The current hypothesis of depression is limited by back reasoning from the action of antidepressant, because both the pharmacological and pathological mechanisms are not fully understood.Recent evidence shows that genes and early life stress are associated with depression, and the mechanisms are converged on those of neural plasticity. These developments open a new avenue to understand the pathological and pharmacological mechanisms of depression.
Antidepressive Agents ; pharmacology ; therapeutic use ; Depressive Disorder ; drug therapy ; etiology ; physiopathology ; Genetic Predisposition to Disease ; genetics ; Humans ; Neuronal Plasticity ; drug effects

OBJECTIVETo assess the co-morbidity of anxiety and depression in hospitalized patients and to analyze the degree of symptoms and the influential factors.

METHODSThirty patients with malignant tumor were injected with thymosin alpha 1 subcutaneously at the dose of 1.6 mg q.d. for the first month and q.o.d. for the following month. The number of T cell subgroups and the activity of NK cell in peripheral blood were detected and the quality of life of the patients were evaluated before treatment and at the end of treatment.

RESULT(1) About 39.9 % of the patients presented the symptoms of anxiety and depression and out of them 6.7 % were taken psychotropic medication. (2) Stepwise Logistic Regression showed that the factors related to anxiety and depression could be classified into four categories: economic factor, sleeping status, cognition of disease, the other factors such as course of disease and the environment of hospital. (3) Data analysis of oncology patients showed that the cognition of disease would be an important factor, which would affect anxiety and depression status.

CONCLUSIONMultiple factors can affect anxiety and depression symptoms of inpatients. The results suggest that psychological intervention such as cognitive therapy should be considered in clinical practice.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anxiety ; etiology ; therapy ; Depressive Disorder ; etiology ; therapy ; Female ; Hospitals, General ; Humans ; Inpatients ; Logistic Models ; Male ; Middle Aged ; Psychotherapy

PURPOSE: Chronic kidney disease (CKD) is a condition characterized by the gradual loss of kidney function over time. Self-management programs have been widely applied to chronic disease education programs, which are designed to delay deteriorating kidney functions, preclude depression, and improve quality of life. This study aims to analyze effectiveness of self-management programs in bettering CKD patients' eGFR, mitigating depression symptoms and improving quality of life in randomized control or clinical trials. METHODS: Using key terms, a search was conducted in English-language, peer-reviewed journals on CKD that were published between 2002 and 2014 on databases including CINAHL, Cochrane Library, MEDLINE. The measurable variables included CKD patients' eGFR, depression, and quality of life. Random and fixed effects meta analysis were applied with standard error and correlation based measure of effect size. RESULTS: Eight studies met the inclusion criteria. A self-management program significantly impacted CKD patients' depression and mental quality-of-life dimensions, with an effect size of .29 [95% confidence interval (CI) (0.07, 0.53)] and −.42 [95% CI (−0.75, −0.10)]. However, the intervention of a self-management program had no significant effect on patients' eGFR as well as physical quality-of-life dimensions, with effect sizes of .06 [95% CI (−0.69, 0.81)] and −.16 [95% CI (−0.81, 0.50)]. CONCLUSIONS: Self-management programs of patients with chronic kidney disease can improve the depression and mental quality of life. Aside from providing more objective evidence-based results, this study provides a reference for clinical health care personnel who tend to patients with CKD.
Cognitive Therapy/methods ; Depressive Disorder/*etiology/therapy ; Glomerular Filtration Rate/*physiology ; Humans ; *Quality of Life ; Randomized Controlled Trials as Topic ; Renal Insufficiency, Chronic/physiopathology/psychology/*therapy ; Self Care/*methods

