BACKGROUNDThe etiology and pathology of functional constipation (FC) is unclear. Some researches suggest that psychological factors may be related to this common problem. This study aimed to investigate the relationship between attention processing and emotional status in FC patients compared with healthy controls.

METHODSWe investigated selective attention and emotional status in patients with FC using the counting Stroop task. Thirty-five FC patients (FCP group) and 24 healthy controls (HCs) underwent an event-related potential (ERP) study while performing the task. Response time, latency and amplitude of P300 were collected and compared between the two groups. The Hamilton Depression Rating Scale (HAMD-17), Hamilton Anxiety Scale (HAMA), Symptom Checklist-90 (SCL-90) and Eysenck Personality Questionnaire (EPQ) were administered prior to the counting Stroop task.

RESULTSScores for the FCP group differed significantly from those for the HCs on the HAMD-17, HAMA, SCL-90 (Global Severity Index, Positive Symptoms Total, dimensions of somatization, obsessive-compulsive, depression, anxiety, and psychosis), as well as extraversion and neurosis dimensions of the EPQ (P < 0.05). There was no significant difference in response time or accuracy rate between the two groups (P > 0.05). ERP results showed prolonged latency at F4, additionally found enhanced activation at F3, FC1 and T8, and decreased activation at sites FC6 and P7 in the patients with FC. Statistically, significant differences of P300 latency at site F4 (P < 0.05) and P300 amplitude at F3, F4, T8, P7, FC1 and FC6 (P < 0.05) between the patients with FC and the HC were revealed.

CONCLUSIONSThe findings suggest that patients with FC are more susceptible to depression and anxiety, as well as somatization, obsessive-compulsive tendencies and other neurotic personality characteristics. Patients may employ psychological defense mechanisms to avoid the pain of depression and anxiety. ERP results imply there may be some brain dysfunction and attention deficits in patients with FC.

Adolescent ; Adult ; Aged ; Anxiety ; etiology ; physiopathology ; Constipation ; complications ; physiopathology ; Depression ; etiology ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Young Adult

Adult ; Anxiety ; etiology ; physiopathology ; therapy ; Depression ; etiology ; physiopathology ; therapy ; Female ; Hepatitis B ; complications ; psychology ; Hepatitis B virus ; Humans ; Male ; Psychotherapy

PURPOSE: Patients with chronic kidney disease frequently show cognitive dysfunction. The association of depression and cognitive function is not well known in maintenance dialysis patients. We evaluated cognitive impairment and depression, as well as their relationship in regards to methods of dialysis, maintenance hemodialysis (MHD) and chronic peritoneal dialysis (CPD). MATERIALS AND METHODS: Fifty-six maintenance dialysis patients were recruited and their clinical and laboratory data were collected. The Korean version of the mini-mental state exam (K-MMSE) was applied to screen the patient's cognitive function, while the Korean version of the Beck Depression Inventory (K-BDI) was used for depression screening. RESULTS: The average age of the participants was 54.2+/-10.2 years; 29 (51.8%) were female. The average dialysis vintage was 4.2+/-3.8 years. The CPD group showed significantly higher K-MMSE score (27.8+/-2.9 vs. 26.1+/-3.1, p=0.010) and lower K-BDI score (12.0+/-8.4 vs. 20.2+/-10.4, p=0.003) compared with the MHD group. The percentage of patients with depression symptoms was higher in the MHD group (51.7% vs. 18.5%). There was a negative correlation between cognitive function and prevalence of depressive symptoms. Depression and education level were shown to be independent predictors for cognitive impairment in multivariate analysis. CONCLUSION: Cognitive impairment was closely correlated with depression. It is important to detect cognitive impairment and depression early in maintenance dialysis patients with simple bedside screening tools.
Adult ; Cognition Disorders/etiology/*physiopathology ; Depression/etiology/*physiopathology ; Female ; Humans ; Kidney Failure, Chronic/physiopathology/psychology/therapy ; Male ; Middle Aged ; Renal Dialysis/*adverse effects/*psychology

OBJECTIVETo explore the clinical effect of post stroke depression treated by differentiation of spleen and stomach, so as to search better treatment.

