OBJECTIVE: Ketamine has been widely used in refractory pain as an opioid adjuvant. Evidence suggests that ketamine can also have an essential role in easing depressive symptoms. Its rapid onset of action makes it a valuable choice in palliative care.
METHODS: We present a case of a 70-year-old man with stage IV renal carcinoma and bone metastasis. The main symptoms included neuropathic pain, depression, and a persistent and severe desire for death.
RESULTS: We started continuous subcutaneous infusion with morphine 30 mg and ketamine 100 mg/day. The dose of ketamine was incremented to the maximum of 250 mg/day. During the 28-day treatment, we observed an overall improvement in neuropathic pain, depressive symptoms, and other end-of-life psychological aspects of distress. Only minor psychological side effects were identified, which were controlled by using midazolam in the continuous subcutaneous infusion.
CONCLUSIONS: Some studies have already demonstrated the benefits of ketamine use in alleviating depression, using parental infusion or oral formulas, which are administered in hospice care. Our report enhances the benefit of the subcutaneous route for palliative patients cared for at home.

Using data from a population survey, this article explores whether perceptions of having a fertility problem among 926 U.S. couples in heterosexual relationships (women aged 25-45 and male partners) are associated with distress. Most couples did not perceive a fertility problem (58%). In almost a third (30%) of the couples, only women perceived a fertility problem; in 4%, only the men; and in nearly a fifth (19%), both perceived a problem. Adjusted for characteristics associated with fertility problems and depressive symptoms, those who perceived a problem exhibited significantly more depressive symptoms than those who did not. Fertility problems are sometimes experienced as individual because in some couples only one partner perceives a problem or has higher distress in response to their own rather than to their partners\' perceived problems. For women, fertility problems are experienced as a couple phenomenon because women were more distressed when both partners perceive a problem. The perception of fertility problems is gendered in that women were more likely to perceive a problem than men. Furthermore, men are most distressed when they perceive a problem and their partner does not.

Depressive symptoms are a customary finding in hospitalized patients, particularly those who are undergoing long hospitalizations, underwent major surgical procedures or suffer from high levels of multimorbidity and frailty. The patients included in this case series shared high degrees of frailty-complexity and were evaluated within the ordinary consultation and liaison psychiatry service of the University Hospital in Pisa, Italy, from September 2021 to June 2023. Patients were administered at least one follow-up evaluation after a week and before discharge. To relate this case series to the extant literature, a comprehensive systematic review of vortioxetine safety and efficacy was performed. None of the six patients included developed serious safety issues, but one patient complained of mild-to-moderate nausea for some days after the vortioxetine introduction. Five out of six patients exhibited at least a slight clinical benefit as measured by the clinical global impression scale. Of the 858 entries screened via Scopus and Medline/PubMed, a total of 134 papers were included in our review. The present case series provides preliminary evidence for vortioxetine\'s safety in this healthcare domain. The literature reviewed in this paper seems to endorse a promising safety profile and a very peculiar efficacy niche for vortioxetine in consultation and liaison psychiatry.

The aim of this study was to investigate the obsessive-compulsive and depressive symptoms of healthcare workers in a case-control setting as longitudinal.
In this study included 49 healthcare workers and 47 non-health workers. A sociodemographic data form, the Maudsley Obsessive-Compulsive Inventory (MOCI), the Symptom Checklist-90 (SCL-90), and the Hamilton Depression Rating Scale (HAM-D) were used to assess individuals between June 1, 2020 and June 30, 2021. We assessed the same healthcare workers after 12 months on June 30, 2021 using MOCI, HAM-D, and SCL-90.
MOCI and SCL-90 obsessive-compulsive subscale scores were significantly higher in the healthcare workers than in the non-health workers. When we assessed MOCI, HAM-D, and SCL-90 obsessive-compulsive subscale scores after 12 months, there was a statistically significant decrease in the scores of all three scales among the healthcare workers.
The results of the study showed that healthcare workers were more likely to have obsessive-compulsive symptoms than non-health workers in the early part of the pandemic on June 1, 2020, as shown by their scores on MOCI and the obsessive-compulsive subscale of SCL-90. When we assessed the same participants after 12 months (June 30, 2021), both MOCI and SCL-90 obsessive-compulsive subscale scores had decreased significantly. In contrast to these results, HAM-D scores significantly increased.