PURPOSE: To determine the effects of music therapy on pain, discomfort, and depression for patients with leg fractures. METHODS: Data were collected from 40 patients admitted in an orthopedic surgery care unit. The subjects included 20 intervention group members and 20 control group members. Music therapy was offered to intervention group members once a day for 3 days for 30-60 minutes per day. Pain was measured with a numeric rating scale and by measuring vital signs. Discomfort and depression were measured with self-administered questionnaires. RESULTS: Patients who received music therapy had a lower degree of pain than patients who did not receive music therapy as measured by the numeric pain score (p<0.001), systolic blood pressure (p<0.01), diastolic blood pressure (p<0.001), pulse rate (p<0.001) and respiration (p<0.001). Patients who were provided with music therapy also had a lower degree of discomfort than patients who were not provided with this therapy (p<0.01). CONCLUSIONS: These results demonstrate that music therapy is an effective method for decreasing pain and dis-comfort for patients with leg fractures.
Adult ; Analysis of Variance ; Depressive Disorder/etiology/*prevention & control ; Female ; Fractures, Bone/*complications/psychology ; Humans ; *Leg ; Male ; Middle Aged ; *Music Therapy ; Pain/etiology/*prevention & control

OBJECTIVETo observe the therapeutic effect of Huoxue Jieyu decoction (HJD) on patients with depression after craniotomy.

METHODSNinety patients were randomly divided into 2 groups according to the sequence of their consultation. The 45 patients in the treated group were treated with conventional symptomatic treatment plus oral administration of HJD, and the 38 patients in the control group were treated in the same way but with chlorimipramine (anafranil) instead of HJD. Hamilton depression (HAMD) scores before and after treatment, occurrence of adverse effects and long-term therapeutic effect of treatment were observed.

RESULTSThe score of HAMD was insignificantly different in 2 groups before and after treatment (P >0.05), but the occurrence of adverse effects between them was significantly different (P < 0.01).

CONCLUSIONThe therapeutic effect of HJD on depression was similar to that of anafranil, but HJD has less adverse effect and more stabilized long-term effect.

Adolescent ; Adult ; Craniotomy ; adverse effects ; Depressive Disorder ; drug therapy ; etiology ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Postoperative Complications ; drug therapy

OBJECTIVE: To investigate the association between health related quality of life (HRQoL) and severity of depression in patients with major depressive disorder (MDD). METHODS: Short Form 36 Health Survey Questionnaire (SF-36) was administered to 103 MDD patients at the baseline and 6-week follow-up. Hamilton Depression Rating for Depression (HAMD) and Clinical Global Impression (CGI) were administered at the baseline, 2- and 6-week follow-up, respectively. RESULTS: All SF-36 component scores in the 6-week follow-up were significantly higher than those at the baseline (P<0.01). The overall and subscale scores of HAMD except weight and CGI scores at the 2- and 6-week follow-up were significantly lower than those at the baseline (all P<0.01). The role-emotion score of the clinical remission group was significantly lower than that of the non-remission group. After a 6-week antidepressant treatment, all SF-36 component scores in both groups were significantly higher than those at the baseline, except body pain in the non-remission group. While scores of role-physical, general health, vitality, social functioning, role-emotion and mental health were significantly higher in the remission group than those in the non-remission group (P<0.05 or P<0.01). A higher overall score of HAMD, scores of cognitive disturbance and CGI were significantly associated with a worse SF-36 at the baseline (P<0.05 or P<0.01). After the 6-week treatment, a worse health transition was significantly associated with higher scores of HAMD and sleep disturbance at the baseline (P<0.01), a worse general health and role-emotion were strongly associated with higher score of anxiety/somatization at the baseline (both P<0.05). Score of general health was positively associated with reduction rate of cognitive disturbance at the 2-week endpoint (P<0.05) and scores of vitality and reported health transition were positively associated with the reduction rate of sleep disturbance at the 2-week endpoint (both P<0.05). CONCLUSION The increasing severity of depression was significantly associated with a worse HRQoL in patients with MDD. A 6-week antidepressant treatment may result in comparable HRQoL improvements. The components of HRQoL vary with severity of various symptoms of depression at the baseline and their early improvement after the treatment.
Adolescent ; Adult ; Antidepressive Agents ; therapeutic use ; Cognition Disorders ; drug therapy ; etiology ; Depressive Disorder, Major ; complications ; drug therapy ; psychology ; Female ; Health Status ; Humans ; Male ; Middle Aged ; Prospective Studies ; Quality of Life ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo compare the efficacy between moving cupping at Hechelu combined with rubbing method and western medication for depression of diabetes mellitus (DM).

