Main variables studied  Semi‐structured interview questions focused on patients’ prior experiences with depression and treatment, perceptions of the treatment decision‐making process, and needs and expectations about treatment. Current depression severity was also assessed. Results  Patient lack of insight regarding depression severity substantially delayed patient engagement in treatment seeking and decision‐making. Patients expected their GPs to be a first and main source of objective information and discussion about depression and treatment and to provide emotional support for decision‐making. Patients also identified needs for additional information about depression and its treatment, as well as concerns about certain aspects of treatment. Conclusions  The depression treatment context has some aspects that differ from treatment decision‐making for other types of health conditions. SDM approaches for depression treatment should be adapted based on depression severity and patient‐identified needs. PMID:17324195

Incidence of Depression and Associated Factors in Patients With Type 2 Diabetes in Quebec, Canada: A Population-Based Cohort Study.

PubMed

Lunghi, Carlotta; Moisan, Jocelyne; Grégoire, Jean-Pierre; Guénette, Line

2016-05-01

It has been reported that the risk of depression is higher among people with type 2 diabetes compared with a nondiabetic population. Among diabetic patients, depression has been associated with worse self-care behaviors, poor glycemic control, and an increased risk of diabetes complications. Identifying factors associated with the occurrence of depression may help physicians identify earlier diabetic patients at a high risk of developing depression, improve prevention, and accelerate proper treatment. To our knowledge, very few population-based studies have reported on the incidence of clinically diagnosed depression as a consequence of type 2 diabetes over a long follow-up period. The objective of this study was to estimate the incidence of clinically diagnosed depression among type 2 diabetic patients newly treated with oral antidiabetic drugs (ADs) and to identify factors associated with the occurrence of depression.Administrative claims data from the public health insurance plan were used to identify a cohort of new oral AD users aged ≥18 years between 2000 and 2006. Patients were followed from oral AD treatment initiation until the diagnosis of depression, ineligibility for the public drug plan, death, or the end of the study, whichever came first. Incidence rates were determined using person-time analysis. Factors associated with depression were identified using multivariable Cox regression analysis.We identified 114,366 new oral AD users, of which 4808 had a diagnosis of depression. The overall incidence rate of depression was 9.47/1000 person-years (PYs) (10.72/1000 PYs for women and 8.27/1000 PYs for men). The incidence of depression was higher during the year after oral AD treatment initiation. Independent factors associated with depression included having had mental disorders other than depression, hospitalization, a higher number of different drugs taken and of physicians visited during the year before oral AD initiation. Moreover, we observed a

[Depression, anxiety and anger in patients with type 1 diabetes mellitus.

PubMed

Muscatello, Maria Rosaria Anna; Troili, Giulia Maria; Pandolfo, Gianluca; Mento, Carmela; Gallo, Giuseppa; Lanza, Giulia; Pintaudi, Basilio; Di Vieste, Giacoma; Di Benedetto, Antonino; Zoccali, Rocco Antonio; Bruno, Antonio

2017-02-01

The aim of this study is to evaluate the influence of negative emotions such as depression, anxiety and anger on clinical expression of type 1 diabetes, also assessing possible gender differences. 75 subjects with type 1 diabetes mellitus afferent to Diabetology Unit of the University Hospital in Messina underwent the following psychodiagnostic tests: Hamilton Rating Scale For Depression (HDRS), State-Trait Anxiety Inventory form Y (STAI-Y), State-Trait Anger Expression Inventory-2 (STAXI-2). Continuous data were expressed as mean ± standard deviation, and the comparison between groups was performed using T Student test; the data not continuous were expressed as a percentage and the differences between groups were evaluated using Chi-square test. We considered the results for values of p<0.05. The mean age of 75 subjects (49.3% males) was 41.0±11.4 years, age of disease onset was 21.1 ± 11.8 years and mean duration of disease was 19.9±11.9 years; 30.7% of subjects were treated with CSII (Subcutaneus Insulin Infusion). Mild levels of depression (HDRS= 10.71±7.9) and anxiety (STAI-Y= 52.37±6.11) were found, whereas STAXI-2 subscales scores were within the normal range. Statistical analysis did not show significant gender differences. Our results, according to data from literature, confirm the association between negative emotions, particularly anxiety, and diabetes. No gender differences were found. Our results suggest the importance of investigating the association between diabetes and negative emotional states and the psychological and psychopathological dimensions which may have a potential role in the therapeutic management of diabetes.

The prevalence of co-morbid depression among employees with type 2 diabetes in a Japanese corporation: a descriptive study using an integrated health database.

PubMed

Arima, Hideaki; Miwa, Makiko; Kawahara, Kazuo

2007-03-01

To determine the prevalence of comorbid depression among people with type 2 diabetes using the integrated health database. A total of 6543 people aged 18-65 years were selected from the employees of a Japanese corporation. Using the corporation's integrated health database, which consisted of medical claims data and a self-reported questionnaire from the fiscal year 2000, this study was undertaken to identify the prevalence, the odds ratio and some related factors. The prevalence of co-morbid depression among people with type 2 diabetes was 2.6%. The crude odds ratio of co-morbid depression among those with type 2 diabetes was 2.20 (95% CI 0.88-5.50). After adjustment for covariates (gender, age, alcohol drinking, smoking, exercise, and dietary restriction), the odds ratio of co-morbid depression among those with type 2 diabetes was 2.33 (0.86-6.33). Using the integrated health database, it was suggested that patients with type 2 diabetes were more likely to suffer from depression and there was a relationship between depression and dietary restriction of portion control.

Patterns of prospective memory impairment among individuals with depression: the influence of cue type and delay interval.

PubMed

Li, Yanqi Ryan; Weinborn, Michael; Loft, Shayne; Maybery, Murray

2013-07-01

The present study investigated the impact of cue type and delay interval on prospective memory performance in depressed, compared to non-depressed, individuals using a clinically relevant measure, the Memory for Intentions Screening Test. The depressed group demonstrated impaired performance on time-based, but not event-based, prospective memory tasks relative to the nondepressed group. The depressed group also demonstrated impaired prospective memory on tasks with longer delay intervals (15 min), but not on tasks with shorter delay intervals (2 min). These data support theoretical frameworks that posit that depression is associated with deficits in cognitive initiative (i.e., reduced ability to voluntarily direct attention to relevant tasks) and thus that depressed individuals are susceptible to poor performance on strategically demanding tasks. The results also raise multiple avenues for developing interventions (e.g., implementation intentions) to improve prospective memory performance among individuals with depression, with potential implications for medication and other treatment adherence.

Refining patterns of joint hypermobility, habitus, and orthopedic traits in joint hypermobility syndrome and Ehlers-Danlos syndrome, hypermobility type.

PubMed

Morlino, Silvia; Dordoni, Chiara; Sperduti, Isabella; Venturini, Marina; Celletti, Claudia; Camerota, Filippo; Colombi, Marina; Castori, Marco

2017-04-01

Joint hypermobility syndrome (JHS) and Ehlers-Danlos syndrome, hypermobility type (EDS-HT) are two overlapping heritable disorders (JHS/EDS-HT) recognized by separated sets of diagnostic criteria and still lack a confirmatory test. This descriptive research was aimed at better characterizing the clinical phenotype of JHS/EDS-HT with focus on available diagnostic criteria, and in order to propose novel features and assessment strategies. One hundred and eighty-nine (163 females, 26 males; age: 2-73 years) patients from two Italian reference centers were investigated for Beighton score, range of motion in 21 additional joints, rate and sites of dislocations and sprains, recurrent soft-tissue injuries, tendon and muscle ruptures, body mass index, arm span/height ratio, wrist and thumb signs, and 12 additional orthopedic features. Rough rates were compared by age, sex, and handedness with a series of parametric and non-parametric tools. Multiple correspondence analysis was carried out for possible co-segregations of features. Beighton score and hypermobility at other joints were influenced by age at diagnosis. Rate and sites of joint instability complications did not vary according to age at diagnosis except for soft-tissue injuries. No major difference was registered by sex and dominant versus non-dominant body side. At multiple correspondence analysis, selected features tend to co-segregate in a dichotomous distribution. Dolichostenomelia and arachnodactyly segregated independently. This study pointed out a more protean musculoskeletal phenotype than previously considered according to available diagnostic criteria for JHS/EDS-HT. Our findings corroborated the need for a re-thinking of JHS/EDS-HT on clinical grounds in order to find better therapeutic and research strategies. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

The association between physical characteristics of the ankle joint and the mobility performance in elderly people with type 2 diabetes mellitus.

PubMed

Ng, Thomas Ka-Wai; Lo, Sing-Kai; Cheing, Gladys Lai-Ying

2014-01-01

Previous studies showed that older adults with diabetes have a worse mobility performance as compared with those without diabetes. Studies also demonstrated that older adults with diabetes have weakened ankle muscle strength, reduced joint range in ankle dorsiflexion and worsened ankle joint proprioception as compared with control population. The purpose of the present study was to examine the relationship between the physical characteristics of the ankle joint and the mobility performance in older adults with type 2 diabetes. Older adults with type 2 diabetes (n=85) were recruited, and Timed Up and Go test (TUG) for mobility assessment was performed. Active ankle joint repositioning test was used for assessing the ankle joint proprioception sense; peak torque of ankle dorsiflexors and plantar flexors were tested by using a Cybex Norm dynamometer, and weight-bearing lunge test (WBLT) was used for assessing the stiffness of ankle dorsiflexion. Our results showed that age, body mass index (BMI), normalized peak torque of plantar flexors and dorsiflexors, active ankle joint repositioning test errors and the WBLT distance were significantly correlated with the TUG (all p<0.001). These ankle characteristics, together with the demographic data of the subjects, contributed 59.9% of the variance in the TUG by multiple regression analysis. Body mass, ankle plantar flexors strength and ankle joint proprioception are important factors contributing to the physical mobility of the older adults with type 2 diabetes. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Depressive Symptoms During Adolescence and Young Adulthood and the Development of Type 2 Diabetes Mellitus.

PubMed

Suglia, Shakira F; Demmer, Ryan T; Wahi, Richa; Keyes, Katherine M; Koenen, Karestan C

2016-02-15

Although depression symptoms have been associated with type 2 diabetes mellitus (T2DM) among adults, little is known about the association of adolescent-onset depression and development of T2DM in young adulthood and whether the association differs by sex. We examined the association between high levels of depressive symptoms in adolescence and T2DM in adulthood in the National Longitudinal Study of Adolescent to Adult Health (n = 12,657). Adolescents completed the 20-item version of Center for Epidemiologic Studies Depression Scale during wave 1 (mean age, 16 years) and the 10-item version during follow-up (mean age, 29 years). A high level of depressive symptoms was defined as a score of 16 or higher on the 20-item version or 11 or higher on the 10-item version. T2DM was identified 13 years after baseline on the basis of either a glycated hemoglobin concentration of at least 6.5% or use of hypoglycemic medication (with or without insulin). Participants who reported taking insulin alone were classified as having type 1 diabetes mellitus and excluded. In models adjusted for demographic characteristics, women were at a higher risk of developing T2DM if they experienced high levels of depressive symptoms during both adolescence and adulthood (odds ratio = 1.96, 95% confidence interval: 1.23, 3.11) than were those who did not experience a high level of symptoms at either time point. No statistically significant associations were noted among men (odds ratio = 0.46, 95% confidence interval: 0.20, 1.05). © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Impact of Alzheimer's-Type Dementia and Information Source on the Assessment of Depression.

ERIC Educational Resources Information Center

Gilley, David W.; And Others

1995-01-01

The level of agreement between the patient and a collateral source with regard to depressive symptomatology was compared for 185 patients with Alzheimer's-type dementia (AD), 57 patients with Parkinson's disease, and 54 nondemented geriatric referrals. Findings highlight the potential insensitivity of patient report in AD. (SLD)

Association of depression with treatment outcomes in Type 2 Diabetes Mellitus: a cross-sectional study from Karachi, Pakistan.

PubMed

Zuberi, Saman I; Syed, Ehsan U; Bhatti, Junaid A

2011-02-15

To assess the associations of depression with glycemic control and compliance to self-care activities in adult patients with Type 2 Diabetes Mellitus This cross-sectional study was conducted at a tertiary-care hospital in Karachi (Aga Khan University Hospital). Equal numbers of depressed and non-depressed patients were consecutively recruited from the diabetic clinic. Information on demographic and clinical characteristics was collected in face-to-face interviews and from medical records. Hospital Anxiety Depression Scale (HADS) was used to measure depression. Associations of depressed status (HADS ≥ 8) with poor glycemic control (Hemoglobin A1c level ≥ 7%) and compliance to self-care activities were assessed by logistic regression analyses. A total of 286 patients were included in this study with a male-female ratio of 1.2:1. Mean age was 52 years and in 64.7% of them, the duration of diabetes was more than 3 years. Depressed patients were more likely to be female (adjusted odds ratio [OR] = 1.88; 95% confidence interval [95%CI] = 1.07-3.31), had a family history of diabetes (OR = 2.64; 95%CI = 1.26-5.55), and poor glycemic control (OR = 5.57; 95%CI = 2.88-10.76) compared with non-depressed patients. Depression was also associated with low compliance to self-care activities such as taking dose as advised (OR = 0.32; 95%CI = 0.14-0.73), dietary restrictions (OR = 0.45; 95%CI = 0.26-0.79) and foot care (OR = 0.38; 95%CI = 0.18-0.83). Adult patients with Type 2 Diabetes who have depression were more likely to have poor glycemic control and lower compliance to self-care activities, and they might need particular attention during follow-up visits.

Factors associated with anxiety and depression among type 2 diabetes outpatients in Malaysia: a descriptive cross-sectional single-centre study

PubMed Central

Ganasegeran, Kurubaran; Renganathan, Pukunan; Manaf, Rizal Abdul; Al-Dubai, Sami Abdo Radman

2014-01-01

Objective To determine the prevalence and factors associated with anxiety and depression among type 2 diabetes outpatients in Malaysia. Design Descriptive, cross-sectional single-centre study with universal sampling of all patients with type 2 diabetes. Setting Endocrinology clinic of medical outpatient department in a Malaysian public hospital. Participants All 169 patients with type 2 diabetes (men, n=99; women, n=70) aged between 18 and 90 years who acquired follow-up treatment from the endocrinology clinic in the month of September 2013. Main outcome measures The validated Hospital Anxiety and Depression Scale (HADS), sociodemographic characteristics and clinical health information from patient records. Results Of the total 169 patients surveyed, anxiety and depression were found in 53 (31.4%) and 68 (40.3%), respectively. In multivariate analysis, age, ethnicity and ischaemic heart disease were significantly associated with anxiety, while age, ethnicity and monthly household income were significantly associated with depression. Conclusions Sociodemographics and clinical health factors were important correlates of anxiety and depression among patients with diabetes. Integrated psychological and medical care to boost self-determination and confidence in the management of diabetes would catalyse optimal health outcomes among patients with diabetes. PMID:24760351

Signaling networks in joint development

PubMed Central

Salva, Joanna E.; Merrill, Amy E.

2016-01-01

Here we review studies identifying regulatory networks responsible for synovial, cartilaginous, and fibrous joint development. Synovial joints, characterized by the fluid-filled synovial space between the bones, are found in high-mobility regions and are the most common type of joint. Cartilaginous joints unite adjacent bones through either a hyaline cartilage or fibrocartilage intermediate. Fibrous joints, which include the cranial sutures, form a direct union between bones through fibrous connective tissue. We describe how the distinct morphologic and histogenic characteristics of these joint classes are established during embryonic development. Collectively, these studies reveal that despite the heterogeneity of joint strength and mobility, joint development throughout the skeleton utilizes common signaling networks via long-range morphogen gradients and direct cell-cell contact. This suggests that different joint types represent specialized variants of homologous developmental modules. Identifying the unifying aspects of the signaling networks between joint classes allows a more complete understanding of the signaling code for joint formation, which is critical to improving strategies for joint regeneration and repair. PMID:27859991

Temporomandibular Joint and Muscle Disorder (TMJMD) - type pain and Co-morbid Pains in a National US Sample

PubMed Central

Plesh, O; Adams, SH; Gansky, SA

2013-01-01

Aims To compare prevalences of self-reported comorbid headaches, neck, back, and joint pains in respondents with temporomandibular joint and muscle disorder (TMJMD)-type pain in the 2000–2005 US National Health Interview Survey (NHIS), and to analyze these self-reported pains by gender and age for Non-Hispanic (NH) Whites (Caucasians), Hispanics and NH Blacks (African Americans). Methods Data from the 2000–2005 NHIS included information on gender, age, race, ethnicity, education, different common types of pain (specifically: TMJMD-type, severe headache/migraine, neck, and low back pains), changes in health status; and health care utilization. Estimates and test statistics (i.e. Pearson correlations, regressions and logistic models) were conducted using SAS survey analysis and SUDAAN software that take into account the complex sample design. Results A total of 189,977 people: 52% female and 48% males; 73% NH Whites, 12% Hispanic, 11% NH Blacks and 4% “Other” were included. A total of 4.6% reported TMJMD-type pain and only 0.77% overall reported it without any comorbid headache/migraine, neck, or low back pains; also 59% of the TMJMD-type pain (N = 8,964) reported ≥two comorbid pain. Females reported more comorbid pain than males (odds ratio (OR) = 1.41, p <0.001), Hispanic and NH Blacks reported more than NH Whites (OR = 1.56, p <0.001; OR = 1.38, p <0.001, respectively). In addition, 53% of those with TMJMD-type pain had severe headache/migraines; 54% had neck pain, 64% low back pain and 62% joint pain. Differences in gender, race by age patterns were detected. For females, headache/migraine pain with TMJMD-type pain peaked around age 40 and decreased thereafter regardless of race/ethnicity. Neck pain continued to increase up to about age 60, with higher prevalence for Hispanic women at younger ages, and more pronounced in males, being the highest in the non-Whites. Low back pain was higher in Black and Hispanic females across the age span and higher

Association of comorbid depression, anxiety, and stress disorders with Type 2 diabetes in Bahrain, a country with a very high prevalence of Type 2 diabetes.

PubMed

Almawi, W; Tamim, H; Al-Sayed, N; Arekat, M R; Al-Khateeb, G M; Baqer, A; Tutanji, H; Kamel, C

2008-11-01

This study examined the association of depression, anxiety, and stress with Type 2 diabetes (T2DM) in Bahrain, an island-country with a very high prevalence of T2DM. This was a cross-sectional study involving administering Depression Anxiety Stress Scales (DASS)-21 structured depression, anxiety, and stress scale to 143 T2DM patients and 132 healthy controls. Higher proportion of T2DM patients were found in the mild-moderate and severe- extremely severe depression (p=0.002), anxiety (p<0.001), and stress (p<0.001) groups. Chronic disease and disease duration were significantly associated with the 3 disturbances, while employment status was associated with anxiety and depression. Logistic regression analysis showed that anxiety, depression, and stress were associated with T2DM after adjusting for all variables, while age was the only significant variable associated with stress. These results suggest a positive contribution of T2DM to increased depressive and/or anxiety and/or stress disorders among the patients examined, thereby recommending counseling for T2DM patients.

Examining Moderation Analyses in Propensity Score Methods: Application to Depression and Substance Use

PubMed Central

Green, Kerry M.; Stuart, Elizabeth A.

2014-01-01

Objective This study provides guidance on how propensity score methods can be combined with moderation analyses (i.e., effect modification) to examine subgroup differences in potential causal effects in non-experimental studies. As a motivating example, we focus on how depression may affect subsequent substance use differently for men and women. Method Using data from a longitudinal community cohort study (N=952) of urban African Americans with assessments in childhood, adolescence, young adulthood and midlife, we estimate the influence of depression by young adulthood on substance use outcomes in midlife, and whether that influence varies by gender. We illustrate and compare five different techniques for estimating subgroup effects using propensity score methods, including separate propensity score models and matching for men and women, a joint propensity score model for men and women with matching separately and together by gender, and a joint male/female propensity score model that includes theoretically important gender interactions with matching separately and together by gender. Results Analyses showed that estimating separate models for men and women yielded the best balance and, therefore, is a preferred technique when subgroup analyses are of interest, at least in this data. Results also showed substance use consequences of depression but no significant gender differences. Conclusions It is critical to prespecify subgroup effects before the estimation of propensity scores and to check balance within subgroups regardless of the type of propensity score model used. Results also suggest that depression may affect multiple substance use outcomes in midlife for both men and women relatively equally. PMID:24731233

Self-efficacy, self-care behavior, anxiety, and depression in Taiwanese with type 2 diabetes: A cross-sectional survey.

PubMed

Wu, Shu-Fang Vivienne; Huang, Yi-Ching; Lee, Mei-Chen; Wang, Tsae-Jyy; Tung, Heng-Hsin; Wu, Meng-Ping

2013-06-01

The relationships between self-efficacy, self-care behavior, anxiety, and depression for Taiwanese individuals with type 2 diabetes were determined in this study. Depression and anxiety are common symptoms that can contribute toward adverse medical outcomes. A descriptive, cross-sectional, correlational design was used. The sample comprised 201 patients with type 2 diabetes from diabetes outpatient clinics at three teaching hospitals in Taiwan. The results of this study revealed that people with diabetes who had received diabetes health education, regularly made clinical visits, underwent treatment, and did not smoke demonstrated a high self-efficacy score (P < 0.05). Self-efficacy among people with diabetes positively correlated with illness duration (P < 0.05), treatment (P < 0.01), and self-care behavior (P < 0.01). Self-efficacy among people with diabetes negatively correlated with anxiety and depression (P < 0.01). Self-efficacy can be a predictor of anxiety and depression (P < 0.01). This study revealed that enhancing self-efficacy levels might reduce anxiety and depression. Self-efficacy-enhancing programs should be held regularly in clinical practices. Conducting psychological research on diabetes drives policy and healthcare system change. © 2012 Wiley Publishing Asia Pty Ltd.

Metformin and ascorbic acid combination therapy ameliorates type 2 diabetes mellitus and comorbid depression in rats.

PubMed

Shivavedi, Naveen; Kumar, Mukesh; Tej, Gullanki Naga Venkata Charan; Nayak, Prasanta Kumar

2017-11-01

Diabetes mellitus and depression are the common comorbid disorders affecting humans worldwide. There is an unmet need to develop therapeutic strategies to treat both diabetes mellitus and comorbid depression. The present study evaluated the effectiveness of metformin and ascorbic acid against type 2 diabetes mellitus and comorbid depression in rats. Four groups of diabetic rats were orally administered with vehicle (1mL/kg), metformin (25mg/kg), ascorbic acid (25mg/kg), or combination of metformin (25mg/kg) and ascorbic acid (25mg/kg) for 11 consecutive days. Diabetes was induced by single-dose administration of streptozotocin (65mg/kg, i.p.) with nicotinamide (120mg/kg, i.p.). Comorbid depression was induced by five inescapable foot-shocks (2mA, 2ms duration) at 10s intervals on days 1, 5, 7, and 10. One group of healthy rats received only vehicles to serve as nondiabetic control group. On day 11, animals were sacrificed, and blood and brain samples were collected from each rat following forced swim test. Plasma glucose, insulin, and corticosterone levels were estimated in plasma. The levels of monoamines, proinflammatory cytokines, and oxidative stress were measured in prefrontal cortex. The combination therapy significantly reduced immobility period, glucose, and corticosterone levels relative to diabetes with comorbid depression group. Furthermore, the combination therapy increased the levels of insulin and monoamines, and caused a significant reductions in oxidative stress and proinflammatory cytokines. In conclusion, the present study revealed that metformin and ascorbic acid combination therapy could be a potential strategy to treat type 2 diabetes mellitus and comorbid depression. Copyright © 2017 Elsevier B.V. All rights reserved.

Co-development of Problem Gambling and Depression Symptoms in Emerging Adults: A Parallel-Process Latent Class Growth Model.

PubMed

Edgerton, Jason D; Keough, Matthew T; Roberts, Lance W

2018-02-21

This study examines whether there are multiple joint trajectories of depression and problem gambling co-development in a sample of emerging adults. Data were from the Manitoba Longitudinal Study of Young Adults (n = 679), which was collected in 4 waves across 5 years (age 18-20 at baseline). Parallel process latent class growth modeling was used to identified 5 joint trajectory classes: low decreasing gambling, low increasing depression (81%); low stable gambling, moderate decreasing depression (9%); low stable gambling, high decreasing depression (5%); low stable gambling, moderate stable depression (3%); moderate stable problem gambling, no depression (2%). There was no evidence of reciprocal growth in problem gambling and depression in any of the joint classes. Multinomial logistic regression analyses of baseline risk and protective factors found that only neuroticism, escape-avoidance coping, and perceived level of family social support were significant predictors of joint trajectory class membership. Consistent with the pathways model framework, we observed that individuals in the problem gambling only class were more likely using gambling as a stable way to cope with negative emotions. Similarly, high levels of neuroticism and low levels of family support were associated with increased odds of being in a class with moderate to high levels of depressive symptoms (but low gambling problems). The results suggest that interventions for problem gambling and/or depression need to focus on promoting more adaptive coping skills among more "at-risk" young adults, and such interventions should be tailored in relation to specific subtypes of comorbid mental illness.

Prevalence and correlates of depressive disorders in people with Type 2 diabetes: results from the International Prevalence and Treatment of Diabetes and Depression (INTERPRET-DD) study, a collaborative study carried out in 14 countries.

PubMed

Lloyd, C E; Nouwen, A; Sartorius, N; Ahmed, H U; Alvarez, A; Bahendeka, S; Basangwa, D; Bobrov, A E; Boden, S; Bulgari, V; Burti, L; Chaturvedi, S K; Cimino, L C; Gaebel, W; de Girolamo, G; Gondek, T M; de Braude, M Guinzbourg; Guntupalli, A; Heinze, M G; Ji, L; Hong, X; Khan, A; Kiejna, A; Kokoszka, A; Kamala, T; Lalic, N M; Lecic Tosevski, D; Mankovsky, B; Li, M; Musau, A; Müssig, K; Ndetei, D; Rabbani, G; Srikanta, S S; Starostina, E G; Shevchuk, M; Taj, R; Vukovic, O; Wölwer, W; Xin, Y

2018-06-01

To assess the prevalence and management of depressive disorders in people with Type 2 diabetes in different countries. People with diabetes aged 18-65 years and treated in outpatient settings were recruited in 14 countries and underwent a psychiatric interview. Participants completed the Patient Health Questionnaire and the Problem Areas in Diabetes scale. Demographic and medical record data were collected. A total of 2783 people with Type 2 diabetes (45.3% men, mean duration of diabetes 8.8 years) participated. Overall, 10.6% were diagnosed with current major depressive disorder and 17.0% reported moderate to severe levels of depressive symptomatology (Patient Health Questionnaire scores >9). Multivariable analyses showed that, after controlling for country, current major depressive disorder was significantly associated with gender (women) (P<0.0001), a lower level of education (P<0.05), doing less exercise (P<0.01), higher levels of diabetes distress (P<0.0001) and a previous diagnosis of major depressive disorder (P<0.0001). The proportion of those with either current major depressive disorder or moderate to severe levels of depressive symptomatology who had a diagnosis or any treatment for their depression recorded in their medical records was extremely low and non-existent in many countries (0-29.6%). Our international study, the largest of this type ever undertaken, shows that people with diabetes frequently have depressive disorders and also significant levels of depressive symptoms. Our findings indicate that the identification and appropriate care for psychological and psychiatric problems is not the norm and suggest a lack of the comprehensive approach to diabetes management that is needed to improve clinical outcomes. © 2018 Diabetes UK.

Cost-effectiveness of a stepped-care intervention to prevent major depression in patients with type 2 diabetes mellitus and/or coronary heart disease and subthreshold depression: design of a cluster-randomized controlled trial.

PubMed

van Dijk, Susan E M; Pols, Alide D; Adriaanse, Marcel C; Bosmans, Judith E; Elders, Petra J M; van Marwijk, Harm W J; van Tulder, Maurits W

2013-05-07

Co-morbid major depression is a significant problem among patients with type 2 diabetes mellitus and/or coronary heart disease and this negatively impacts quality of life. Subthreshold depression is the most important risk factor for the development of major depression. Given the highly significant association between depression and adverse health outcomes and the limited capacity for depression treatment in primary care, there is an urgent need for interventions that successfully prevent the transition from subthreshold depression into a major depressive disorder. Nurse led stepped-care is a promising way to accomplish this. The aim of this study is to evaluate the cost-effectiveness of a nurse-led indicated stepped-care program to prevent major depression among patients with type 2 diabetes mellitus and/or coronary heart disease in primary care who also have subthreshold depressive symptoms. An economic evaluation will be conducted alongside a cluster-randomized controlled trial in approximately thirty general practices in the Netherlands. Randomization takes place at the level of participating practice nurses. We aim to include 236 participants who will either receive a nurse-led indicated stepped-care program for depressive symptoms or care as usual. The stepped-care program consists of four sequential but flexible treatment steps: 1) watchful waiting, 2) guided self-help treatment, 3) problem solving treatment and 4) referral to the general practitioner. The primary clinical outcome measure is the cumulative incidence of major depressive disorder as measured with the Mini International Neuropsychiatric Interview. Secondary outcomes include severity of depressive symptoms, quality of life, anxiety and physical outcomes. Costs will be measured from a societal perspective and include health care utilization, medication and lost productivity costs. Measurements will be performed at baseline and 3, 6, 9 and 12 months. The intervention being investigated is expected

Cell-type-specific role for nucleus accumbens neuroligin-2 in depression and stress susceptibility.

PubMed

Heshmati, Mitra; Aleyasin, Hossein; Menard, Caroline; Christoffel, Daniel J; Flanigan, Meghan E; Pfau, Madeline L; Hodes, Georgia E; Lepack, Ashley E; Bicks, Lucy K; Takahashi, Aki; Chandra, Ramesh; Turecki, Gustavo; Lobo, Mary Kay; Maze, Ian; Golden, Sam A; Russo, Scott J

2018-01-30

Behavioral coping strategies are critical for active resilience to stress and depression; here we describe a role for neuroligin-2 (NLGN-2) in the nucleus accumbens (NAc). Neuroligins (NLGN) are a family of neuronal postsynaptic cell adhesion proteins that are constituents of the excitatory and inhibitory synapse. Importantly, NLGN-3 and NLGN-4 mutations are strongly implicated as candidates underlying the development of neuropsychiatric disorders with social disturbances such as autism, but the role of NLGN-2 in neuropsychiatric disease states is unclear. Here we show a reduction in NLGN-2 gene expression in the NAc of patients with major depressive disorder. Chronic social defeat stress in mice also decreases NLGN-2 selectively in dopamine D1-positive cells, but not dopamine D2-positive cells, within the NAc of stress-susceptible mice. Functional NLGN-2 knockdown produces bidirectional, cell-type-specific effects: knockdown in dopamine D1-positive cells promotes subordination and stress susceptibility, whereas knockdown in dopamine D2-positive cells mediates active defensive behavior. These findings establish a behavioral role for NAc NLGN-2 in stress and depression; provide a basis for targeted, cell-type specific therapy; and highlight the role of active behavioral coping mechanisms in stress susceptibility.

Association between serum endogenous secretory receptor for advanced glycation end products and risk of type 2 diabetes mellitus with combined depression in the Chinese population.

PubMed

Chen, Gang; Wu, Yulian; Wang, Tao; Liang, Jixing; Lin, Wei; Li, Liantao; Wen, Junping; Lin, Lixiang; Huang, Huibin

2012-10-01

The role of the endogenous secretory receptor for advanced glycation end products (esRAGE) in depression of diabetes patients and its clinical significance are unclear. This study investigated the role of serum esRAGE in patients with type 2 diabetes mellitus with depression in the Chinese population. One hundred nineteen hospitalized patients with type 2 diabetes were recruited at Fujian Provincial Hospital (Fuzhou, China) from February 2010 to January 2011. All selected subjects were assessed with the Hamilton Rating Scale for Depression (HAMD). Among them, 71 patients with both type 2 diabetes and depression were included. All selected subjects were examined for the following: esRAGE concentration, glycosylated hemoglobin (HbA1c), blood lipids, C-reactive protein, trace of albumin in urine, and carotid artery intima-media thickness (IMT). Association between serum esRAGE levels and risk of type 2 diabetes mellitus with depression was also analyzed. There were statistically significant differences in gender, age, body mass index, waist circumference, and treatment methods between the group with depression and the group without depression (P<0.05). Multiple linear regression analysis showed that HAMD scores were negatively correlated with esRAGE levels (standard regression coefficient -0.270, P<0.01). HAMD-17 scores were positively correlated with IMT (standard regression coefficient 0.183, P<0.05) and with HbA1c (standard regression coefficient 0.314, P<0.01). Female gender, younger age, obesity, poor glycemic control, complications, and insulin therapy are all risk factors of type 2 diabetes mellitus with combined depression in the Chinese population. Inflammation and atherosclerosis play an important role in the pathogenesis of depression. esRAGE is a protective factor of depression among patients who have type 2 diabetes.