METHODSSixty-three cases were randomly divided into an acupuncture and moxibustion group and a medication group. In acupuncture and moxibustion group, acupuncture and grain sized moxibustion were given at Zhongwan (CV 12), Zhangmen (LV 13), Zusanli (ST 36), Yinlingquan (SP 9), Pishu (BL 20) and Weishu (BL 21); in medication group, Fluoxetine was orally taken for 20 mg after breakfast. Both groups were treated for 4 weeks. Prospective information of spleen and stomach syndrome was collected before treatment; the therapeutic effects and adverse reactions were evaluated by integral scale of spleen and stomach syndrome, Hamilton Depression (HAMD) Scale and Treatment Emergent Symptom Scale (TESS) at the first, second and fourth weekend of treatment.

RESULTSThe prospective information collection of spleen and stomach syndrome before treatment indicated that among these 63 cases of post stroke depression, poor appetite, constipation and less drinking appeared for many times. The cured and markedly effective rate was 81.8% (27/33) in acupuncture and moxibustion group and 63.3% (19/30) in medication group, manifesting the same curative effect (P > 0. 05); the integral scale of spleen and stomach syndrome reduced in both groups (P < 0.001, P < 0.05), and it was superior in acupuncture and moxibustion group to that in medication group. In acupuncture and moxibustion group, HAMD score reduced obviously at the 1st and 2nd week and after treatment ( all P < 0.001), and it was superior to that in medication group at the 1st and 2nd week (P < 0.05, P < 0.01). The TESS showed that the adverse reactions intervention in acupuncture and moxibustion group was superior to that in medication group at the 1st and 2nd week (both P < 0.05).

CONCLUSIONThe patients who get post stroke depression commonly suffer from varying degrees of spleen and stomach functional disturbance. The curative effect of post stroke depression treated by differentiation of spleen and stomach is quick and stable, with less adverse reaction and high safety.

Aged ; Aged, 80 and over ; Depression ; etiology ; physiopathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Spleen ; physiopathology ; Stomach ; physiopathology ; Stroke ; complications ; Treatment Outcome

OBJECTIVETo evaluate the nitric oxide (NO) levels in rat brain cortex and hippocampus after chronic mild stress.

METHODSSixteen male Sprague-Dawley rats were allocated into control group and model group randomly. Model rats were induced by consecutive chronic mild stress; weight gain, open field test and sucrose solution consumption were investigated before and after procedure. Nitric oxide contents in prefrontal cortex and hippocampus were determined by spectrophotometric assays.

RESULTDecreased locomotion, loss of interest and anhedonia were observed in chronic mild stress rat model group. Nitric oxide contents in prefrontal cortex and hippocampus were significantly higher in chronic mild stress group [(31.00 +/-2.55)nmol/mg.pro and (38.11 +/-1.73)nmol/mg.pro, respectively] than those in control group [(26.97 +/-1.38)nmol/mg.pro and (36.06 +/-0.87)nmol/mg.pro, respectively] (P <0.05).

CONCLUSIONChronic stress can stimulate NO release, and dysfunction of nitric oxide pathway may be involved in development of depression.

Animals ; Cerebral Cortex ; metabolism ; Depression ; etiology ; physiopathology ; Hippocampus ; metabolism ; Male ; Motor Activity ; physiology ; Nitric Oxide ; biosynthesis ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Stress, Psychological ; complications ; physiopathology

BACKGROUNDDepression related cognitive deficits are frequently considered as simple epiphenomena of the disorder. However, whether or not the depression might directly bring about cognitive deficits is still under investigation. This study was to investigate the distinct pattern of cognitive deficits in patients with depression by comparing the cognitive function before and after anti-depressive drug therapy.

METHODSSixty cases of patients, first-time diagnosed with depression, were assessed by 17-item Hamilton Rating Scale for Depression (HAMD17scale). The memory ability was tested by quantitatively clinical memory scale, while the attention ability by modified Ruff 2&7 Selective Attention Test. Forty-two healthy volunteers were recruited as controls. The depressive patients were treated with Venlafaxine (75 - 300 mg/d), Fluoxetine (20 - 40 mg/d), Paroxetine (20 - 40 mg/d), and Sertraline (50 - 150 mg/d). After 12 weeks treatment, patients were tested again by HAMD17scale, quantitatively clinical memory scale, and modified Ruff 2&7 selective attention test to assess the effect of anti-depressive drugs on cognitive deficits.

RESULTSThe memory quotient (MQ) was significantly lowered in depressive patients. The selection speed was also significantly decreased and the number of missing and error hits increased in the depression group as compared to control. However, there was no significant difference in clinical memory scale and Ruff 2&7 selective attention test between mild-to-moderate and severe depression group. Importantly, after anti-depressive drug therapy, the HAMD17 scale scores in depressive patients were significantly decreased, but the MQ, directional memory (DM), free recall (FR), associative learning (AL), and face recognition were comparable with those before the treatment. Furthermore, the selection speed and the number of missing and error hits were also not significantly different after anti-depressive drugs treatment.

