major depression

严重抑郁症
  • 文章类型: Journal Article
    自杀意念(SI),自杀的危险因素,在精神病理学的内化中普遍存在,包括抑郁和焦虑.沉思和担忧是经过充分研究的重复性消极思维(RNT)结构,涉及内化精神病理学。这些结构具有共同和独特的特征。然而,在临床样本中,反思和忧虑之间的关系及其与SI之间的关联尚未完全了解.本研究使用相关和回归分析来评估这些关系,作为两个独立样本中具有内在化心理病理学的寻求治疗参与者的次要数据分析(研究1:n=143;研究2:n=133)。结果显示大约一半的参与者认可SI(研究1:n=79;研究2:n=71)。相关性揭示了一个重要的,沉思与担忧之间的正相关关系。以SI为因变量的回归结果表明,两项研究中的反思性均与SI呈正相关。控制症状严重程度的事后部分相关性(抑郁症,焦虑),担心,年龄和年龄表明在两项研究中都保持了反思性与SI的关系。担心和SI的研究结果在研究之间不一致。调查结果表明反省,但不用担心,可能是一个稳定的,SI在内化精神病理学中的独特贡献者。将RNT纳入具有内在化条件的个体的自杀风险评估中可能是有用的。
    Suicidal ideation (SI), a risk factor for suicide, is prevalent in internalizing psychopathologies, including depression and anxiety. Rumination and worry are well-studied repetitive negative thinking (RNT) constructs implicated in internalizing psychopathologies. These constructs have shared and distinct characteristics. However, the relationship between rumination and worry and their associations with SI are not fully understood in clinical samples. The present study used correlational and regression analysis to evaluate these relationships as a secondary data analysis in treatment-seeking participants with internalizing psychopathologies in two independent samples (Study 1:n = 143; Study 2:n = 133). Results showed about half of the participants endorsed SI (Study 1:n = 79; Study 2:n = 71). Correlations revealed a significant, positive relationship between rumination and worry. Regression results with SI as the dependent variable showed rumination significantly positively corresponded with SI in both studies. Post-hoc partial correlations controlling for symptom severity (depression, anxiety), worry, and age showed the rumination-SI relationship was maintained in both studies. Findings for worry and SI were inconsistent between studies. Findings indicate rumination, but not worry, could be a stable, unique contributor to SI in internalizing psychopathologies. It may be useful to incorporate RNT into suicide risk assessment for individuals with internalizing conditions.
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  • 文章类型: Journal Article
    鉴于现有研究的局限性,本研究的目的是探讨当前和缓解的重性抑郁在失眠症合并失眠中的作用。从睡眠实验室数据库中提供的多导睡眠图记录的医学报告中提取了来自1488例呼吸暂停患者的数据。根据美国睡眠医学学会工作组的诊断标准,定义了这些呼吸暂停患者中并发失眠障碍的存在。使用多变量逻辑回归模型研究了失眠症患者与当前或缓解的重度抑郁症相关的合并症失眠障碍的风险。在对主要混杂因素进行调整后,多变量逻辑回归分析显示,缓解和当前的重度抑郁症与呼吸暂停患者并发失眠障碍的发生显着相关。这项研究的结果似乎表明,合并症失眠障碍可能是呼吸暂停患者的残留症状和严重抑郁症的标志,这证明了为重度抑郁发作及其潜在残留症状建立适当的治疗方法,以便更好地管理共病失眠障碍,并更好地预防其在这一特定亚群中的潜在负面影响。
    Given the limitations of available studies, the objective of this study was to explore the role played by current and remitted major depression in the occurrence of comorbid insomnia disorder for apneic patients. Data from 1488 apneic patients were extracted from the medical reports of polysomnographic recordings available in the database of the Sleep Laboratory. The presence of comorbid insomnia disorder in these apneic patients was defined based on the diagnostic criteria of the American Academy of Sleep Medicine Work Group. The risk of comorbid insomnia disorder associated with current or remitted major depression in apneic patients was investigated using multivariate logistic regression models. After adjustment for the main confounding factors, multivariate logistic regression analyses revealed that remitted and current major depression were significantly associated with the occurrence of comorbid insomnia disorder in apneic patients. The findings of this study seem to indicate that comorbid insomnia disorder could be a residual symptom and a marker of major depression in apneic patients, which justifies the establishment of an adequate treatment for major depressive episodes and their potential residual symptoms to allow the better management of comorbid insomnia disorder and the better prevention of its potential negative consequences in this particular subpopulation.