Depression, deficits in functional capacity, and impaired glycemic control in urban African Americans with type 2 diabetes.

PubMed

Musselman, Dominique L; Ziemer, David C; McNutt, Marcia D; Seay, Julia S; Royster, Erica B; Larsen, Bridget; Barham, Terrika; Brown, Angelo R; Vogel, Octavia L; Phillips, Lawrence S; Harvey, Philip D

2014-05-01

Effective depression treatment does not reliably reduce glycosylated hemoglobin (HbA1c) in depressed patients with type 2 diabetes, possibly in part due to deficits in functional capacity, i.e. performance of certain everyday living skills, essential for effective diabetes self-management. We sought to determine: a) the magnitude of deficits in functional capacity among urban, African American (AA) patients with type 2 diabetes, and b) whether these deficits were associated with poorer glycemic control. At their initial visit to an inner-city diabetes clinic, 172 AA patients with type 2 diabetes were assessed with a variety of instruments, including the Mini International Neuropsychiatric Interview (MINI) and the UCSD Performance Skills Assessment-Brief (UPSA-B). They then entered a comprehensive diabetes management intervention, whose success was indexed by HbA1c levels at up to four reassessments over a one-year period. A mixed-effects model repeated-measures method was used to predict HbA1c. The prevalence of depression was 19%; the mean UPSA-B score was 81 ± 17. After multivariate adjustment, increased HbA1c levels over time were predicted by the presence of major depression (B = .911, p = .002) and decreasing (worse) scores on the UPSA-B (B = -.016, p = .027), respectively. Further adjustment for increasing the dosage of oral or insulin during the treatment eliminated the association between the UPSA score and HbA1c level (B = -.010, p = .115). Depression, as well as deficits in functional capacity, predicted reduced effectiveness of a diabetes self-management intervention. Future studies will determine whether interventions targeted at both improve glycemic control. Copyright © 2014 Elsevier Ltd. All rights reserved.

Prevalence of depression and its associated factors in patients with type 2 diabetes: A cross-sectional study in Dhaka, Bangladesh.

PubMed

Islam, Sheikh Mohammed Shariful; Rawal, Lal B; Niessen, Louis W

2015-10-01

Depression is a common feature in patients with type 2 diabetes and often remains undetected and untreated, causing increased morbidity and mortality. We explored the prevalence of co-morbid depression and its associated factors, including major life-events among patients with type 2 diabetes in Bangladesh. We conducted a cross-sectional study among 515 patients with type 2 diabetes between September 2013 and July 2014 in a tertiary hospital in Dhaka city. We assessed depression using Patient Health Questionnaire-9 (PHQ-9) with predefined cut-off scores of 5, 10, 15 and 20 to indicate minimal, mild, moderate, moderately-severe, and severe depression. Associations between depression and its associated factors were explored using univariate and multivariate regression. Overall, 61.9% participants had depressive symptoms, and the prevalence was higher among females (70.9%) compared to males (50.6%). One-third (35.7%) of participants had mild depression and 36.2% had moderate to severe depression. In the multivariate analysis, factors significantly associated with depression were: age≤60 years (OR: 2.1, 95% CI=1.2-3.6; p≤0.006), female gender (OR=1.9, 95% CI=1.3-3.0; p≤0.002), those having 1-3 complications (OR=2.3, 95% CI=1.2-4.3; p=0.010), experienced loss of business or crop failure (OR=2.1, 95% CI=1.2-3.6; p=0.006), major family conflicts (OR=2.2, 95% CI=1.4-3.5; p≤0.001), separation or deaths of family members or divorce (OR=2.2, 95% CI=1.4-3.5; p≤0.001), and those who experienced unavailability of food or medicines (OR=2.2, 95% CI=1.0-4.5; p=0.038). Patients with diabetes, especially females, those having other complications, and major life-events should routinely be screened for symptoms of depression with adequate management of these conditions. Copyright © 2015 Elsevier B.V. All rights reserved.

Open capsular and ligament reconstruction with semitendinosus hamstring autograft successfully controls superior and posterior translation for type V acromioclavicular joint dislocation.

PubMed

Garofalo, Raffaele; Ceccarelli, Enrico; Castagna, Alessandro; Calvisi, Vittorio; Flanagin, Brody; Conti, Marco; Krishnan, Sumant G

2017-07-01

Appropriate surgical management for type V complete acromioclavicular (AC) joint dislocation remains controversial. The purpose of this paper is to retrospectively report the clinical and radiographic outcomes of an open surgical technique consisting for AC joint ligamentous and capsular reconstruction using autologous hamstring tendon grafts and semi-permanent sutures. Between January 2005 and December 2011, 32 consecutive patients with symptomatic type V complete AC joint dislocation underwent surgical treatment using the same technique. The median time from injury to surgery was 45 days (range 24-90). The average median postoperative clinical and radiographic follow-up time was 30 months (range 24-33). Clinical outcomes measures included the ASES score, the visual analog score (VAS), and subjective patient satisfaction score. Minimum follow-up was 2 years. ASES score increased from a median of 38.2 ± 6.2 preoperative to 92.1 ± 4.7 postoperatively (p ≤ 0.05). The median VAS score improved from 62 mm (range 45-100 mm) preoperatively to 8 mm (range 0-20 mm) at final follow-up (p ≤ 0.05). No patient experienced pain or discomfort with either direct palpation of the AC joint or with cross-body adduction. Final radiographs demonstrated symmetric AC joint contour in 25/32 (78%) patients. Seven patients (22%) radiographically demonstrated superior translation of the distal clavicle relative to the superior margin of the acromion but less than 50% of the clavicular width. 30/32 patients (93%) were able to return to their pre-injury level of work and sports activities. This novel surgical technique using a free graft and braided suture for simultaneous coracoclavicular ligament and AC joint capsular reconstruction successfully controls superior and posterior translations after type V AC joint dislocation and minimizes the incidence of persistent postoperative AC joint subluxation. Retrospective case series, Level IV.

Prevalence and determinants of anxiety and depression symptoms in patients with type 2 diabetes in Lithuania.

PubMed

Mikaliūkštienė, Aldona; Žagminas, Kęstutis; Juozulynas, Algirdas; Narkauskaitė, Laura; Sąlyga, Jonas; Jankauskienė, Konstancija; Stukas, Rimantas; Šurkienė, Genė

2014-02-04

Depression is associated with a variety of diabetes complications, including diabetic retinopathy, nephropathy, neuropathy, and macrovascular complications. The prevalence of the symptoms of anxiety (32%) and depression (22.4%) in patients with diabetes is considerably higher than in general population samples (10%). The aim of this study was to evaluate the prevalence and determinants of anxiety and depression symptoms in patients with type 2 diabetes (T2DM). This survey was conducted during 2007-2010. In total, 1500 patients were invited to participate in the study. The Hospital Anxiety and Depression Scale (HADS) was used to measure depression and anxiety for the evaluation of the depressive state and anxiety. Statistical analysis was carried out using SPSS 17.0. More than 70% of all respondents who participated in the study had diabetes mellitus complications (72.2%). The prevalence of mild to severe depression score was 28.5% (95% CI 25.7-31.4). The prevalence of anxiety was 42.4% (95% CI 39.3-45.5). Anxiety was more frequent among females (46.8%) than among males (34.7%) (p<0.001). A significant negative trend was observed between prevalence of anxiety and depression, and age and education (p for trend <0.001). A significant association between depression and diabetic complications was identified (p<0.05). Duration of diabetes was a risk factor significantly associated with higher scores of anxiety among the patients with T2DM.

[Treatment of a patient with type-2 diabetes mellitus and a depressive disorder].

PubMed

Köhler, B; Kruse, J

2014-03-01

A 65-year-old man with type 2 diabetes mellitus and unfavorable metabolic values in combination with obesity and arterial hypertension and considerable psychosocial strains presented at a psychosomatic outpatient clinic. During the course of diagnostic sessions a problematic illness behavior as well as a depressive symptomatology that had developed after the death of his wife a few years earlier became apparent. DIAGNOSIS, THERAPY, COURSE: An avoidant illness behavior and a moderate depressive episode were diagnosed. Within a low threshold psychosomatic intervention an understanding of illness could be established and psychosocial barriers of diabetes therapy were reduced. The patient was able to outline achievable goals of his diabetes treatment and began their successful implementation. Within a stepped-care approach the patient could also be motivated for an inpatient psychosomatic treatment. During the course of treatment the patient experienced a remission from his depressive symptomatology and a notable improvement of metabolic values. With the help of a close cooperation between diabetes specific and psychotherapeutic treatment in psychosomatic outpatient clinics, patients with high blood glucose levels and comorbid depression can be enabled to gain a better understanding of their illness behavior and change it in their favor. © Georg Thieme Verlag KG Stuttgart · New York.

Physical activity, social network type, and depressive symptoms in late life: an analysis of data from the National Social Life, Health and Aging Project.

PubMed

Litwin, Howard

2012-01-01

To clarify whether physical activity among older Americans is associated with depressive symptoms, beyond the effects of social network type, physical health, and sociodemographic characteristics. The analysis used data from a sub-sample, aged 65–85, from the National Social Life, Health and Aging Project (N=1349). Hierarchical regressions examined the respective effects of selected network types and extent of engagement in physical activity on depressive symptoms, controlling for physical health and sociodemographic background. The findings showed that physical activity was correlated inversely with late life depressive symptoms. However, when interaction terms for the selected social network types and the extent of physical activity were also considered, the main effect of social network on depressive symptoms increased, while that of physical activity was eliminated. The results show that older American adults embedded in family network types are at risk of limited physical activity. However, interventions aimed to increase their engagement in physical activity might help to reduce depressive symptoms within this group.

[Development and clinical application of a new type of anatomical locking plate for sternoclavicular joint fracture and dislocation].

PubMed

Sun, Yuanlin; Yang, Yunkang; Ge, Jianhua; Yang, Kun; Xiang, Feifan; Zhou, Ju; Liang, Jie

2018-03-01

To report a new type of anatomical locking plate for sternocalvicular joint, and investigate its effectiveness in treatment of sternoclavicular joint fracture and dislocation. A new type of anatomical locking plate for sternoclavicular joint was developed, which accorded with the anatomical features and biomechanical characteristics of Chinese sternoclavicular joint. By adopting the method of clinical randomized controlled study, 32 patients with the sternoclavicular joint fracture and dislocation who met the selection criteria between June 2008 and May 2015 were randomly divided into groups A and B ( n =16), and the patients were treated with new anatomic locking plate and distal radial T locking plate internal fixation, respectively. There was no significant difference between 2 groups in gender, age, injured side, body mass index, cause of injury, type of injury, the time from injury to operation, and preoperative Rockwood grading score ( P >0.05). The operation time, intraoperative blood loss, incision length, hospitalization time, and postoperative complications in 2 groups were recorded, and the effectiveness was evaluated by Rockwood grading score. The operations of 2 groups completed successfully. The operation time, intraoperative blood loss, and hospitalization time in group A were significantly less than those in group B ( P <0.05), but there was no significant difference in the incision length between 2 groups ( t =0.672, P =0.507). All the patients were followed up 18-30 months (mean, 24 months). In group A, there were 1 case of sternoclavicular joint pain and 2 cases of wound infection; in group B, there were 1 case of sternoclavicular joint pain, 1 case of internal fixation loosening, and 1 case of sternoclavicular joint re-dislocation; there was no significant difference in complication incidence between 2 groups ( P =1.000). The Rockwood grading scores at each time point after operation in 2 groups were significantly higher than those before

Periprosthetic joint infection: are patients with multiple prosthetic joints at risk?

PubMed

Jafari, S Mehdi; Casper, David S; Restrepo, Camilo; Zmistowski, Benjamin; Parvizi, Javad; Sharkey, Peter F

2012-06-01

Patients who present with a periprosthetic joint infection in a single joint may have multiple prosthetic joints. The risk of these patients developing a subsequent infection in another prosthetic joint is unknown. Our purposes were (1) to identify the risk of developing a subsequent infection in another prosthetic joint and (2) to describe the time span and organism profile to the second prosthetic infection. We retrospectively identified 55 patients with periprosthetic joint infection who had another prosthetic joint in place at the time of presentation. Of the 55 patients, 11 (20%) developed a periprosthetic joint infection in a second joint. The type of organism was the same as the first infection in 4 (36%) of 11 patients. The time to developing a second infection averaged 2.0 years (range, 0-6.9 years). Copyright © 2012 Elsevier Inc. All rights reserved.

Joint design of QC-LDPC codes for coded cooperation system with joint iterative decoding

NASA Astrophysics Data System (ADS)

Zhang, Shunwai; Yang, Fengfan; Tang, Lei; Ejaz, Saqib; Luo, Lin; Maharaj, B. T.

2016-03-01

In this paper, we investigate joint design of quasi-cyclic low-density-parity-check (QC-LDPC) codes for coded cooperation system with joint iterative decoding in the destination. First, QC-LDPC codes based on the base matrix and exponent matrix are introduced, and then we describe two types of girth-4 cycles in QC-LDPC codes employed by the source and relay. In the equivalent parity-check matrix corresponding to the jointly designed QC-LDPC codes employed by the source and relay, all girth-4 cycles including both type I and type II are cancelled. Theoretical analysis and numerical simulations show that the jointly designed QC-LDPC coded cooperation well combines cooperation gain and channel coding gain, and outperforms the coded non-cooperation under the same conditions. Furthermore, the bit error rate performance of the coded cooperation employing jointly designed QC-LDPC codes is better than those of random LDPC codes and separately designed QC-LDPC codes over AWGN channels.

Association of N-Terminal Pro-Brain Natriuretic Peptide with Cognitive Function and Depression in Elderly People with Type 2 Diabetes

PubMed Central

Feinkohl, Insa; Sattar, Naveed; Welsh, Paul; Reynolds, Rebecca M.; Deary, Ian J.; Strachan, Mark W. J.; Price, Jackie F.

2012-01-01

Background Type 2 diabetes mellitus is associated with risk of congestive heart failure (CHF), cognitive dysfunction and depression. CHF itself is linked both to poor cognition and depression. The ventricular N-terminal pro-brain natriuretic peptide (NT-proBNP) is a marker of CHF, suggesting potential as a marker for cognitive impairment and/or depression. This was tested in the Edinburgh Type 2 Diabetes Study (ET2DS). Methodology and Principal Findings Cross-sectional analysis of 1066 men and women aged 60–75 with type 2 diabetes. Results from seven neuropsychological tests were combined in a standardised general cognitive ability factor, ‘g’. A vocabulary-based test estimated pre-morbid cognitive ability. The Hospital Anxiety and Depression Scale (HADS) assessed possible depression. After adjustment for age and sex, raised plasma NT-proBNP was weakly associated with lower ‘g’ and higher depression scores (ß −0.09, 95% CI −0.13 to −0.03, p = 0.004 and ß 0.08, 95% CI 0.04 to 0.12, p<0.001, respectively). Comparing extreme quintiles of NT-proBNP, subjects in the highest quintile were more likely to have reduced cognitive ability (within the lowest tertile of ‘g’) and ‘possible’ depression (HADS depression ≥8) (OR 1.80; 95% CI: 1.20, 2.70; p = 0.005 and OR 2.18; 95% CI: 1.28, 3.71; p = 0.004, respectively). Associations persisted when pre-morbid ability was adjusted for, but as expected were no longer statistically significant following the adjustment for diabetes-related and vascular co-variates (β −0.02, 95% CI −0.07 to 0.03, p>0.05 for ‘g’; β 0.03, 95% CI −0.02 to 0.07, p>0.05 for depression scores). Conclusion Raised plasma NT-proBNP was weakly but statistically significantly associated with poorer cognitive function and depression. The prospective phases of the ET2DS will help determine whether or not NT-proBNP can be considered a risk marker for subsequent cognitive impairment and incident depression and

A descriptive and comparative study of the prevalence of depressive and anxiety disorders in low-income adults with type 2 diabetes and other chronic illnesses.

PubMed

Thomas, Janet; Jones, Glenn; Scarinci, Isabel; Brantley, Phillip

2003-08-01

To determine whether type 2 diabetes contributes to the presence of depressive and anxiety disorder diagnoses in low-income adults with hypertension, asthma, and/or arthritis. Using a cross-sectional design, this study administered a structured diagnostic interview to low-income primary care patients diagnosed with type 2 diabetes, hypertension, arthritis, and asthma, as well as to those with no chronic illness (n = 326), to determine the 12-month prevalence of depressive and anxiety disorders. A logistic regression (LR) model was used to assess whether a diagnosis of depression and/or anxiety was associated with type 2 diabetes after adjusting for known risk factors. A high prevalence rate of depressive and/or anxiety disorders was found in the total sample (29%) and in all three illness groups: type 2 diabetes (36%), other chronic illnesses (24%), and no chronic illness (31%). Using LR, a main effect was detected for illness group when age and education were controlled (chi(2) = 22.66, df 4, P = 0.000). Specifically, the odds of occurrence of a depressive and/or anxiety disorder in those with comorbid type 2 diabetes were twice that in the nondiabetic, chronically ill comparison group (odds ratio 2.26, 95% CI 1.28-4.01, P = 0.005). These results suggest a positive contribution of type 2 diabetes to increased rates of depressive and/or anxiety disorders in patients with hypertension, asthma, and/or arthritis and support prior research that type 2 diabetes may serve as an indicator of depression and anxiety in low-income adults treated in primary care clinics.

Neurodevelopmental attributes of joint hypermobility syndrome/Ehlers-Danlos syndrome, hypermobility type: Update and perspectives.

PubMed

Ghibellini, Giulia; Brancati, Francesco; Castori, Marco

2015-03-01

In the last decade, increasing attention has been devoted to the extra-articular and extra-cutaneous manifestations of joint hypermobility syndrome, also termed Ehlers-Danlos syndrome, hypermobility type (i.e., JHS/EDS-HT). Despite the fact that the current diagnostic criteria for both disorders remain focused on joint hypermobility, musculoskeletal pain and skin changes, medical practice and research have started investigating a wide spectrum of visceral, neurological and developmental complications, which represent major burdens for affected individuals. In particular, children with generalized joint hypermobility often present with various neurodevelopmental issues and can be referred for neurological consultation. It is common that investigations in these patients yield negative or inconsistent results, eventually leading to the exclusion of any structural neurological or muscle disorder. In the context of specialized clinics for connective tissue disorders, a clear relationship between generalized joint hypermobility and a characteristic neurodevelopmental profile affecting coordination is emerging. The clinical features of these patients tend to overlap with those of developmental coordination disorder and can be associated with learning and other disabilities. Physical and psychological consequences of these additional difficulties add to the chief manifestations of the pre-existing connective tissue disorder, affecting the well-being and development of children and their families. In this review, particular attention is devoted to the nature of the link between joint hypermobility, coordination difficulties and neurodevelopmental issues in children. Presumed pathogenesis and management issues are explored in order to attract more attention on this association and nurture future clinical research. © 2015 Wiley Periodicals, Inc.

Differential Autonomic Nervous System Reactivity in Depression and Anxiety During Stress Depending on Type of Stressor.

PubMed

Hu, Mandy X; Lamers, Femke; de Geus, Eco J C; Penninx, Brenda W J H

2016-06-01

It remains unclear whether depressive and anxiety disorders are associated with hyporeactivity or hyperreactivity of the autonomic nervous system (ANS) and whether deviant reactivity occurs in all types of stressors. This study compared ANS reactivity in people with current or remitted depression/anxiety with reactivity in healthy controls during two stress conditions. From the Netherlands Study of Depression and Anxiety, data of 804 individuals with current depression/anxiety, 913 individuals with remitted depression/anxiety, and 466 healthy controls (mean age = 44.1 years; 66.4% female) were available. Two conditions were used to evoke stress: a) an n-back task, a cognitively challenging stressor, and 2) a psychiatric interview, evoking personal-emotional stress related to the occurrence of symptoms of depression/anxiety. Indicators of ANS activity were heart rate (HR), root mean square of differences between successive interbeat intervals (RMSSD), respiratory sinus arrhythmia (RSA), and preejection period. As compared with controls, participants with psychopathology had significant hyporeactivity of HR (controls = 4.1 ± 4.2 beats/min; remitted = 3.5 ± 3.5 beats/min; current psychopathology = 3.1 ± 3.4 beats/min), RMSSD (controls = -6.2 ± 14.5 milliseconds; remitted = -5.4 ± 17.8 milliseconds; current psychopathology = -3.5 ± 15.4 milliseconds), and RSA (controls = -9.3 ± 17.0 milliseconds; remitted = -7.4 ± 16.5 milliseconds; current psychopathology = -6.9 ± 15.0 milliseconds) during the n-back task. In contrast, during the psychiatric interview, they showed significant hyperreactivity of HR (controls = 2.7 ± 3.4 beats/min; remitted = 3.5 ± 3.4 beats/min; current psychopathology = 4.0 ± 3.3 beats/min), RMSSD (controls = -3.4 ± 12.2 milliseconds; remitted = -4.1 ± 12.1 milliseconds; current psychopathology = -5.6 ± 11.8 milliseconds), and RSA (controls = -3.8 ± 8.1 milliseconds; remitted = -4.3 ± 7.9 milliseconds; current psychopathology = -5.0 �

Depressive symptoms and type 2 diabetes mellitus in rural appalachia: an 18-month follow-up study.

PubMed

de Groot, Mary; Doyle, Todd; Averyt, Jennifer; Risaliti, Carleen; Shubroo, Jay

2015-01-01

Despite high rates of diabetes and depression in rural areas, limited data exists to document patterns and predictors of depressive symptoms in rural patients with type 2 diabetes (T2DM). The purpose of this study was to assess the rates and predictors of co-morbid depressive symptoms over an 18-month period in a cohort of rural Appalachian adults with T2DM. N = 100 adult T2DM patients were recruited from family medicine and endocrinology practices located in the rural Appalachian counties of southeastern Ohio and West Virginia. Data were collected using a longitudinal observational survey design. The sample consisted of predominantly White (93%) females (62%) who were married (71%), completed high school or less (48%), and had a mean age of 60 years (SD 11). Mean BDI score was 14.0 (SD 12) with 27% scoring in the moderate/severe range for depressive symptoms. A majority of patients (77%) reported depressive symptoms, at both time points, with 88% of these reporting consistent depressive symptoms in the year prior to study follow-up. Patients with depressive symptoms at Time 1 and Time 2 did not differ from other groups in the number of treatment strategies or medications used. Predictors of depressive symptoms in this group were increased diabetes treatment complexity (OR = 2.3), lack of home ownership (OR = 11.4), and decreased satisfaction with antidepressant medications (OR = 2.0; χ(2) = 28.9, p < .0001). Rural T2DM patients reported high rates of repeated depressive symptoms without corresponding rates of depression treatment. These patients may benefit from close monitoring and ongoing adjustment of their treatment for depression and diabetes by primary care providers. © 2015, The Author(s).

DEPRESSIVE SYMPTOMS AND TYPE 2 DIABETES MELLITUS IN RURAL APPALACHIA: AN 18-MONTH FOLLOW-UP STUDY*

PubMed Central

de Groot, Mary; Doyle, Todd; Averyt, Jennifer; Risaliti, Carleen; Shubrook, Jay

2015-01-01

Objective Despite high rates of diabetes and depression in rural areas, limited data exists to document patterns and predictors of depressive symptoms in rural patients with type 2 diabetes (T2DM). The purpose of this study was to assess the rates and predictors of co-morbid depressive symptoms over an 18-month period in a cohort of rural Appalachian adults with T2DM. Methods N = 100 adult T2DM patients were recruited from family medicine and endocrinology practices located in the rural Appalachian counties of southeastern Ohio and West Virginia. Data were collected using a longitudinal observational survey design. Results The sample consisted of predominantly White (93%) females (62%) who were married (71%), completed high school or less (48%), and had a mean age of 60 years (SD 11). Mean BDI score was 14.0 (SD 12) with 27% scoring in the moderate/severe range for depressive symptoms. A majority of patients (77%) reported depressive symptoms, at both time points, with 88% of these reporting consistent depressive symptoms in the year prior to study follow-up. Patients with depressive symptoms at Time 1 and Time 2 did not differ from other groups in the number of treatment strategies or medications used. Predictors of depressive symptoms in this group were increased diabetes treatment complexity (OR = 2.3), lack of home ownership (OR = 11.4), and decreased satisfaction with antidepressant medications (OR = 2.0; χ2 = 28.9, p < .0001). Conclusions Rural T2DM patients reported high rates of repeated depressive symptoms without corresponding rates of depression treatment. These patients may benefit from close monitoring and ongoing adjustment of their treatment for depression and diabetes by primary care providers. PMID:25817523

The Relation Between Depressive Symptoms and Self-Care in Patients with Diabetes Mellitus Type 2 in Kosovo.

PubMed

Sopjani, Idriz; Vehapi, Shemsedin; Gorani, Daut; Imeri, Miradije; Vitoja, Sidita; Tahiri, Shqipe

2016-12-01

The depression is a significant problem in patients with diabetes. This research is the first of it's kind conducted in the Republic of Kosovo to determine the prevalence of depression diagnosed in people with diabetes mellitus type 2 (DMT2) and interrelation between depressive symptoms and behavior of diabetes self-care (glucose monitoring, exercise, diet, and self- health care). Research was conducted in the University Clinical Center of Kosovo (UCCK), in Pristine. The sample consisted of 200 individuals. Data collection was done through structured questionnaires. HANDS (Harvard Department of Psychiatry / National Depression Screening Day Scale) questionnaire was used to assess depressive symptoms and DSMQ (The Diabetes Self-Management Questionnaire) was used to assess self-care behavior. Data analysis was run through SSPS program, version 21. The results showed that the prevalence of depression in diabetic patients was 66.5% in Kosovo. Being a woman, a resident of rural areas or with low level of education, there were significant predictors and were associated with increased chance of developing the symptoms of major depression. Significant relations were found between major depression and physical activity (p<0.05). While between major depression and management of blood glucose level, dietary control and self health care, no significant correlation was found. This paper concluded the involvement of psychological aspect in health care plan for diabetics, in order to reduce the number of individuals affected by depression, to diagnose and to treat these individuals for a better quality of life.

Diabetes self-management, depressive symptoms, metabolic control and satisfaction with quality of life over time in Chinese youth with type 1 diabetes.

PubMed

Guo, Jia; Whittemore, Robin; Jeon, Sangchoon; Grey, Margaret; Zhou, Zhi-Guang; He, Guo-Ping; Luo, Zi-Qiang

2015-05-01

To describe the patterns of diabetes self-management, depressive symptoms, metabolic control and satisfaction with quality of life over time in a cohort of Chinese youth with type 1 diabetes and to determine the relationships between these variables over time. Nurses have an important role in facilitating optimal self-management and health outcomes in youth with type 1 diabetes. Only a few studies have focused on patterns of diabetes adaptation over time in youth with type 1 diabetes, especially in China. Understanding changes in diabetes self-management, depressive symptoms, metabolic control and satisfaction with quality of life can facilitate assessment and intervention. This is a multi-site longitudinal descriptive study. Data for this report were collected at baseline with 136 eligible Chinese youth and 86 of them were followed up for the second time, 6-12 months after baseline data collection. Instruments to measure diabetes self-management, depressive symptoms, metabolic control and satisfaction with quality of life were collected at two time points. The data were collected from July 2009-October 2010. Linear mixed model analysis was used to analyse the longitudinal data. Self-management decreased over time; however, depressive symptoms, metabolic control and satisfaction with quality of life did not change from baseline to 6-12 months in this sample of Chinese youth with type 1 diabetes. A decrease in diabetes self-management over time was associated with worse metabolic control, while an increase in depressive symptoms over time was associated with poorer quality of life satisfaction in this sample. Chinese youth faced difficulties with diabetes adaptation, especially with the deterioration of diabetes self-management. Improving self-management and decreasing depressive symptoms may enhance diabetes adaptation with respect to metabolic control and quality of life. The deterioration of diabetes self-management over time in youth with type 1 diabetes in

Pressure-induced depression of synaptic transmission in the cerebellar parallel fibre synapse involves suppression of presynaptic N-type Ca2+ channels.

PubMed

Etzion, Y; Grossman, Y

2000-11-01

High pressure induces CNS hyperexcitability while markedly depressing synaptic transmitter release. We studied the effect of pressure (up to 10.1 MPa) on the parallel fibre (PF) synaptic response in biplanar cerebellar slices of adult guinea pigs. Pressure mildly reduced the PF volley amplitude and to a greater extent depressed the excitatory field postsynaptic potential (fPSP). The depression of the PF volley was noted even at supramaximal stimulus intensities, indicating an effect of pressure on the amplitude of the action potential in each axon. Low concentrations of TTX mimicked the effects of pressure on the PF volley without affecting the fPSP. Application omega-conotoxin GVIA (omega-CgTx) reduced the synaptic efficacy by 34.3+/-2.7%. However, in the presence of omega-CgTx the synaptic depression at pressure was significantly reduced. Reduced Ca2+ entry by application of Cd2+ or low [Ca2+]o did not have a similar influence on the effects of pressure. Application of omega-AGA IVA, omega-AGA TK and Funnel-web spider toxin did not affect the synaptic response in concentrations that usually block P-type Ca2+ channels, whilst the N/P/Q-type blocker omega-conotoxin MVIIC reduced the response to 52.7+/-5.0% indicating the involvement of Q-type channels and R-type channels in the non-N-type fraction of Ca2+ entry. The results demonstrate that N-type Ca2+ channels play a crucial role in the induction of PF synaptic depression at pressure. This finding suggests a coherent mechanism for the induction of CNS hyperexcitability at pressure.

Depression: What We Know.

ERIC Educational Resources Information Center

Lobel, Brana; Hirschfeld, Robert M. A.

This booklet is concerned with the area of clinical depression. Questions about clinical depression are briefly answered in an overview section and are examined in greater detail in the five chapters that follow. In chapter 1, depression is defined and various types of depression are identified. The origins of depression are explored in the second…

Sociodemographic, clinical, and psychosocial factors associated with depression among type 2 diabetic outpatients in Black Lion General Specialized Hospital, Addis Ababa, Ethiopia: a cross-sectional study.

PubMed

Habtewold, Tesfa Dejenie; Alemu, Sisay Mulugeta; Haile, Yohannes Gebreegziabhere

2016-04-15

Depression is a common comorbidity among patients with type 2 diabetes. There are several reports supporting a bidirectional association between depression and type 2 diabetes. However, there is limited data from non-western countries. Therefore, the aim of this study was to assess the sociodemographic, clinical, and psychosocial factors associated with co-morbid depression among type 2 diabetic outpatients presenting to Black Lion General Specialized Hospital, Addis Ababa, Ethiopia. This institution based cross-sectional study design was conducted on a random sample of 276 type 2 diabetic outpatients. Type 2 diabetes patients were evaluated for depression by administering a validated nine-item Patient Health Questionnaire (PHQ-9). Risk factors for depression among type 2 diabetes patients were identified using multiple logistic regression analysis. In total, 264 study participants were interviewed with a response rate of 95.6%. The prevalence of depression was 44.7%. In the multivariate analysis, the statistically significant risk factors for depression were monthly family income ≤ 650 (p-value = 0.056; OR = 2.0; 95% CI = 1.01, 4.2), presence of ≥3 diabetic complications (p-value = 0.03; OR = 3.3; 95% CI = 1.1, 10.0), diabetic nephropathy (p-value = 0.01; OR = 2.9; 95% CI = 1.2, 6.7), negative life events (p-value = 0.01; OR = 2.4; 95% CI = 1.2, 4.5), and poor social support (p-value = 0.001; OR = 2.7; 95% CI = 1.5, 5.0). This study demonstrated that depression is a common co-morbid health problem with a prevalence rate of 44.7%. The presence of diabetic complications, low monthly family income, diabetic nephropathy, negative life event, and poor social support were the statistically significant risk factors associated with depression. We presume that the burden of mental health especially depression is high in the population with type 2 diabetes mellitus co-morbidity. Therefore, specific

[Severe depression : psychoanalysis].

PubMed

Bouvet de la Maisonneuve, O

2009-12-01

The indication for psychoanalysis in severe depression is not clear. And yet, demands for this type of intervention are increasing, despite the absence of any form of consensus on the subject. Freud considered depression as a failure of analytical efforts and, based on this observation, revised his theory, in particular to include the notions of narcissism and the death drive. Many analysts have been reluctant to follow his teachings on this last point and provide depressed patients with analytical-type therapies aimed at restoring narcissism. Melanie Klein pushed Freud's ideas about depression even further and brought such therapies back to the heart of analytical practice. Jacques Lacan took the debate to another level by proposing an overhaul of the principles on which analysis has been based. Today, while following certain precautionary rules, true psychoanalyses can be proposed to patients with severe depression, whether of the bipolar, recurring or even neurotic type that can reach this level of severity. Copyright 2009 L'Encéphale. Published by Elsevier Masson SAS.. All rights reserved.