CONCLUSIONSDepressive patients suffer from short-term memory deficits, and attention extent, stability and rearrangement deficiency. Even though anti-depressive drugs sufficiently relieve the cardinal presentation of depression, they could not successfully alleviate the accompanying cognitive deficits. This might indicate a distinct pattern of cognitive deficits in patients with depression.

Adolescent ; Adult ; Antidepressive Agents ; therapeutic use ; Cognition Disorders ; etiology ; physiopathology ; Depression ; complications ; drug therapy ; physiopathology ; Female ; Humans ; Male ; Memory ; drug effects ; physiology ; Middle Aged ; Neuropsychological Tests ; Young Adult

AIMTo explore the relationship between the pathology of depression and glutamate (Glu) in hippocampus, and the effect on gastric mobility.

METHODSDepression model was established by using the chronic unpredicted mild stress (CUMS). And stereotaxic and intra-hippocampal microinjection were also used in this experiment. Rat emotion and behaviors were observed by the change in body weight, sucrose preference-test, open field-test and forced swimming-test. Intragastric pressure and mobility were recorded with the instrument of Powerlab/8sp.

RESULTSCompared with the control, 21-day CUMS significantly reduced the increase in body weight, rat sucrose preference, locomotor activity and rearing in open field test, while it significantly increased duration of immobility time in forced swimming test. Meanwhile, magnitudes of intragastric pressure and mobility were significantly declined after 21 days CUMS. Microinjection of Glu into hippocampus mimics the behaviors which were produced in CUMS. The down-rang of gastric mobility in the group of Glu injection was smaller than CUMS, but was much larger than the control. Intrahippocampal microinjection of MK-801 attenuated depression-like behaviors induced by stress, weakened stress-induced inhibition of intragastric pressure, and augmented the magnitudes of gastric contraction.

CONCLUSIONGlu and NMDA receptor in hippocampus are to do much with the etiology of stress- induced depression. They are not only concerned with behavioral changes induced by stress, but also with the variation of gastric activities, nevertheless, differences exist between the effects of behaviors and gastric activities.

Animals ; Depression ; physiopathology ; Gastrointestinal Diseases ; etiology ; Gastrointestinal Motility ; physiology ; Glutamic Acid ; physiology ; Hippocampus ; metabolism ; physiopathology ; Male ; Rats ; Rats, Sprague-Dawley ; Receptors, N-Methyl-D-Aspartate ; physiology

Depression is an important post-stroke sequela with negative impact on mortality, functional outcome and quality of life. Changes in cytokines have been hypothesized to be associated with the etiology of post-stroke depression (PSD). The altere dhypothalamic-pituitary-adrenal (HPA) functioning is associated with the onset of depression. The activity of HPA could induce the fluctuations of cortisol levels. In this study, we prospectively checked interleukin 6 (IL-6) and cortisol levels in patients with early ischemic stroke. It was hypothesized that early serum IL-6 and cortisol fluctuations in stroke patients were the predictions of PSD. Totally, 100 participants were selected from stroke inpatients consecutively admitted to the Department of Neurology, Tongji Hospital from July 2014 to December 2015. Fifty health people served as the controls. The serum of all the patients was collected at 8:00 am and 4:00 pm respectively one week after stroke. The serum of controls was collected only at 8:00 am. The levels of IL-6 were analyzed by enzyme-linked immunosorbent assay kit, and those of cortisol were detected by chemiluminescence immunoassay. On the 3rd week after stroke, the patients were enrolled to the PSD group and non-PSD group based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and The Hamilton Depression Rating Scale (HAMD-21, score>7). The IL-6 level (13.24±2.89 ng/L) was elevated significantly in PSD groups as compared with that in non-PSD group and control group respectively (P<0.05 for both), but there was no significant difference in the IL-6 level between non-PSD group and control group. The patients in both PSD group and non-PSD group had significantly elevated morning cortisol levels in comparison with those in the control group (P<0.05; for PSD, non-PSD and control: 508.86±119.51, 420.83±70.04 and 340.40±76.30 nmol/L respectively). Moreover, afternoon cortisol levels in PSD group were significantly higher than those in non-PSD group, and the morning baseline cortisol levels in these two groups were similar (P>0.05). It was suggested that PSD generally runs a chronic course and is related to a variety of adverse health outcomes including increased disability, morbidity and mortality. This study will help the screening of potential PSD in the early stage.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Depression ; blood ; etiology ; physiopathology ; Female ; Humans ; Hydrocortisone ; blood ; Hypothalamo-Hypophyseal System ; metabolism ; Interleukin-6 ; blood ; Male ; Middle Aged ; Stroke ; blood ; complications ; physiopathology