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  • 文章类型: Journal Article
    在双相情感障碍中,在情绪发作期间观察到睡眠模式和活动的昼夜节律异常,但也持续在津津乐道。已经提出了情绪障碍与睡眠模式异常和活动昼夜节律之间的共有脆弱性。这项探索性研究调查了双相情感障碍多基因风险评分与重度抑郁障碍之间的关联。活动记录对睡眠模式的估计,和活动的昼夜节律在62名患有双相情感障碍的人的样本中。多基因风险评分-双相情感障碍和多基因风险评分-重度抑郁障碍被计算为三个严格的显著性阈值。使用主成分分析将数据缩减应用于将活动数据测量汇总为维度。较高的多基因风险评分-重度抑郁症与更多的零散睡眠有关,而较高的多基因风险评分-双相情感障碍与活动的昼夜节律高峰较晚有关。这些结果在调整了年龄后仍然很重要,性别,双相情感障碍亚型,身体质量指数,目前的抑郁症状,目前的烟草使用,和列入时规定的药物,但不是在多次测试校正后。总之,严重抑郁症和双相情感障碍的遗传脆弱性可能与睡眠模式和活动昼夜节律的不同异常有关。结果应在较大且独立的样品中重复。
    In bipolar disorders, abnormalities of sleep patterns and of circadian rhythms of activity are observed during mood episodes, but also persist during euthymia. Shared vulnerabilities between mood disorders and abnormalities of sleep patterns and circadian rhythms of activity have been suggested. This exploratory study investigated the association between polygenic risk scores for bipolar disorder and major depressive disorder, actigraphy estimates of sleep patterns, and circadian rhythms of activity in a sample of 62 euthymic individuals with bipolar disorder. The polygenic risk score - bipolar disorder and polygenic risk score - major depressive disorder were calculated for three stringent thresholds of significance. Data reduction was applied to aggregate actigraphy measures into dimensions using principal component analysis. A higher polygenic risk score - major depressive disorder was associated with more fragmented sleep, while a higher polygenic risk score - bipolar disorder was associated with a later peak of circadian rhythms of activity. These results remained significant after adjustment for age, sex, bipolar disorder subtype, body mass index, current depressive symptoms, current tobacco use, and medications prescribed at inclusion, but not after correction for multiple testing. In conclusion, the genetic vulnerabilities to major depression and to bipolar disorder might be associated with different abnormalities of sleep patterns and circadian rhythms of activity. The results should be replicated in larger and independent samples.
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  • 文章类型: Journal Article
    方法:电惊厥疗法(ECT)是老年人严重精神疾病的常用治疗方法,包括80岁及以上的老年人口。然而,由于医疗合并症,有时可能不愿意用ECT治疗80岁以上的年龄组,脆弱,以及对认知的担忧。
    这个多站点,澳大利亚纵向研究旨在调查老年人与年轻年龄组相比ECT的有效性和安全性。在自然环境中收集了在三家参与医院接受ECT治疗抑郁症的310人的数据,2015年至2022年。
    方法:使用蒙哥马利-奥斯贝格抑郁量表(MADRS)进行ECT前和急性终末期ECT的临床评分。使用蒙特利尔认知评估(MoCA)评估认知结果。
    结果:老年患者治疗后MADRS评分显著降低。与年轻年龄组相比,他们更有可能达到缓解标准。老年人也不太可能在ECT后表现出临床上显著的认知能力下降,与年轻年龄组相比,ECT后更有可能显示出临床上显著的认知改善。
    结论:ECT在治疗老年人的严重精神疾病方面非常有效。相对于年轻的年龄组,年龄较大的老年组更有可能接受ECT治疗,ECT后认知功能改善的比例更高.这些发现表明,ECT应被视为老年抑郁症患者的一种有价值且安全的治疗选择。
    METHODS: Electroconvulsive therapy (ECT) is a commonly used treatment for severe psychiatric illness in older adults, including in the \'older old\' population aged 80 years and above. However, there can sometimes be a reluctance to treat the 80+ year old age group with ECT due to medical comorbidities, frailty, and concerns about cognition.