Effects of a 6-days-a-week low protein diet regimen on depressive symptoms in young-old type 2 diabetic patients.

PubMed

Ciarambino, Tiziana; Ferrara, Nicoletta; Castellino, Pietro; Paolisso, Giuseppe; Coppola, Ludovico; Giordano, Mauro

2011-01-01

Late-life depression is one of the main health problems among elderly diabetic subjects. In addition, depression is a common psychopathological condition among renal failure patients and most of these patients follow a low protein diet regimen (LPD). However, the effects of LPD on depressive symptoms are unclear. In the present study, the effects of LPD regimen on depressive symptoms in elderly type 2 diabetic subjects with renal failure were investigated. Fifty-two young-old type 2 diabetic patients with renal failure were enrolled in the study. All participants after normal protein diet regimen providing 1.2g/kg per d were instructed to consume either a LPD providing 0.8 g/kg per d, 7 d a wk (LPD 7/7), or a LPD providing 0.8 g/kg per d 6 d a wk (LPD 6/7) randomly. Mean 15-item Geriatric Depression Scale (GDS-15) (2.0±0.6) and Beck Depression Inventory (BDI) (4.1±1.0), during normal protein diet regimen, significantly increased to (6.7±1.6) and (12.2±1.4), respectively, after LPD 7/7 (P<0.05 versus normal protein diet). However, after LPD 6/7, mean GDS-15 and BDI significantly decreased to (4.4±1.5) and (6.7±1.6), respectively (P<0.05 versus LPD 7/7). LPD 6/7 regimen significantly decreased depressive symptoms in young-old type 2 diabetic patients. Copyright © 2011 Elsevier Inc. All rights reserved.

Shading aboveground L-joint and lap-joint tests : comparison of white pine and sugar maple test assemblies

Treesearch

Carol A. Clausen; Daniel L. Lindner

2011-01-01

Five-year performance ratings are presented for two types of untreated, uncoated wood joints (L and lap) in aboveground tests under shaded conditions. The effect of shading on moisture entrapment in pine and maple L and lap joints was evaluated in a moderate decay zone (Madison, Wisconsin). Variations were observed between wood species, visual ratings, joint type,...

Financial difficulties but not other types of recent negative life events show strong interactions with 5-HTTLPR genotype in the development of depressive symptoms.

PubMed

Gonda, X; Eszlari, N; Kovacs, D; Anderson, I M; Deakin, J F W; Juhasz, G; Bagdy, G

2016-05-03

Several studies indicate that 5-HTTLPR mediates the effect of childhood adversity in the development of depression, while results are contradictory for recent negative life events. For childhood adversity the interaction with genotype is strongest for sexual abuse, but not for other types of childhood maltreatment; however, possible interactions with specific recent life events have not been investigated separately. The aim of our study was to investigate the effect of four distinct types of recent life events in the development of depressive symptoms in a large community sample. Interaction between different types of recent life events measured by the List of Threatening Experiences and the 5-HTTLPR genotype on current depression measured by the depression subscale and additional items of the Brief Symptom Inventory was investigated in 2588 subjects in Manchester and Budapest. Only a nominal interaction was found between life events overall and 5-HTTLPR on depression, which failed to survive correction for multiple testing. However, subcategorising life events into four categories showed a robust interaction between financial difficulties and the 5-HTTLPR genotype, and a weaker interaction in the case of illness/injury. No interaction effect for the other two life event categories was present. We investigated a general non-representative sample in a cross-sectional approach. Depressive symptoms and life event evaluations were self-reported. The 5-HTTLPR polymorphism showed a differential interaction pattern with different types of recent life events, with the strongest interaction effects of financial difficulties on depressive symptoms. This specificity of interaction with only particular types of life events may help to explain previous contradictory findings.

Pain in Parkinson's Disease: A Cross-Sectional Study of Its Prevalence, Types, and Relationship to Depression and Quality of Life.

PubMed

Valkovic, Peter; Minar, Michal; Singliarova, Helena; Harsany, Jan; Hanakova, Marta; Martinkova, Jana; Benetin, Jan

2015-01-01

Pain is an important and distressing symptom in Parkinson's disease (PD). Our aim was to determine the prevalence of pain, its various types and characteristics, as well as its impact on depression and quality of life (QoL) in patients with PD. How pain differs in early- and advanced-stage PD and male and female PD patients was of special interest. One hundred PD patients on dopaminergic medications had a neurological examination and participated in a structured interview on pain characteristics and completed standardized questionnaires. A total of 76% of the patients had pain. The following types of pain were present: musculoskeletal pain accounted for 41% of the total pain, dystonic pain for 17%, central neuropathic pain for 22%, radicular pain for 27%, and other pains (non-radicular low back pain, arthritic, and visceral pain) made up 24%. One type of pain affected 29% of all the subjects, two types 35%, three types 10%, and four types of pain were reported by 2%. All types of pain were more prevalent in advanced-stage PD subjects than in early-stage PD subjects, except for arthritic pain (subclassified under"other pain"). The frequency and intensity of actual, average, and worst experienced pain were significantly more severe in advanced-stage subjects. PD subjects with general pain and in advanced stages were more depressed and had poorer QoL. Depression correlated with worst pain in the last 24 hours and with pain periodicity (the worst depression score in patients with constant pain). QoL correlated with average pain in the last 7 days. Pain is a frequent problem in PD patients, and it worsens during the course of the disease.

Prevalence of mental disorders among depressed coronary patients with and without Type D personality. Results of the multi-center SPIRR-CAD trial.

PubMed

Lambertus, Frank; Herrmann-Lingen, Christoph; Fritzsche, Kurt; Hamacher, Stefanie; Hellmich, Martin; Jünger, Jana; Ladwig, Karl-Heinz; Michal, Matthias; Ronel, Joram; Schultz, Jobst-Hendrik; Vitinius, Frank; Weber, Cora; Albus, Christian

Type D personality, as with formal mental disorders, is linked to increased mortality in coronary heart disease (CHD). Our aim was to determine the prevalence of mental disorders among depressed CHD patients with and without Type D personality. Depressive symptoms (HADS, HAM-D), Type D personality (DS-14) and mental disorders based on DSM-IV (SCID I and II) were assessed. Results were calculated by Kruskal-Wallis tests, Fisher's exact tests and logistic regression analyses. 570 CHD patients were included (age 59.2±9.5years; male 78.9%, HADS-D depression 10.4±2.5; HAM-D 11.3±6.6; Type D 60.1%). 84.8% of patients with Type D personality and 79.3% of non-Type D patients suffered from at least one mental disorder (p=0.092), while 41.8% of Type D positives and 27.8% of Type D negatives had at least two mental disorders (p=0.001). Patients with Type D personality significantly more often had social phobia [odds ratio (95% confidence interval): 3.79 (1.1 to 13.12); p=0.035], dysthymia [1.78 (1.12 to 2.84); p=0.015], compulsive [2.25 (1.04 to 4.86); p=0.038] or avoidant [8.95 (2.08 to 38.49); p=0.003] personality disorder. Type D personality among depressed CHD patients is associated with more complex and enduring mental disorders. This implies higher treatment demands. ISRCTN 76240576; NCT00705965. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Effects of Twenty-four Move Shadow Boxing Combined with psychosomatic relaxation on Depression and Anxiety in Patients with Type-2 Diabetes.

PubMed

Zheng, Yingying; Zhou, Yiyi; Lai, Qiujia

2015-06-01

The aim of the current study was to observe the effects of Twenty-four Move Shadow Boxing combined with psychosomatic relaxation on depression and anxiety in patients with Type-2 Diabetes. One hundred and twenty (120) patients with Type-2 Diabetes and depressive/anxious symptoms were divided into intervention group (60 cases) and control group (60 cases) according to the minimum distribution principle of unbalanced indicators. Twenty-four Move Shadow Boxing group used this intervention combined with psychosomatic relaxation. Control group underwent conventional treatment. All the patients in the two groups completed the Self-rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) before and after treatment. Among the 52 people included in the statistical analysis, the recovery rate was 13.3%. The differences between depression and anxiety scores in the intervention group before and after treatment were statistically significant (P<0.001), whereas these differences were non-significant in the control group (P=0.123). After the treatment, the glycated hemoglobin reduction in the intervention group was greater than that of the control group (t=2.438, P=0.016). The combination of Twenty-four Move Shadow Boxing and psychosomatic relaxation has a beneficial auxiliary therapeutic effect on depression and anxiety accompanying Type-2 Diabetes.

The Prevalence and Specificity of Depression Diagnosis in a Clinic-Based Population of Adults With Type 2 Diabetes Mellitus.

PubMed

Golden, Sherita Hill; Shah, Nina; Naqibuddin, Mohammad; Payne, Jennifer L; Hill-Briggs, Felicia; Wand, Gary S; Wang, Nae-Yuh; Langan, Susan; Lyketsos, Constantine

To estimate the crude prevalence of minor depressive disorder (MinD) in a clinic-based population of adults with type 2 diabetes. We screened a clinical sample of 702 adults with type 2 diabetes for depressive symptoms using the Patient Health Questionnaire-2 and performed a structured diagnostic psychiatric interview on 52 screen-positive and a convenience sample of 51 screen-negative individuals. Depressive disorder diagnoses were made using Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) Text Revised criteria and categorized as MinD, major depressive disorder (MDD), or no depressive disorder. We estimated prevalence of MinD and MDD and derived 95% CIs. The crude prevalence of current, past, and current or past MinD was 4.3% (95% CI: 0.9-9.2%), 9.6% (95% CI: 3.9-15.9%), and 13.9% (95% CI: 7.7-21.2%), respectively. The crude prevalence of current, past, and current or past MDD was slightly higher-5.0% (95% CI: 1.9-9.4%), 12.0% (95% CI: 6.1-19.5%), and 17.0% (95% CI: 10.1-24.8%), respectively. There was a high prevalence of coexisting anxiety disorders in individuals with MinD (42.2%) and MDD (8.1%). Hemoglobin A1c levels were not significantly different in individuals with MinD or MDD compared to those without a depressive disorder. MinD is comparably prevalent to MDD in patients with type 2 diabetes; both disorders are associated with concomitant anxiety disorders. MinD is not included in the DSM-5; however, our data support continuing to examine patients with chronic medical conditions for MinD. Copyright © 2017 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

The Prevalence and Specificity of Depression Diagnosis in a Clinic-Based Population of Adults With Type 2 Diabetes Mellitus

PubMed Central

Golden, Sherita Hill; Shah, Nina; Naqibuddin, Mohammad; Payne, Jennifer L.; Hill-Briggs, Felicia; Wand, Gary S.; Wang, Nae-Yuh; Langan, Susan; Lyketsos, Constantine

2018-01-01

Objective To estimate the crude prevalence of minor depressive disorder (MinD) in a clinic-based population of adults with type 2 diabetes. Methods We screened a clinical sample of 702 adults with type 2 diabetes for depressive symptoms using the Patient Health Questionnaire-2 and performed a structured diagnostic psychiatric interview on 52 screen-positive and a convenience sample of 51 screen-negative individuals. Depressive disorder diagnoses were made using Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) Text Revised criteria and categorized as MinD, major depressive disorder (MDD), or no depressive disorder. We estimated prevalence of MinD and MDD and derived 95% CIs. Results The crude prevalence of current, past, and current or past MinD was 4.3% (95% CI: 0.9–9.2%), 9.6% (95% CI: 3.9–15.9%), and 13.9% (95% CI: 7.7–21.2%), respectively. The crude prevalence of current, past, and current or past MDD was slightly higher—5.0% (95% CI: 1.9–9.4%), 12.0% (95% CI: 6.1–19.5%), and 17.0% (95% CI: 10.1–24.8%), respectively. There was a high prevalence of coexisting anxiety disorders in individuals with MinD (42.2%) and MDD (8.1%). Hemoglobin A1c levels were not significantly different in individuals with MinD or MDD compared to those without a depressive disorder. Conclusions MinD is comparably prevalent to MDD in patients with type 2 diabetes; both disorders are associated with concomitant anxiety disorders. MinD is not included in the DSM-5; however, our data support continuing to examine patients with chronic medical conditions for MinD. PMID:27692654

[Depressive symptoms and type 2 diabetes mellitus in outpatients of an Armed Forces hospital in Lima, Peru, 2012: a cross-sectional study].

PubMed

Urrutia-Aliano, Débora; Segura, Eddy R

2016-04-29

Patients with type 2 diabetes mellitus (DB2) are more prone to poor quality of life, disability and even death. They also have a greater predisposition to depression compared with non-diabetic patients; as well as a favorable prognosis after mental health-oriented interventions. The aim of this study was to explore the presence of depressive symptoms in an outpatient population diagnosed with DB2 and military affiliation. Also, to examine the factors associated with the presence of depressive symptoms. We performed a cross sectional study in 108 people with type 2 diabetes mellitus in January 2012 in an outpatient sample of a military hospital. Depressive symptoms were assessed with Zung’s self-administered test. We used the chi-square test or Fisher's exact test to examine associations between depressive symptoms and factors of interest. We use crude and adjusted generalized linear models to estimate prevalence ratios (PRs) for association between clinical and sociodemographic characteristics with the presence of depressive symptoms. The prevalence of depressive symptoms was 56.5% (95% CI: 46.6 to 66.0%). The bivariate analysis showed significant association between depressive symptoms and variables: sex, age and clinical complications of diabetes. Adjusted analysis showed that diabetic retinopathy [RP: 1.3; 95% CI: 1.1-1.7], and diabetic neuropathy [RP: 1.4; 95% CI: 1.1-1.7] were associated with a greater presence of depressive symptoms after taking into account sex of participants. We observed a high prevalence of depressive symptoms in the study population, especially in female or elderly patients. This was also true among subjects with late complications of type 2 diabetes mellitus that likely represent the impact of the disease on quality of life and its ultimate effect being manifested as depressive symptoms. A multidisciplinary approach focusing on mental health-oriented aspects should be considered, as it could benefit the evolution of these patients in

Endothelial dysfunction and history of recurrent depression in postmenopausal women with Type 2 diabetes: a case-control study.

PubMed

Wagner, Julie; Tennen, Howard; Mansoor, George; Abbott, Gina

2009-01-01

This study of postmenopausal women with Type 2 diabetes mellitus (T2DM) investigated (1) history of depression as a predictor of endothelium-dependent flow-mediated dilation (FMD); (2) the relative associations of single and recurrent depressive disorders with FMD; and (3) cortisol as a potential mechanism. Participants were nonsmoking, naturally postmenopausal women with T2DM with no known vascular disease. All were free of current mood disorder. On average, the 44 participants were 63 years of age, White, diabetic for 6 years, and were in adequate glycemic control. Thirty-eight percent were never depressed, 19% had experienced one disorder, and 43% had experienced recurrent disorders. History of depression was assessed with Structured Clinical Interview for Diagnostic and Statistical Manual-IV. Current depressive symptoms were measured with Center for Epidemiological Studies Depression (CESD) scale. FMD was assessed by standard procedures and calculated as percent change in brachial artery diameter from baseline. Women with history of recurrent depression showed vasoconstriction (mean=-1%), which was significantly different from women with history of single depression (mean=+6) and never depressed women (mean=+5) (P<.05), both of whom showed similar levels of vasodilation. In logistic regression controlling for hypertension, duration of diabetes, and glycemic control, history of recurrent depressive disorders predicted greater likelihood of vasoconstriction (P<.05, odds ratio=4.23) but history of single depressive disorder did not. Controlling for current depressive symptoms did not account for effects of past recurrent depressive disorders. Cortisol was not related to FMD. In postmenopausal women with T2DM, recurrent depressive disorders, even in full remission, are associated with endothelial dysfunction. Potential mechanisms of the relationship between depression and endothelial dysfunction other than cortisol warrant investigation.

A retrospective comparative study of arthroscopic fixation in acute Rockwood type IV acromioclavicular joint dislocation: single versus double paired Endobutton technique.

PubMed

Xu, Jian; Liu, Haifeng; Lu, Wei; Li, Dingfu; Zhu, Weimin; Ouyang, Kan; Wu, Bing; Peng, Liangquan; Wang, Daping

2018-05-24

Rockwood type IV acromioclavicular joint (ACJ) dislocation is a trauma usually needs surgical treatment. Paired EndoButton technique (PET) is used in treating such condition. However, the effect of using different types of PET (single versus double PET) for fixation remains controversial. This study aims to evaluate and compare the efficacy of single and double PET and to provide a suitable option for the surgeons. We retrospectively reviewed the charts of patients with acute Rockwood type IV ACJ dislocation who had undergone arthroscopic fixation using single or double PET fixation between March 2009 and March 2015. Seventy-eight consecutive patients identified from chart review were picked and were divided into the single and double PET group with 39 cases in each group. The indexes of visual analog scale score (VAS) for pain, the radiographs of the affected shoulder at different time points of the follow-up, the time of return to activities and sports, the constant functional score, and the Karlsson acromioclavicular joint (ACJ) score, were assessed in a minimum of 2 years postoperation. The average coracoclavicular (CC) and acromioclavicular (AC) distances of the affected joints in the double PET group were significantly smaller than those of the single PET group 2 years postoperation (P < 0.05). The average AC and CC distances in the healthy shoulder joints were significantly smaller than those of the affected joints in the single PET group (P < 0.05); however, these values were not significantly different from those of the affected joints in the double PET group (P > 0.05). The mean VAS pain score was not significantly different, while significant difference was found for the number and times of cases return to activities and sports, constant functional score, and Karlsson ACJ score (P < 0.05) between the two groups. Therefore, the double PET group has better outcome than the single PET group. Complications including redislocation, button

Cognitive behavior therapy for comorbid migraine and/or tension-type headache and major depressive disorder: An exploratory randomized controlled trial.

PubMed

Martin, Paul R; Aiello, Rachele; Gilson, Kathryn; Meadows, Graham; Milgrom, Jeannette; Reece, John

2015-10-01

Numerous studies have demonstrated comorbidity between migraine and tension-type headache on the one hand, and depression on the other. Presence of depression is a negative prognostic indicator for behavioral treatment of headaches. Despite the recognised comorbidity, there is a limited research literature evaluating interventions designed for comorbid headaches and depression. Sixty six participants (49 female, 17 male) suffering from migraine and/or tension-type headache and major depressive disorder were randomly allocated to a Routine Primary Care control group or a Cognitive Behavior Therapy group that also received routine primary care. The treatment program involved 12 weekly 50-min sessions administered by clinical psychologists. Participants in the treatment group improved significantly more than participants in the control group from pre-to post-treatment on measures of headaches, depression, anxiety, and quality of life. Improvements achieved with treatment were maintained at four month follow-up. Comorbid anxiety disorders were not a predictor of response to treatment, and the only significant predictor was gender (men improved more than women). The new integrated treatment program appears promising and worthy of further investigation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Deterministic Joint Remote Preparation of an Arbitrary Sevenqubit Cluster-type State

NASA Astrophysics Data System (ADS)

Ding, MengXiao; Jiang, Min

2017-06-01

In this paper, we propose a scheme for joint remotely preparing an arbitrary seven-qubit cluster-type state by using several GHZ entangled states as the quantum channel. The coefficients of the prepared states can be not only real, but also complex. Firstly, Alice performs a three-qubit projective measurement according to the amplitude coefficients of the target state, and then Bob carries out another three-qubit projective measurement based on its phase coefficients. Next, one three-qubit state containing all information of the target state is prepared with suitable operation. Finally, the target seven-qubit cluster-type state can be prepared by introducing four auxiliary qubits and performing appropriate local unitary operations based on the prepared three-qubit state in a deterministic way. The receiver's all recovery operations are summarized into a concise formula. Furthermore, it's worth noting that our scheme is more novel and feasible with the present technologies than most other previous schemes.

Symptoms of Eating Disorders and Depression in Emerging Adults with Early-Onset, Long-Duration Type 1 Diabetes and Their Association with Metabolic Control

PubMed Central

Bächle, Christina; Lange, Karin; Stahl-Pehe, Anna; Castillo, Katty; Scheuing, Nicole; Holl, Reinhard W.; Giani, Guido; Rosenbauer, Joachim

2015-01-01

Background This study analyzed the prevalence of and association between symptoms of eating disorders and depression in female and male emerging adults with early-onset, long-duration type 1 diabetes and investigated how these symptoms are associated with metabolic control. Methods In a nationwide population-based survey, 211 type 1 diabetes patients aged 18-21 years completed standardized questionnaires, including the SCOFF questionnaire for eating disorder symptoms and the Patient Health Questionnaire (PHQ-9) for symptoms of depression and severity of depressive symptoms (PHQ-9 score). Multiple linear and logistic regression models were used to analyze the association between eating disorder and depressive symptoms and their associations with HbA1c. Results A total of 30.2% of the women and 9.5% of the men were screening positive for eating disorders. The mean PHQ-9 score (standard deviation) was 5.3 (4.4) among women and 3.9 (3.6) among men. Screening positive for an eating disorder was associated with more severe depressive symptoms among women (βwomen 3.8, p<0.001). However, neither eating disorder symptoms nor severity of depressive symptoms were associated with HbA1c among women, while HbA1c increased with the severity of depressive symptoms among men (βmen 0.14, p=0.006). Conclusions Because of the high prevalence of eating disorder and depressive symptoms, their interrelationship, and their associations with metabolic control, particularly among men, regular mental health screening is recommended for young adults with type 1 diabetes. PMID:26121155

Symptoms of Eating Disorders and Depression in Emerging Adults with Early-Onset, Long-Duration Type 1 Diabetes and Their Association with Metabolic Control.

PubMed

Bächle, Christina; Lange, Karin; Stahl-Pehe, Anna; Castillo, Katty; Scheuing, Nicole; Holl, Reinhard W; Giani, Guido; Rosenbauer, Joachim

2015-01-01

This study analyzed the prevalence of and association between symptoms of eating disorders and depression in female and male emerging adults with early-onset, long-duration type 1 diabetes and investigated how these symptoms are associated with metabolic control. In a nationwide population-based survey, 211 type 1 diabetes patients aged 18-21 years completed standardized questionnaires, including the SCOFF questionnaire for eating disorder symptoms and the Patient Health Questionnaire (PHQ-9) for symptoms of depression and severity of depressive symptoms (PHQ-9 score). Multiple linear and logistic regression models were used to analyze the association between eating disorder and depressive symptoms and their associations with HbA1c. A total of 30.2% of the women and 9.5% of the men were screening positive for eating disorders. The mean PHQ-9 score (standard deviation) was 5.3 (4.4) among women and 3.9 (3.6) among men. Screening positive for an eating disorder was associated with more severe depressive symptoms among women (βwomen 3.8, p<0.001). However, neither eating disorder symptoms nor severity of depressive symptoms were associated with HbA1c among women, while HbA1c increased with the severity of depressive symptoms among men (βmen 0.14, p=0.006). Because of the high prevalence of eating disorder and depressive symptoms, their interrelationship, and their associations with metabolic control, particularly among men, regular mental health screening is recommended for young adults with type 1 diabetes.

Difficulty eating and significant weight loss in joint hypermobility syndrome/Ehlers-Danlos syndrome, hypermobility type.

PubMed

Baeza-Velasco, Carolina; Van den Bossche, Thomas; Grossin, Daniel; Hamonet, Claude

2016-06-01

Joint Hypermobility Syndrome, also known as Ehlers-Danlos Syndrome Hypermobility Type (JHS/EDS-HT), is a heritable disorder of connective tissue, common but poorly known by the medical community. Although generalized joint hypermobility and fragility of tissues have been described as core features, recent research highlights the multisystemic nature of JHS/EDS-HT, which presents with a wide range of articular and extra-articular symptoms. Among these, gastrointestinal problems, temporomandibular disorders, and smell and taste abnormalities are common among those affected, having significant implications for eating. The present work reviews the literature linking JHS/EDS-HT and eating problems. Two illustrative case reports, in which JHS/EDS-HT manifestations contribute to developing and maintaining disturbed eating behaviors and significant weight loss, are presented.

Synovial deposition of wild-type transthyretin-derived amyloid in knee joint osteoarthritis patients.

PubMed

Takanashi, Tetsuo; Matsuda, Masayuki; Yazaki, Masahide; Yamazaki, Hideshi; Nawata, Masashi; Katagiri, Yoshiki; Ikeda, Shu-Ichi

2013-09-01

To investigate histological features of deposited amyloid in the synovial tissue and its clinical significance in knee joint osteoarthritis (OA) patients. We prospectively enrolled 232 consecutive patients who underwent arthroplasty or total replacement of the knee joint for treatment of OA. Congo red staining and immunohistochemistry were performed in the synovial tissue obtained at surgery. When transthyretin (TTR)-derived amyloid was positive, we analyzed all 4 exons of the TTR gene using the direct DNA sequencing method in order to detect mutations. We analyzed 322 specimens in this study. Twenty-six specimens (8.1%) obtained from 21 patients (5 men and 16 women; mean, 79.0 ± 4.6 years) showed deposition of amyloid, which was positively stained with the anti-TTR antibody. Eighteen patients showed inhomogeneous accumulations of amyloid in the loose connective tissue under the synovial epithelia sometimes with nodule formation, while in the remaining three, small vessels in the adipose tissue were involved. Medical records of these patients revealed nothing remarkable in the clinical course, laboratory data or macroscopic intraarticular findings at surgery. No mutations were detectable in the TTR gene analysis. Wild-type TTR-derived amyloid may affect the synovial tissue as a result of long-term mechanical stress or as a part of senile systemic amyloidosis in approximately 8% of knee joint OA patients. No obvious clinical significance was found in synovial deposition of amyloid.

Ethnic differences in the relationship between depressive symptoms and health-related quality of life in people with type 2 diabetes.

PubMed

Kaholokula, Joseph Keawe'aimoku; Haynes, Stephen N; Grandinetti, Andrew; Chang, Healani K

2006-02-01

To examine ethnic differences in the relationship between depressive symptoms and specific aspects of heath-related quality of life in people with type 2 diabetes. Cross-sectional data from 190 people with type 2 diabetes of Native Hawaiian (50%), Filipino (16%), Japanese (18%), and mixed-ethnic (16%) ancestries from the rural community of North Kōhala, Hawai'i were examined in this study. Depressive symptoms were measured with the Center for Epidemiological Studies-Depression (CES-D) scale. Health-related quality of life was measured with the Short Form-36 Health Survey (SF-36). Eight health-related quality of life constructs were examined: Physical Functioning, Role-Physical Functioning, Role-Emotional Functioning, Social Functioning, Bodily Pain, Vitality, General Health, and Health Transition. Hierarchical regression analyses of the interaction between ethnicity and the SF-36 subscales of Physical Functioning, Role-Emotional Functioning, Bodily Pain, Vitality, and General Health indicated statistically significant associations with CES-D scores after controlling for sociodemographic factors, glycemic status, and social support. Ethnicity moderated the relationship between depressive symptoms and the health-related quality of life aspects of physical and role-emotional functioning, bodily pain, vitality, and general health perception in people with type 2 diabetes. This relationship was strongest for Filipinos followed by Native Hawaiians and people of mixed-ethnic ancestries.

Cobalamin status and its relation with depression, cognition and neuropathy in patients with type 2 diabetes mellitus using metformin.

PubMed

Biemans, Elke; Hart, Huberta E; Rutten, Guy E H M; Cuellar Renteria, Viviana G; Kooijman-Buiting, Antoinette M J; Beulens, Joline W J

2015-04-01

To investigate the associations of vitamin B12 (cobalamin and holotranscobalamin) status with depression, cognition and neuropathy in patients with type 2 diabetes using metformin. In an observational study, among 550 type 2 diabetes patients using metformin, cobalamin and holotranscobalamin (holoTCII) levels were measured at the annual diabetes checkup, and deficiencies were defined as <148 and <21 pmol/L, respectively. Depression and cognitive function were assessed with corresponding International Classification of Primary Care codes and questionnaires; neuropathy with medical record data and a questionnaire. Confounding variables were retrieved from medical records. Multivariable logistic and linear regressions were used with cobalamin status as independent variable; depression, cognition and neuropathy as dependent variables. The mean duration of diabetes was 8.4 years (±5.8); mean duration of metformin use was 64.1 months (±43.2), with a mean metformin dose of 1,306 mg/day. A sufficient cobalamin level was independently associated with a decreased risk of depression (OR 0.42; 95 % CI 0.23-0.78) and better cognitive performance (β = 1.79; 95 % CI 0.07-3.52) adjusted for confounders. This indicates that cobalamin-deficient patients had a 2.4 times higher chance of depression and a 1.79 point lower cognitive performance score. HoloTCII was not associated with any outcome. Cobalamin deficiency was associated with an increased risk of depression and worse cognitive performance, while holoTCII was not. Screening for cobalamin deficiency may be warranted in diabetes patients using metformin. Physicians should consider a cobalamin deficiency in diabetes patients using metformin with a depression or cognitive decline.

Factors related to quality of life for patients with type 2 diabetes with or without depressive symptoms - results from a community-based study in China.

PubMed

Liu, Yu; Maier, Manfred; Hao, Yufang; Chen, Yan; Qin, Yuelan; Huo, Ran

2013-01-01

To explore the factors related to quality of life for patients with type 2 diabetes with or without depressive symptoms in China. In patients with type 2 diabetes with or without depressive symptoms, different factors such as gender, social context or regional setting may affect their quality of life. This was a cross-sectional study. Of 791 registered patients with type 2 diabetes from four communities in Beijing, cluster sampling was used to recruit patients for participation. Self-rating depression scale was used to screen for depressive symptoms; demographic and clinical data were collected, and quality of life and social support were assessed using appropriate tools. The factors associated with quality of life were tested using multivariate linear regression. The prevalence of depressive symptoms in 667 patients with diabetes was 44·2%. Quality of life of patients with depressive symptoms was worse than that of patients without depressive symptoms, and this was associated negatively with history of diabetic complications, usage of hypoglycaemic agents or insulin and self-rating depression scale scores and positively with salary and subjective social support. The factors related to quality of life for patients with or without depressive symptoms are different. For patients with depressive symptoms, better salary and subjective social support are associated positively with their quality of life, while the presence of diabetic complications, a higher score for depressive symptoms and need for hypoglycaemic agents or insulin are negatively associated with quality of life. It is suggested that the nurse should screen depression for patients with diabetes, especially for those with diabetic complications or low social support. This should be done in the community regularly in order to find diabetic patients with depression in time. In addition, the results can provide a reference to clinical nursing care for patients with diabetes in hospitals. © 2012 Blackwell

Association between N-terminal proB-type Natriuretic Peptide and Depressive Symptoms in Patients with Acute Myocardial Infarction

PubMed Central

Ren, Yan; Jia, Jiao; Sa, Jian; Qiu, Li-Xia; Cui, Yue-Hua; Zhang, Yue-An; Yang, Hong; Liu, Gui-Fen

2017-01-01

Background: While depression and certain cardiac biomarkers are associated with acute myocardial infarction (AMI), the relationship between them remains largely unexplored. We examined the association between depressive symptoms and biomarkers in patients with AMI. Methods: We performed a cross-sectional study using data from 103 patients with AMI between March 2013 and September 2014. The levels of depression, N-terminal proB-type natriuretic peptide (NT-proBNP), and troponin I (TnI) were measured at baseline. The patients were divided into two groups: those with depressive symptoms and those without depressive symptoms according to Zung Self-rating Depression Scale (SDS) score. Baseline comparisons between two groups were made using Student's t-test for continuous variables, Chi-square or Fisher's exact test for categorical variables, and Wilcoxon test for variables in skewed distribution. Binomial logistic regression and multivariate linear regression were performed to assess the association between depressive symptoms and biomarkers while adjusting for demographic and clinical variables. Results: Patients with depressive symptoms had significantly higher NT-proBNP levels as compared to patients without depressive symptoms (1135.0 [131.5, 2474.0] vs. 384.0 [133.0, 990.0], Z = −2.470, P = 0.013). Depressive symptoms were associated with higher NT-proBNP levels (odds ratio [OR] = 2.348, 95% CI: 1.344 to 4.103, P = 0.003) and higher body mass index (OR = 1.169, 95% confidence interval [CI]: 1.016 to 1.345, P = 0.029). The total SDS score was associated with the NT-proBNP level (β = 0.327, 95% CI: 1.674 to 6.119, P = 0.001) after multivariable adjustment. In particular, NT-proBNP was associated with three of the depressive dimensions, including core depression (β = 0.299, 95% CI: 0.551 to 2.428, P = 0.002), cognitive depression (β = 0.320, 95% CI: 0.476 to 1.811, P = 0.001), and somatic depression (β = 0.333, 95% CI: 0.240 to 0.847, P = 0.001). Neither the

Do depression and anxiety reduce the likelihood of remission in rheumatoid arthritis and psoriatic arthritis? Data from the prospective multicentre NOR-DMARD study.

