ObjectivesTo systematically review the detection rate of depression in Chinese individuals with type 2 diabetes mellitus (T2DM).MethodsPubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data and VIP databases were electronically searched to collect observational studies on the detection rate of depression in Chinese with T2DM from inception to January, 2019. Two reviewers independently screened literature, extracted data and evaluated the quality of included studies. Meta-analysis was performed by R 3.6.1 software.ResultsA total of 29 studies involving 96 557 cases were included. Meta-analysis results showed that the total detection rate of depression in Chinese with T2DM was 27% (95%CI 24% to 30%). Subgroup analysis showed that the detection rate of depression in female was 32% (95%CI 20% to 45%), and in male was 26% (95%CI 18% to 37%). The detection rate of depression in rural areas was 36% (95%CI 18% to 54%), and in urban areas was 30% (95%CI 16% to 43%). The detection rate of depression in individuals aged 60 and above was 31% (95%CI 24% to 39%), and in individuals aged less than 60 was 23% (95%CI 10% to 36%). Individuals with a primary school education and below, a middle or high school education and college degree and above education had detection rate of 31%, 23% and 22%, respectively. Individuals with diabetes duration less than 5 years, 5 to 10 years and more than 10 years had detection rates of 23%, 25% and 30%, respectively. Individuals with and without complications had detection rates of 43% and 26%, respectively. The detection rates of mild and moderate to major depression were 20% and 10%, respectively.ConclusionsThe detection rate of depression in Chinese with T2DM is high. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusion.
ObjectiveTo systematically review the efficacy of different stimulation modalities of repetitive transcranial magnetic stimulation (rTMS) combined with SSRI in improving depressed mood after stroke using network meta-analysis. MethodsThe PubMed, EMbase, Cochrane Library, Web of Science, CNKI, VIP, CBM and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) related to the objectives from inception to October 1, 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Network meta-analysis was then performed by using R 4.2.1software. ResultsA total of 25 RCTs involving 2 152 patients were included. Four types of rTMS stimulation combined with SSRIs were included: high-frequency stimulation of the left dorsolateral prefrontal (l-DLPFC), low-frequency stimulation of l-DLPFC, low-frequency stimulation of the right dorsolateral prefrontal (r-DLPFC), and low-frequency stimulation of the bilateral DLPFC. The results of the network meta-analysis showed that the effect of combining four stimulation methods with SSRI in treating depression was better than that of SSRI alone (P<0.05). Probability sorting results showed that low-frequency stimulated bilateral DLPFC (88.9%) > low-frequency stimulated l-DLPFC (63.1%) > high-frequency stimulation l-DLPFC (57.1%) > low-frequency stimulation r-DLPFC (40.4%). There was no statistically significant difference in the incidence of adverse reactions between the four stimulation methods combined with SSRI and the use of SSRI alone (P>0.05). Conclusion?rTMS combined with SSRIs is better than SSRIs alone in improving depressed mood after stroke. Low-frequency rTMS stimulation of bilateral DLPFC may be the best. Meanwhile, the safety of different stimulation methods is good.
Electroconvulsive therapy (ECT) is an interventional technique capable of highly effective neuromodulation in major depressive disorder (MDD), but its antidepressant mechanism remains unclear. By recording the resting-state electroencephalogram (RS-EEG) of 19 MDD patients before and after ECT, we analyzed the modulation effect of ECT on the resting-state brain functional network of MDD patients from multiple perspectives: estimating spontaneous EEG activity power spectral density (PSD) using Welch algorithm; constructing brain functional network based on imaginary part coherence (iCoh) and calculate functional connectivity; using minimum spanning tree theory to explore the topological characteristics of brain functional network. The results show that PSD, functional connectivity, and topology in multiple frequency bands were significantly changed after ECT in MDD patients. The results of this study reveal that ECT changes the brain activity of MDD patients, which provides an important reference in the clinical treatment and mechanism analysis of MDD.
