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

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

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

This study is to investigate the amelioration effect of glucocorticoid receptor (GR) antagonist mifepristone on the changes of learning and memory abilities in rat model of depression. In the present study, a 35-day rat chronic unpredictable stress (CUS) model was used to observe both depression-like behaviors with sucrose preference test and open-field test and learning and memory-associated behaviors with Morris water maze test. A total of 45 male adult Sprague-Dawley rats were randomly assigned to three groups of equal size: control group (CON); CUS group (CUS); CUS + mifepristone group (CM). Animals in CM group were first exposed to CUS for 14 days, and then were administered with 50 mg x kg(-1) x d(-1) of mifepristone with continued CUS procedure. Corticosterone EIA Kit was used to detect the concentration of plasma corticosterone (CORT). Nissl staining was used to observe the structure of hippocampus. The results demonstrated that CUS exposure induced both depressive-like and learning and memory-associated behaviors and these deficits were reversed by mifepristone. Compared to CON group, the concentration of plasma CORT increased significantly in CUS group. CUS exposure damaged the structure of hippocampus, whereas mifepristone had an amelioration effect. Together, the structural deficits of hippocampus resulting from long-term stress exposure, which could contribute to the impairment of learning and memory in depression, are reversed by the GR receptor antagonist mifepristone.
Animals ; Behavior, Animal ; drug effects ; Corticosterone ; blood ; Depression ; blood ; etiology ; pathology ; physiopathology ; Hippocampus ; pathology ; Learning ; drug effects ; Male ; Memory ; drug effects ; Mifepristone ; pharmacology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Receptors, Glucocorticoid ; antagonists & inhibitors ; Stress, Psychological ; complications

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 observe the effect of hesperidin on behavior and hypothalamic-pituitary-adrenal (HPA) axis of ratmodel of chronic stress-induced depression.

METHODChronic unpredictable mild stress (CUMS) was used to establish the rat depression model. Sixty male SD rats were divided randomly into six groups: the normal group, the model group, the hesperidin (40, 80, 160 mg x kg(-1)) group and the positive fluoxetine (10 mg x kg(-1)) group. They were orally administered with drugs for three weeks. The sucrose preference test and the forced swimming test (FST) were assayed to detect animal behavior. The levels of corticosterone (CORT) in serum, mRNA of corticotropin release factor (CRF) in hypothalamus as well as protein expression of glucocorticoid receptor (GR) in paraventricular nucleus (PVN) were determined to clarify the anti-depression effect and mechanism of hesperidin.

RESULTCompared with the model group, rats in the hesperidin (40, 80, 160 mg x kg(-1)) treatment group showed significant increase in the sucrose consumption and decrease in the immobility time in FST to varying degrees. Meanwhile, the excessively high serum CORT and adrenal index of CUMS rats were reversed by treatment with hesperidin. In addition, hesperidin inhibited CRF mRNA expression in hypothalamus and up-regulated GR protein expression in PVN among CUMS rats.

CONCLUSIONHesperidin could effectively improve the behavior of CUMS rats and show the anti-depression effect. Its mechanisms may be related to the function of regulating HPA axis.

Administration, Oral ; Animals ; Behavior, Animal ; drug effects ; Corticosterone ; blood ; Corticotropin-Releasing Hormone ; genetics ; metabolism ; Depression ; drug therapy ; etiology ; Fluoxetine ; administration & dosage ; Gene Expression Regulation ; drug effects ; Hesperidin ; administration & dosage ; pharmacology ; Hypothalamo-Hypophyseal System ; drug effects ; physiopathology ; Hypothalamus ; metabolism ; Male ; Models, Animal ; Pituitary-Adrenal System ; drug effects ; physiopathology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Receptors, Glucocorticoid ; metabolism ; Stress, Psychological ; complications ; drug therapy ; Sucrose ; metabolism ; Swimming ; Up-Regulation

We retrospectively evaluated demographic and biochemical parameters associated with depression and health-related quality of life (HRQOL) in maintenance peritoneal dialysis (PD) patients. This study included 105 patients maintaining PD at Seoul National University Hospital. Data were collected from electronic medical record. Korean Beck's Depression Inventory and Korean version of Kidney Disease Quality of Life short form, version 1.3 were used to evaluate depression and HRQOL, respectively. Moderate to severe depression was found in 24.8% of patients. Patients with lower normalized protein equivalent of nitrogen appearance (nPNA) (< 1.2 g/kg/day), lower weekly renal Kt/V(urea) (< 0.2), and lower serum albumin level (< or = 4.0 g/dL) were associated with depression (P < 0.05). Among them, lower weekly renal Kt/V(urea) was the only independent risk factor associated with depression (OR = 3.1, P = 0.007). Depressed patients showed significantly lower scores in every dimension of HRQOL (P < 0.001). Lower weekly renal Kt/V(urea) (beta = 0.24, P = 0.005) and lower nPNA (beta = 0.15, P = 0.03) were the independent risk factors associated with lower kidney dialysis component summary, whereas lower plasma hemoglobin level was the consistent risk factor for lower physical component summary (beta = 0.22, P = 0.03) and mental component summary (beta = 0.22, P = 0.01). Depression is a prevalent psychological problem in PD population. Residual renal function is the most important factor associated with depression and impaired HRQOL in PD patients.
Adult ; Aged ; Demography ; Depression/*etiology ; Female ; Health Status ; Hemoglobins/analysis ; Humans ; Kidney Diseases/*complications/physiopathology/*psychology ; Male ; Middle Aged ; Peritoneal Dialysis ; *Quality of Life ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Serum Albumin/analysis ; Software

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

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

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