PubMed

Michelsen, Brigitte; Kristianslund, Eirik Klami; Sexton, Joseph; Hammer, Hilde Berner; Fagerli, Karen Minde; Lie, Elisabeth; Wierød, Ada; Kalstad, Synøve; Rødevand, Erik; Krøll, Frode; Haugeberg, Glenn; Kvien, Tore K

2017-11-01

To investigate the predictive value of baseline depression/anxiety on the likelihood of achieving joint remission in rheumatoid arthritis (RA) and psoriatic arthritis (PsA) as well as the associations between baseline depression/anxiety and the components of the remission criteria at follow-up. We included 1326 patients with RA and 728 patients with PsA from the prospective observational NOR-DMARD study starting first-time tumour necrosis factor inhibitors or methotrexate. The predictive value of depression/anxiety on remission was explored in prespecified logistic regression models and the associations between baseline depression/anxiety and the components of the remission criteria in prespecified multiple linear regression models. Baseline depression/anxiety according to EuroQoL-5D-3L, Short Form-36 (SF-36) Mental Health subscale ≤56 and SF-36 Mental Component Summary ≤38 negatively predicted 28-joint Disease Activity Score <2.6, Simplified Disease Activity Index ≤3.3, Clinical Disease Activity Index ≤2.8, ACR/EULAR Boolean and Disease Activity Index for Psoriatic Arthritis ≤4 remission after 3 and 6 months treatment in RA (p≤0.008) and partly in PsA (p from 0.001 to 0.73). Baseline depression/anxiety was associated with increased patient's and evaluator's global assessment, tender joint count and joint pain in RA at follow-up, but not with swollen joint count and acute phase reactants. Depression and anxiety may reduce likelihood of joint remission based on composite scores in RA and PsA and should be taken into account in individual patients when making a shared decision on a treatment target. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A Joint Model for Longitudinal Measurements and Survival Data in the Presence of Multiple Failure Types

PubMed Central

Elashoff, Robert M.; Li, Gang; Li, Ning

2009-01-01

Summary In this article we study a joint model for longitudinal measurements and competing risks survival data. Our joint model provides a flexible approach to handle possible nonignorable missing data in the longitudinal measurements due to dropout. It is also an extension of previous joint models with a single failure type, offering a possible way to model informatively censored events as a competing risk. Our model consists of a linear mixed effects submodel for the longitudinal outcome and a proportional cause-specific hazards frailty submodel (Prentice et al., 1978, Biometrics 34, 541-554) for the competing risks survival data, linked together by some latent random effects. We propose to obtain the maximum likelihood estimates of the parameters by an expectation maximization (EM) algorithm and estimate their standard errors using a profile likelihood method. The developed method works well in our simulation studies and is applied to a clinical trial for the scleroderma lung disease. PMID:18162112

Interaction between anxiety, depression, quality of life and clinical parameters in chronic tension-type headache.

PubMed

Peñacoba-Puente, Cecilia; Fernández-de-Las-Peñas, César; González-Gutierrez, Jose L; Miangolarra-Page, Juan C; Pareja, Juan A

2008-10-01

Our aim was to investigate the mediating or moderating role of anxiety and depression in the relationship between headache clinical parameters and quality of life in Chronic Tension-Type Headache (CTTH). Twenty-five patients diagnosed with CTTH according to the criteria of the International Headache Society were studied. A headache diary was kept for 4 weeks in order to substantiate the diagnosis and record the pain history. Quality of life was assessed by means of the Medical Outcome Study (MOS) 36-Item Short-Form (SF-36) questionnaire. The Beck Depression Inventory (BDI-II) was used to assess depression, and the Trait Anxiety Scale (TA) from the State-Trait Anxiety Inventory was administered in order to assess anxiety. Moderating and mediating analyses were conducted with ordinary least squares multiple regression analysis using the SPSS General Linear Model procedure. Anxiety mediated the effect between headache frequency and quality of life, but not the effect of either headache intensity or duration. Anxiety totally mediated the effects of headache frequency on vitality, social functioning and mental health. On the other hand, depression modulated the effect in the mental health domain. The effect in the mental health domain was a function of the interaction between headache duration and depression (beta=-0.34, p<0.05), after controlling for age, gender, the main effects of headache duration, and depression. We did not find anxiety to be a moderating factor between intensity, frequency or duration of headache and perceived quality of life. Anxiety exerts a mediating effect, conditioning the relationship between headache frequency and some quality of life domains; depression seems to play an inherent role in the reduced quality of life of these patients, that is, it has a moderating effect.

Reevaluating Antidepressant Selection in Patients With Bruxism and Temporomandibular Joint Disorder.

PubMed

Rajan, Royce; Sun, Ye-Ming

2017-05-01

Temporomandibular joint disorder (TMD) is a broad pain disorder that refers to several conditions affecting the temporomandibular joint of the jaw and the muscles of mastication. As with most pain disorders, a high prevalence of depression and anxiety is associated with TMD. Research has shown that selective serotonin reuptake inhibitors (SSRIs), the first-line drug therapy for major depressive disorder, may not be suitable for TMD patients because SSRIs can induce teeth-grinding, otherwise known as bruxism. This is problematic because bruxism is believed to further exacerbate TMD. Therefore, the purpose of this literature review is to better understand the mechanism of SSRI-induced bruxism, as well as discuss alternative antidepressant options for treating depression and anxiety in patients with bruxism and TMD. Alternative classes of antidepressants reviewed include serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, atypical antidepressants, and monoamine oxidase inhibitors. Findings indicate that dopamine agonists and buspirone are currently the most effective medications to treat the side effects of SSRI-induced bruxism, but results regarding the effectiveness of specific antidepressants that avoid bruxism altogether remain inconclusive.

Depressive Symptoms, Psychiatric Medication Use, and Risk of Type 2 Diabetes: Results from the Health and Retirement Study

PubMed Central

Ratliff, Scott; Mezuk, Briana

2015-01-01

Objective This prospective study investigates the relationships between depressive symptoms, psychiatric medication use, and their interaction on risk of developing type 2 diabetes. Method Data come from the 1998 – 2010 waves of the Health and Retirement Study, a U.S. nationally-representative cohort of adults aged 51 and older. Analysis is restricted to participants <65 who did not have diabetes in 1998 (N=8,704). Depressive symptoms were assessed using the 8-item Center for Epidemiologic Studies–Depression scale. Risk of diabetes over the 12-year follow-up period was assessed using Cox proportional hazard models with time-varying covariates. Results After adjusting for covariates, both depressive symptoms (hazard ratio [HR]: 1.06, 95% Confidence Interval [CI]: 1.02 – 1.09) and psychiatric medication use (HR: 1.57, 95% CI: 1.25 – 1.96) were associated with development of diabetes. The interaction between depressive symptoms and medication use was significant (beta = −0.240, p = .049), indicating that the association between elevated depressive symptoms and diabetes was higher among respondents not taking medications. The associations between depressive symptoms and medication use were also attenuated by increasing BMI. Conclusion Findings highlight the complex relationship between depressive symptoms and psychiatric medications on diabetes risk, and the need for a nuanced understanding of these factors. PMID:26094130

Mechanisms of force depression caused by different types of physical exercise studied by direct electrical stimulation of human quadriceps muscle.

PubMed

Skurvydas, Albertas; Mamkus, Gediminas; Kamandulis, Sigitas; Dudoniene, Vilma; Valanciene, Dovile; Westerblad, Håkan

2016-12-01

Force production frequently remains depressed for several hours or even days after various types of strenuous physical exercise. We hypothesized that the pattern of force changes during the first hour after exercise can be used to reveal muscular mechanisms likely to underlie the decline in muscle performance during exercise as well as factors involved in the triggering the prolonged force depression after exercise. Nine groups of recreationally active male volunteers performed one of the following types of exercise: single prolonged or repeated short maximum voluntary contractions (MVCs); single or repeated all-out cycling bouts; repeated drop jumps. The isometric force of the right quadriceps muscle was measured during stimulation with brief 20 and 100 Hz trains of electrical pulses given before and at regular intervals for 60 min after exercise. All exercises resulted in a prolonged force depression, which was more marked at 20 Hz than at 100 Hz. Short-lasting (≤2 min) MVC and all-out cycling exercises showed an initial force recovery (peak after ~ 5 min) followed by a secondary force depression. The repeated drop jumps, which involve eccentric contractions, resulted in a stable force depression with the 20 Hz force being markedly more decreased after 100 than 10 jumps. In accordance with our hypothesis, the results propose at least three different mechanisms that influence force production after exercise: (1) a transiently recovering process followed by (2) a prolonged force depression after metabolically demanding exercise, and (3) a stable force depression after mechanically demanding contractions.

Does emotional stress cause type 2 diabetes mellitus? A review from the European Depression in Diabetes (EDID) Research Consortium.

PubMed

Pouwer, Frans; Kupper, Nina; Adriaanse, Marcel C

2010-02-01

According to the World Health Organization, approximately 220 million people worldwide have type 2 diabetes mellitus. Patients with type 2 diabetes not only have a chronic disease to cope with, they are also at increased risk for coronary heart disease, peripheral vascular disease, retinopathy, nephropathy, and neuropathy. The exact causes of type 2 diabetes are still not clear. Since the 17th century, it has been suggested that emotional stress plays a role in the etiology of type 2 diabetes mellitus. So far, review studies have mainly focused on depression as a risk factor for the development of type 2 diabetes mellitus. Yet, chronic emotional stress is an established risk factor for the development of depression. The present review provides an overview of mainly prospective epidemiological studies that have investigated the associations between different forms of emotional stress and the development of type 2 diabetes mellitus. Results of longitudinal studies suggest that not only depression but also general emotional stress and anxiety, sleeping problems, anger, and hostility are associated with an increased risk for the development of type 2 diabetes. Conflicting results were found regarding childhood neglect, life events, and work stress. It is important to emphasize that publication-bias may have occurred, resulting from "fishing-expeditions," where authors search their data for significant associations. Publication bias may also be caused by the tendency of reviewers and Editors to reject manuscripts with negative results for publication. It is therefore essential that research groups, who aim to conduct a new epidemiological cohort study, prospectively describe and publish the design of their study. Future research should focus on identifying mechanisms linking different forms of stress and incident type 2 diabetes.

A randomized controlled trial of cognitive behavioral therapy for adherence and depression (CBT-AD) in patients with uncontrolled type 2 diabetes.

PubMed

Safren, Steven A; Gonzalez, Jeffrey S; Wexler, Deborah J; Psaros, Christina; Delahanty, Linda M; Blashill, Aaron J; Margolina, Aleksandra I; Cagliero, Enrico

2014-01-01

To test cognitive behavioral therapy for adherence and depression (CBT-AD) in type 2 diabetes. We hypothesized that CBT-AD would improve adherence; depression; and, secondarily, hemoglobin A1c (A1C). Eighty-seven adults with unipolar depression and uncontrolled type 2 diabetes received enhanced treatment as usual (ETAU), including medication adherence, self-monitoring of blood glucose (SMBG), and lifestyle counseling; a provider letter documented psychiatric diagnoses. Those randomized to the intervention arm also received 9-11 sessions of CBT-AD. Immediately after acute treatment (4 months), adjusting for baseline, CBT-AD had 20.7 percentage points greater oral medication adherence on electronic pill cap (95% CI -31.14 to -10.22, P = 0.000); 30.2 percentage points greater SMBG adherence through glucometer downloads (95% CI -42.95 to -17.37, P = 0.000); 6.44 points lower depression scores on the Montgomery-Asberg Depression Rating Scale (95% CI 2.33-10.56, P = 0.002); 0.74 points lower on the Clinical Global Impression (95% CI 0.16-1.32, P = 0.01); and 0.72 units lower A1C (95% CI 0.29-1.15, P = 0.001) relative to ETAU. Analyses of 4-, 8-, and 12-month follow-up time points indicated that CBT-AD maintained 24.3 percentage points higher medication adherence (95% CI -38.2 to -10.3, P = 0.001); 16.9 percentage points greater SMBG adherence (95% CI -33.3 to -0.5, P = 0.043); and 0.63 units lower A1C (95% CI 0.06-1.2, P = 0.03) after acute treatment ended. For depression, there was some evidence of continued improvement posttreatment, but no between-group differences. CBT-AD is an effective intervention for adherence, depression, and glycemic control, with enduring and clinically meaningful benefits for diabetes self-management and glycemic control in adults with type 2 diabetes and depression.

Elucidating the Biological Mechanisms Linking Depressive Symptoms With Type 2 Diabetes in Men: The Longitudinal Effects of Inflammation, Microvascular Dysfunction, and Testosterone.

PubMed

Tully, Phillip J; Baumeister, Harald; Martin, Sean; Atlantis, Evan; Jenkins, Alicia; Januszewski, Andrzej; OʼLoughlin, Peter; Taylor, Anne; Wittert, Gary A

2016-01-01

This prospective cohort study sought to examine key biological measures linking depressive symptoms with Type 2 diabetes, specifically inflammation, microvascular dysfunction, and androgens. A cohort of 688 men without diabetes who were 35 years or older were followed up for 5 years. Venous interleukin-6, high-sensitivity C-reactive protein, sE-selectin, endogenous total testosterone, fasting glucose, and glycated hemoglobin (HbA1c) were quantified at baseline and 5 years later. Depressive symptoms were assessed using the Beck Depression Inventory-I, and men were categorized into persistent, remitted, incident, and nondepressed groups (reference). Logistic regression was used to determine odds ratios (ORs) for diabetes adjusted for propensity score calculated from 18 established risk factors. Diabetes developed in 112 men (16.3% of sample). Persistent depressive symptoms were associated with diabetes (adjusted OR = 2.45, 95% confidence interval [CI] = 1.16-5.20, p = .019). Baseline testosterone (OR = 0.43, 95% CI = 0.22-0.81, p = .01) and follow-up testosterone (OR = 0.51, 95% CI = 0.31-0.84, p = .008) were inversely associated with Type 2 diabetes. Annualized HbA1c was positively associated with annualized change in cognitive Beck Depression Inventory symptoms (β = 0.14, p = .001) and inversely associated with annualized change in testosterone (β = -0.10, p = .014). Annualized change in fasting glucose was associated with sE-selectin (β = 0.12, p < .001) and somatic depressive symptoms (β = -0.12, p = .002). The findings suggest that lower endogenous total testosterone levels and persistent depressive symptoms were associated with Type 2 diabetes risk and HbA1c in men over a 5-year period.

Depression, anxiety disorders, and metabolic syndrome in a population at risk for type 2 diabetes mellitus.

PubMed

Kahl, Kai G; Schweiger, Ulrich; Correll, Christoph; Müller, Conrad; Busch, Marie-Luise; Bauer, Michael; Schwarz, Peter

2015-03-01

Depressive symptoms have been associated with type 2 diabetes mellitus (T2DM), but less is known about anxiety disorders that can be comorbid or exist without depression. We evaluated the prevalence of psychiatric disorders in subjects consecutively examined at an outpatient clinic for diabetes prevention who were at-risk for T2DM, defined by FINDRISK scores, and compared metabolic syndrome (MetS) frequencies between subjects with and without psychiatric morbidity, entering also relevant variables for MetS into multivariate analyses. All subjects underwent an oral glucose tolerance test (OGTT). Psychiatric diagnosis was confirmed using a Structured Clinical Interview for DSM-IV. Of 260 consecutively screened subjects, 150 (56.9±8.1 years old, males=56.7%, BMI=27.2±4.1 kg/m2) were at-risk for T2DM and were included. MetS, present in 27% of males and 25% of females, was significantly associated with having a current anxiety disorder (P<0.001) and lifetime major depression (P<0.001). In logistic regression analysis, MetS was significantly associated with lifetime major depression, presence of any anxiety disorder, body weight, and physical activity. Our data in a high-risk group for T2DM support the association between depressive disorders and MetS, pointing to a similar role of anxiety disorders. Screening for anxiety and depression is recommended in this group at risk for T2DM.

Joint analysis of multiple high-dimensional data types using sparse matrix approximations of rank-1 with applications to ovarian and liver cancer.

PubMed

Okimoto, Gordon; Zeinalzadeh, Ashkan; Wenska, Tom; Loomis, Michael; Nation, James B; Fabre, Tiphaine; Tiirikainen, Maarit; Hernandez, Brenda; Chan, Owen; Wong, Linda; Kwee, Sandi

2016-01-01

Technological advances enable the cost-effective acquisition of Multi-Modal Data Sets (MMDS) composed of measurements for multiple, high-dimensional data types obtained from a common set of bio-samples. The joint analysis of the data matrices associated with the different data types of a MMDS should provide a more focused view of the biology underlying complex diseases such as cancer that would not be apparent from the analysis of a single data type alone. As multi-modal data rapidly accumulate in research laboratories and public databases such as The Cancer Genome Atlas (TCGA), the translation of such data into clinically actionable knowledge has been slowed by the lack of computational tools capable of analyzing MMDSs. Here, we describe the Joint Analysis of Many Matrices by ITeration (JAMMIT) algorithm that jointly analyzes the data matrices of a MMDS using sparse matrix approximations of rank-1. The JAMMIT algorithm jointly approximates an arbitrary number of data matrices by rank-1 outer-products composed of "sparse" left-singular vectors (eigen-arrays) that are unique to each matrix and a right-singular vector (eigen-signal) that is common to all the matrices. The non-zero coefficients of the eigen-arrays identify small subsets of variables for each data type (i.e., signatures) that in aggregate, or individually, best explain a dominant eigen-signal defined on the columns of the data matrices. The approximation is specified by a single "sparsity" parameter that is selected based on false discovery rate estimated by permutation testing. Multiple signals of interest in a given MDDS are sequentially detected and modeled by iterating JAMMIT on "residual" data matrices that result from a given sparse approximation. We show that JAMMIT outperforms other joint analysis algorithms in the detection of multiple signatures embedded in simulated MDDS. On real multimodal data for ovarian and liver cancer we show that JAMMIT identified multi-modal signatures that were

Depression in the elderly: Does family system play a role? A cross-sectional study

PubMed Central

Taqui, Ather M; Itrat, Ahmed; Qidwai, Waris; Qadri, Zeeshan

2007-01-01

Background The most common geriatric psychiatric disorder is depression. The role of family systems in depression among the elderly has not been studied extensively. It has been suggested that urbanization promotes nucleation of family systems and a decrease in care and support for the elderly. We conducted this study in Karachi, a large urban city of Pakistan, to determine the relationship between the type of family system and depression. We also determined the prevalence of depression in the elderly, as well as correlation of depression with other important socio-demographic variables. Methods A cross-sectional study was carried out in the premises of a tertiary care hospital in Karachi, Pakistan. Questionnaire based interviews were conducted among the elderly people visiting the hospital. Depression was assessed using the 15-item Geriatric Depression Scale. Results Four hundred subjects aged 65 and above were interviewed. The age of majority of the subjects ranged from 65 to 74 years. Seventy eight percent of the subjects were male. The prevalence of depression was found to be 19.8%. Multiple logistic regression analysis revealed that the following were significant (p < 0.05) independent predictors of depression: nuclear family system, female sex, being single or divorced/widowed, unemployment and having a low level of education. The elderly living in a nuclear family system were 4.3 times more likely to suffer from depression than those living in a joint family system (AOR = 4.3 [95% CI = 2.4–7.6]). Conclusion The present study found that residing in a nuclear family system is a strong independent predictor of depression in the elderly. The prevalence of depression in the elderly population in our study was moderately high and a cause of concern. The transition in family systems towards nucleation may have a major deleterious effect on the physical and mental health of the elderly. PMID:17961255

Depressive vulnerabilities predict depression status and trajectories of depression over 1 year in persons with acute coronary syndrome.

PubMed

Doyle, Frank; McGee, Hannah; Delaney, Mary; Motterlini, Nicola; Conroy, Ronán

2011-01-01

Depression is prevalent in patients hospitalized with acute coronary syndrome (ACS). We determined whether theoretical vulnerabilities for depression (interpersonal life events, reinforcing events, cognitive distortions, Type D personality) predicted depression, or depression trajectories, post-hospitalization. We followed 375 ACS patients who completed depression scales during hospital admission and at least once during three follow-up intervals over 1 year (949 observations). Questionnaires assessing vulnerabilities were completed at baseline. Logistic regression for panel/longitudinal data predicted depression status during follow-up. Latent class analysis determined depression trajectories. Multinomial logistic regression modeled the relationship between vulnerabilities and trajectories. Vulnerabilities predicted depression status over time in univariate and multivariate analysis, even when controlling for baseline depression. Proportions in each depression trajectory category were as follows: persistent (15%), subthreshold (37%), never depressed (48%). Vulnerabilities independently predicted each of these trajectories, with effect sizes significantly highest for the persistent depression group. Self-reported vulnerabilities - stressful life events, reduced reinforcing events, cognitive distortions, personality - measured during hospitalization can identify those at risk for depression post-ACS and especially those with persistent depressive episodes. Interventions should focus on these vulnerabilities. Copyright © 2011 Elsevier Inc. All rights reserved.

Management of acromioclavicular joint injuries.

PubMed

Li, Xinning; Ma, Richard; Bedi, Asheesh; Dines, David M; Altchek, David W; Dines, Joshua S

2014-01-01

Acromioclavicular joint injuries are among the most common shoulder girdle injuries in athletes and most commonly result from a direct force to the acromion with the arm in an adducted position. Acromioclavicular joint injuries often present with associated injuries to the glenohumeral joint, including an increased incidence of superior labrum anterior posterior (SLAP) tears that may warrant further evaluation and treatment. Anteroposterior stability of the acromioclavicular joint is conferred by the capsule and acromioclavicular ligaments, of which the posterior and superior ligaments are the strongest. Superior-inferior stability is maintained by the coracoclavicular (conoid and trapezoid) ligaments. Type-I or type-II acromioclavicular joint injuries have been treated with sling immobilization, early shoulder motion, and physical therapy, with favorable outcomes. Return to activity can occur when normal shoulder motion and strength are obtained and the shoulder is asymptomatic as compared with the contralateral normal extremity. The management of type-III injuries remains controversial and is individualized. While a return to the previous level of functional activity with nonsurgical treatment has been documented in a number of case series, surgical reduction and coracoclavicular ligament reconstruction has been associated with a favorable outcome and can be considered in patients who place high functional demands on their shoulders or in athletes who participate in overhead sports. Surgical management is indicated for high-grade (≥type IV) acromioclavicular joint injuries to achieve anatomic reduction of the acromioclavicular joint, reconstruction of the coracoclavicular ligaments, and repair of the deltotrapezial fascia. Outcomes after surgical reconstruction of the coracoclavicular ligaments have been satisfactory with regard to achieving pain relief and return to functional activities, but further improvements in the biomechanical strength of these

Optimization and Prediction of Angular Distortion and Weldment Characteristics of TIG Square Butt Joints

NASA Astrophysics Data System (ADS)

Narang, H. K.; Mahapatra, M. M.; Jha, P. K.; Biswas, P.

2014-05-01

Autogenous arc welds with minimum upper weld bead depression and lower weld bead bulging are desired as such welds do not require a second welding pass for filling up the upper bead depressions (UBDs) and characterized with minimum angular distortion. The present paper describes optimization and prediction of angular distortion and weldment characteristics such as upper weld bead depression and lower weld bead bulging of TIG-welded structural steel square butt joints. Full factorial design of experiment was utilized for selecting the combinations of welding process parameter to produce the square butts. A mathematical model was developed to establish the relationship between TIG welding process parameters and responses such as upper bead width, lower bead width, UBD, lower bead height (bulging), weld cross-sectional area, and angular distortions. The optimal welding condition to minimize UBD and lower bead bulging of the TIG butt joints was identified.

Correlation of magnesium intake with metabolic parameters, depression and physical activity in elderly type 2 diabetes patients: a cross-sectional study

PubMed Central

2012-01-01

Background Type 2 diabetes mellitus is a major global public health problem in the worldwide and is increasing in aging populations. Magnesium intake may be one of the most important factors for diabetes prevention and management. Low magnesium intake may exacerbate metabolic abnormalities. In this study, the relationships of magnesium intake with metabolic parameters, depression and physical activity in elderly patients with type 2 diabetes were investigated. Methods This cross-sectional study involved 210 type 2 diabetes patients aged 65 years and above. Participants were interviewed to obtain information on lifestyle and 24-hour dietary recall. Assessment of depression was based on DSM-IV criteria. Clinical variables measured included anthropometric measurements, blood pressure, and biochemical determinations of blood and urine samples. Linear regression was applied to determine the relationships of magnesium intake with nutritional variables and metabolic parameters. Results Among all patients, 88.6% had magnesium intake which was less than the dietary reference intake, and 37.1% had hypomagnesaemia. Metabolic syndromes and depression were associated with lower magnesium intake (p < 0.05). A positive relationship was found between magnesium intake and HDL-cholesterol (p = 0.005). Magnesium intake was inversely correlated with triglyceride, waist circumference, body fat percent and body mass index (p < 0.005). After controlling confounding factor, HDL-cholesterol was significantly higher with increasing quartile of magnesium intake (p for trend = 0005). Waist circumference, body fat percentage, and body mass index were significantly lower with increase quartile of magnesium intake (p for trend < 0.001). The odds of depression, central obesity, high body fat percentage, and high body mass index were significantly lower with increasing quartile of magnesium intake (p for trend < 0.05). In addition, magnesium intake was related to high

Various forms of depression

PubMed Central

Benazzi, Franco

2006-01-01

The current subtyping of depression is based on the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Text Revision (DSM-IV-TR) categorical division of bipolar and depressive disorders. Current evidence, however, supports a dimensional approach to depression, as a continuum/spectrum of overlapping disorders, ranging from bipolar I depression to major depressive disorder. Types of depression which have recently been the focus of most research will be reviewed ; bipolar II depression, mixed depression, agitated depression, atypical depression, melancholic depression, recurrent brief depression, minor depressive disorder, seasonal depression, and dysthymic disorder. Most research has focused on bipolar II depression, mixed depression (defined by depression and superimposed manicfhypomanic symptoms), and atypical depression. Mixed depression, by its combination of opposite polarity symptoms, has been found to be common by systematic probing for co-occurring manic/hypomanic symptoms. Mixed depression is a treatment challenge for clinicians, because antidepressants alone (ie, not protected by mood-stabilizing agents) may worsen its manidhypomanic symptoms, such as irritability and psychomotor agitation, w/hich the Food and Drug Administration (FDA) has listed as possible precursors to suiddality. PMID:16889102

Determination of Parachute Joint Factors using Seam and Joint Testing

NASA Technical Reports Server (NTRS)

Mollmann, Catherine

2015-01-01

This paper details the methodology for determining the joint factor for all parachute components. This method has been successfully implemented on the Capsule Parachute Assembly System (CPAS) for the NASA Orion crew module for use in determining the margin of safety for each component under peak loads. Also discussed are concepts behind the joint factor and what drives the loss of material strength at joints. The joint factor is defined as a "loss in joint strength...relative to the basic material strength" that occurs when "textiles are connected to each other or to metals." During the CPAS engineering development phase, a conservative joint factor of 0.80 was assumed for each parachute component. In order to refine this factor and eliminate excess conservatism, a seam and joint testing program was implemented as part of the structural validation. This method split each of the parachute structural joints into discrete tensile tests designed to duplicate the loading of each joint. Breaking strength data collected from destructive pull testing was then used to calculate the joint factor in the form of an efficiency. Joint efficiency is the percentage of the base material strength that remains after degradation due to sewing or interaction with other components; it is used interchangeably with joint factor in this paper. Parachute materials vary in type-mainly cord, tape, webbing, and cloth -which require different test fixtures and joint sample construction methods. This paper defines guidelines for designing and testing samples based on materials and test goals. Using the test methodology and analysis approach detailed in this paper, the minimum joint factor for each parachute component can be formulated. The joint factors can then be used to calculate the design factor and margin of safety for that component, a critical part of the design verification process.

Lifetime depression and anxiety increase prevalent psychological symptoms and worsen glycemic control in type 2 diabetes: The Fremantle Diabetes Study Phase II.

PubMed

Whitworth, S R; Bruce, D G; Starkstein, S E; Davis, W A; Davis, T M E; Bucks, R S

2016-12-01

To determine the contribution of lifetime major depressive disorder (L-MDD) and lifetime generalized anxiety disorder (L-GAD) to current psychological symptom severity, health behaviour and glycaemic control in type 2 diabetes. 1285 community-dwelling people with type 2 diabetes (Fremantle Diabetes Study Phase-II; FDS2) completed the PHQ-9 and Brief Life-Time Depression Scale (BLDS) to assess current and past MDD. The Generalized Anxiety Disorder Scale (GADS) and the Generalized Anxiety Disorder Scale-Lifetime (GAD-LT), designed for FDS2, assessed current and past anxiety. Data were analysed using analysis of covariance and multiple mediation models, controlling for age, gender, marital status, and diabetes duration. L-MDD and L-GAD were independently associated with more severe current depression (both P<0.001) and anxiety (both P<0.001) symptoms. Mediation models revealed that, through increasing the severity of current depressive symptoms, L-MDD was associated with higher HbA 1c and body mass index (BMI), greater likelihood of current smoking, and reduced self-monitoring of blood glucose (SMBG) (indirect regression path ab, all P<0.001). In combination, L-MDD+L-GAD additionally elevated the risk of higher HbA 1c and worse diabetes management, by increasing the severity of current depressive symptoms (indirect regression path ab, all P<0.001). Lifetime depression and anxiety increase risk of more severe psychological symptoms, hyperglycaemia, and difficulties with health behaviour in type 2 diabetes. Early screening for these disorders at diabetes diagnosis may be warranted to maximize long-term health outcomes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Pain in Parkinson´s Disease: A Cross-Sectional Study of Its Prevalence, Types, and Relationship to Depression and Quality of Life

PubMed Central

Singliarova, Helena; Harsany, Jan; Hanakova, Marta; Martinkova, Jana; Benetin, Jan

2015-01-01

Pain is an important and distressing symptom in Parkinson’s disease (PD). Our aim was to determine the prevalence of pain, its various types and characteristics, as well as its impact on depression and quality of life (QoL) in patients with PD. How pain differs in early- and advanced-stage PD and male and female PD patients was of special interest. One hundred PD patients on dopaminergic medications had a neurological examination and participated in a structured interview on pain characteristics and completed standardized questionnaires. A total of 76% of the patients had pain. The following types of pain were present: musculoskeletal pain accounted for 41% of the total pain, dystonic pain for 17%, central neuropathic pain for 22%, radicular pain for 27%, and other pains (non-radicular low back pain, arthritic, and visceral pain) made up 24%. One type of pain affected 29% of all the subjects, two types 35%, three types 10%, and four types of pain were reported by 2%. All types of pain were more prevalent in advanced-stage PD subjects than in early-stage PD subjects, except for arthritic pain (subclassified under”other pain”). The frequency and intensity of actual, average, and worst experienced pain were significantly more severe in advanced-stage subjects. PD subjects with general pain and in advanced stages were more depressed and had poorer QoL. Depression correlated with worst pain in the last 24 hours and with pain periodicity (the worst depression score in patients with constant pain). QoL correlated with average pain in the last 7 days. Pain is a frequent problem in PD patients, and it worsens during the course of the disease. PMID:26309254

Inscription of type I and depressed cladding waveguides in lithium niobate using a femtosecond laser.

PubMed

Bhardwaj, S; Mittholiya, K; Bhatnagar, A; Bernard, R; Dharmadhikari, J A; Mathur, D; Dharmadhikari, A K

2017-07-10

We describe two types of waveguides (type I and depressed cladding) inscribed in lithium niobate using a variable repetition rate (200 kHz-25 MHz), 270 fs duration fiber laser. The type I modification-based waveguides have propagation losses in the range from 1.2 to 10 dB/cm at 1550 nm, depending on experimental parameters. These waveguides are not permanent; they deteriorate over time. Such deterioration of waveguides can be slowed down from 30 days to 100 days by pre-annealing the samples and by writing at a 720 kHz laser repetition rate. The propagation losses measured at 1550 nm show significant improvement for pre-annealed samples. The depressed cladding-inscribed waveguides are permanent, but the propagation loss depends on the number of damage tracks. A track separation of ∼1  μm between adjacent damage tracks yields the lowest propagation loss of 0.5 dB/cm at 1550 nm for a 40 μm diameter waveguide. We observe multimode guidance for sizes in the range of 20-80 μm in these waveguide structures at 1550 nm. Their crystalline nature is found to remain intact, as inferred from second-harmonic generation within the waveguide region.