    UNASSIGNED: This multi-site, longitudinal Australian study aimed to investigate the effectiveness and safety of ECT in older old people compared with younger age groups. Data from 310 people receiving ECT for depression at three participating hospitals was collected in a naturalistic setting, between 2015 and 2022.
    METHODS: Clinical ratings were conducted pre-ECT and end-acute ECT using the Montgomery-Åsberg Depression Rating Scale (MADRS). Cognitive outcomes were assessed using the Montreal Cognitive Assessment (MoCA).
    RESULTS: Older old adults demonstrated a significant reduction MADRS scores at post-treatment. They were more likely to meet remission criteria compared with the younger age groups. Older old adults were also less likely to show clinically significant cognitive decline post-ECT, and were more likely to show clinically significant cognitive improvement post-ECT compared with younger age groups.
    CONCLUSIONS: ECT is highly effective in treating severe psychiatric illness in older old adults. Relative to the younger age groups, the older old group were more likely to remit with ECT and a greater proportion showed cognitive improvement post-ECT. These findings suggest that ECT should be considered as a valuable and safe treatment option for older old individuals with depression.
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  • 文章类型: Journal Article
    背景:脂肪变性肝病(SLD)的特征是肝脏中脂质的过度积累。它与肝脏和心脏代谢疾病的风险升高有关,以及抑郁症等精神障碍。先前的研究表明,SLD的灰质整体减少。为了研究抑郁症可能存在的共同神经生物学,我们检查了SLD中与肝脏脂肪相关的区域灰质改变及其最显著的临床亚组代谢功能障碍相关脂肪变性肝病(MASLD).
    方法:我们分析了英国生物库29,051名参与者的脑MRI获得的区域皮质厚度和面积。肝脏脂肪量计算为来自肝脏MRI扫描的质子密度脂肪分数(PDFF)。我们研究了大脑结构和PDFF之间的关系,适应社会人口统计学,物理,生活方式,和环境因素,以及酒精摄入量和一系列心脏代谢协变量。最后,我们使用先前发表的结果比较了SLD/MASLD和重度抑郁症(MDD)患者的脑改变模式.
    结果:PDFF相关的灰质改变是区域特异性的,涉及皮质厚度的增加和减少,皮质面积增加。在几个地区,PDFF对灰质的影响也可以归因于心脏代谢协变量。然而,PDFF始终与中,上颞区的皮质厚度较低有关,而与钙皮和右额极区的皮质厚度较高有关。SLD和MASLD组的PDFF相关改变与MDD中观察到的改变相关(Pearsonr=0.45-0.54,p<0.01)。
    结论:这些发现表明存在将MDD与SLD和MASLD联系起来的共同生物学机制。他们可能解释了这些人群中众所周知的抑郁症风险升高,并支持早期生活方式干预和代谢风险因素的治疗,以成功管理相互关联的疾病抑郁症和SLD/MASLD。
    BACKGROUND: Steatotic liver disease (SLD) is characterized by excessive accumulation of lipids in the liver. It is associated with elevated risk of hepatic and cardiometabolic diseases, as well as mental disorders such as depression. Previous studies revealed global gray matter reduction in SLD. To investigate a possible shared neurobiology with depression, we examined liver fat-related regional gray matter alterations in SLD and its most significant clinical subgroup metabolic dysfunction-associated steatotic liver disease (MASLD).
    METHODS: We analyzed regional cortical thickness and area obtained from brain MRI in 29,051 participants in UK Biobank. Liver fat amount was computed as proton density fat fraction (PDFF) from liver MRI scans. We examined the relationship between brain structure and PDFF, adjusting for sociodemographic, physical, lifestyle, and environmental factors, as well as alcohol intake and a spectrum of cardiometabolic covariates. Finally, we compared patterns of brain alterations in SLD/MASLD and major depressive disorder (MDD) using previously published results.