METHODSTwo hundred and sixteen patients were randomly divided into an observation group and a control group, 108 cases in each group. Patients in the observation group were treated with moving cupping at Hechelu combined with rubbing method, once every: other day; six treatments were considered as one course, and totally two courses were given with an interval of: 4 days between courses. Patients in the control group were treated with oral administration of fluoxetine hydrochloride capsules, once a day for consecutive 4 weeks. The Hamilton depression scale (HAMD), self-rating depression scale (SDS) and TCM symptom score were measured before treatment, after the treatment and in follow-up visit one and a half months after treatment. The fasting blood glucose was tested before and after treatment. The glycosylated hemoglobin (HbA1c) was tested in the follow-up visit.

RESULTSThe total effective rate was 90.9% (90/99) in the observation group, which was superior to 73.7% (70/95) in the control group (P < 0.05). After the treatment, HAMD, SDS and TCM symptom scores were all reduced apparently in the observation group and the control group (all P < 0.05). After the treatment and the follow-up visit, the TCM symptom score in the observation group was lower than that in the control group (P < 0.05). The levels of HbA1c and GLU were stable in the observation group, and were decreased compared with those before treatment; but the difference between the, two groups was not significant (P > 0.05).

CONCLUSIONThe Hechelu theory-based TCM treatment has better: efficacy for depression of diabetes mellitus than fluoxetine hydrochloride capsule, which has less adverse effects.

Acupuncture Points ; Adult ; Aged ; Blood Glucose ; metabolism ; Combined Modality Therapy ; Depressive Disorder ; etiology ; metabolism ; psychology ; therapy ; Diabetes Mellitus, Type 2 ; complications ; metabolism ; psychology ; Female ; Humans ; Male ; Massage ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Treatment Outcome

OBJECTIVEWe observed the therapeutic effectiveness and safety of different antidepressants as well as the correlation between symptomatic improvement of depression and improvement of chest pain in patients with susceptible "angina pectoris" and negative coronary angiogram complicating comorbid depression.

METHODSIn this double-blinded randomized study, a total of 123 eligible patients were allocated into three groups: (1) Group F: fluoxetine 20 mg QN (n = 41); (2) Group P: Placebo 1 tablet QN (n = 40); (3) Group F + O: fluoxetine 20 mg + olanzapine 2.5 mg QN for the former 2 weeks and only fluoxetine 20 mg QN for the latter 2 weeks (n = 42). The total therapy duration was 4 weeks. HAMD, HAMA and self-evaluation table of chest pain were obtained before therapy, at the end of 1 and 2 weeks after therapy.

RESULTSBaseline HAMD and HAMA scores and self-evaluation score of chest pain were similar among 3 groups and all scores were significantly improved post various therapies in the order of group F + O > group F > group P. The rate of score decrease were seen after 1 week treatment in group F + O and after 2 week treatment in group F. There was a significant positive correlation between the rates of self-evaluation chest pain score decrease and HAMD (r = 0.867, P < 0.001) and HAMA (r = 0.854, P < 0.001) score decreases after 4 weeks therapies (P < 0.05). During the whole course of treatment, no serious adverse reaction was found in all patients.

CONCLUSIONIn patients with suspected "angina pectoris" and negative coronary angiogram complicating comorbid depression, the antidepressants were safe and significantly improved the symptoms of depression and anxiety and chest pain. Low dose fluoxetine plus short term olanzapine regimen was superior to fluoxetine alone regimen in terms of stronger and quicker symptom improvement.

Aged ; Angina Pectoris ; diagnostic imaging ; drug therapy ; psychology ; Antidepressive Agents, Second-Generation ; therapeutic use ; Benzodiazepines ; therapeutic use ; Coronary Angiography ; Depressive Disorder ; drug therapy ; etiology ; Double-Blind Method ; Female ; Fluoxetine ; therapeutic use ; Humans ; Male ; Middle Aged