Displacement, county social cohesion and depression after a large-scale traumatic event

PubMed Central

Lê, Félice; Tracy, Melissa; Norris, Fran H.; Galea, Sandro

2013-01-01

Background Depression is a common and potentially debilitating consequence of traumatic events. Mass traumatic events cause wide-ranging disruptions to community characteristics, influencing the population risk of depression. In the aftermath of such events, population displacement is common. Stressors associated with displacement may increase risk of depression directly. Indirectly, persons who are displaced may experience erosion in social cohesion, further exacerbating their risk for depression. Methods Using data from a population-based cross-sectional survey of adults living in the 23 southernmost counties of Mississippi (N = 708), we modeled the independent and joint relations of displacement and county-level social cohesion with depression 18–24 months after Hurricane Katrina. Results After adjustment for individual- and county-level sociodemographic characteristics and county-level hurricane exposure, joint exposure to both displacement and low social cohesion was associated with substantially higher log-odds of depression (b = 1.34 [0.86–1.83]). Associations were much weaker for exposure only to low social cohesion (b = 0.28 [−0.35–0.90]) or only to displacement (b = 0.04 [−0.80– 0.88]). The associations were robust to additional adjustment for individually perceived social cohesion and social support. Conclusion Addressing the multiple, simultaneous disruptions that are a hallmark of mass traumatic events is important to identify vulnerable populations and understand the psychological ramifications of these events. PMID:23644724

Displacement, county social cohesion, and depression after a large-scale traumatic event.

PubMed

Lê, Félice; Tracy, Melissa; Norris, Fran H; Galea, Sandro

2013-11-01

Depression is a common and potentially debilitating consequence of traumatic events. Mass traumatic events cause wide-ranging disruptions to community characteristics, influencing the population risk of depression. In the aftermath of such events, population displacement is common. Stressors associated with displacement may increase risk of depression directly. Indirectly, persons who are displaced may experience erosion in social cohesion, further exacerbating their risk for depression. Using data from a population-based cross-sectional survey of adults living in the 23 southernmost counties of Mississippi (N = 708), we modeled the independent and joint relations of displacement and county-level social cohesion with depression 18-24 months after Hurricane Katrina. After adjustment for individual- and county-level socio-demographic characteristics and county-level hurricane exposure, joint exposure to both displacement and low social cohesion was associated with substantially higher log-odds of depression (b = 1.34 [0.86-1.83]). Associations were much weaker for exposure only to low social cohesion (b = 0.28 [-0.35-0.90]) or only to displacement (b = 0.04 [-0.80-0.88]). The associations were robust to additional adjustment for individually perceived social cohesion and social support. Addressing the multiple, simultaneous disruptions that are a hallmark of mass traumatic events is important to identify vulnerable populations and understand the psychological ramifications of these events.

Lithostratigraphic interpretation from joint analysis of seismic tomography and magnetotelluric resistivity models using self-organizing map techniques

NASA Astrophysics Data System (ADS)

Bauer, K.; Muñoz, G.; Moeck, I.

2012-12-01

from MT inversion. The synthetic data are used as a benchmark test to demonstrate the performance of the SOM method. The real data were collected along a 40 km profile across parts of the NE German basin. The lithostratigraphic model from the joint SOM interpretation consists of eight litho-types and covers Cenozoic, Mesozoic and Paleozoic sediments down to 5 km depth. There is a remarkable agreement between the SOM based model and regional marker horizons interpolated from surrounding 2D industrial seismic data. The most interesting results include (1) distinct properties of the Jurassic (low P velocity gradients, low resistivities) interpreted as the signature of shaly clastics, and (2) a pattern within the Upper Permian Zechstein with decreased resistivities and increased P velocities within the salt depressions on the one hand, and increased resistivities and decreased P velocities in the salt pillows on the other hand. In our interpretation this pattern is related with flow of less dense salt matrix components into the pillows and remaining brittle evaporites within the depressions.

One-year changes in symptoms of depression and weight in overweight/obese individuals with type 2 diabetes in the Look AHEAD study.

PubMed

Faulconbridge, Lucy F; Wadden, Thomas A; Rubin, Richard R; Wing, Rena R; Walkup, Michael P; Fabricatore, Anthony N; Coday, Mace; Van Dorsten, Brent; Mount, David L; Ewing, Linda J

2012-04-01

Depressed individuals are frequently excluded from weight loss trials because of fears that weight reduction may precipitate mood disorders, as well as concerns that depressed participants will not lose weight satisfactorily. The present study examined participants in the Look AHEAD study to determine whether moderate weight loss would be associated with incident symptoms of depression and suicidal ideation, and whether symptoms of depression at baseline would limit weight loss at 1 year. Overweight/obese adults with type 2 diabetes (n = 5,145) were randomly assigned to an Intensive Lifestyle Intervention (ILI) or a usual care group, Diabetes Support and Education (DSE). Of these, 5,129 participants completed the Beck Depression Inventory (BDI) and had their weight measured at baseline and 1 year. Potentially significant symptoms of depression were defined by a BDI score ≥10. Participants in ILI lost 8.6 ± 6.9% of initial weight at 1 year, compared to 0.7 ± 4.8% for DSE (P < 0.001, effect size = 1.33), and had a reduction of 1.4 ± 4.7 points on the BDI, compared to 0.4 ± 4.5 for DSE (P < 0.001, effect size = 0.23). At 1 year, the incidence of potentially significant symptoms of depression was significantly lower in the ILI than DSE group (6.3% vs. 9.6%) (relative risk (RR) = 0.66, 95% confidence interval (CI) = 0.5, 0.8; P < 0.001). In the ILI group, participants with and without symptoms of depression lost 7.8 ± 6.7% and 8.7 ± 6.9%, respectively, a difference not considered clinically meaningful. Intentional weight loss was not associated with the precipitation of symptoms of depression, but instead appeared to protect against this occurrence. Mild (or greater) symptoms of depression at baseline did not prevent overweight/obese individuals with type 2 diabetes from achieving significant weight loss.

The sacroiliac joint: anatomy, physiology and clinical significance.

PubMed

Forst, Stacy L; Wheeler, Michael T; Fortin, Joseph D; Vilensky, Joel A

2006-01-01

The sacroiliac joint (SIJ) is a putative source of low back pain. The objective of this article is to provide clinicians with a concise review of SIJ structure and function, diagnostic indicators of SIJ-mediated pain, and therapeutic considerations. The SIJ is a true diarthrodial joint with unique characteristics not typically found in other diarthrodial joints. The joint differs with others in that it has fibrocartilage in addition to hyaline cartilage, there is discontinuity of the posterior capsule, and articular surfaces have many ridges and depressions. The sacroiliac joint is well innervated. Histological analysis of the sacroiliac joint has verified the presence of nerve fibers within the joint capsule and adjoining ligaments. It has been variously described that the sacroiliac joint receives its innervation from the ventral rami of L4 and L5, the superior gluteal nerve, and the dorsal rami of L5, S1, and S2, or that it is almost exclusively derived from the sacral dorsal rami. Even though the sacroiliac joint is a known putative source of low back and lower extremity pain, there are few findings that are pathognomonic of sacroiliac joint pain. The controlled diagnostic blocks utilizing the International Association for the Study of Pain (IASP) criteria demonstrated the prevalence of pain of sacroiliac joint origin in 19% to 30% of the patients suspected to have sacroiliac joint pain. Conservative management includes manual medicine techniques, pelvic stabilization exercises to allow dynamic postural control, and muscle balancing of the trunk and lower extremities. Interventional treatments include sacroiliac joint, intra-articular joint injections, radiofrequency neurotomy, prolotherapy, cryotherapy, and surgical treatment. The evidence for intra-articular injections and radiofrequency neurotomy has been shown to be limited in managing sacroiliac joint pain.

Child multi-type maltreatment and associated depression and PTSD symptoms: The role of social support and stress

PubMed Central

Vranceanu, Ana-Maria; Hobfoll, Stevan E.; Johnson, Robert J.

2007-01-01

Objective This retrospective, cross-sectional study explored the hypothesis that multiple forms of child abuse and neglect (child multi-type maltreatment; CMM) would be associated with women’s lower social support and higher stress in adulthood, and that this, in turn, would amplify their vulnerability to symptoms of depression and posttraumatic stress disorder (PTSD). Method Participants were 100 women recruited from an inner-city gynecological treatment center for low-income women. Data were analyzed via structural equation modeling (SEM) with Lisrel 8.0. Results CMM was directly predictive of decreased social support and increased stress in adulthood. CMM was also directly predictive of PTSD symptoms, but not depression symptoms in adulthood. Social support partially mediated the relationship between CMM and adult PTSD symptoms, and stress fully mediated the relationship between CMM and adult symptoms of depression. Conclusions Findings support both direct and mediational effects of social resources on adult depression and PTSD symptoms in women with histories of CMM, suggesting that resources are key factors in psychological adjustment of CMM victims. PMID:17215039

Stressful life events preceding the onset of depression in Asian patients with major depressive disorder.

PubMed

Park, Subin; Hatim, Ahmad; Si, Tian-Mei; Jeon, Hong Jin; Srisurapanont, Manit; Bautista, Dianne; Liu, Shen-ing; Chua, Hong Choon; Hong, Jin Pyo

2015-12-01

Previous studies have identified the significant role of stressful life events in the onset of depressive episodes. However, there is a paucity of cross-national studies on stressful life events that precede depression. We aimed to compare types of stressful life events associated with the onset of depressive episodes in patients with major depressive disorder (MDD) in five Asian countries. A total of 507 outpatients with MDD were recruited in China (n = 114), South Korea (n = 101), Malaysia (n = 90), Thailand (n = 103) and Taiwan (n = 99). All patients were assessed with the Mini-International Neuropsychiatric Interview and the List of Threatening Experiences. The prevalence of each type of stressful life events was calculated and compared between each country. The type of stressful life event that preceded the onset of a depressive episode differed between patients in China and Taiwan and those in South Korea, Malaysia and Thailand. Patients in China and Taiwan were less likely to report interpersonal relationship problems and occupational/financial problems than patients in South Korea, Malaysia and Thailand. Understanding the nature and basis of culturally determined susceptibilities to specific stressful life events is critical for establishing a policy of depression prevention and providing effective counseling services for depressed patients. © The Author(s) 2015.

Thermal Cycling Life Prediction of Sn-3.0Ag-0.5Cu Solder Joint Using Type-I Censored Data

PubMed Central

Mi, Jinhua; Yang, Yuan-Jian; Huang, Hong-Zhong

2014-01-01

Because solder joint interconnections are the weaknesses of microelectronic packaging, their reliability has great influence on the reliability of the entire packaging structure. Based on an accelerated life test the reliability assessment and life prediction of lead-free solder joints using Weibull distribution are investigated. The type-I interval censored lifetime data were collected from a thermal cycling test, which was implemented on microelectronic packaging with lead-free ball grid array (BGA) and fine-pitch ball grid array (FBGA) interconnection structures. The number of cycles to failure of lead-free solder joints is predicted by using a modified Engelmaier fatigue life model and a type-I censored data processing method. Then, the Pan model is employed to calculate the acceleration factor of this test. A comparison of life predictions between the proposed method and the ones calculated directly by Matlab and Minitab is conducted to demonstrate the practicability and effectiveness of the proposed method. At last, failure analysis and microstructure evolution of lead-free solders are carried out to provide useful guidance for the regular maintenance, replacement of substructure, and subsequent processing of electronic products. PMID:25121138

Effect of Electromigration on the Type of Drop Failure of Sn-3.0Ag-0.5Cu Solder Joints in PBGA Packages

NASA Astrophysics Data System (ADS)

Huang, M. L.; Zhao, N.

2015-10-01

Board-level drop tests of plastic ball grid array (PBGA) packages were performed in accordance with the Joint Electron Devices Engineering Council standard to investigate the effect of electromigration (EM) on the drop reliability of Sn-3.0Ag-0.5Cu solder joints with two substrate surface finishes, organic solderability preservative (OSP) and electroless nickel electroless palladium immersion gold (ENEPIG). In the as-soldered state, drop failures occurred at the substrate sides only, with cracks propagating within the interfacial intermetallic compound (IMC) layer for OSP solder joints and along the IMC/Ni-P interface for ENEPIG solder joints. The drop lifetime of OSP solder joints was approximately twice that of ENEPIG joints. EM had an important effect on crack formation and drop lifetime of the PBGA solder joints. ENEPIG solder joints performed better in drop reliability tests after EM, that is, the drop lifetime of ENEPIG joints decreased by 43% whereas that of OSP solder joints decreased by 91%, compared with the as-soldered cases. The more serious polarity effect, i.e., excessive growth of the interfacial IMC at the anode, was responsible for the sharper decrease in drop lifetime. The different types of drop failure of PBGA solder joints before and after EM, including the position of initiation and the propagation path of cracks, are discussed on the basis of the growth behavior of interfacial IMC.

Surgical treatment of acute type V acromioclavicular joint dislocations in professional athletes: an anatomic ligament reconstruction with synthetic implant augmentation.

PubMed

Triantafyllopoulos, Ioannis K; Lampropoulou-Adamidou, Kalliopi; Schizas, Nikitas P; Karadimas, Eleftherios V

2017-12-01

Most acromioclavicular (AC) joint injuries occur in men in their third decade of life during high-speed or high-impact body contact sports. The management of acute complete AC joint dislocation is surgical. Current surgical techniques include anatomic reconstruction of the main restraints of the AC joint and aim to improve functional outcomes and to reduce the complication rate. We present 10 cases of acute type V AC joint dislocation in professional athletes treated surgically with anatomic reconstruction of the coracoclavicular and AC ligaments and augmentation with the use of a synthetic polyester tape. The minimum follow-up of the patients was 2 years (mean, 48 months; range, 24-86 months). The postoperative functional outcome was assessed at 1 year and 2 years using the Constant-Murley, American Shoulder and Elbow Surgeons, and modified University of California-Los Angeles scoring systems. In all cases, the postoperative scores were significantly improved (P < .005 in all comparisons with the preoperative scores), and all patients returned to their preinjury high level of activity 6 months postoperatively. Radiographs at 1 month and 6 months revealed the maintenance of reduction. There were no complications. According to the results of our series of patients, demanding cases of acute AC joint dislocation Rockwood type V, in professional athletes, require anatomic fixation of both coracoclavicular and AC ligaments for return to sports as soon as possible and at the preinjury level of performance. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Treatment-related stresses and anxiety-depressive symptoms among Chinese outpatients with type 2 diabetes mellitus in Hong Kong.

PubMed

Lee, Sing; Chiu, Alice; Tsang, Adley; Chow, Chun-Chung; Chan, Wing-Bun

2006-12-01

Based on focus group findings, a descriptive instrument was developed to examine the relationship among treatment-related stress, anxiety and depressive symptoms, distress, and impairment of 333 Chinese outpatients with type 2 diabetes mellitus (DM) in Hong Kong. It was found that the main stresses included fears of diabetes complications, work impairment, lifestyle adjustment, stigmatization, and discrimination. Over 1/4 of patients concealed their DM from family members in order not to make the latter worry. 28.3% felt that life was not worth living. 33.6% of patients exhibited four or more anxiety and depressive symptoms accompanied by significant distress and/or impairment. These patients were more likely to be female, of lower educational level, and unemployed. Diabetes complications, concealment of DM, and feeling of being a burden to the family predicted anxious-depressed status. The study showed that treatment-related stresses and anxiety-depressive symptoms were common and associated among Chinese diabetes outpatients in Hong Kong.

Validation of the Turkish version of the Centre for Epidemiologic Studies Depression Scale (CES-D) in patients with type 2 diabetes mellitus.

PubMed

Lehmann, Vicky; Makine, Ceylan; Karşıdağ, Cagatay; Kadıoğlu, Pinar; Karşıdağ, Kubilay; Pouwer, François

2011-07-26

Depression is a common co-morbid health problem in patients with diabetes that is underrecognised. Current international guidelines recommend screening for depression in patients with diabetes. Yet, few depression screening instruments have been validated for use in this particular group of patients. Aim of the present study was to investigate the psychometric properties of the Turkish version of the Centre for Epidemiologic Studies Depression Scale (CES-D) in patients with type 2 diabetes. A sample of 151 Turkish outpatients with type 2 diabetes completed the CES-D, the World Health Organization-Five Well-Being Index (WHO-5), and the Problem Areas in Diabetes scale (PAID). Explanatory factor analyses, various correlations and Cronbach's alpha were investigated to test the validity and reliability of the CES-D in Turkish diabetes outpatients. The original four-factor structure proposed by Radloff was not confirmed. Explanatory factor analyses revealed a two-factor structure representing two subscales: (1) depressed mood combined with somatic symptoms of depression and (2) positive affect. However, one item showed insufficient factor loadings. Cronbach's alpha of the total score was high (0.88), as were split-half coefficients (0.77-0.90). The correlation of the CES-D with the WHO-5 was the strongest (r = -0.70), and supported concurrent validity. The CES-D appears to be a valid measure for the assessment of depression in Turkish diabetes patients. Future studies should investigate its sensitivity and specificity as well as test-retest reliability.

Correlation of binge eating disorder with level of depression and glycemic control in type 2 diabetes mellitus patients.

PubMed

Çelik, Selime; Kayar, Yusuf; Önem Akçakaya, Rabia; Türkyılmaz Uyar, Ece; Kalkan, Kübra; Yazısız, Veli; Aydın, Çiğdem; Yücel, Başak

2015-01-01

It is reported that eating disorders and depression are more common in patients with type 2 diabetes mellitus (T2DM). In this study, we aimed to determine the prevalence of binge eating disorder (BED) in T2DM patients and examine the correlation of BED with level of depression and glycemic control. One hundred fifty-two T2DM patients aged between 18 and 75 years (81 females, 71 males) were evaluated via a Structured Clinical Interview for DSM-IV Axis I Disorder, Clinical Version in terms of eating disorders. Disordered eating attitudes were determined using the Eating Attitudes Test (EAT) and level of depression was determined using the Beck Depression Scale. Patients who have BED and patients who do not were compared in terms of age, gender, body mass index, glycosylated hemoglobin (HbA1c) levels, depression and EAT scores. Eight of the patients included in the study (5.26%) were diagnosed with BED. In patients diagnosed with BED, depression and EAT scores were significantly high (P<.05). A positive correlation was found between EAT scores and depression scores (r = +0.196, P<.05). No significant difference was found in HbA1c levels between patients with BED and those without (P<.05). T2DM patients should be examined in terms of the presence of BED and disordered eating attitudes. Psychiatric treatments should be organized for patients diagnosed with BED by taking into consideration comorbid depression. Copyright © 2015 Elsevier Inc. All rights reserved.

Developmental association of prosocial behaviour with aggression, anxiety and depression from infancy to preadolescence.

PubMed

Nantel-Vivier, Amélie; Pihl, Robert O; Côté, Sylvana; Tremblay, Richard E

2014-10-01

Research on associations between children's prosocial behaviour and mental health has provided mixed evidence. The present study sought to describe and predict the joint development of prosocial behaviour with externalizing and internalizing problems (physical aggression, anxiety and depression) from 2 to 11 years of age. Data were drawn from the National Longitudinal Survey of Children and Youth (NLSCY). Biennial prosocial behaviour, physical aggression, anxiety and depression maternal ratings were sought for 10,700 children aged 0 to 9 years at the first assessment point. While a negative association was observed between prosociality and physical aggression, more complex associations emerged with internalizing problems. Being a boy decreased the likelihood of membership in the high prosocial trajectory. Maternal depression increased the likelihood of moderate aggression, but also of joint high prosociality/low aggression. Low family income predicted the joint development of high prosociality with high physical aggression and high depression. Individual differences exist in the association of prosocial behaviour with mental health. While high prosociality tends to co-occur with low levels of mental health problems, high prosociality and internalizing/externalizing problems can co-occur in subgroups of children. Child, mother and family characteristics are predictive of individual differences in prosocial behaviour and mental health development. Mechanisms underlying these associations warrant future investigations. © 2014 The Authors. Journal of Child Psychology and Psychiatry. © 2014 Association for Child and Adolescent Mental Health.

Efficacy and cost-effectiveness of a web-based intervention with mobile phone support to treat depressive symptoms in adults with diabetes mellitus type 1 and type 2: design of a randomised controlled trial.

PubMed

Nobis, Stephanie; Lehr, Dirk; Ebert, David Daniel; Berking, Matthias; Heber, Elena; Baumeister, Harald; Becker, Annette; Snoek, Frank; Riper, Heleen

2013-11-15

A diagnosis of diabetes mellitus types 1 or 2 doubles the odds of a comorbid depressive disorder. The combined diseases have a wide range of adverse outcomes, such as a lower quality of life, poorer diabetes outcomes and increased healthcare utilisation. Diabetes patients with depression can be treated effectively with psychotherapy, but access to psychological care is limited. In this study we will examine the efficacy and cost-effectiveness of a newly developed web-based intervention (GET.ON Mood Enhancer Diabetes) for people with diabetes and comorbid depressive symptoms. A two-arm randomised controlled trial will be conducted. Adults with diabetes (type 1 or type 2) with increased depression scores (> 22 on the German version of the Center for Epidemiological Studies Depression Scale (CES-D)) will be included. Eligible participants will be recruited through advertisement in diabetes patient journals and via a large-scale German health insurance company. The participants will be randomly assigned to either a 6-week minimally guided web-based self-help program or an online psychoeducation program on depression. The study will include 260 participants, which will enable us to detect a statistically significant difference with a group effect size of d = 0.35 at a power of 80% and a significance level of p = 0.05. The primary outcome measure will be the level of depression as assessed by the CES-D. The secondary outcome measures will be: diabetes-specific emotional distress, glycaemic control, self-management behaviour and the participants' satisfaction with the intervention. Online self-assessments will be collected at baseline and after a 2 months period, with additional follow-up measurements 6 and 12 months after randomisation. The data will be analysed on an intention-to-treat basis and per protocol. In addition, we will conduct an economic evaluation from a societal perspective. If this intervention is shown to be cost-effective, it has considerable potential

Are depression and frailty overlapping syndromes in mid- and late-life? A latent variable analysis.

PubMed

Mezuk, Briana; Lohman, Matthew; Dumenci, Levent; Lapane, Kate L

2013-06-01

Depression and frailty both predict disability and morbidity in later life. However, it is unclear to what extent these common geriatric syndromes represent overlapping constructs. To examine the joint relationship between the constructs of depression and frailty. Data come from 2004-2005 wave of the Baltimore Epidemiologic Catchment Area Study, and the analysis is limited to participants 40 years and older, with complete data on frailty and depression indicators (N = 683). Depression was measured using the Diagnostic Interview Schedule, and frailty was indexed by modified Fried criteria. A series of confirmatory latent class analyses were used to assess the degree to which depression and frailty syndromes identify the same populations. A latent kappa coefficient (κl) was also estimated between the constructs. Confirmatory latent class analyses indicated that depression and frailty represent distinct syndromes rather than a single construct. The joint modeling of the two constructs supported a three-class solution for depression and two-class solution for frailty, with 2.9% categorized as severely depressed, 19.4% as mildly depressed, and 77.7% as not depressed, and 21.1% categorized as frail and 78.9% as not frail. The chance-corrected agreement statistic indicated moderate correspondence between the depression and frailty constructs (κl: 66, 95% confidence interval: 0.58-0.74). Results suggest that depression and frailty are interrelated concepts, yet their operational criteria identify substantively overlapping subpopulations. These findings have implications for understanding factors that contribute to the etiology and prognosis of depression and frailty in later life. Copyright © 2013 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Plain Talk about Depression. Plain Talk Series.

ERIC Educational Resources Information Center

Sargent, Marilyn

Depression is defined as a "whole-body" illness, involving the body, mood, and thoughts. Three of the most prevalent types of depressive disorders are described: major depression, dysthymia, and bipolar disorders (formerly called manic-depressive illness). Eleven symptoms of depression and 10 symptoms of mania are listed. Causes of depression are…

Mixed models approaches for joint modeling of different types of responses.

PubMed

Ivanova, Anna; Molenberghs, Geert; Verbeke, Geert

2016-01-01

In many biomedical studies, one jointly collects longitudinal continuous, binary, and survival outcomes, possibly with some observations missing. Random-effects models, sometimes called shared-parameter models or frailty models, received a lot of attention. In such models, the corresponding variance components can be employed to capture the association between the various sequences. In some cases, random effects are considered common to various sequences, perhaps up to a scaling factor; in others, there are different but correlated random effects. Even though a variety of data types has been considered in the literature, less attention has been devoted to ordinal data. For univariate longitudinal or hierarchical data, the proportional odds mixed model (POMM) is an instance of the generalized linear mixed model (GLMM; Breslow and Clayton, 1993). Ordinal data are conveniently replaced by a parsimonious set of dummies, which in the longitudinal setting leads to a repeated set of dummies. When ordinal longitudinal data are part of a joint model, the complexity increases further. This is the setting considered in this paper. We formulate a random-effects based model that, in addition, allows for overdispersion. Using two case studies, it is shown that the combination of random effects to capture association with further correction for overdispersion can improve the model's fit considerably and that the resulting models allow to answer research questions that could not be addressed otherwise. Parameters can be estimated in a fairly straightforward way, using the SAS procedure NLMIXED.

Effects of Antiretroviral Therapy and Depressive Symptoms on All-Cause Mortality Among HIV-Infected Women

PubMed Central

Todd, Jonathan V.; Cole, Stephen R.; Pence, Brian W.; Lesko, Catherine R.; Bacchetti, Peter; Cohen, Mardge H.; Feaster, Daniel J.; Gange, Stephen; Griswold, Michael E.; Mack, Wendy; Rubtsova, Anna; Wang, Cuiwei; Weedon, Jeremy; Anastos, Kathryn; Adimora, Adaora A.

2017-01-01

Abstract Depression affects up to 30% of human immunodeficiency virus (HIV)-infected individuals. We estimated joint effects of antiretroviral therapy (ART) initiation and depressive symptoms on time to death using a joint marginal structural model and data from a cohort of HIV-infected women from the Women's Interagency HIV Study (conducted in the United States) from 1998–2011. Among 848 women contributing 6,721 years of follow-up, 194 participants died during follow-up, resulting in a crude mortality rate of 2.9 per 100 women-years. Cumulative mortality curves indicated greatest mortality for women who reported depressive symptoms and had not initiated ART. The hazard ratio for depressive symptoms was 3.38 (95% confidence interval (CI): 2.15, 5.33) and for ART was 0.47 (95% CI: 0.31, 0.70). Using a reference category of women without depressive symptoms who had initiated ART, the hazard ratio for women with depressive symptoms who had initiated ART was 3.60 (95% CI: 2.02, 6.43). For women without depressive symptoms who had not started ART, the hazard ratio was 2.36 (95% CI: 1.16, 4.81). Among women reporting depressive symptoms who had not started ART, the hazard ratio was 7.47 (95% CI: 3.91, 14.3). We found a protective effect of ART initiation on mortality, as well as a harmful effect of depressive symptoms, in a cohort of HIV-infected women. PMID:28430844

Prosthetic Joint Infections

PubMed Central

Aslam, Saima; Darouiche, Rabih O.

2012-01-01

Prosthetic joint infections represent a major therapeutic challenge for both healthcare providers and patients. This paper reviews the predisposing factors, pathogenesis, microbiology, diagnosis, treatment and prophylaxis of prosthetic joint infection. The most optimal management strategy should be identified based on a number of considerations including type and duration of infection, antimicrobial susceptibility of the infecting pathogen, condition of infected tissues and bone stock, patient wishes and functional status. PMID:22847032

The prevalence of depressive symptoms in a white European and South Asian population with impaired glucose regulation and screen-detected Type 2 diabetes mellitus: a comparison of two screening tools.

PubMed

Aujla, N; Skinner, T C; Khunti, K; Davies, M J

2010-08-01

To compare the identification of prevalent depressive symptoms by the World Health Organization-5 Wellbeing Index (WHO-5) and Centre for Epidemiological Studies Depression Scale (CES-D) for South Asian and white European people, male and female, attending a diabetes screening programme, and to explore the adequacy of the screening tools for this population. An additional aim was to further explore associations of depressive symptoms with impaired glucose regulation (IGR) and Type 2 diabetes mellitus (Type2 DM). Eight hundred and sixty-four white European (40-75 years old) and 290 South Asian people (25-75 years old) underwent an oral glucose tolerance test (OGTT), detailed history and anthropometric measurements and completed the WHO-5 and CES-D. Depressive symptoms were defined by a WHO-5 score or= 16. Unadjusted prevalence of depressive symptoms with the WHO-5, for people with Type2 DM was 42.3% (47.4% in white European; 28.6% in South Asian) and for IGR 30.7% (26% in white European; 45.8% in South Asian). With the CES-D, the prevalence in Type2 DM was 27.2% (25.4% in white European; 31.8% in South Asian) and for IGR 30.7% (27.8% in white European; 40.7% in South Asian). Statistically significant differences in the prevalence of depressive symptoms for sex or ethnicity were not identified. Odds ratios adjusted for age, sex and ethnicity showed no significant association of depression with Type2 DM or IGR, with either WHO-5 or CES-D. Agreement was moderate (kappa = 0.48, 95% confidence intervals 0.42-0.54), and reduced when identifying depressive symptoms in people with Type2 DM. For this group, a WHO-5 cut-point of Depressive symptoms, identified by WHO-5 or CES-D, were not significantly more prevalent in people with Type2 DM or IGR. The WHO-5 and CES-D differed in their identification of depressive symptoms in people with Type2 DM, though discrepancies between sex and ethnicity were not identified.

Psychiatric referral and glycemic control of Egyptian type 2 diabetes mellitus patients with depression.

PubMed

Fawzi, Mounir H; Said, Nagwa S; Fawzi, Maggie M; Kira, Ibrahim A; Fawzi, Mohab M; Abdel-Moety, Hanaa

2016-01-01

To evaluate the relationship between psychiatric referral acceptance for fluoxetine treatment and glycemic control in type 2 diabetes mellitus (T2DM) Egyptian patients with depression. Patients with T2DM who attended the diabetes outpatients clinic at Zagazig University Hospital, Egypt, between May 2013 and April 2015 and who scored ≥20 on screening with the Major Depression Inventory (MDI) (n=196) were offered a psychiatric referral for fluoxetine treatment and monitoring. Decliners (56.1%) received time/attention matched care via diabetologist visits (attentional controls). Fluoxetine patients and controls were compared at the time of the offer (T1) and 8weeks later (T2). Factors that significantly correlated with glycemic control were used in a linear regression analysis as the independent variables. Eighty-six patients (43.9%) accepted psychiatric referral. Most of them (97.7%) remained throughout the study adherent to fluoxetine (mean daily dose=31.9mg). At T2, these patients, in comparison to controls, showed a reduction from baseline in MDI, fasting plasma glucose and glycosylated hemoglobin (HbA1c) levels (P for all comparisons <.001). In the final model of a regression analysis, 65.9% of the variation in percentage change in HbA1c was explained by adherence to antidiabetics, psychiatric referral acceptance and Internalized Stigma of Mental Illness (ISMI) and MDI scores. In T2DM patients with depression, psychiatric referral acceptance for fluoxetine treatment is a significant predictor of both depression and glycemic control improvements. Copyright © 2016 Elsevier Inc. All rights reserved.

Measurement of the passive stiffness of ankle joint in 3 DOF using stewart platform type ankle foot device.

PubMed

Nomura, Kenta; Yonezawa, Teru; Mizoguchi, Hiroshi; Takemura, Hiroshi

2016-08-01

This paper presents a method to measure the passive stiffness of an ankle joint in three degrees of freedom (DOF) under two motion speeds (1 Hz and 5 degree/s) using a developed Stewart platform-type device. The developed device can reproduce input motions of the foot in 6 DOF by controlling six pneumatic linear motion actuators. We used the device to measure the passive stiffness of an ankle joint undergoing three kinds of motion, namely dorsi-plantar flexion, inversion-eversion, and adduction-abduction. The measured values of the passive stiffness of the ankle joint in dorsiflexion that we obtained agreed well with that obtained in a previous study, indicating that the developed device is useful for measuring the passive stiffness of ankle joint. In addition, the developed device can be used to measure the stiffness in inversion-eversion and adduction-abduction motions as well, parameters that have never been measured. The results we obtained demonstrated certain interesting features as we varied both the direction and pace of motion (e.g., there were significant differences in the stiffness not only between adduction and abduction during the faster pace, but also between these and the other motions).

