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.
Rapid and accurate identification and effective non-drug intervention are the worldwide challenges in the field of depression. Electroencephalogram (EEG) signals contain rich quantitative markers of depression, but whole-brain EEG signals acquisition process is too complicated to be applied on a large-scale population. Based on the wearable frontal lobe EEG monitoring device developed by the authors’ laboratory, this study discussed the application of wearable EEG signal in depression recognition and intervention. The technical principle of wearable EEG signals monitoring device and the commonly used wearable EEG devices were introduced. Key technologies for wearable EEG signals-based depression recognition and the existing technical limitations were reviewed and discussed. Finally, a closed-loop brain-computer music interface system for personalized depression intervention was proposed, and the technical challenges were further discussed. This review paper may contribute to the transformation of relevant theories and technologies from basic research to application, and further advance the process of depression screening and personalized intervention.
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.
Objective To systematically evaluate the efficacy and safety of duloxetine versus paroxetine for adults’ depression. Methods A search was conducted in The Cochrane Library (Issue 6, 2011), Pubmed (1998 to June 2011), CNKI (1998 to June 2011), VIP (1998 to June 2011), CBM (1998 to June 2011), Wanfang database (1998 to June 2011), MEDLINE (1996 to June 2011) and Science Direct (1998 to June 2011). The randomized controlled trials (RCTs) on duloxetine versus paroxetine for adults’ depression were collected. The quality of the included trials was assessed according to the Cochrane Handbook 5.0, and the systematic analysis was conducted by using RevMan 5.0 software. Results Six RCTs involving 1 106 patients were included. The results of meta-analysis showed that: a) After eight-week treatment, there were no significant differences in the effective rate (RR=0.96, 95%CI 0.89 to 1.05, P=0.39) and the final cure rate (RR=0.99, 95%CI 0.86 to 1.15, P=0.93) between the duloxetine and paroxetine groups; b) Adverse reaction: The incidence rate of somnolence in the duloxetine group was lower than that of the paroxetine group (RR=0.63, 95%CI 0.41 to 0.96, P=0.03), oppositely, the incidence rate of abnormal ECG was higher in the duloxetine group (RR=1.91, 95%CI, 1.02 to 3.58, P=0.04). And the other common adverse reactions were not significantly different between the two groups (Pgt;0.05). Conclusion After eight-week treatment, there are no significant differences in the effective rate and the final cure rate between duloxetine and paroxetine. Duloxetine tends easily to induce the abnormal ECG compared with paroxetine.
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.
Objective To study the effect of comprehensive nursing on the treatment compliance and depression of patients with pulmonary tuberculosis complicated with depression. Methods Fifty-seven patients with pulmonary tuberculosis complicated with depression treated between May 2012 and June 2014 were randomly divided into study group (n=30) which was given comprehensive nursing, and control group (n=27) which accepted routine nursing. The scores of depression, treatment compliance and clinical treatment outcome were compared between the two groups. Results The scores of Hamilton Depression Scale were respectively 19.18±2.36, 18.65±2.61, 17.43±1.78 and 16.57±2.05 at the time of 3, 4, 5 and 6 months after nursing intervention, while the same scores of the control group were 22.05±3.03, 21.88±2.85, 20.96±2.06 and 20.04±1.39. The sputum negative conversion rates in the study group at those time periods were respectively 66.7%, 76.7%, 80.0% and 86.7%, while the rates in the control group were 37.0%, 44.4%, 51.6% and 63.0%. The CT lung lesions absorption rates in the study group were 43.3%, 56.7%, 63.3% and 76.7%, while the rates in the control group were 18.5%, 25.9%, 35.3% and 40.7%. The above indicators between the two groups were all statistically significant (P<0.05). The compliance of treatment in the study group was 90.0%, which was significantly higher than that in the control group (63.0%) (P<0.05). Conclusion Comprehensive nursing can help to improve negative emotion, enhance treatment compliance and clinical treatment effect, and promote the early recovery of patients with pulmonary tuberculosis combined with depression.
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.
ObjectiveTo explore the mediating effect of depression between fatigue and quality of life in patients with bronchial asthma, and to provide a clinical basis for alleviating fatigue and improving the quality of life in asthma patients.MethodsBronchial asthma patiens were recruited with convenience sampling method to conducta questionnaire survey in outpatients department of respiratory of a tertiary hospital in Guangxi from November 2018 to March 2019. The general data questionnaire, the Chinese version of Checklist Individual Strength-Fatigue, the Self-rating Depression Scale, the Questionnaire for Asthma Quality of Life in Adult, and the Asthma Control Test were used. We collected data to analyze the mediating effects of depression between fatigue and quality of life in patients with bronchial asthma.ResultsFinally, 120 patients were included. There were statistically significant differences in quality of life among patients with different ages, education levels, residences, time of high incidence of symptoms, degrees of lung function impairment, asthma control conditions, and degrees of depression, and between patients with fatigue and the ones without fatigue (P<0.05). The quality of life score was negatively correlated with depression score and fatigue score (r=?0.749, ?0.770; P<0.001). The depression score was positively correlated with fatigue score (r=0.769, P<0.001). The fatigue score had a negative predictive effect on quality of life score [standardized partial regression coefficient (β’)=?0.587, P<0.001], and a positive predictive effect on depression scores (β’=0.657, P<0.001). After adding depression score, the effect of fatigue score on quality of life score decreased and the β’ changed from ?0.587 to ?0.319, suggesting that depression played a partial mediating role in the relationship between fatigue and quality of life. Mediation tests showed significant mediation effects.ConclusionsRelieving or eliminating fatigue can improve the quality of life in asthma patients directly. At the same time, it can indirectly improve the quality of life in asthma patients through relieving depression.
ObjectiveTo investigate the estimated prevalence of depression and its associated factors among inpatients in the Department of Oncology in general hospitals. MethodsOn October 29th, 2013, we surveyed all hospitalized patients from the Department of Oncology in West China Hospital, Sichuan University. The questionnaire on patients’ demographic characteristics and the Patient Health Questionnaire-9 (PHQ-9) were combined to form one questionnaire to investigate the incidence of depression in hospitalized patients in general hospitals and its influencing factors. ResultsWe gave out 546 questionnaires and retrieved 528 with a retrieval rate of 96.6%. Seven questionnaires had 15 or more empty items and were deleted. The final number of valid questionnaires was 521, with a validity rate of 95.4%. The estimated prevalence of depression among inpatients from the Department of Oncology was 32.8% (171/521). Risk factors for depression in patients in the Department of Oncology included female gender [OR=1.550, 95%CI (1.034, 2.325), P=0.034] illiterate and primary school education [OR=2.534, 95%CI (1.329, 4.832), P=0.005] and annual household income lower than 10 000 RMB [OR=1.850, 95%CI (1.056, 3.243), P=0.032]. A total of 135 patients had suicidal risks, among whom 90 (52.6%) had depression, and Spearman correlation analysis showed that suicidal risk was moderately and positively correlated with PHQ-9 scores (r=0.558, P<0.001). ConclusionsThe estimated total prevalence of depression is high in hospitalized patients in the Department of Oncology, especially in female, low educational level and low family income patients. We must pay more attention to the mental health of cancer patients, evaluate depression and suicidal tendency carefully and provide psychological service timely.