ObjectiveTo explore the relationship between the impairment of empathy and anxiety and depression in patients with epilepsy. MethodsAll the patients were collected in the Neurology Department of the First Affiliated Hospital of DaLian Medical University from March 2015 to January 2016, included 93 cases of adult patients with epilepsy and 100 cases of normal control group, all of them were given the test of HAMA, HAMD, MoCA and IRI-C.To analyze the relationship between the ability of empathy and anxiety and depression in patients with epilepsy, in the difference seizure type, frequency and duration of onset. Results1.Compared with the control group, the patients with epilepsy showed impaired ability of dissociative empathy, which was impaired cognitive empathy and emotional empathy, anxiety and depression were also significantly higher than those in the control group, the difference was significant.2.Different types:2.1 GTCS:cognitive empathy:no GTCS, pure GTCS group, SGS group, there were no significant differences between the three groups of empathy scores, emotional empathy, the SGS group had decrease in cognitive empathy with no GTCS, anxiety and depression more serious.There was no difference in cognitive empathy between the SGS group and the pure GTCS group, but the anxiety and depression of the SGS group were significantly serious than those of the pure GTCS group.There was no significant difference between no GTCG group and GTCS group in cognitive empathy, anxiety and depression.There was a significant negative correlation between emotional empathy and anxiety and depression in group SGS.There was no correlation between GTCS and pure GTCS group scores and anxiety depression.2.2CPS:CPS group were worse than those of the non CPS group, and the anxiety and depression were higher than those of the non CPS group.The total score of empathy, emotional empathy and anxiety and depression were significantly negatively correlated.There was no correlation in non CPS group.3.Different seizure frequency:high frequency group empathy scores, cognitive empathy lower in low frequency, anxiety and depression is more serious; empathy and anxiety and depression emotion has showed a significant negative correlation, no correlation between empathy scores, cognitive empathy and anxiety and depression.There was no correlation between empathy scores, cognitive empathy, emotional empathy and anxiety and depression.4.Different onset period:>5 years, empathy scores, cognitive empathy were lower than ≤5 years group and anxiety depression was more serious; emotional empathy and anxiety and depression was negatively related, no correlation between empathy score and cognitive empathy and anxiety and depression. ConclusionsEmpathy ability, cognitive empathy injury, emotional empathy retention declined in adult patients with epilepsy.Anxiety and depression were more severe in adult patients with epilepsy.There is negatively correlated in emotional empathy and anxiety and depression in patients with epilepsy, the scores of cognitive empathy and anxiety and depression have no correlation.The types of epilepsy, seizure frequency, age of onset is associated with cognitive empathy and anxiety and depression in epilepsy, and affect the correlation between empathy and anxiety and depression.
ObjectiveTo systematically review the efficacy of antidepressants in the prevention of poststroke depression (PSD). MethodsWe searched The Cochrane Library (Issue 2, 2015), PubMed, MEDLINE, EMbase, CNKI and VIP databases to collect randomized controlled trials (RCTs) about antidepressants in preventing PSD from inception to April 2015. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. ResultsA total of 26 RCTs involving 2 190 patients were included. The results of meta-analysis showed that:compared with the control group, the antidepressants group could significantly reduce the incidence of PSD (OR=0.24, 95%CI 0.17 to 0.36, P<0.000 01). Subgroup analysis based on types of drugs showed that:the selective serotonin reuptake Inhibitor (SSRI) could significantly reduce the incidence of PSD (OR=0.23, 95%CI 0.15 to 0.37, P<0.000 01). Subgroup analysis based on length of time showed that antidepressants could decrease the incidence of PSD in short term (OR=0.11, 95%CI 0.06 to 0.19, P<0.000 01), middle term (OR=0.31, 95%CI 0.21 to 0.46, P<0.000 01) and long term (OR=0.30, 95%CI 0.19 to 0.49, P<0.000 01). In addition, there was no statistical difference in the incidence of adverse effect between the antidepressants group and the control group (P>0.05). ConclusionAntidepressants is effective in the prevention of PSD, and may not affect patient's life quality. Due to the limited quantity and quality of included studies, more high quality studies are needed to verify the above conclusion.
Based on literatures on Meta-analysis and randomized controlled trial, drug use and some geriatrics syndromes such as cognitive impairment and depression, in elderly diabetic patients were reviewed. Insulin plus oral hypoglycemic drugs was more rational therapy for insulin resistance and islet dysfunction in type 2 diabetes mellitus. We should pay more attention to cognitive impairment and depression in elderly type 2 diabetic patients.