BACKGROUNDPsychological distress has been widely studied in many cardiovascular and pulmonary diseases, but the condition in acute pulmonary embolism (APE) is unknown. The purpose of this study was to investigate levels of depression and anxiety and their influencing factors in APE patients.

METHODSSixty consecutive patients with APE were subjected to investigation of depression and anxiety by the Beck Depression Inventory and State-Trait Anxiety Inventory, and 60 community-based subjects were enrolled as controls. APE patients were stratified as high-risk, intermediate-risk and low-risk according to the disease severity. Scores of depression and anxiety were compared by statistical analysis using paired t tests between APE patients and controls, and by analysis of variance within the APE patients with the three risk stratification. Factors influencing depression and anxiety were evaluated.

RESULTSThe mean age of the patients (38 males and 22 females) was (52 ± 12) years. APE patients displayed higher scores of depression (P = 0.04) and anxiety (P = 0.001) compared with controls. Patients in the high-risk group displayed higher scores of depression (P = 0.004) and anxiety (P = 0.001) compared with those in the intermediate- and low-risk groups. Depression scores were highly correlated with anxiety scores (r = 0.60, P < 0.001). Both depression and anxiety inversely related to risk stratification (P < 0.01), age (P < 0.05), and arterial blood oxygen pressure (PaO2) (P < 0.05). Linear regression analysis showed that PaO2 was independently inversely related to both depression (P < 0.01) and anxiety (P < 0.05); risk stratification and age were independently inversely related to anxiety (P < 0.05).

CONCLUSIONSPatients of APE suffered high levels of depression and anxiety, which were negatively influenced by PaO2, risk stratification and age.

Adult ; Age Factors ; Aged ; Anxiety ; diagnosis ; etiology ; Depression ; diagnosis ; etiology ; Female ; Humans ; Male ; Middle Aged ; Pulmonary Embolism ; psychology ; Sex Factors ; Stress, Psychological ; physiopathology

BACKGROUNDPolycystic ovary syndrome (PCOS) and its characteristic symptoms have been associated with physical and psychological issues in women of reproductive age. The current study was conducted in response to the dearth of systematic research related to psychological functioning and quality of life in patients with PCOS in Southwest China, and to determine whether patients with PCOS exhibit poorer mental health (MH) compared to healthy women of the same age and living in the same region, without a PCOS diagnosis.

METHODSWe enrolled 120 outpatients with PCOS and 100 healthy controls in this study. Standardized questionnaires were administered to assess general MH conditions (General Health Questionnaire-12-item version), anxiety (State-Trait Anxiety Inventory), depression (Beck Depression Inventory), as well as health-related quality of life (HRQoL) measured using the 36-item short-form health survey. The independent samples t-test was conducted for continuous study variables. For categorical variables, the Pearson Chi-square test, Fisher's exact test, and logistic regression were performed.

RESULTSThe prevalence of anxiety (13.3% vs. 2.0%) and depression (27.5% vs. 3.0%) was higher in patients with PCOS compared to the controls (both P< 0.05). Patients with PCOS had decreased HRQoL. Patients with PCOS who had fertility requirements were more likely to be anxious and depressed than those without fertility requirements (anxiety: 22.6% [12/53] vs. 5.9% [4/67], χ2 = 7.117, P = 0.008; depression: 37.7% (20/53) vs.19.4% (13/67), χ2 = 4.988, P = 0.026).

CONCLUSIONSPCOS and related symptoms may be risk factors for depression and anxiety. Professionals should be concerned with the MH of women with PCOS, and psychological therapy should be considered.

Adult ; Anxiety ; diagnosis ; etiology ; China ; Depression ; diagnosis ; etiology ; Female ; Humans ; Mental Disorders ; diagnosis ; etiology ; Polycystic Ovary Syndrome ; complications ; physiopathology ; psychology ; Psychiatric Status Rating Scales ; Quality of Life ; Surveys and Questionnaires ; Young Adult