    RESULTS: PDFF-related gray matter alterations were region-specific, involving both increases and decreases in cortical thickness, and increased cortical area. In several regions, PDFF effects on gray matter could also be attributed to cardiometabolic covariates. However, PDFF was consistently associated with lower cortical thickness in middle and superior temporal regions and higher cortical thickness in pericalcarine and right frontal pole regions. PDFF-related alterations for the SLD and the MASLD group correlated with those observed in MDD (Pearson r = 0.45-0.54, p < 0.01).
    CONCLUSIONS: These findings suggest the presence of shared biological mechanisms linking MDD to SLD and MASLD. They might explain the well-known elevated risk of depression in these groups and support early lifestyle interventions and treatment of metabolic risk factors for the successful management of the interconnected diseases depression and SLD/MASLD.
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  • 文章类型: Journal Article
    烦躁的正确分类对于评估青少年情绪障碍的预后和治疗指征极为重要。我们使用情感反应性指数(ARI)在289名被诊断为双相性或重度抑郁症的青少年样本中评估了与低父母和高父母和自我评估的易怒相关的因素。双变量分析后采用多元线性逻辑回归模型。与高和低父母ARI评分显著和独立相关的因素是:更严重的情绪失调和双相情感障碍的诊断。与自我评估的ARI得分高和低显着且独立相关的因素是:较低的儿童抑郁评定量表(CDRS-R),大儿抑郁量表(CDI-2)自我报告评分,更严重的情绪失调,和更大的CDRS-R食欲紊乱项目评分。高父母等级的易怒与双相情感障碍的诊断密切相关,而青年级的高易怒与以食欲/食物摄入失调为特征的抑郁表型有关,情绪不稳定,少了快感和冷漠.
    Correct classification of irritability is extremely important to assess prognosis and treatment indications of juvenile mood disorders. We assessed factors associated with low versus high parent- and self-rated irritability using the affective reactivity index (ARI) in a sample of 289 adolescents diagnosed with a bipolar or a major depressive disorder. Bivariate analyses were followed by multilinear logistic regression model. Factors significantly and independently associated with high versus low parent-rated ARI score were: more severe emotional dysregulation and bipolar disorders diagnosis. Factors significantly and independently associated with high versus low self-rated ARI score were: lower children depression rating scale (CDRS-R) difficulty of having fun item score, greater children depression inventory (CDI-2) self-report score, more severe emotional dysregulation, and greater CDRS-R appetite disturbance item score. High parent-rated irritability was strictly related with a bipolar disorder diagnosis, whereas high youth-rated irritability was related to depressive phenotype characterized by appetite/food-intake dysregulation, mood lability, and less anhedonia and apathy.
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  • 文章类型: Journal Article
    我们调查了在CBT(CBTH)中添加催眠是否可以改善双臂MDD的治疗结果,平行处理,使用匿名自我报告和临床医生盲法评估的随机对照试验。期望,信誉,对催眠的态度也进行了检查。参与者(n=66)被随机分配到10周的基于组的CBT或CBTH会议。治疗后ITT和Completer数据的LMM分析,6个月和12个月的随访显示,两种治疗方法都可能有效,但我们没有发现两者之间的显著差异.对缓解和对治疗数据的反应的分析显示,在12个月的随访中,CBTHCompleter组的表现明显优于CBT(p=.011)。CBTH还显示出显著较高的可信度之间的关联,预期和情绪结果长达12个月的随访(所有p<0.05或更高),而对催眠的态度显示出显着关联(r=-0.57,p<0.05)。这些结果表明,催眠有望作为MDD治疗的辅助手段,但需要更大的样本量才能充分测试其优点。
    We investigated whether adding hypnosis to CBT (CBTH) improved treatment outcomes for MDD with a two-armed, parallel-treated, randomized-controlled trial using anonymous self-report and clinician-blinded assessments. Expectancy, credibility, and attitude to hypnosis were also examined. Participants (n = 66) were randomly allocated to 10-weekly sessions of group-based CBT or CBTH. LMM analyses of ITT and Completer data at post-treatment, six-month and 12-month follow-up showed that both treatments were probably efficacious but we did not find significant differences between them. Analyses of remission and response to treatment data revealed that the CBTH Completer group significantly outperformed CBT at 12-month follow-up (p = .011). CBTH also displayed significantly higher associations between credibility, expectancy and mood outcomes up to 12-month follow-up (all p < .05 or better), while attitude to hypnosis showed one significant association (r = -0.57, p < .05). These results suggest that hypnosis shows promise as an adjunct in the treatment of MDD but a larger sample size is required to fully test its merits.