ObjectivTo investigate the incidence of depression and its etiological factors in patients with hypospadias after operation. MethodsFrom January to June 2015, we investigated the incidence of depression symptoms among patients with hypospadias after surgical treatment from January 1990 to December 1994 in Zhangzhou Affiliated Hospital of Fujian Medical University, and we matched them with mentally healthy adults of the same age to 1:1 ratio. Zung Self-Rating Depression Scale and Correlation Factor Questionnaire were used to investigate and analyze the related factors of depression symptoms between the patients with hypospadias and the healthy males. ResultsA total of 80 patients with hypospadias after surgical treatment and 80 healthy males as control were included. There were no significant differences in male secondary sexual development, testis development, serum testosterone levels and postoperative length and girth of the penis in two groups. The incidence rate of depression symptoms was 45.0% (16/80) in the hypospadias patients after operation, extremely significantly higher than 6.3% (5/80) in the control group (χ2=6.632, P=0.01). The result of multiple stepwise regression analysis showed that the main risk factors of depression symptoms were worries about dissatisfaction with penile and scrotal appearance (F=16.210 3, P=0.001), sexual satisfaction (F=4.621 2, P=0.036) and sexual function (F=4.103 2, P=0.043). ConclusionSymptoms of depression often occur in hypospadias patients after operation, and the major etiological factors are dissatisfaction with penile and scrotal appearance, sexual satisfaction and sexual function.
【摘要】 目的 了解結直腸癌患者術后發生抑郁、焦慮狀況，分析其影響因素。 方法 2010年1-3月，采用Zung抑郁自評量表（SDS）、焦慮自評量表（SAS）和一般資料調查問卷，結合病歷資料及心理評估，對64例結直腸癌術后患者進行測評，采用SPSS 13.0軟件對數據進行統計分析。 結果 64例患者SDS（47.02±10.38）分，SAS評分（42.42±7.96）分，均高于國內常模（Plt;0.001）。抑郁和焦慮發生率分別為42.2%、20.3%。造口患者抑郁得分高于非造口患者（P=0.004），Miles術患者抑郁得分高于非造瘺根治術患者（P=0.039），姑息術患者抑郁得分高于非造瘺根治術患者（P=0.007）；家庭月收入≤1 000元者抑郁得分高于1 001~3 000元及gt;3 000元者（P=0.040，0.017）。不同情況患者焦慮得分差異無統計學意義（Pgt;0.05）。SDS與SAS呈正相關（Plt;0.001）。 結論 結直腸癌術后患者存在不同程度的抑郁和焦慮。護理人員尤其應關注造口術后、晚期患者及收入低下患者，并進行針對性健康教育和心理干預。【Abstract】 Objective To evaluate the postoperative anxiety and depression of patients with colorectal cancer and investigate its related factors. Methods From January to March 2010, 64 patients who were diagnosed to have colorectal cancer and received therapeutic operations were investigated with self-rating depressive scale (SDS), self-rating anxiety scale (SAS) and self-made related questionnaire respectively. Psychological assessment and medical records gathering were also carried out. The data collected were analyzed by SPSS 13.0. Results The total score of SDS (47.02±10.38) and SAS (42.42±7.96) of the 64 patients were both higher than those of the general population (Plt;0.001). The incidence rate of depression and anxiety was 42.2% and 20.3% respectively. Patients without stoma had lower SDS scores than those with stoma (P=0.004); patients undergoing Miles operation had higher SDS scores than those receiving non-fistula formation radical operations (P=0.039); patients receiving palliative treatment had higher SDS scores than those receiving non-fistula formation radical operations (P=0.007); patients with family monthly income less than 1 000 RMB had higher SDS scores than those with more than 3 000 RMB and between 1 001-3 000 RMB (P=0.017, 0.040). SAS scores among different patients were not significantly different (Pgt;0.05). SDS had positive correlation with SAS (Plt;0.001). Conclusions Patients with colorectal cancer have higher emotions of anxiety and depression after operation than those in the general population. It is suggested that more psychological consultation, treatment and nursing should be carried out to promote the overall physical and mental rehabilitation of the patients, especially for those having undergone stoma formation, late-stage patients and those with a low income.
Objective To investigate the association between types of rapid eye movements during sleep and ICD-10 as a mothod for diagnosing depression. Methods Depression was diagnosed according to ICD-10 and changes of 9 variables of REM sleep in 120 psychiatric outpatients and inpatients by calculating the Kappa values. Results In 120 psychiatric patients, 52 depressive patients were diagnosed by using ICD-10, and 58 patients were diagnosed as depression according to decreased REM sleep latency and increased REM activity, REM intensity, REM density, and increasing amount of REM sleep. Kappa value was 0.73, Plt;0.05, which implied that these two diagnosing ways were significantly consistent. Conclusions Measuremen of REM sleep variable should be investigated further as a supplementary method for diagnosing depression.