Mechanical Behavior of Dowel-Type Joints Made of Wood Scrimber Composite

PubMed Central

He, Minjuan; Tao, Duo; Li, Zheng; Li, Maolin

2016-01-01

As a renewable building material with low embodied energy characteristics, wood has gained more and more attention in the green and sustainable building industry. In terms of material resource and physical properties, scrimber composite not only makes full use of fast-growing wood species, but also has better mechanical performance and less inherent variability than natural wood material. In this study, the mechanical behavior of bolted beam-to-column joints built with a kind of scrimber composite was investigated both experimentally and numerically. Two groups of specimens were tested under monotonic and low frequency cyclic loading protocols. The experimental results showed that the bolted joints built with scrimber composite performed well in initial stiffness, ductility, and energy dissipation. A three-dimensional (3D) non-linear finite element model (FEM) for the bolted beam-to-column joints was then developed and validated by experimental results. The validated model was further used to investigate the failure mechanism of the bolted joints through stress analysis. This study can contribute to the application of the proposed scrimber composite in structural engineering, and the developed FEM can serve as a useful tool to evaluate the mechanical behavior of such bolted beam-to-column joints with different configurations in future research. PMID:28773703

Mechanical Behavior of Dowel-Type Joints Made of Wood Scrimber Composite.

PubMed

He, Minjuan; Tao, Duo; Li, Zheng; Li, Maolin

2016-07-15

As a renewable building material with low embodied energy characteristics, wood has gained more and more attention in the green and sustainable building industry. In terms of material resource and physical properties, scrimber composite not only makes full use of fast-growing wood species, but also has better mechanical performance and less inherent variability than natural wood material. In this study, the mechanical behavior of bolted beam-to-column joints built with a kind of scrimber composite was investigated both experimentally and numerically. Two groups of specimens were tested under monotonic and low frequency cyclic loading protocols. The experimental results showed that the bolted joints built with scrimber composite performed well in initial stiffness, ductility, and energy dissipation. A three-dimensional (3D) non-linear finite element model (FEM) for the bolted beam-to-column joints was then developed and validated by experimental results. The validated model was further used to investigate the failure mechanism of the bolted joints through stress analysis. This study can contribute to the application of the proposed scrimber composite in structural engineering, and the developed FEM can serve as a useful tool to evaluate the mechanical behavior of such bolted beam-to-column joints with different configurations in future research.

Examining a Bidirectional Association Between Depressive Symptoms and Diabetes

PubMed Central

Golden, Sherita Hill; Lazo, Mariana; Carnethon, Mercedes; Bertoni, Alain G.; Schreiner, Pamela J.; Roux, Ana V. Diez; Lee, Hochang Benjamin; Lyketsos, Constantine

2008-01-01

Context Depressive symptoms are associated with development of type 2 diabetes, but it is unclear whether type 2 diabetes is a risk factor for elevated depressive symptoms. Objective To examine the bidirectional association between depressive symptoms and type 2 diabetes. Design, Setting, and Participants Multi-Ethnic Study of Atherosclerosis, a longitudinal, ethnically diverse cohort study of US men and women aged 45 to 84 years enrolled in 2000-2002 and followed up until 2004-2005. Main Outcome Measures Elevated depressive symptoms defined by Center for Epidemiologic Studies Depression Scale (CES-D) score of 16 or higher, use of antidepressant medications, or both. The CES-D score was also modeled continuously. Participants were categorized as normal fasting glucose (<100 mg/dL), impaired fasting glucose (100-125 mg/dL), or type 2 diabetes (≥126 mg/dL or receiving treatment). Analysis 1 included 5201 participants without type 2 diabetes at baseline and estimated the relative hazard of incidenttype2diabetesover3.2yearsforthosewithandwithoutdepressivesymptoms.Analysis 2 included 4847 participants without depressive symptoms at baseline and calculated the relative odds of developing depressive symptoms over 3.1 years for those with and without type 2 diabetes. Results In analysis 1, the incidence rate of type 2 diabetes was 22.0 and 16.6 per 1000 person-years for those with and without elevated depressive symptoms, respectively. The risk of incident type 2 diabetes was 1.10 times higher for each 5-unit increment in CES-D score (95% confidence interval [CI], 1.02-1.19) after adjustment for demographic factors and body mass index. This association persisted following adjustment for metabolic, inflammatory, socioeconomic, or lifestyle factors, although it was no longer statistically significant following adjustment for the latter (relative hazard, 1.08; 95% CI, 0.99-1.19). In analysis 2, the incidence rates of elevated depressive symptoms per 1000-person years were

Circadian Rhythm Sleep Disorder, Free-Running Type in a Sighted Male with Severe Depression, Anxiety, and Agoraphobia

PubMed Central

Brown, Mark A.; Quan, Stuart F.; Eichling, Philip S.

2011-01-01

Circadian rhythm sleep disorder, free-running type (CRSD, FRT) is a disorder in which the intrinsic circadian rhythm is no longer entrained to the 24-hour schedule. A unique case of CRSD, FRT in a 67-year-old sighted male is presented. The patient had a progressively delayed time in bed (TIB) each night, so that he would cycle around the 24-h clock approximately every 30 days. This was meticulously documented each night by the patient over the course of 22 years. The patient's CRSD, FRT was associated with severe depression, anxiety, and agoraphobia. The agoraphobia may have exacerbated the CRSD, FRT. Entrainment and stabilization of his circadian rhythm was accomplished after treatment that included melatonin, light therapy, and increased sleep structure. Citation: Brown MA; Quan SF; Eichling PS. Circadian rhythm sleep disorder, free-running type in a sighted male with severe depression, anxiety, and agoraphobia. J Clin Sleep Med 2011;7(1):93-94. PMID:21344043

Depression among people with type 2 diabetes mellitus, US National Health and Nutrition Examination Survey (NHANES), 2005-2012.

PubMed

Wang, Yiting; Lopez, Janice M S; Bolge, Susan C; Zhu, Vivienne J; Stang, Paul E

2016-04-05

Depression in people with diabetes can result in increased risk for diabetes-related complications. The prevalence of depression has been estimated to be 17.6 % in people with type 2 diabetes mellitus (T2DM), based on studies published between 1980 and 2005. There is a lack of more recent estimates of depression prevalence among the US general T2DM population. The present study used the US National Health and Nutrition Examination Survey (NHANES) 2005-2012 data to provide an updated, population-based estimate for the prevalence of depression in people with T2DM. NHANES is a cross-sectional survey of a nationally representative sample of the civilian, non-institutionalized US population. Starting from 2005, the Patient Health Questionnaire (PHQ-9) was included to measure signs and symptoms of depression. We defined PHQ-9 total scores ≥ 10 as clinically relevant depression (CRD), and ≥ 15 as clinically significant depression (CSD). Self-reported current antidepressant use was also combined to estimate overall burden of depression. Predictors of CRD and CSD were investigated using survey logistic regression models. A total of 2182 participants with T2DM were identified. The overall prevalence of CRD and CSD among people with T2DM is 10.6 % (95 % confidence interval (CI) 8.9-12.2 %), and 4.2 % (95 % CI 3.4-5.1 %), respectively. The combined burden of depressive symptoms and antidepressants may be as high as 25.4 % (95 % CI 23.0-27.9 %). Significant predictors of CRD include age (younger than 65), sex (women), income (lower than 130 % of poverty level), education (below college), smoking (current or former smoker), body mass index (≥30 kg/m(2)), sleep problems, hospitalization in the past year, and total cholesterol (≥200 mg/dl). Significant predictors of CSD also include physical activity (below guideline) and cardiovascular diseases. The prevalence of CRD and CSD among people with T2DM in the US may be lower than in earlier studies, however, the burden of

Efficacy and moderators of psychological interventions in treating subclinical symptoms of depression and preventing major depressive disorder onsets: protocol for an individual patient data meta-analysis of randomised controlled trials

PubMed Central

Reins, Jo Annika; Zimmermann, Johannes; Cuijpers, Pim

2018-01-01

Introduction The long-term effectiveness of psychological interventions for the treatment of subthreshold depression and the prevention of depression is unclear and effects vary among subgroups of patients, indicating that not all patients profit from such interventions. Randomised clinical trials are mostly underpowered to examine adequately subgroups and moderator effects. The aim of the present study is, therefore, to examine the short-term and long-term as well as moderator effects of psychological interventions compared with control groups in adults with subthreshold depression on depressive symptom severity, treatment response, remission, symptom deterioration, quality of life, anxiety and the prevention of major depressive disorder (MDD) onsets on individual patient level and study level using an individual patient data meta-analysis approach. Methods and analysis Systematic searches in PubMed, PsycINFO, Embase and the Cochrane Central Register of Controlled Trials were conducted. We will use the following types of outcome criteria: (A) onset of major depression; (B) time to major depression onset; (C) observer-reported and self-reported depressive symptom severity; (D) response; (E) remission; (F) symptom deterioration; (G) quality of life, (H) anxiety; and (I) suicidal thoughts and behaviours. Multilevel models with participants nested within studies will be used. Missing data will be handled using a joint modelling approach to multiple imputation. A number of sensitivity analyses will be conducted in order test the robustness of our findings. Ethics and dissemination The investigators of the primary trials have obtained ethical approval for the data used in the present study and for sharing the data, if this was necessary, according to local requirements and was not covered from the initial ethic assessment. This study will summarise the available evidence on the short-term and long-term effectiveness of preventive psychological interventions for the

Symptoms of anxiety and depression in type 2 diabetes: Associations with clinical diabetes measures and self-management outcomes in the Norwegian HUNT study.

PubMed

Naicker, Kiyuri; Øverland, Simon; Johnson, Jeffrey A; Manuel, Douglas; Skogen, Jens C; Sivertsen, Børge; Colman, Ian

2017-10-01

To determine if symptoms of depression and anxiety are differentially associated with clinical diabetes measures and self-management behaviours in individuals with Type 2 diabetes, and whether these associations vary by patient sex. A cross-sectional analysis using data from 2035 adults with Type 2 diabetes in the Nord-Trøndelag Health Study. Multivariate logistic regression was used to explore associations between symptoms of depression and anxiety and waist girth, HDL cholesterol, systolic blood pressure, triglycerides, c-reactive protein, glycemic control, diet adherence, exercise, glucose monitoring, foot checks for ulcers, and the subjective patient experience. Analyses were stratified by sex. Depression was associated with a lower likelihood of avoiding saturated fats (OR=0.20 [95% CI: 0.06, 0.68]) and increased odds of physical inactivity (OR=1.69 [95% CI: 1.37, 2.72]). Anxiety was associated with increased odds of eating vegetables (OR=1.66 [95% CI: 1.02, 2.73]), and an over two-fold increase of feeling that having diabetes is difficult. In women, anxiety was associated with elevated c-reactive protein levels (OR=1.57 [95% CI: 1.05, 2.34]). In men, depressive symptoms were associated with elevated HbA1c (OR=5.00 [95% CI: 1.15, 8.23). Symptoms of depression and anxiety were differentially associated with some key diabetes-related measures. Our results suggest sex-specific differences with respect to two important clinical outcomes (i.e., anxiety and CRP in women and depression and glycemic control in men). These findings should alert practitioners to the importance of detection and management of psychological symptoms in individuals with Type 2 diabetes. Copyright © 2017. Published by Elsevier Ltd.

Lamotrigine in binge-eating disorder associated with bipolar II depression and treatment-resistant type 2 diabetes mellitus: a case report.

PubMed

Yamamoto, Tetsuya; Kanahara, Nobuhisa; Hirai, Aizan; Watanabe, Hiroyuki; Iyo, Masaomi

2013-01-01

Lamotrigine (LMG) is an anticonvulsant currently registered for the treatment of bipolar disorder (BP) depression. We report the case of a 61-year-old woman with comorbid binge-eating disorder (BED), BP depression, and treatment-resistant type 2 diabetes mellitus (T2DM), in which LMG showed significant efficacy against BED and BP depression and resulted in a drastic decrease in plasma glucose levels. The patient had had untreated BP depression, BED, and T2DM for more than 30 years. We prescribed LMG at 25 mg/d for BP depression and titrated it up to 50 mg/d over 4 weeks, then maintained this dose for the next 16 weeks. At follow-up after the first 4-week period, she reported a significant decrease in compulsive eating impulses and depressive mood, and her positive reports were consistent in the following months. Hemoglobin A1c levels at National Glycohemoglobin Standardization Program decreased drastically from 9.6% to 7.1% over the 20 weeks after initiating treatment. This case suggests that LMG might be beneficial for BED with concomitant BP depression, and potentially for treatment-resistant T2DM, if this refractoriness is identified to result from comorbidity of BED and BP.

A Review of Natural Joint Systems and Numerical Investigation of Bio-Inspired GFRP-to-Steel Joints

PubMed Central

Avgoulas, Evangelos I.; Sutcliffe, Michael P. F.

2016-01-01

There are a great variety of joint types used in nature which can inspire engineering joints. In order to design such biomimetic joints, it is at first important to understand how biological joints work. A comprehensive literature review, considering natural joints from a mechanical point of view, was undertaken. This was used to develop a taxonomy based on the different methods/functions that nature successfully uses to attach dissimilar tissues. One of the key methods that nature uses to join dissimilar materials is a transitional zone of stiffness at the insertion site. This method was used to propose bio-inspired solutions with a transitional zone of stiffness at the joint site for several glass fibre reinforced plastic (GFRP) to steel adhesively bonded joint configurations. The transition zone was used to reduce the material stiffness mismatch of the joint parts. A numerical finite element model was used to identify the optimum variation in material stiffness that minimises potential failure of the joint. The best bio-inspired joints showed a 118% increase of joint strength compared to the standard joints. PMID:28773688

A Review of Natural Joint Systems and Numerical Investigation of Bio-Inspired GFRP-to-Steel Joints.

PubMed

Avgoulas, Evangelos I; Sutcliffe, Michael P F

2016-07-12

There are a great variety of joint types used in nature which can inspire engineering joints. In order to design such biomimetic joints, it is at first important to understand how biological joints work. A comprehensive literature review, considering natural joints from a mechanical point of view, was undertaken. This was used to develop a taxonomy based on the different methods/functions that nature successfully uses to attach dissimilar tissues. One of the key methods that nature uses to join dissimilar materials is a transitional zone of stiffness at the insertion site. This method was used to propose bio-inspired solutions with a transitional zone of stiffness at the joint site for several glass fibre reinforced plastic (GFRP) to steel adhesively bonded joint configurations. The transition zone was used to reduce the material stiffness mismatch of the joint parts. A numerical finite element model was used to identify the optimum variation in material stiffness that minimises potential failure of the joint. The best bio-inspired joints showed a 118% increase of joint strength compared to the standard joints.

Prevalence of depression among people with type 2 diabetes mellitus: a cross sectional study in Palestine.

PubMed

Sweileh, Waleed M; Abu-Hadeed, Hanadi M; Al-Jabi, Samah W; Zyoud, Sa'ed H

2014-02-13

Diabetes mellitus is a common chronic metabolic disorder and one of the main causes of death in Palestine. Palestinians are continuously living under stressful economic and military conditions which make them psychologically vulnerable. The purpose of this study was to investigate the prevalence of depression among type II diabetic patients and to examine the relationship between depression and socio-demographic factors, clinical factors, and glycemic control. This was a cross-sectional study at Al-Makhfiah primary healthcare center, Nablus, Palestine. Two hundred and ninety-four patients were surveyed for the presence of depressive symptoms using Beck Depression Inventory (BDI-II) scale. Patients' records were reviewed to obtain data pertaining to age, sex, marital status, Body Mass Index (BMI), level of education, smoking status, duration of diabetes mellitus, glycemic control using HbA1C test, use of insulin, and presence of additional illnesses. Patients' medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). One hundred and sixty four patients (55.8%) of the total sample were females and 216 (73.5%) were < 65 years old. One hundred and twenty patients (40.2%) scored ≥ 16 on BDI-II scale. Statistical significant association was found between high BDI-II score (≥ 16) and female gender, low educational level, having no current job, having multiple additional illnesses, low medication adherence and obesity (BMI ≥ 30 kg/m2). No significant association between BDI score and glycemic control, duration of diabetes, and other socio-demographic factors was found. Multivatriate analysis showed that low educational level, having no current job, having multiple additional illnesses and low medication adherence were significantly associated with high BDI-II scores. Prevalence of depression found in our study was higher than that reported in other countries. Although 40% of the screened patients were potential cases of

Sacroiliac joint tuberculosis: surgical management by posterior open-window focal debridement and joint fusion.

PubMed

Zhu, Guo; Jiang, Li-Yuan; Yi, Zhang; Ping, Li; Duan, Chun-Yue; Yong, Cao; Liu, Jin-Yang; Hu, Jian-Zhong

2017-11-29

Sacroiliac joint tuberculosis(SJT) is relatively uncommon, but it may cause severe sacroiliac joint destruction and functional disorder. Few studies in the literature have been presented on SJT, reports of surgical treatment for SJT are even fewer. In this study, we retrospectively reviewed surgical management of patients with severe SJT of 3 different types and proposed to reveal the clinical manifestations and features and aim to determine the efficiency and security of such surgical treatment. We reviewed 17 patients with severe SJT of 3 different types who underwent posterior open-window focal debridement and bone graft for joint fusion. Among them,five patients with anterior sacral abscess had anterior abscess curettage before debridement. Two patients with lumbar vertebral tuberculosis received one-stage posterior tuberculous debridement, interbody fusion and instrumentation. Follow-up was performed 36 months (26 to 45 months) using the following parameters: erythrocyte sedimentation rate(ESR), status of joint bony fusion on CT scan, visual analogue scale (VAS) and the Oswestry Disability Index (ODI). Buttock pain and low back pain were progressively relieved with time. 6 months later, pain was not obvious, and ESR resumed to normal levels within 3 months. Solid fusion of the sacroiliac joint occurred within 12 months in all cases. No complications or recurrence occurred. At final follow-up, all patients had no pain or only minimal discomfort over the affected joint and almost complete functional recovery. Posterior open-window focal debridement and joint fusion is an efficient and secure surgical method to treat severe SJT. If there is an abscess in the front of the sacroiliac joint, anterior abscess curettage should be performed as a supplement.

Bayesian inference for joint modelling of longitudinal continuous, binary and ordinal events.

PubMed

Li, Qiuju; Pan, Jianxin; Belcher, John

2016-12-01

In medical studies, repeated measurements of continuous, binary and ordinal outcomes are routinely collected from the same patient. Instead of modelling each outcome separately, in this study we propose to jointly model the trivariate longitudinal responses, so as to take account of the inherent association between the different outcomes and thus improve statistical inferences. This work is motivated by a large cohort study in the North West of England, involving trivariate responses from each patient: Body Mass Index, Depression (Yes/No) ascertained with cut-off score not less than 8 at the Hospital Anxiety and Depression Scale, and Pain Interference generated from the Medical Outcomes Study 36-item short-form health survey with values returned on an ordinal scale 1-5. There are some well-established methods for combined continuous and binary, or even continuous and ordinal responses, but little work was done on the joint analysis of continuous, binary and ordinal responses. We propose conditional joint random-effects models, which take into account the inherent association between the continuous, binary and ordinal outcomes. Bayesian analysis methods are used to make statistical inferences. Simulation studies show that, by jointly modelling the trivariate outcomes, standard deviations of the estimates of parameters in the models are smaller and much more stable, leading to more efficient parameter estimates and reliable statistical inferences. In the real data analysis, the proposed joint analysis yields a much smaller deviance information criterion value than the separate analysis, and shows other good statistical properties too. © The Author(s) 2014.

Modeling Progressive Failure of Bonded Joints Using a Single Joint Finite Element

NASA Technical Reports Server (NTRS)

Stapleton, Scott E.; Waas, Anthony M.; Bednarcyk, Brett A.

2010-01-01

Enhanced finite elements are elements with an embedded analytical solution which can capture detailed local fields, enabling more efficient, mesh-independent finite element analysis. In the present study, an enhanced finite element is applied to generate a general framework capable of modeling an array of joint types. The joint field equations are derived using the principle of minimum potential energy, and the resulting solutions for the displacement fields are used to generate shape functions and a stiffness matrix for a single joint finite element. This single finite element thus captures the detailed stress and strain fields within the bonded joint, but it can function within a broader structural finite element model. The costs associated with a fine mesh of the joint can thus be avoided while still obtaining a detailed solution for the joint. Additionally, the capability to model non-linear adhesive constitutive behavior has been included within the method, and progressive failure of the adhesive can be modeled by using a strain-based failure criteria and re-sizing the joint as the adhesive fails. Results of the model compare favorably with experimental and finite element results.

Inbreeding depression in an insect with maternal care: influences of family interactions, life stage and offspring sex.

PubMed

Meunier, J; Kölliker, M

2013-10-01

Although inbreeding is commonly known to depress individual fitness, the severity of inbreeding depression varies considerably across species. Among the factors contributing to this variation, family interactions, life stage and sex of offspring have been proposed, but their joint influence on inbreeding depression remains poorly understood. Here, we demonstrate that these three factors jointly shape inbreeding depression in the European earwig, Forficula auricularia. Using a series of cross-breeding, split-clutch and brood size manipulation experiments conducted over two generations, we first showed that sib mating (leading to inbred offspring) did not influence the reproductive success of earwig parents. Second, the presence of tending mothers and the strength of sibling competition (i.e. brood size) did not influence the expression of inbreeding depression in the inbred offspring. By contrast, our results revealed that inbreeding dramatically depressed the reproductive success of inbred adult male offspring, but only had little effect on the reproductive success of inbred adult female offspring. Overall, this study demonstrates limited effects of family interactions on inbreeding depression in this species and emphasizes the importance of disentangling effects of sib mating early and late during development to better understand the evolution of mating systems and population dynamics. © 2013 The Authors. Journal of Evolutionary Biology © 2013 European Society For Evolutionary Biology.

Efficacy and cost-effectiveness of a web-based intervention with mobile phone support to treat depressive symptoms in adults with diabetes mellitus type 1 and type 2: design of a randomised controlled trial

PubMed Central

2013-01-01

Background A diagnosis of diabetes mellitus types 1 or 2 doubles the odds of a comorbid depressive disorder. The combined diseases have a wide range of adverse outcomes, such as a lower quality of life, poorer diabetes outcomes and increased healthcare utilisation. Diabetes patients with depression can be treated effectively with psychotherapy, but access to psychological care is limited. In this study we will examine the efficacy and cost-effectiveness of a newly developed web-based intervention (GET.ON Mood Enhancer Diabetes) for people with diabetes and comorbid depressive symptoms. Methods/Design A two-arm randomised controlled trial will be conducted. Adults with diabetes (type 1 or type 2) with increased depression scores (> 22 on the German version of the Center for Epidemiological Studies Depression Scale (CES-D)) will be included. Eligible participants will be recruited through advertisement in diabetes patient journals and via a large-scale German health insurance company. The participants will be randomly assigned to either a 6-week minimally guided web-based self-help program or an online psychoeducation program on depression. The study will include 260 participants, which will enable us to detect a statistically significant difference with a group effect size of d = 0.35 at a power of 80% and a significance level of p = 0.05. The primary outcome measure will be the level of depression as assessed by the CES-D. The secondary outcome measures will be: diabetes-specific emotional distress, glycaemic control, self-management behaviour and the participants’ satisfaction with the intervention. Online self-assessments will be collected at baseline and after a 2 months period, with additional follow-up measurements 6 and 12 months after randomisation. The data will be analysed on an intention-to-treat basis and per protocol. In addition, we will conduct an economic evaluation from a societal perspective. Discussion If this intervention is shown to be

Impact of childhood trauma on postpartum depression: a prospective study.

PubMed

De Venter, Maud; Smets, Jorien; Raes, Filip; Wouters, Kristien; Franck, Erik; Hanssens, Myriam; Jacquemyn, Yves; Sabbe, Bernard G C; Van Den Eede, Filip

2016-04-01

Studies on the impact of childhood trauma on postpartum depression show inconsistencies and methodological limitations. The present study examines the effect of childhood trauma on depression 12 and 24 weeks after childbirth, while controlling for history of depression, depression symptoms during pregnancy and type D personality. During the third trimester of pregnancy, 210 women completed self-report questionnaires assessing depression (current and/or past episodes), childhood trauma and type D personality, of whom 187 participated in the postpartum follow-up, with depression symptoms being reassessed at 12 and 24 weeks after delivery with three depression outcome measures. Eventually, 183 participants were retained for analysis. Results indicated no predictive value of childhood trauma on postpartum depression in the univariate analyses, nor after controlling for previous depression, depression symptoms during pregnancy and type D personality. However, past depression and depression symptoms during pregnancy did independently and convincingly predict postpartum depression, especially at 12 weeks and to a lesser extent at 24 weeks following childbirth. Overall, we found no significant association between childhood trauma and postpartum depression. Past depression and depression symptoms during pregnancy are more relevant factors to assess before childbirth.

Major depressive disorder and type II diabetes mellitus: mechanisms underlying risk for Alzheimer's disease.

PubMed

Cha, Danielle S; Carvalho, Andre F; Rosenblat, Joshua D; Ali, Muna M; McIntyre, Roger S

2014-01-01

Objectives/Introduction: Major Depressive Disorder is associated age-related medical conditions (e.g., diabetes mellitus type II, Alzheimer's disease) that frequently manifest at an earlier age, contributing to excess and premature mortality. The foregoing observation provides the impetus to further refine potential mechanisms and molecular pathways subserving these disorders in order to more effectively treat these clinical populations by aiming to reduce and prevent cognitive impairment as well as downstream neurodegeneration. A review of computerized databases was performed to identify original studies that investigated the impact of the independent and comorbid association of major depressive disorder and type II diabetes mellitus on cognitive function and conversion to Alzheimer's disease. English-written articles were selected for review based on the adequacy of sample size, the use of standardized diagnostic instruments, and validated assessment measures. Individuals with persistent neuropsychiatric illness account for a disproportionate overall burden of disability mediated largely by decrements in cognitive performance. Mixed results from epidemiological and clinical studies suggest that insulin may mediate and/or moderate risk for cognitive dysfunction in subsets of individuals. Moreover, physiological changes, such as insulin resistance and the activation of neuroimmunoinflammatory systems result in glial and neuroendangerment. Disturbances in the metabolic milieu exert a neurotoxic effect on the central nervous system and poses a hazard to other organ systems.

Design and methods for a pilot randomized clinical trial involving exercise and behavioral activation to treat comorbid type 2 diabetes and major depressive disorder

PubMed Central

Schneider, Kristin L.; Pagoto, Sherry L.; Handschin, Barbara; Panza, Emily; Bakke, Susan; Liu, Qin; Blendea, Mihaela; Ockene, Ira S.; Ma, Yunsheng

2011-01-01

Background The comorbidity of type 2 diabetes mellitus (T2DM) and depression is associated with poor glycemic control. Exercise has been shown to improve mood and glycemic control, but individuals with comorbid T2DM and depression are disproportionately sedentary compared to the general population and report more difficulty with exercise. Behavioral activation, an evidence-based depression psychotherapy, was designed to help people with depression make gradual behavior changes, and may be helpful to build exercise adherence in sedentary populations. This pilot randomized clinical trial will test the feasibility of a group exercise program enhanced with behavioral activation strategies among women with comorbid T2DM and depression. Methods/Design Sedentary women with inadequately controlled T2DM and depression (N=60) will be randomly assigned to one of two conditions: exercise or usual care. Participants randomized to the exercise condition will attend 38 behavioral activation-enhanced group exercise classes over 24 weeks in addition to usual care. Participants randomized to the usual care condition will receive depression treatment referrals and print information on diabetes management via diet and physical activity. Assessments will occur at baseline and 3-, 6-, and 9-months following randomization. The goals of this pilot study are to demonstrate feasibility and intervention acceptability, estimate the resources and costs required to deliver the intervention and to estimate the standard deviation of continuous outcomes (e.g., depressive symptoms and glycosylated hemoglobin) in preparation for a fully-powered randomized clinical trial. Discussion A novel intervention that combines exercise and behavioral activation strategies could potentially improve glycemic control and mood in women with comorbid type 2 diabetes and depression. Trial registration NCT01024790 PMID:21765864

The transitional vertebra and sacroiliac joint dysfunction association.

PubMed

Illeez, Ozge Gulsum; Atıcı, Arzu; Ulger, Esra Bahadır; Kulcu, Duygu Geler; Ozkan, Feyza Unlu; Aktas, Ilknur

2018-01-01

The purpose of this study was to investigate whether transitional vertebrae contribute to the development of sacroiliac joint dysfunction. The prevalence of transitional vertebrae in patients with lumbar pain was determined during this process, and the prevalence of sacroiliac dysfunction was compared between patients with low back pain and healthy volunteers. 700 subjects, 500 with low back pain and 200 healthy volunteers were included in this study. Five tests were applied to all participants to determine sacroiliac joint dysfunction. Positivity in three tests was regarded as dysfunction. Lateral lumbosacral and Ferguson angle X-rays were taken from the group with low back pain. The patient was evaluated a specialist radiologist in terms of presence or absence of transitional vertebrae, and if identified, what type. Transitional vertebrae were determined in 26% (n = 130) of the patients with low back pain. Type 1a was determined in 20%, type 1b in 10%, type 2a in 26.9%, type 2b in 30.8%, type 3a in 0.8%, type 3b in 4.6% and type 4 in 6.9%. The prevalence of sacroiliac joint dysfunction in the low back pain group (15.4%) and the prevalence of sacroiliac joint dysfunction in cases of transitional vertebra (28.5%) were significantly higher compared to the control groups (p < 0.05). Sacroiliac joint dysfunction must be considered when investigating the etiology of low back pain. Particular sensitivity must be exhibited on this subject in patients with transitional vertebrae.

[Primary headache and depression].

PubMed

Gesztelyi, Gyöngyi

2004-11-28

Primary headaches--mainly tension-type headache and migraine--affect a significant portion of the population. Depression is also highly prevalent. The co-existence of a primary headache and depression in the same patient therefore might be a coincidence due to the high prevalence of these conditions, but there might be a causal relationship between them, or headaches and depression might have a common background. This review of the literature summarizes the features of the relationship between primary headaches and depression. Depression is more prevalent in headache patients than in the headache-free population. Prospective epidemiological studies suggest a common genetic, biochemical or environmental background behind primary headaches and depression. This theory is supported by the role of the same neurotransmitter systems (mostly serotonin and dopamine) in headaches as well as in depression. Comorbid depression is associated with female gender, higher age, and higher frequency of headaches. Most depression inventories--questionnaires used to screen for the severity of depressive symptoms--contain transdiagnostic items, therefore their use in their original form is limited in organic diseases: due to the somatic items they might overestimate the severity of depression. When examining a headache patient special attention should be paid to the recognition of comorbid depression. The diagnosis of suspected mood disorder could be supported by using simple screening methods, such as the original or the abbreviated versions of standard depression inventories, but the final diagnosis of major depression needs psychiatric evaluation. Quality of life of the headache patient is affected not only by the characteristics of pain (frequency, duration, severity) but also by the disability caused by headache and the associating mood disorder. Recognizing coexisting mood disorder and disability helps to make the best treatment choice for the acute and preventive treatment of

Depressive symptoms prior to and following insulin initiation in patients with type 2 diabetes mellitus: Prevalence, risk factors and effect on physician resource utilisation.

PubMed

Dzida, Grzegorz; Karnieli, Eddy; Svendsen, Anne Louise; Sølje, Kristine Steensen; Hermanns, Norbert

2015-10-01

To study the frequency and intensity of depressive symptoms and associations with physician resource utilisation following insulin initiation in patients with type 2 diabetes mellitus. SOLVE was a 24-week observational study. In this sub-analysis of data from Poland, depressive symptoms were evaluated using the Patient Health Questionnaire (PHQ)-9. PHQ-9 was completed by 942 of 1169 patients (80.6%) at baseline, and 751 (64.2%) at both baseline and final (24-week) visit. PHQ-9 scores indicated depressive symptoms in 45.6% (n=430) at baseline, and 27.2% (n=223) at final visit. Mean PHQ-9 change was -2.38 [95% CI -2.73, -2.02], p<0.001. Depressive symptoms at baseline (OR 6.32, p<0.001), microvascular disease (OR 2.45, p=0.016), number of physician contacts (OR 1.16, p=0.009), and change in HbA1c (OR 0.60, p=0.025) were independently associated with moderate/severe depressive symptoms at final visit. Patients with more severe depressive symptoms spent more time training to self-inject (p=0.0016), self-adjust (p=0.0023) and manage other aspects of insulin delivery (p<0.0001). Patients with persistent depressive symptoms had more telephone contacts and dose changes at final visit than those without (both p<0.05). Depressive symptoms are common with type 2 diabetes and associated with increased healthcare utilisation, reinforcing the need for holistic interdisciplinary management approaches. Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

Construct, concurrent and discriminant validity of Type D personality in the general population: associations with anxiety, depression, stress and cardiac output.