Immigrants often face increased vulnerabilities to disaster-related poor health and recovery, compared to mainstream populations. Little is known about Hurricane Harvey\'s impacts among the storm affected area\'s large Vietnamese American population. Our study documented diverse psychological experiences and recovery challenges 1 year post-storm among a sample of 120 Vietnamese Americans residing in the Houston, Texas area. Using linear regression modeling, we examined the association between social support and depressive symptom development among these storm-affected Vietnamese Americans. Social support encapsulating both social embeddedness and perceived support was measured by the Louisville Social Support Scale and depressive symptom development was measured by 18 items that assessed emotional distress. These items included loss of appetite, loss of concentration, exposure to persistent pain, and the exhibition of hopelessness, tiredness, sadness, frustration, discouragement, desperation, exhaustion, disgraced, anger, and craziness. We found adverse post-disaster health outcomes, as well as potential avenues to mitigate them, that should be taken into consideration in the design and implementation of inclusive disaster programs. A high level of social support lowered depressive symptomology among Vietnamese Americans post-Hurricane Harvey, even when accounting for Hurricane Harvey-related home damages and injuries/illness. The negative association between social support and depressive symptom development remained after accounting for both post-storm self-rated mental and physical health. Our results suggested that public health practitioners and emergency management entities should prioritize social support resources to foster mental well-being after hurricanes among Vietnamese Americans as future hurricanes are expected to be stronger and more prevalent along the United States Gulf Coast.

The role of diet is gaining attention among the modifiable factors associated with depression; thus, this case-control study examined the association between nutrition and depression in young Korean adults. Dietary surveys in individuals with depression (n = 39) and age- and gender-matched controls (n = 76) were conducted using food records and food frequency questionnaires. Men with depression consumed less mushrooms and meat, while women consumed significantly less grains (p < 0.05). Overall, the depression group consumed less energy and nutrients, and the difference was more pronounced in men. The male depression group had lower nutrient adequacy ratio (NAR) for energy, protein, vitamin A, thiamine, niacin, folate, and phosphorus, whereas the female depression group had lower NARs for energy, protein, niacin, and vitamin B12. The depression group had a significantly lower mean adequacy ratio in both genders. Furthermore, the proportion of inappropriate nutrient intake was higher in both genders of the depression group, exhibiting significant differences in energy, protein, niacin, folate, and zinc in men and energy, riboflavin, folate, and vitamin C in women. Hence, both men and women in the depression group had poor nutrient intake and high rates of nutrient inadequacy and improper consumption. This suggests that the quantity and quality of meals should be improved for individuals with depressive symptoms.

BACKGROUND: Homelessness is associated with high prevalence of psychiatric disorders such as substance use disorders, including alcohol use disorder, and depression.
METHODS: This case series and feasibility trial evaluated a novel integrated cognitive behavioral treatment (ICBT), which was adapted specifically for homeless individuals and developed to treat substance use and depressive symptoms simultaneously. The ICBT was delivered among four homeless individuals enrolled in the Treatment First program (a social services program where treatment is offered in conjunction with temporary transitional housing), who had access to stable and sober housing milieus.
RESULTS: The ICBT was rated high in expectancy of improvement, credibility, and satisfaction, with few treatment-related adverse events, and fairly high treatment retention. At 12 months follow-up, three of four participants were not homeless anymore. Some participants experienced short-term reductions in substance use and/or depressive symptoms.
CONCLUSIONS: The study provided preliminary support that the ICBT can be a feasible and potentially effective treatment for homeless individuals with substance use and/or depressive symptoms. However, the delivery format within the Treatment First program was not feasible. The ICBT could be offered within the social services Housing First program instead (where permanent housing is offered before treatment), or to non-homeless individuals.
BACKGROUND: The study was registered retrospectively at ClinicalTrials.gov (NCT05329181).