PubMed

Howard, Siobhán; Hughes, Brian M

2012-01-01

The Type D personality, identified by high negative affectivity paired with high social inhibition, has been associated with a number of health-related outcomes in (mainly) cardiac populations. However, despite its prevalence in the health-related literature, how this personality construct fits within existing personality theory has not been directly tested. Using a sample of 134 healthy university students, this study examined the Type D personality in terms of two well-established personality traits; introversion and neuroticism. Construct, concurrent and discriminant validity of this personality type was established through examination of the associations between the Type D personality and psychometrically assessed anxiety, depression and stress, as well as measurement of resting cardiovascular function. Results showed that while the Type D personality was easily represented using alternative measures of both introversion and neuroticism, associations with anxiety, depression and stress were mainly accounted for by neuroticism. Conversely, however, associations with resting cardiac output were attributable to the negative affectivity-social inhibition synergy, explicit within the Type D construct. Consequently, both the construct and concurrent validity of this personality type were confirmed, with discriminant validity evident on examination of physiological indices of well-being.

Support for disease management, depression, self-care, and clinical indicators among Hispanics with type 2 diabetes in San Diego County, United States of America.

PubMed

Fortmann, Addie L; Gallo, Linda C; Walker, Chris; Philis-Tsimikas, Athena

2010-09-01

This study used a social-ecological framework to examine predictors of depression, diabetes self-management, and clinical indicators of health risk among Hispanics with type 2 diabetes residing in the United States (U.S.)-Mexico border region in San Diego County, California, United States of America. Important links were observed between greater social-environmental support for disease management and less depression, better diabetes self-management, and lower body mass index and serum triglyceride concentrations. Less depressive symptomatology was also related to lower hemoglobin A1c levels. Findings suggest that programs aiming to improve diabetes self-management and health outcomes in Hispanics with type 2 diabetes should consider multilevel, social, and environmental influences on health, behavior, and emotional well-being.

Prevalence and predictors of depression and anxiety in adult patients with type 1 diabetes in tertiary care setting.

PubMed

Castellano-Guerrero, A M; Guerrero, R; Relimpio, F; Losada, F; Mangas, M A; Pumar, A; Martínez-Brocca, M A

2018-06-13

To determine gender and age differences in the prevalence of depression and anxiety and their predictive factors in adult patients with type 1 diabetes (DM1). Random sample of DM1 adult patients from a tertiary care hospital cohort. To evaluate the presence of depression and anxiety, psychological evaluation was performed using structured clinical interview (MINI). For the specific evaluation of fear of hypoglycemia (FH), FH-15 questionnaire was used. 339 patients [51.6% male; 38.5 ± 12.9 years; HbA 1c 7.5 ± 1.1% (58.5 ± 14.2 mmol/mol); 20.1 ± 12.0 years of DM1] met the inclusion criteria. Prevalence of depression, anxiety, and FH in men vs. women was as follows (%): depression: 15.4 vs. 33.5 (p < 0.05); anxiety: 13.7 vs. 26.2 (p < 0.05); and FH: 42.8 vs. 46.0 (p = NS). Among midlife female patients, prevalence of depression and anxiety was higher compared to male. Moreover, comorbid depressive and anxious symptoms were also higher in midlife female patients compared to age-matched male patients (3.5 vs. 14%, p < 0.05). Apart from age-related vulnerability, female gender, poor glycemic control, and microvascular and macrovascular complications were predictive factors for depressive and anxious symptomatology. Unawareness hypoglycemia and anxiety-prone personality were predictor factors for FH. In adults with DM1, prevalence of depression and anxiety is higher in women. Midlife patients, in particular women, show a significantly higher prevalence of anxiety symptoms and comorbid depression and anxiety. The presence of secondary complications and sustained poor glycemic control should alert to the possibility of these mental disorders, especially in the most vulnerable age population; clinical, gender and age-related patterns could help to design more effective psychological assessment and support in adult patients with DM1.

Gastrointestinal disorders in joint hypermobility syndrome/Ehlers-Danlos syndrome hypermobility type: A review for the gastroenterologist.

PubMed

Beckers, A B; Keszthelyi, D; Fikree, A; Vork, L; Masclee, A; Farmer, A D; Aziz, Q

2017-08-01

Joint hypermobility syndrome (JHS)/Ehlers-Danlos syndrome hypermobility type (EDS-HT) is the most common hereditary non-inflammatory disorder of connective tissue, characterized by a wide range of symptoms, mainly joint hyperextensibility and musculoskeletal symptoms. A majority of patients also experiences gastrointestinal (GI) symptoms. Furthermore, JHS/EDS-HT has specifically been shown to be highly prevalent in patients with functional GI disorders, such as functional dyspepsia and irritable bowel syndrome. The aim of this review was to examine the nature of GI symptoms and their underlying pathophysiology in JHS/EDS-HT. In addition, we consider the clinical implications of the diagnosis and treatment of JHS/EDS-HT for practicing clinicians in gastroenterology. Observations summarized in this review may furthermore represent the first step toward the identification of a new pathophysiological basis for a substantial subgroup of patients with functional GI disorders. © 2017 John Wiley & Sons Ltd.

Neural substrates of trait ruminations in depression

PubMed Central

Mandell, Darcy; Siegle, Greg; Shutt, Luann; Feldmiller, Josh; Thase, Michael E.

2014-01-01

Rumination in depression is a risk factor for longer, more intense, and harder-to-treat depressions. But there appear to be multiple types of depressive rumination – whether they all share these vulnerability mechanisms, and thus would benefit from the same types of clinical attention is unclear. In the current study, we examined neural correlates of empirically-derived dimensions of trait rumination in 35 depressed participants. These individuals and 29 never-depressed controls completed 17 self-report measures of rumination and an alternating emotion-processing/executive-control task during functional magnetic resonance imaging (fMRI) assessment. We examined associations of regions of interest—the amygdala and other cortical regions subserving a potential role in deficient cognitive control and elaborative emotion-processing—with trait rumination. Rumination of all types was generally associated with increased sustained amygdala reactivity. When controlling for amygdala reactivity, distinct activity patterns in hippocampus were also associated with specific dimensions of rumination. We discuss the possibly utility of targeting more basic biological substrates of emotional reactivity in depressed patients who frequently ruminate. PMID:24661157

The association of different types of cerebral infarction with post-stroke depression and cognitive impairment.

PubMed

Tu, Jun; Wang, Ling-Xiao; Wen, Hong-Feng; Xu, Yi-Cheng; Wang, Pei-Fu

2018-06-01

The aim of this study was to investigate post-stroke depression (PSD) and cognitive impairments in patients with different types of cerebral infarction.A total of 110 patients with cerebral infarction treated in our hospital from January 2015 to February 2016 were included in present study. Forty-seven patients were PSD patients and 63 patients were non-PSD patients. The Hamilton Depression Rating Scale (HAMD) and Mini-Mental State Examination (MMSE) were employed to assess depression and cognition of patientsAmong PSD patients, the proportion of patients with partial anterior circulation infarction (PACI, 68.75%) was significantly higher than patients with lacunar circulation infarction (LACI, 29.17%) and posterior circulation infarction (POCI, 26.67%) (P < .05). No significant difference was found in PSD patients with LACI and POCI (P > .05). The MMSE score of patients with PACI (18.05 ± 2.61) was lower than patients with POCI and LACI (P < .05), however, no significant difference was found in patients with LACI and POCI (P > 0.05). The incidences of cognitive impairment in patients with PACI, LACI, and POCI were 12.50%, 14.58%, and 13.33%, respectively. The MMSE score of PSD patients (21.23 ± 2.12) was significantly lower than non-PSD patients (P < .05).Compared with LACI and POCI patients, PACI patients had a higher incidence of PSD and impaired cognitive functions. In addition, affective disorders such as depression may be correlated with cognitive impairment in patients with cerebral infarction.

Growth of Interfacial Intermetallic Compound Layer in Diffusion-Bonded SAC-Cu Solder Joints During Different Types of Thermomechanical Excursion

NASA Astrophysics Data System (ADS)

Kanjilal, Anwesha; Kumar, Praveen

2018-01-01

The effects of mechanical strain on the growth kinetics of interfacial intermetallic compounds (IMCs) sandwiched between Cu substrate and Sn-1.0 wt.%Ag-0.5 wt.%Cu (SAC105) solder have been investigated. Isothermal aging (IA) at 70°C and 125°C, and thermal cycling (TC) as well as thermomechanical cycling (TMC) with shear strain of 12.8% per cycle between -25°C and 125°C were applied to diffusion-bonded solder joints to study the growth behavior of the interfacial IMC layer under various types of thermomechanical excursion (TME). The microstructure of the solder joint tested under each TME was observed at regular intervals. It was observed that the growth rate of the IMC layer was higher in the case of TMC compared with TC or IA. This increased growth rate of the IMC layer in the presence of mechanical strain suggests an additional driving force that enhances the growth kinetics of the IMC. Finite element analysis was performed to gain insight into the effect of TC and TMC on the stress field in the solder joint, especially near the interface between the solder and the substrate. Finally, an analytical model was developed to quantify the effect of strain on the effective diffusivity and express the growth kinetics for all three types of TME using a single expression.

Social relations, depressive symptoms, and incident type 2 diabetes mellitus: The English Longitudinal Study of Ageing.

PubMed

Laursen, Karin Rosenkilde; Hulman, Adam; Witte, Daniel R; Terkildsen Maindal, Helle

2017-04-01

We examined whether social relations are associated with the risk of developing type 2 diabetes mellitus (T2DM) and furthermore, whether social relations modify the association between depressive symptoms and incident T2DM. We hypothesized that the risk of developing T2DM would be lower for individuals with stronger social relations compared to those with weaker social relations, and that the association between depressive symptoms and incident T2DM would be attenuated for those with stronger social relations. Non-diabetic participants (n=7662) of the "English Longitudinal Study of Ageing" (3398 men) aged 50-91years were followed until 2012/2013, after baseline assessment of depressive symptoms, social support, relational strain, and network size. Hazard ratios (HR) for incident diabetes were calculated using Cox proportional hazard models, adjusting for relevant confounders. Age and sex adjusted HRs showed that social relations were associated with incident diabetes (Support: HR 0.98 95% CI 0.97; 0.99, Strain: HR 1.02 95% CI 1.01; 1.04, Network limited : HR 1.19 95% CI 0.98; 1.44), however, when adjusted for age, sex, ethnicity, marital status, household wealth, health behaviour, and body mass index the associations were attenuated and were no longer statistically significant. Depressive symptoms were associated with higher diabetes risk. This effect was not modified by any of the social variables. People with stronger social relations are at lower risk of developing T2DM; however, this effect is largely explained by known diabetes risk factors. No evidence was found that stronger social relations reduce the association between depressive symptoms and incident T2DM. Copyright © 2017 Elsevier B.V. All rights reserved.

Polymorphisms in the type I deiodinase gene and frontal function in recurrent depressive disorder.

PubMed

Gałecka, Elżbieta; Talarowska, Monika; Orzechowska, Agata; Górski, Paweł; Szemraj, Janusz

2016-09-01

Significant impairment of some psychological functions, including cognitive functioning, has been characteristically found in depressed patients. Memory disturbances may be related to the levels of thyroid hormones (TH) that are under the influence of different mechanisms and molecules, including deiodinase type 1(D1) - an important determinant of circulating triiodothyronine (T3). We investigated the relationship between two functionally known polymorphisms within the DIO1 gene, i.e. DIO1a-C/T and DIO1b-A/G, and cognitive functioning in patients diagnosed with recurrent depressive disorder (rDD). In the planned analysis we mainly concentrated on the frontal function: working memory, executive functions and verbal fluency. Genetic variants were genotyped in 128 patients using a method based on polymerase chain reaction (PCR). Cognitive functions were assessed by the Trail Making Test, the Stroop Test and the Verbal Fluency Test (VFT). No significant associations were found between DIO1 polymorphisms and cognitive functioning in rDD. Only the CT and TT genotypes of the DIO1a variant were significantly related to verbal fluency. There were no significant differences between the distribution of the genotypes and demographic/medical variables. Based on the study, the examined polymorphisms are not an important risk or protective factor for cognitive impairment in depressive patients. Functional variants within the DIO1 gene that affect triiodothyronine (T3) levels seem not to be associated with cognitive functions. Nevertheless, considering the fact that the DIO1 gene is related to the course and management of depression, further studies on a larger sample size might be suggested. Copyright © 2016 Medical University of Bialystok. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

Psychometric testing of a Mandarin Chinese Version of the Clinically Useful Depression Outcome Scale for patients diagnosed with type 2 diabetes mellitus.

PubMed

Hsu, Lan-Fang; Kao, Ching-Chiu; Wang, Mei-Yeh; Chang, Chun-Jen; Tsai, Pei-Shan

2014-12-01

The Clinically Useful Depression Outcome Scale (CUDOS) is a self-report instrument that assesses symptoms and the severity of depression, but its psychometric properties in patients with type 2 diabetes mellitus in Chinese-Speaking populations are unknown. To examine the psychometric properties of the Mandarin Chinese version of the CUDOS (CUDOS-Chinese). A methodological research design. Endocrinology and metabolism outpatient clinics at 2 university-affiliated hospitals in northern Taiwan. Two-hundred and fourteen type 2 diabetic patients with the mean age of 62.6 years were enrolled, and two-hundred and twelve of them completed the study. Internal consistency, test-retest reliability, concurrent, and contrasted-groups validity were assessed. A receiver operating characteristic curve analysis was performed to assess sensitivity and specificity. Construct validity by means of confirmatory factor analysis was conducted. Internal consistency (Cronbach α of total scale and four subscales=0.93, 0.80, 0.66, 0.80, and 0.83, respectively), test-retest reliability (intra-class correlation coefficients of total scale and four subscales=0.92, 0.89, 0.94, 0.89, and 0.91, respectively), and strong correlations with the Beck Depression Inventory-II (r=0.87) suggested good reliability and validity. The confirmatory factor analysis supported a four-factor model. A cut-off score of 19/20 yielded 77.8% sensitivity and 75.6% specificity. The CUDOS-Chinese demonstrated satisfactory validity and reliability for detecting depression in type 2 diabetic patients in Taiwan. Copyright © 2014 Elsevier Ltd. All rights reserved.

Depression: What Every Woman Should Know.

ERIC Educational Resources Information Center

National Inst. of Mental Health (DHHS), Bethesda, MD.

This publication, written in English, explains why women are at greater risk for depression than men. Types of depressive illnesses are explained along with the symptoms. It states that some women are predisposed genetically to depression but biochemical, environmental, psychological, and social factors also contribute to its occurrence.…

Prevalence of depression and its associations with cardio-metabolic control in Aboriginal and Anglo-Celt patients with type 2 diabetes: the Fremantle Diabetes Study Phase II.

PubMed

Davis, Timothy M E; Hunt, Kerry; Bruce, David G; Starkstein, Sergio; Skinner, Timothy; McAullay, Daniel; Davis, Wendy A

2015-03-01

To determine the prevalence and associates of depression in Aboriginal and Anglo-Celt (AC) Australians with type 2 diabetes. Community-based patients were screened using the Patient Health Questionnaire (PHQ-9) as part of detailed assessment. The prevalence of any current depression, major depression and antidepressant use by racial group was compared after adjustment for age, sex, educational attainment and marital status. Multiple logistic regression was used to determine associates of current depression. The 107 Aboriginal participants were younger (mean±SD 54.3±11.8 vs. 67.2±10.6 years), less often male (34.6% vs. 50.9%) and married (39.3% vs. 61.7%), and more likely to smoke (44.6% vs. 8.1%) than the 793 AC subjects (P≤0.002). Fifty-two Aboriginal (48.5%) and 772 AC participants (97.4%) completed the PHQ-9; these Aboriginals had similar socio-demographic, anthropometric and diabetes-related characteristics to those without PHQ-9 data. A quarter of the Aboriginals had current depression vs 10.6% of ACs (P=0.16), 15.4% vs. 4.1% had major depression (P=0.029), and 68.8% vs. 29.7% had untreated depression (P=0.032). Compared with non-depressed participants, patients with current depression were younger and more likely to smoke, to be overweight/obese and to have worse glycaemic control (P≤0.024). Significant independent associates of current depression were educational attainment (inversely), smoking status, body mass index and fasting plasma glucose in the AC group and alcohol use in the Aboriginal group. Although prevalence of depression was not significantly increased in the Aboriginal patients, it was more likely to be major and untreated. Depression complicating type 2 diabetes is associated with adverse cardiovascular risk. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Effects of Antiretroviral Therapy and Depressive Symptoms on All-Cause Mortality Among HIV-Infected Women.

PubMed

Todd, Jonathan V; Cole, Stephen R; Pence, Brian W; Lesko, Catherine R; Bacchetti, Peter; Cohen, Mardge H; Feaster, Daniel J; Gange, Stephen; Griswold, Michael E; Mack, Wendy; Rubtsova, Anna; Wang, Cuiwei; Weedon, Jeremy; Anastos, Kathryn; Adimora, Adaora A

2017-05-15

Depression affects up to 30% of human immunodeficiency virus (HIV)-infected individuals. We estimated joint effects of antiretroviral therapy (ART) initiation and depressive symptoms on time to death using a joint marginal structural model and data from a cohort of HIV-infected women from the Women's Interagency HIV Study (conducted in the United States) from 1998-2011. Among 848 women contributing 6,721 years of follow-up, 194 participants died during follow-up, resulting in a crude mortality rate of 2.9 per 100 women-years. Cumulative mortality curves indicated greatest mortality for women who reported depressive symptoms and had not initiated ART. The hazard ratio for depressive symptoms was 3.38 (95% confidence interval (CI): 2.15, 5.33) and for ART was 0.47 (95% CI: 0.31, 0.70). Using a reference category of women without depressive symptoms who had initiated ART, the hazard ratio for women with depressive symptoms who had initiated ART was 3.60 (95% CI: 2.02, 6.43). For women without depressive symptoms who had not started ART, the hazard ratio was 2.36 (95% CI: 1.16, 4.81). Among women reporting depressive symptoms who had not started ART, the hazard ratio was 7.47 (95% CI: 3.91, 14.3). We found a protective effect of ART initiation on mortality, as well as a harmful effect of depressive symptoms, in a cohort of HIV-infected women. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Prevalence of depression among people with type 2 diabetes mellitus: a cross sectional study in Palestine

PubMed Central

2014-01-01

Background Diabetes mellitus is a common chronic metabolic disorder and one of the main causes of death in Palestine. Palestinians are continuously living under stressful economic and military conditions which make them psychologically vulnerable. The purpose of this study was to investigate the prevalence of depression among type II diabetic patients and to examine the relationship between depression and socio-demographic factors, clinical factors, and glycemic control. Methods This was a cross-sectional study at Al-Makhfiah primary healthcare center, Nablus, Palestine. Two hundred and ninety-four patients were surveyed for the presence of depressive symptoms using Beck Depression Inventory (BDI-II) scale. Patients' records were reviewed to obtain data pertaining to age, sex, marital status, Body Mass Index (BMI), level of education, smoking status, duration of diabetes mellitus, glycemic control using HbA1C test, use of insulin, and presence of additional illnesses. Patients’ medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). Results One hundred and sixty four patients (55.8%) of the total sample were females and 216 (73.5%) were < 65 years old. One hundred and twenty patients (40.2%) scored ≥ 16 on BDI-II scale. Statistical significant association was found between high BDI-II score (≥ 16) and female gender, low educational level, having no current job, having multiple additional illnesses, low medication adherence and obesity (BMI ≥ 30 kg/m2). No significant association between BDI score and glycemic control, duration of diabetes, and other socio-demographic factors was found. Multivatriate analysis showed that low educational level, having no current job, having multiple additional illnesses and low medication adherence were significantly associated with high BDI-II scores. Conclusion Prevalence of depression found in our study was higher than that reported in other countries. Although 40% of the

A series of Mousterian occupations in a new type of site: the Nesher Ramla karst depression, Israel.

PubMed

Zaidner, Yossi; Frumkin, Amos; Porat, Naomi; Tsatskin, Alexander; Yeshurun, Reuven; Weissbrod, Lior

2014-01-01

We report the discovery of a new type of hominin site in the Levant, inhabited during MIS 6-5. The site, found within a karst depression at Nesher Ramla, Israel, provides novel evidence for Middle Paleolithic lifeways in an environmental and depositional setting that is previously undocumented in the southern Levant. The carbonate bedrock in the area is characterized by surface depressions formed by gravitational sagging of the rock into underlying karst voids. In one such depression, an 8 m thick sequence comprising rich and well-preserved lithic and faunal assemblages, combustion features, hundreds of manuports and ochre was discovered. Here we focus on the geological and environmental setting and present optically stimulated luminescence (OSL) ages for the 8 m sequence, aiming to place the site within a firm chronological framework and determine its significance for a more complete reconstruction of cultural developments in the Levantine Middle Paleolithic. To that end, preliminary results of the lithic and faunal studies are also presented. Copyright © 2013 Elsevier Ltd. All rights reserved.

Assessment of health-related quality of life of clients in vocational rehabilitation: association with depressive symptoms and type of services.

PubMed

Ferdiana, A; Post, M W; Finger, M; Bültmann, U; Escorpizo, R

2014-06-01

Health-related quality of life (HRQOL) has been frequently used as an outcome measure in disability-related studies, yet little is known about HRQOL in vocational rehabilitation (VR). To evaluate HRQOL in VR clients and identify factors associated with their HRQOL DESIGN, SETTING AND POPULATION: Cross-sectional study of 149 clients from 5 VR centers in Switzerland and Germany HRQOL was measured by 8 dimensions of the Medical Outcomes Study 36-item Short Form Health Survey (SF-36) and compared with sex-matched German population norms. Multiple regression analyses were conducted to identify whether VR-related variables (VR duration and type, sick leave duration) and depressive symptoms were associated with HRQOL dimensions independent of sociodemographics (age, sex, education) and clinical characteristics (type of disorders, number of comorbidities) HRQOL in VR clients was significantly lower in all dimensions measured by the SF-36 compared to the general population. Returning to the former workplace and being oriented to a new job were associated with less functional limitation due to physical problems, less pain and better mental health. Being oriented to a new job was also associated with better vitality. Presence of depressive symptoms was negatively related with all dimensions of HRQOL. Overall, the regression models explained 10%-25% variance of the physical HRQOL domain and 18%-27% variance of the mental HRQOL domain. Multiple dimensions of HRQOL were significantly decreased in VR clients. Depressive symptoms were prevalent and contributed significantly to poorer HRQOL, thus should be considered in the VR process. Further research is needed to ascertain the effect of different VR types to HRQOL and to elaborate the role of depressive symptoms in HRQOL over time. Rehabilitation professionals should be informed of the level of HRQOL in VR clients in order to tailor effective interventions to improve HRQOL by not only focusing on functional ability but also the

The association between Diabetes mellitus and Depression.

PubMed

Bădescu, S V; Tătaru, C; Kobylinska, L; Georgescu, E L; Zahiu, D M; Zăgrean, A M; Zăgrean, L

2016-01-01

Depression occurrence is two to three times higher in people with diabetes mellitus, the majority of the cases remaining under-diagnosed. The purpose of this review was to show the links between depression and diabetes, point out the importance of identifying depression in diabetic patients and identify the possible ways to address both diseases. Possible common pathophysiological mechanisms as stress and inflammation were explained, while emphasis was made on screening for depression in diabetic patients. An important aspect for the diabetic specialist would be the understanding of the common origins of diabetes and depression and the awareness of this quite common comorbidity, in order to improve the outcomes of both diseases. DALYS = disability adjusted life years, DSM-5 = American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, DM1 = Type 1 diabetes mellitus, DM2 = Type 2 diabetes mellitus, HPA-axis = hypothalamus - pituitary - adrenal axis, SNS = sympathetic nervous system, BDI = Beck Depression Inventory, CES-D = Centre for Epidemiologic Studies Depression Scale, HADS = Hospital Anxiety and Depression Scale, PHQ = Patient Health Questionnaire.

Relationship between depression and diabetes in pregnancy: A systematic review

PubMed Central

Ross, Glynis P; Falhammar, Henrik; Chen, Roger; Barraclough, Helen; Kleivenes, Ole; Gallen, Ian

2016-01-01

AIM To systematically review the literature on women with both diabetes in pregnancy (DIP) and depression during or after pregnancy. METHODS In this systematic literature review, PubMed/MEDLINE and EMBASE were searched (13 November 2015) using terms for diabetes (type 1, type 2, or gestational), depression, and pregnancy (no language or date restrictions). Publications that reported on women who had both DIP (any type) and depression or depressive symptoms before, during, or within one year after pregnancy were considered for inclusion. All study types were eligible for inclusion; conference abstracts, narrative reviews, nonclinical letters, editorials, and commentaries were excluded, unless they provided treatment guidance. RESULTS Of 1189 articles identified, 48 articles describing women with both DIP and depression were included (sample sizes 36 to > 32 million). Overall study quality was poor; most studies were observational, and only 12 studies (mostly retrospective database studies) required clinical depression diagnosis. The prevalence of concurrent DIP (any type) and depression in general populations of pregnant women ranged from 0% to 1.6% (median 0.61%; 12 studies). The prevalence of depression among women with gestational diabetes ranged from 4.1% to 80% (median 14.7%; 16 studies). Many studies examined whether DIP was a risk factor for depression or depression was a risk factor for DIP. However, there was no clear consensus for either relationship. Importantly, we found limited guidance on the management of women with both DIP and depression. CONCLUSION Given the increasing prevalence of diabetes and depression, high-quality research and specific guidance for management of pregnant women with both conditions are warranted. PMID:27895824

[The changes of EEG correlation synchrony at depressive disorder of psychogenic type].

PubMed

Kulaichev, A P; Iznak, A F; Iznak, E V; Kornilov, V V; Sorokin, S A

2014-01-01

In this work we use the alternative method of assessing the EEG-synchrony which previously has proved its high sensitivity to the differentiation of psychopathological and functional states. The original recording of EEG had been performed in the state of quiet wakefulness with eyes closed for two groups of examinees/patients at the age of 49-82 years: a group of normal subjects (n = 29) and the group of subjects with depressive deviations of F43.21 category according to ICD-10 (n = 51). As a result of research it is received the comprehensive picture of significant topographical, interhemispheric and regional differences between groups of norm and depression. One of basic features of the obtained integrated picture is existence at a depression of the extended zones of reduced EEG-synchrony covering the entire premedial region in the frontal-occiptal direction, including intrahemispheric connections as well as lateral frontal-temporal connections in both hemispheres. It testifies to the deep deprivation with depression frontal-occipital and interhemispheric interaction. As a compensatory reaction during depression the increase of synchrony in axial aimed intrahemispheric pairs of derivations. It is noted the similarity of changes in EEG-synchrony topography of depression to those observed in schizophrenia. The used method has provided close to 100% reliability of the classification of the EEG norms and depressive deviations, which makes possible and promising its use as an auxiliary quantitative differential indicator.

Depression-related behavioural and neuroendocrine changes in the Spontaneously Diabetic Torii (SDT) fatty rat, an animal model of Type 2 Diabetes Mellitus.

PubMed

Sakimura, Katsuya; Maekawa, Tatsuya; Sasagawa, Kazuo; Ishii, Yukihito; Kume, Shin-Ichi; Ohta, Takeshi

2018-05-14

Depression is one of the most common psychiatric diseases and is commonly comorbid with type 1 or 2 diabetes mellitus (DM). However, the pathophysiology underlying the depressive state in DM remains poorly understood. Animal models are useful tools to investigate the association between depression and DM. In the present study we investigated whether the Spontaneously Diabetic Torii (SDT) fatty rat, a novel animal model of type 2 DM, shows depression-related features. We assessed depression-like behaviour, hyperactivation of the hypothalamic-pituitary-adrenal (HPA) axis, and neurotransmitter levels in the brain. Behaviour was evaluated using a forced swimming test, and the HPA axis was evaluated with changes in plasma corticosterone levels after a swimming stress exposure or dexamethasone challenge. In addition, serotonin (5-hydroxytryptamine; 5-HT), noradrenaline, glutamate and γ-aminobutyric acid (GABA) concentrations in the frontal cortex, hippocampus and brain stem were measured. In the forced swimming test, SDT fatty rats exhibited increased duration of immobility compared with control Sprague-Dawley (SD) rats. Moreover, basal corticosterone levels were significantly elevated in SDT fatty compared with control SD rats. However, there were no stress-induced increases or changes in dexamethasone-induced suppression of corticosterone in SDT fatty compared with control SD rats. Furthermore, there were significant changes in 5-HT concentrations in the prefrontal cortex, and in GABA and glutamate concentrations in the hippocampus in SDT fatty compared with controls. The results of the present study suggest that the SDT fatty rat may be an appropriate model for diabetes with comorbid depression associated with neurotransmitter impairments and aberrant basal HPA hyperactivity. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Joint Online Thesis and Research System (JOTARS)

DTIC Science & Technology

2006-09-01

NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA THESIS Approved for public release; distribution is unlimited JOINT ONLINE ...September 2006 3. REPORT TYPE AND DATES COVERED Master’s Thesis 4. TITLE AND SUBTITLE: Joint Online Thesis and Research System (JOTARS) 6. AUTHOR...prototype website is the Joint Online Thesis and Research System (JOTARS). The specific functional objectives of JOTARS are to establish standard

The Relationship between PTSD and Chronic Pain: Mediating Role of Coping Strategies and Depression

PubMed Central

Morasco, Benjamin J.; Lovejoy, Travis I.; Lu, Mary; Turk, Dennis C.; Lewis, Lynsey; Dobscha, Steven K.

2013-01-01

People with chronic pain and comorbid posttraumatic stress disorder (PTSD) report more severe pain and poorer quality of life than those with chronic pain alone. This study evaluated the extent to which associations between PTSD and chronic pain interference and severity are mediated by pain-related coping strategies and depressive symptoms. Veterans with chronic pain were divided into two groups, those with (n=65) and those without (n=136) concurrent PTSD. All participants completed measures of pain severity, interference, emotional functioning, and coping strategies. Those with current PTSD reported significantly greater pain severity and pain interference, had more symptoms of depression, and were more likely to meet diagnostic criteria for a current alcohol or substance use disorder (all p-values ≤ 0.01). Participants with PTSD reported more use of several coping strategies, including guarding, resting, relaxation, exercise/stretching, and coping self-statements. Illness-focused pain coping (i.e., guarding, resting, and asking for assistance) and depressive symptoms jointly mediated the relationship between PTSD and both pain interference (total indirect effect = 0.194, p < 0.001) and pain severity (total indirect effect = 0.153, p = 0.004). Illness-focused pain coping also evidenced specific mediating effects, independent of depression. In summary, specific pain coping strategies and depressive symptoms partially mediated the relationship between PTSD and both pain interference and severity. Future research should examine whether changes in types of coping strategies following targeted treatments predict improvements in pain-related function for chronic pain patients with concurrent PTSD. PMID:23398939

Relationships of Sexual Dysfunction with Depression and Acceptance of Illness in Women and Men with Type 2 Diabetes Mellitus.

PubMed

Bąk, Ewelina; Marcisz, Czeslaw; Krzemińska, Sylwia; Dobrzyn-Matusiak, Dorota; Foltyn, Agnieszka; Drosdzol-Cop, Agnieszka

2017-09-16

An increased prevalence of sexual disorders has been reported in patients with type 2 diabetes. The aim of this study is the assessment of the influence of the psychical condition, the concentration of glycated hemoglobin, the duration of diabetes, the body mass index, the age, and the subjective acceptance of the illness on sexual disorders occurring in women and men with type 2 diabetes. The study enrolled 215 patients (114 women and 101 men) with type 2 diabetes and 183 controls. Sexuality was determined in all of the studied subjects using: the Female Sexual Function Index (FSFI) in women and the International Index of Erectile Function (IIEF) in men. The occurrence of depression symptoms was determined using the Beck Depression Inventory (BDI), whereas the acceptance of the illness in diabetic patients using the Acceptance of Illness Scale (AIS). A sexual dysfunction was found in 68% of the studied diabetic women and 17% of controls. The point values of all the examined FSFI domains were significantly lower in women with diabetes than in controls ( p < 0.001). Erectile disorders occurred in 82% of the studied men with diabetes and in 41% of the controls ( p < 0.001). The point values of all the domains of FSFI and IIEF demonstrated a significantly negative correlation with the total BDI score, which was higher in patients with diabetes than in patients without diabetes, and a positive correlation with the total AIS score ( p < 0.001). The occurrence of sexual dysfunction in patients with diabetes correlated with the age and the duration of diabetes. We conclude that sexual disorders in patients with type 2 diabetes demonstrate the correlation with the occurrence of depression and the acceptance of their illness. Sexual disorders in diabetic patients occur more frequently in older patients and in those with a longer duration of diabetes.