Although parent-child discrepancies in reports of parenting are known to be associated with child depressive symptoms, the direction of causality is unknown. To address this knowledge gap, this study contributes to existing literature by examining longitudinal within-family linkages between parent-child discrepancies in their reports on autonomy support and depressive symptoms of children, while also assessing these linkages with parents\' depressive symptoms. In addition, this study explored whether these linkages differ for father- versus mother-child discrepancies. Longitudinal data (six annual waves) of 497 adolescents (56.9% boys, Mage at T1 = 13.03, SD = 0.46), their mothers (N = 495), and their fathers (N = 446) of the Dutch study Research on Adolescent Development and Relationships (RADAR) were used. Counter to expectations, the results of a Random Intercept Cross-Lagged Panel Model provided no evidence for within-family cross-lagged effects. Instead, stable differences between families explained linkages; in families where children reported on average higher levels of depressive symptoms, children also reported lower levels of autonomy support relative to their parents. There were no associations between parent-child discrepancies and parents\' depressive symptoms. Thus, the findings suggest that depressive symptoms are neither a consequence, nor a predictor of parent-child discrepancies in adolescence. The hypotheses and analytical plan of this study were preregistered in a project on the Open Science Framework.

While research found heterogeneous changes in mental health during the COVID-19 pandemic, less is known about the long-term changes in mental health in psychiatric groups. Therefore, we applied a data-driven method to detect sub-groups with distinct trajectories across two years into the pandemic in psychiatric groups, and described their differences in socio-demographic and clinical characteristics.
We conducted sixteen rounds of questionnaires between April 2020 and February 2022 among participants (n = 1722) of three psychiatric case-control cohorts that started in the 2000\'s. We used Growth Mixture Modelling and (multinomial) logistic regression to identify characteristics associated with trajectory membership.
We found low decreasing (1228 [72%] participants), intermediate (n = 348 [22%] participants) and high stable (106 [6%] participants) trajectories of depressive symptoms; decreasing low/intermediate (1507 [90%] participants) and high stable (161 [10%] participants) trajectories of anxiety symptoms; and stable low (1109 [61%] participants), stable high (315 [17%] participants), temporary lowered (123 [9%]) and temporary heightened (175 [13%] participants) trajectories of loneliness. Chronicity and severity of pre-pandemic mental disorders predicted unfavourable sub-group membership for all outcomes. Being female, having a low education and income level were associated with unfavourable trajectories of depression, being younger with unfavourable trajectories of anxiety and being female and living alone with unfavourable trajectories of loneliness.
We found relatively stable trajectories of depression and anxiety symptoms over two years, suggesting low heterogeneity in outcomes during the pandemic. For loneliness, we found two specific sub-groups with temporary increase and decrease in loneliness during the pandemic.

UNASSIGNED: Parkinson\'s disease (PD) is a common neurodegenerative disorder, characterised by both motor and nonmotor symptoms. There is currently no cure for PD, although there are several treatment options for relieving PD symptoms. Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive brain stimulation therapy that shows promising results for the treatment of PD.
UNASSIGNED: Here, we present a patient with PD. We investigated whether an accelerate form of high-frequency (HF) rTMS on the contralateral side to the patient\'s main difficulties is clinically effective in treating health-related quality of life (QoL) symptomatology and depressive symptoms in PD as well as the long-term effects of rTMS in PD during the maintenance phase.
UNASSIGNED: Results showed that HF-rTMS administered over the right primary motor cortex (M1) is a safe and well-tolerated treatment that improved the patient\'s health related QoL and depressive symptoms. These positive effects lasted at least five months post treatment.
UNASSIGNED: Therefore, HF-rTMS over the right M1 can be a possible treatment option for patients with PD, although further investigations are necessary to validate the findings of the present case report.