Finite element model updating of riveted joints of simplified model aircraft structure

NASA Astrophysics Data System (ADS)

Yunus, M. A.; Rani, M. N. Abdul; Sani, M. S. M.; Shah, M. A. S. Aziz

2018-04-01

Thin metal sheets are widely used to fabricate a various type of aerospace structures because of its flexibility and easily to form into any type shapes of structure. The riveted joint has turn out to be one of the popular joint types in jointing the aerospace structures because they can be easily be disassembled, maintained and inspected. In this paper, thin metal sheet components are assembled together via riveted joints to form a simplified model of aerospace structure. However, to model the jointed structure that are attached together via the mechanical joints such as riveted joint are very difficult due to local effects. Understandably that the dynamic characteristic of the joined structure can be significantly affected by these joints due to local effects at the mating areas of the riveted joints such as surface contact, clamping force and slips. A few types of element connectors that available in MSC NATRAN/PATRAN have investigated in order to presented as the rivet joints. Thus, the results obtained in term of natural frequencies and mode shapes are then contrasted with experimental counterpart in order to investigate the acceptance level of accuracy between element connectors that are used in modelling the rivet joints of the riveted joints structure. The reconciliation method via finiteelement model updating is used to minimise the discrepancy of the initial finite element model of the riveted joined structure as close as experimental data and their results are discussed.

Focusing in Arthurs-Kelly-type joint measurements with correlated probes.

PubMed

Bullock, Thomas J; Busch, Paul

2014-09-19

Joint approximate measurement schemes of position and momentum provide us with a means of inferring pieces of complementary information if we allow for the irreducible noise required by quantum theory. One such scheme is given by the Arthurs-Kelly model, where information about a system is extracted via indirect probe measurements, assuming separable uncorrelated probes. Here, following Di Lorenzo [Phys. Rev. Lett. 110, 120403 (2013)], we extend this model to both entangled and classically correlated probes, achieving full generality. We show that correlated probes can produce more precise joint measurement outcomes than the same probes can achieve if applied alone to realize a position or momentum measurement. This phenomenon of focusing may be useful where one tries to optimize measurements with limited physical resources. Contrary to Di Lorenzo's claim, we find that there are no violations of Heisenberg's error-disturbance relation in these generalized Arthurs-Kelly models. This is simply due to the fact that, as we show, the measured observable of the system under consideration is covariant under phase space translations and as such is known to obey a tight joint measurement error relation.

Robotic joint experiments under ultravacuum

NASA Technical Reports Server (NTRS)

Borrien, A.; Petitjean, L.

1988-01-01

First, various aspects of a robotic joint development program, including gearbox technology, electromechanical components, lubrication, and test results, are discussed. Secondly, a test prototype of the joint allowing simulation of robotic arm dynamic effects is presented. This prototype is tested under vacuum with different types of motors and sensors to characterize the functional parameters: angular position error, mechanical backlash, gearbox efficiency, and lifetime.

Effects of exercise training on quality of life, symptoms of depression, symptoms of anxiety and emotional well-being in type 2 diabetes mellitus: a systematic review.

PubMed

van der Heijden, M M P; van Dooren, F E P; Pop, V J M; Pouwer, F

2013-06-01

Psychological problems are relatively common in people with type 2 diabetes. It is unclear whether exercise training exerts an effect on quality of life, symptoms of depression, symptoms of anxiety and emotional well-being in people with type 2 diabetes. The aim of this study was to conduct a systematic review to assess the effects of exercise training on these outcomes in people with type 2 diabetes. MEDLINE, PsycINFO, Embase and ClinicalTrials.gov databases were searched. The review included randomised controlled trials (RCTs) of at least 4 weeks' duration in people with type 2 diabetes that evaluated the effect of exercise training on quality of life, symptoms of depression, symptoms of anxiety and/or emotional well-being compared with usual care. Of 1,261 retrieved articles, 20 RCTs were included with a total of 1,719 participants. Quality of life was assessed in 16 studies. Between-group comparisons showed no significant results for aerobic training with the exception of one study, and mixed results for resistance and combined training. Symptoms of depression were assessed in four studies. In only one study did the intervention decrease symptoms of depression. Emotional well-being was evaluated in four studies, which also showed conflicting results. Symptoms of anxiety were evaluated in one study, which showed a significant improvement. The effects of exercise training on psychological outcomes in people with type 2 diabetes are conflicting. Therefore, there is a need for further high-quality RCTs in order to gain greater insight into the role of exercise training in people with type 2 diabetes.

Peer Victimization, Depression, and Suicidiality in Adolescents

ERIC Educational Resources Information Center

Klomek, Anat Brunstein; Marrocco, Frank; Kleinman, Marjorie; Schonfeld, Irvin Sam; Gould, Madelyn S.

2008-01-01

The association between specific types of peer victimization with depression, suicidal ideation, and suicide attempts among adolescents was examined. A self-report survey was completed by 2,342 high-school students. Regression analyses indicated that frequent exposure to all types of peer victimization was related to high risk of depression,…

Efficacy and moderators of psychological interventions in treating subclinical symptoms of depression and preventing major depressive disorder onsets: protocol for an individual patient data meta-analysis of randomised controlled trials.

PubMed

Ebert, David D; Buntrock, Claudia; Reins, Jo Annika; Zimmermann, Johannes; Cuijpers, Pim

2018-03-16

The long-term effectiveness of psychological interventions for the treatment of subthreshold depression and the prevention of depression is unclear and effects vary among subgroups of patients, indicating that not all patients profit from such interventions. Randomised clinical trials are mostly underpowered to examine adequately subgroups and moderator effects. The aim of the present study is, therefore, to examine the short-term and long-term as well as moderator effects of psychological interventions compared with control groups in adults with subthreshold depression on depressive symptom severity, treatment response, remission, symptom deterioration, quality of life, anxiety and the prevention of major depressive disorder (MDD) onsets on individual patient level and study level using an individual patient data meta-analysis approach. Systematic searches in PubMed, PsycINFO, Embase and the Cochrane Central Register of Controlled Trials were conducted. We will use the following types of outcome criteria: (A) onset of major depression; (B) time to major depression onset; (C) observer-reported and self-reported depressive symptom severity; (D) response; (E) remission; (F) symptom deterioration; (G) quality of life, (H) anxiety; and (I) suicidal thoughts and behaviours. Multilevel models with participants nested within studies will be used. Missing data will be handled using a joint modelling approach to multiple imputation. A number of sensitivity analyses will be conducted in order test the robustness of our findings. The investigators of the primary trials have obtained ethical approval for the data used in the present study and for sharing the data, if this was necessary, according to local requirements and was not covered from the initial ethic assessment.This study will summarise the available evidence on the short-term and long-term effectiveness of preventive psychological interventions for the treatment of subthreshold depression and prevention of MDD onset

Reduction of depressive symptoms in an elderly Mexican-American female with type 2 diabetes mellitus: a single-subject study.

PubMed

Haltiwanger, Emily Piven; Galindo, David

2013-03-01

The purpose of this study was to determine if occupation-based activities improve diabetes self-management and reduce depressive symptoms in an elderly Mexican-American woman with type 2 diabetes mellitus (T2DM). There have been no known studies showing occupational therapy's role in self-care management of T2DM in people with depressive symptoms. The individual in this single-subject research was evaluated using glycosylated haemoglobin blood tests, four self-reported standardized questionnaires, participant reflective logs and clinical observations following an 8-week intervention. The participant improved on all measures, which were sustained 1 month after treatment ended. Clinical implications highlight a new role for occupational therapists providing early intervention in people with diabetes and depression for secondary prevention of complications of uncontrolled diabetes. Research suggestions include multiple single-subject studies showing occupational therapy contributions. Copyright © 2012 John Wiley & Sons, Ltd.

Joint torques and joint reaction forces during squatting with a forward or backward inclined Smith machine.

PubMed

Biscarini, Andrea; Botti, Fabio M; Pettorossi, Vito E

2013-02-01

We developed a biomechanical model to determine the joint torques and loadings during squatting with a backward/forward-inclined Smith machine. The Smith squat allows a large variety of body positioning (trunk tilt, foot placement, combinations of joint angles) and easy control of weight distribution between forefoot and heel. These distinctive aspects of the exercise can be managed concurrently with the equipment inclination selected to unload specific joint structures while activating specific muscle groups. A backward (forward) equipment inclination decreases (increases) knee torque, and compressive tibiofemoral and patellofemoral forces, while enhances (depresses) hip and lumbosacral torques. For small knee flexion angles, the strain-force on the posterior cruciate ligament increases (decreases) with a backward (forward) equipment inclination, whereas for large knee flexion angles, this behavior is reversed. In the 0 to 60 degree range of knee flexion angles, loads on both cruciate ligaments may be simultaneously suppressed by a 30 degree backward equipment inclination and selecting, for each value of the knee angle, specific pairs of ankle and hip angles. The anterior cruciate ligament is safely maintained unloaded by squatting with backward equipment inclination and uniform/forward foot weight distribution. The conditions for the development of anterior cruciate ligament strain forces are clearly explained.

Sn-Ag-Cu Nanosolders: Solder Joints Integrity and Strength

NASA Astrophysics Data System (ADS)

Roshanghias, Ali; Khatibi, Golta; Yakymovych, Andriy; Bernardi, Johannes; Ipser, Herbert

2016-08-01

Although considerable research has been dedicated to the synthesis and characterization of lead-free nanoparticle solder alloys, only very little has been reported on the reliability of the respective joints. In fact, the merit of nanoparticle solders with depressed melting temperatures close to the Sn-Pb eutectic temperature has always been challenged when compared with conventional solder joints, especially in terms of inferior solderability due to the oxide shell commonly present on the nanoparticles, as well as due to compatibility problems with common fluxing agents. Correspondingly, in the current study, Sn-Ag-Cu (SAC) nanoparticle alloys were combined with a proper fluxing vehicle to produce prototype nanosolder pastes. The reliability of the solder joints was successively investigated by means of electron microscopy and mechanical tests. As a result, the optimized condition for employing nanoparticles as a competent nanopaste and a novel procedure for surface treatment of the SAC nanoparticles to diminish the oxide shell prior to soldering are being proposed.

Simultaneous Middle Third Clavicle Fracture and Type 3 Acromioclavicular Joint Dislocation; A Case Report

PubMed Central

Solooki, Saeed; Azad, Ali

2014-01-01

Simultaneous middle third clavicle fracture and acromioclavicular joint dislocation is a rare combination injury, as a result of high-energy trauma. We report a patient with a middle third clavicle fracture and ipsilateral grade three-acromioclavicular joint dislocation, which is a rare combination. The patient wanted to get back to work as soon as possible, so the fracture was fixed with reconstruction plate after open reduction and plate contouring; and acromioclavicular joint dislocation was reduced and fixed with two full threaded cancellous screws. One screw was inserted through the plate to the coracoid process. Clinical and radiographic finding revealed complete union of clavicle fracture and anatomical reduction of acromioclavicular joint with pain free full joint range of motion one year after operation. PMID:25207318

Covariation of depressive mood and spontaneous physical activity in major depressive disorder: toward continuous monitoring of depressive mood.

PubMed

Kim, Jinhyuk; Nakamura, Toru; Kikuchi, Hiroe; Yoshiuchi, Kazuhiro; Sasaki, Tsukasa; Yamamoto, Yoshiharu

2015-07-01

The objective evaluation of depressive mood is considered to be useful for the diagnosis and treatment of depressive disorders. Thus, we investigated psychobehavioral correlates, particularly the statistical associations between momentary depressive mood and behavioral dynamics measured objectively, in patients with major depressive disorder (MDD) and healthy subjects. Patients with MDD ( n = 14) and healthy subjects ( n = 43) wore a watch-type computer device and rated their momentary symptoms using ecological momentary assessment. Spontaneous physical activity in daily life, referred to as locomotor activity, was also continuously measured by an activity monitor built into the device. A multilevel modeling approach was used to model the associations between changes in depressive mood scores and the local statistics of locomotor activity simultaneously measured. We further examined the cross validity of such associations across groups. The statistical model established indicated that worsening of the depressive mood was associated with the increased intermittency of locomotor activity, as characterized by a lower mean and higher skewness. The model was cross validated across groups, suggesting that the same psychobehavioral correlates are shared by both healthy subjects and patients, although the latter had significantly higher mean levels of depressive mood scores. Our findings suggest the presence of robust as well as common associations between momentary depressive mood and behavioral dynamics in healthy individuals and patients with depression, which may lead to the continuous monitoring of the pathogenic processes (from healthy states) and pathological states of MDD.

Improvement in Depressive Symptoms Is Associated with Reduced Oxidative Damage and Inflammatory Response in Type 2 Diabetic Patients with Subsyndromal Depression: The Results of a Randomized Controlled Trial Comparing Psychoeducation, Physical Exercise, and Enhanced Treatment as Usual

PubMed Central

Vučić Lovrenčić, Marijana; Pibernik-Okanović, Mirjana; Šekerija, Mario; Prašek, Manja; Ajduković, Dea; Kos, Jadranka; Hermanns, Norbert

2015-01-01

Aims. To examine one-year changes in oxidative damage and inflammation level in type 2 diabetic patients undergoing behavioral treatment for subsyndromal depression. Materials and Methods. A randomized controlled comparison of psychoeducation (A), physical exercise (B), and enhanced treatment as usual (C) was performed in 209 eligible subjects in a tertiary diabetes care setting. Depressive symptoms (primary outcome) and selected biomarkers of oxidative damage and inflammation (secondary outcomes) were assessed at baseline and six- and twelve-month follow-up. Results. Out of the 74, 67, and 68 patients randomised into groups A, B, and C, respectively, 201 completed the interventions, and 179 were analysed. Participants in all three groups equally improved in depressive symptoms from baseline to one-year follow-up (repeated measures ANOVA; F = 12.51, p < 0.0001, η 2 = 0.07). Urinary 8-oxo-deoxyguanosine (u-8-oxodG) decreased (F = 10.66, p < 0.0001, η 2 = 0.06), as did sialic acid and leukocytes (F = 84.57, η 2 = 0.32 and F = 12.61, η 2 = 0.07, resp.; p < 0.0001), while uric acid increased (F = 12.53, p < 0.0001, η 2 = 0.07) in all subjects during one year. Improvement of depressive symptoms at 6 months significantly predicted one-year reduction in u-8-oxodG (β = 0.15, p = 0.044). Conclusion. Simple behavioral interventions are capable not only of alleviating depressive symptoms, but also of reducing the intensity of damaging oxidative/inflammatory processes in type 2 diabetic patients with subsyndromal depression. This trial is registered with ISRCTN05673017. PMID:26347775

Minocycline reduces mechanical allodynia and depressive-like behaviour in type-1 diabetes mellitus in the rat.

PubMed

Amorim, Diana; Puga, Sónia; Bragança, Rui; Braga, António; Pertovaara, Antti; Almeida, Armando; Pinto-Ribeiro, Filipa

2017-06-01

A common and devastating complication of diabetes mellitus is painful diabetic neuropathy (PDN) that can be accompanied by emotional disorders such as depression. A few studies have suggested that minocycline that inhibits microglia may attenuate pain hypersensitivity in PDN. Moreover, a recent study reported that minocycline has an acute antidepressive-like effect in diabetic animals. Here we studied whether (i) prolonged minocycline treatment suppresses pain behaviour in PDN, (ii) the minocycline effect varies with submodality of pain, and (iii) the suppression of pain behaviour by prolonged minocycline treatment is associated with antidepressive-like effect. The experiments were performed in streptozotocin-induced rat model of type-1 diabetes. Pain behaviour was evoked by innocuous (monofilaments) and noxious (paw pressure) mechanical stimulation, innocuous cold (acetone drops) and noxious heat (radiant heat). Depression-like behaviour was assessed using forced swimming test. Minocycline treatment (daily 80mg/kg per os) of three-week duration started four weeks after induction of diabetes. Diabetes induced mechanical allodynia and hyperalgesia, cold allodynia, heat hypoalgesia, and depression-like behaviour. Minocycline treatment significantly attenuated mechanical allodynia and depression-like behaviour, while it failed to produce significant changes in mechanical hyperalgesia, cold allodynia or heat hypoalgesia. The results indicate that prolonged per oral treatment with minocycline has a sustained mechanical antiallodynic and antidepressive-like effect in PDN. These results support the proposal that minocycline might provide a treatment option for attenuating sensory and comorbid emotional symptoms in chronic PDN. Copyright © 2017 Elsevier B.V. All rights reserved.

Dissimilar metals joint evaluation

NASA Technical Reports Server (NTRS)

Wakefield, M. E.; Apodaca, L. E.

1974-01-01

Dissimilar metals tubular joints between 2219-T851 aluminum alloy and 304L stainless steel were fabricated and tested to evaluate bonding processes. Joints were fabricated by four processes: (1) inertia (friction) weldings, where the metals are spun and forced together to create the weld; (2) explosive welding, where the metals are impacted together at high velocity; (3) co-extrusion, where the metals are extruded in contact at high temperature to promote diffusion; and (4) swaging, where residual stresses in the metals after a stretching operation maintain forced contact in mutual shear areas. Fifteen joints of each type were prepared and evaluated in a 6.35 cm (2.50 in.) O.D. size, with 0.32 cm (0.13 in.) wall thickness, and 7.6 cm (3.0 in) total length. The joints were tested to evaluate their ability to withstand pressure cycle, thermal cycle, galvanic corrosion and burst tests. Leakage tests and other non-destructive test techniques were used to evaluate the behavior of the joints, and the microstructure of the bond areas was analyzed.

A Randomized Controlled Trial to Prevent Depression and Ameliorate Insulin Resistance in Adolescent Girls at Risk for Type 2 Diabetes.

PubMed

Shomaker, Lauren B; Kelly, Nichole R; Pickworth, Courtney K; Cassidy, Omni L; Radin, Rachel M; Shank, Lisa M; Vannucci, Anna; Thompson, Katherine A; Armaiz-Flores, Sara A; Brady, Sheila M; Demidowich, Andrew P; Galescu, Ovidiu A; Courville, Amber B; Olsen, Cara; Chen, Kong Y; Stice, Eric; Tanofsky-Kraff, Marian; Yanovski, Jack A

2016-10-01

Prospective data suggest depressive symptoms worsen insulin resistance and accelerate type 2 diabetes (T2D) onset. We sought to determine whether reducing depressive symptoms in overweight/obese adolescents at risk for T2D would increase insulin sensitivity and mitigate T2D risk. We conducted a parallel-group, randomized controlled trial comparing a 6-week cognitive-behavioral (CB) depression prevention group with a 6-week health education (HE) control group in 119 overweight/obese adolescent girls with mild-to-moderate depressive symptoms (Center for Epidemiological Studies-Depression Scale [CES-D] ≥16) and T2D family history. Primary outcomes were baseline to post-intervention changes in CES-D and whole body insulin sensitivity index (WBISI), derived from 2-h oral glucose tolerance tests. Outcome changes were compared between groups using ANCOVA, adjusting for respective baseline outcome, puberty, race, facilitator, T2D family history degree, baseline age, adiposity, and adiposity change. Multiple imputation was used for missing data. Depressive symptoms decreased (p < 0.001) in CB and HE from baseline to posttreatment, but did not differ between groups (ΔCESD = -12 vs. -11, 95 % CI difference = -4 to +1, p = 0.31). Insulin sensitivity was stable (p > 0.29) in CB and HE (ΔWBISI = 0.1 vs. 0.2, 95 % CI difference = -0.6 to +0.4, p = 0.63). Among all participants, reductions in depressive symptoms were associated with improvements in insulin sensitivity (p = 0.02). Girls at risk for T2D displayed reduced depressive symptoms following 6 weeks of CB or HE. Decreases in depressive symptoms related to improvements in insulin sensitivity. Longer-term follow-up is needed to determine whether either program causes sustained decreases in depressive symptoms and improvements in insulin sensitivity. The trial was registered with clinicaltrials.gov (NCT01425905).

Method of forming a joint

DOEpatents

Butt, Darryl Paul; Cutler, Raymond Ashton; Rynders, Steven Walton; Carolan, Michael Francis

2006-08-22

A method of joining at least two sintered bodies to form a composite structure, including providing a first multicomponent metallic oxide having a perovskitic or fluorite crystal structure; providing a second sintered body including a second multicomponent metallic oxide having a crystal structure of the same type as the first; and providing at an interface a joint material containing at least one metal oxide containing at least one metal identically contained in at least one of the first and second multicomponent metallic oxides. The joint material is free of cations of Si, Ge, Sn, Pb, P and Te and has a melting point below the sintering temperatures of both sintered bodies. The joint material is heated to a temperature above the melting point of the metal oxide(s) and below the sintering temperatures of the sintered bodies to form the joint. Structures containing such joints are also disclosed.

Strength Variation of Parachute Joints

NASA Technical Reports Server (NTRS)

Mollmann, Catherine

2017-01-01

A parachute joint is defined as a location where a component is sewn or connected to another component. During the design and developmental phase of a parachute system, the joints for each structural component are isolated and tested through a process called seam and joint testing. The objective of seam and joint testing is to determine the degradation on a single component due to interaction with other components; this data is then used when calculating the margin of safety for that component. During the engineering developmental phase of CPAS (Capsule Parachute Assembly System), the parachute system for the NASA Orion Crew Module, testing was completed for every joint of the six subsystems: the four parachutes (main, drogue, pilot, and FBCP [forward bay cover parachute]), the retention release bridle, and the retention panels. The number of joint tests for these subsystems totaled 92, which provides a plethora of data and results for further analysis. In this paper, the data and results of these seam and joint tests are examined to determine the effects, if any, of different operators and sewing machines on the strength of parachute joints. Other variables are also studied to determine their effect on joint strength, such as joint complexity, joint strength magnitude, material type, and material construction. Findings reveal that an optimally-run seam and joint test program could result in an increased understanding of the structure of the parachute; this should lead to a parachute built with optimal components, potentially saving system weight and volume.

Post-adoption Depression: Parental Classes of Depressive Symptoms Across Time

PubMed Central

Foli, Karen J.; South, Susan C.; Lim, Eunjung; Jarnecke, Amber

2016-01-01

Background Approximately 10%-15% of birth mothers and fathers experience postpartum depression, but reports of depressive symptoms in adoptive parents are more variable. Findings from investigators range from 10%-32%, which may mask the experiences of distinct groups of adoptive parents from pre-to post-placement of a child. Methods We performed latent class growth analysis using the Center for Epidemiologic Studies-Depression scores of 129 primarily heterosexual, adoptive parents (50% females) for three time points: 4-6 weeks pre-placement of the child, 4-6 weeks post-placement, and 5-6 months post-placement. Mixed effects models by parent depressive trajectories were also conducted for three types of variables: interpersonal, psychological symptoms, and life orientation. Results Five classes of depressive symptom trajectories were found. The majority of parents (71%) belonged to a class with low levels of depressive symptoms across time. However, two classes of parents were above the threshold for depressive symptoms at placement, and three classes of parents were above the threshold at 6 months post-placement. The majority of interpersonal, psychological symptom, and life orientation variables were significant across classes and by time. Limitations The homogeneity of the sample calls for replication of study findings. Conclusions An explanation for inconsistencies in the range of adoptive parent depressive symptoms may be explained by different subgroups of parents who vary by their trajectory of depressive symptoms before and after placement of the child. Adoption and mental health professionals should be aware that select adoptive parents may struggle pre-and post-placement of a child. PMID:27155072

Post-adoption depression: Parental classes of depressive symptoms across time.

PubMed

Foli, Karen J; South, Susan C; Lim, Eunjung; Jarnecke, Amber M

2016-08-01

Approximately 10-15% of birth mothers and fathers experience postpartum depression, but reports of depressive symptoms in adoptive parents are more variable. Findings from investigators range from 10% to 32%, which may mask the experiences of distinct groups of adoptive parents from pre-to post-placement of a child. We performed latent class growth analysis using the Center for Epidemiologic Studies-Depression scores of 129 primarily heterosexual, adoptive parents (50% females) for three time points: 4-6 weeks pre-placement of the child, 4-6 weeks post-placement, and 5-6 months post-placement. Mixed effects models by parent depressive trajectories were also conducted for three types of variables: interpersonal, psychological symptoms, and life orientation. Five classes of depressive symptom trajectories were found. The majority of parents (71%) belonged to a class with low levels of depressive symptoms across time. However, two classes of parents were above the threshold for depressive symptoms at placement, and three classes of parents were above the threshold at 6 months post-placement. The majority of interpersonal, psychological symptom, and life orientation variables were significant across classes and by time. The homogeneity of the sample calls for replication of study findings. An explanation for inconsistencies in the range of adoptive parent depressive symptoms may be explained by different subgroups of parents who vary by their trajectory of depressive symptoms before and after placement of the child. Adoption and mental health professionals should be aware that select adoptive parents may struggle pre-and post-placement of a child. Copyright © 2016 Elsevier B.V. All rights reserved.

Somatization as a core symptom of melancholic type depression. Evidence from a cross-cultural study.

PubMed

Ebert, D; Martus, P

1994-12-01

The study questions whether different types of somatization may be a core symptom of melancholia, thus, being invariable across cultures and being a candidate for neurobiological research and diagnostic criteria. 51 Turkish patients and 51 education-matched German patients with melancholic depression were compared for two types of somatization. Turkish patients had higher frequencies of somatic preoccupation and hypochondriasis but they were not different in the perception and experience of somatic symptoms. It is concluded that: (1) somatization has to be differentiated psychopathologically; (2) it may be a neurobiological core symptom of melancholia in the well-defined sense of 'perceiving abnormal somatic symptoms'; and (3) it may be a culture-bound symptom in the sense of 'being abnormally concerned with somatic symptoms or hypochondrial fears'.

Participation in Training for Depression Care Quality Improvement: A Randomized Trial of Community Engagement or Technical Support.

PubMed

Chung, Bowen; Ngo, Victoria K; Ong, Michael K; Pulido, Esmeralda; Jones, Felica; Gilmore, James; Stoker-Mtume, Norma; Johnson, Megan; Tang, Lingqi; Wells, Kenneth Brooks; Sherbourne, Cathy; Miranda, Jeanne

2015-08-01

Community engagement and planning (CEP) could improve dissemination of depression care quality improvement in underresourced communities, but whether its effects on provider training participation differ from those of standard technical assistance, or resources for services (RS), is unknown. This study compared program- and staff-level participation in depression care quality improvement training among programs enrolled in CEP, which trained networks of health care and social-community agencies jointly, and RS, which provided technical support to individual programs. Matched programs from health care and social-community service sectors in two communities were randomly assigned to RS or CEP. Data were from 1,622 eligible staff members from 95 enrolled programs. Primary outcomes were any staff trained (for programs) and total hours of training (for staff). Secondary staff-level outcomes were hours of training in specific depression collaborative care components. CEP programs were more likely than RS programs to participate in any training (p=.006). Within health care sectors, CEP programs were more likely than RS programs to participate in training (p=.016), but within social-community sectors, there was no difference in training by intervention. Among staff who participated in training, mean training hours were greater among CEP programs versus RS programs for any type of training (p<.001) and for training related to each component of depression care (p<.001) except medication management. CEP may be an effective strategy to promote staff participation in depression care improvement efforts in underresourced communities.

Depression, anxiety and self-care behaviours of young adults with Type 2 diabetes: results from the International Diabetes Management and Impact for Long-term Empowerment and Success (MILES) Study.

PubMed

Browne, J L; Nefs, G; Pouwer, F; Speight, J

2015-01-01

Young adults with Type 2 diabetes have higher physical morbidity and mortality than other diabetes sub-groups, but differences in psychosocial outcomes have not yet been investigated. We sought to compare depression and anxiety symptoms and self-care behaviours of young adults with Type 2 diabetes with two matched control groups. Using cross-sectional survey data from the Australian and Dutch Diabetes Management and Impact for Long-term Empowerment and Success (MILES) studies, we matched 93 young adults (aged 18-39 years) with Type 2 diabetes (case group) with: (i) 93 older adults ( ≥ 40 years) with Type 2 diabetes (Type 2 diabetes control group; matched on country, gender, education, diabetes duration and insulin use) and (ii) 93 young adults with Type 1 diabetes (Type 1 diabetes control group; matched on country, gender, age and education). Groups were compared with regard to depression symptoms (nine-item Patient Health Questionnaire), anxiety symptoms (seven-item Generalised Anxiety Disorder questionnaire) and frequency of selected self-care behaviours (single item per behaviour). Participants in the case group had higher depression scores (Cohen's d = 0.40) and were more likely to have clinically meaningful depressive symptoms (Cramer's V = 0.23) than those in the Type 2 diabetes control group. Participants in the case group had statistically equivalent depression scores to the Type 1 diabetes control group. The groups did not differ in anxiety scores. Those in the case group were less likely than both control groups to take insulin as recommended (Cramer's V = 0.24-0.34), but there were no significant differences between the groups in oral medication-taking. The case group were less likely than the Type 2 diabetes control group to eat healthily (Cramer's V = 0.16), and less likely than the Type 1 diabetes control group to be physically active (Cramer's V = 0.15). Our results suggest that Type 2 diabetes is as challenging as Type 1 diabetes for young adults

Browsing, Posting, and Liking on Instagram: The Reciprocal Relationships Between Different Types of Instagram Use and Adolescents' Depressed Mood.

PubMed

Frison, Eline; Eggermont, Steven

2017-10-01

Although studies have shown that Instagram use and young adults' mental health are cross-sectionally associated, longitudinal evidence is lacking. In addition, no study thus far examined this association, or the reverse, among adolescents. To address these gaps, we set up a longitudinal panel study among 12- to 19-year-old Flemish adolescents to investigate the reciprocal relationships between different types of Instagram use and depressed mood. Self-report data from 671 adolescent Instagram users (61% girls; M Age  = 14.96; SD = 1.29) were used to examine our research question and test our hypotheses. Structural equation modeling showed that Instagram browsing at Time 1 was related to increases in adolescents' depressed mood at Time 2. In addition, adolescents' depressed mood at Time 1 was related to increases in Instagram posting at Time 2. These relationships were similar among boys and girls. Potential explanations for the study findings and suggestions for future research are discussed.

Genetic overlap between type 2 diabetes and major depressive disorder identified by bioinformatics analysis.

PubMed

Ji, Hong-Fang; Zhuang, Qi-Shuai; Shen, Liang

2016-04-05

Our study investigated the shared genetic etiology underlying type 2 diabetes (T2D) and major depressive disorder (MDD) by analyzing large-scale genome wide association studies statistics. A total of 496 shared SNPs associated with both T2D and MDD were identified at p-value ≤ 1.0E-07. Functional enrichment analysis showed that the enriched pathways pertained to immune responses (Fc gamma R-mediated phagocytosis, T cell and B cell receptors signaling), cell signaling (MAPK, Wnt signaling), lipid metabolism, and cancer associated pathways. The findings will have potential implications for future interventional studies of the two diseases.

Depression, women, and the workplace.

PubMed

Wollersheim, J P

1993-01-01

Depression is a highly prevalent disorder that causes much personal distress and difficulties in functioning at home and in the workplace. In the workplace, as elsewhere, depression can manifest as a variation in normal mood, as a symptom, as a disorder, or as a disease. Occupational health professionals are more concerned with clinical depression, a term used to signify any type of depression that causes significant personal distress and/or problems in functioning. Clinical depression is manifest in the workplace and adversely affects the employee's work satisfaction and performance. For most types of depression, women are at a higher risk than men. A number of events and variables related to women and depression were reviewed. Although the effects of some of these events, such as menopause, can be manifest in the workplace, they are not associated with an increased incidence of clinical depression. Other events, such as victimization (e.g., childhood sexual abuse or battering by an intimate partner), are associated with higher risks of depression in women. Women derive substantial satisfaction from interpersonal relationships but also are at greater risk for depression when strains and conflicts in these relationships occur. In the workplace women who have no difficulty in arranging for child care and whose spouses share in the care of children show lower rates of depression. When marriages are unhappy, women are three times as likely as men to be depressed. These findings speak to the importance of relationships to women. In the workplace, when women are depressed, problems with relationships are likely to be involved. Clinically depressed women are not difficult to identify in work settings. Dejected mood and loss of interest in usual activities are noticeable, along with numerous other symptoms that accompany depression. The effective treatment of depression depends on careful diagnosis and assessment. Both drug therapy and the more structured psychotherapies

Deterministic Joint Remote Preparation of Arbitrary Four-Qubit Cluster-Type State Using EPR Pairs