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  • 文章类型: Journal Article
    背景:精神分裂症,据报道,双相情感障碍和重度抑郁症与某些癌症有关。然而,两者之间因果关系的大小尚不清楚.本研究旨在探讨三种主要精神疾病与某些癌症风险之间的潜在关联。
    方法:我们使用公开的全基因组关联研究(GWAS)统计数据进行了双样本孟德尔随机化(MR)分析,以调查这三种精神疾病与某些常见类型癌症之间的因果关系。包括乳腺癌,卵巢癌,肺癌,结直肠癌,膀胱癌,前列腺癌,甲状腺癌,胰腺癌,恶性黑色素瘤和神经胶质瘤.我们获得了精神分裂症的遗传关联估计,来自精神病学基因组学联盟的双相情感障碍和抑郁症。癌症的遗传关联估计是从英国生物银行获得的,MRC-IEU财团和GliomaScan财团。
    结果:对异质性和水平多效性进行校正后,我们发现了甲状腺癌与遗传预测的精神分裂症之间关联的暗示性证据(OR=1.543,95%CI:1.023-2.328,P=0.039),甲状腺癌和重度抑郁症(OR=3.573,95%CI:1.068-11.953,P=0.039)。没有精神分裂症因果效应的证据,其他类型癌症的严重抑郁症和双相情感障碍。
    结论:我们的发现提示精神分裂症和重度抑郁症与甲状腺癌的发展有关。
    BACKGROUND: Schizophrenia, bipolar disorder and major depression have been reported to be associated with some cancers. However, the magnitude of the causal relationship between them remains unclear. This study aims to explore the potential association between three major mental diseases and the risk of some cancers.
    METHODS: We performed the two-sample Mendelian randomization(MR) analysis using publicly available genome-wide association studies (GWAS) statistics to investigate the causal relationship between these three mental diseases and some common types of cancers, including breast cancer, ovarian cancer, lung cancer, colorectal cancer, bladder cancer, prostate cancer, thyroid cancer, pancreatic cancer, malignant melanoma and glioma. We obtained genetic association estimates for schizophrenia, bipolar disorder and depression from the Psychiatric Genomics Consortium.The genetic association estimates for cancers were obtained from the UK Biobank, the MRC-IEU consortium and the GliomaScan consortium.
    RESULTS: After correction for heterogeneity and horizontal pleiotropy, we detected suggestive evidence for the association between thyroid cancer and genetically predicted schizophrenia (OR = 1.543, 95% CI: 1.023-2.328, P = 0.039), and thyroid cancer and major depression (OR = 3.573, 95% CI: 1.068-11.953, P = 0.039). No evidence of causal effects of schizophrenia, major depression and bipolar disorder on other types of cancers.
    CONCLUSIONS: Our findings suggest the association of schizophrenia and major depression and the development of thyroid cancer.
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  • 文章类型: Journal Article
    背景:认知行为疗法(CBT)是社交焦虑症(SAD)或重度抑郁症(MDD)患者的有效治疗方法,然而,在临床改善方面存在差异。尽管先前的研究表明,支持认知重新评估的大脑区域(例如背外侧前额叶皮层[dlPFC])的治疗前参与预示着SAD的CBT反应,尚不清楚这是否扩展到MDD或特定于CBT。当前的研究检查了CBT或支持疗法(ST)试验后SAD或MDD患者在重新评估期间的治疗前神经活动与临床改善之间的关系。一个共同的因素比较臂。
    方法:参与者是75例寻求治疗的SAD(n=34)或MDD(n=41)患者,随机分为CBT(n=40)或ST(n=35)。随机化前,患者在功能磁共振成像期间完成了认知重新评估任务.此外,患者在治疗前和整个治疗期间每2周完成临床医生管理的症状测量和自我报告认知再评估.
    结果:结果表明,重新评估期间治疗前的神经活动差异预测了CBT和ST反应。具体来说,在整个治疗期间症状改善的更大轨迹与CBT患者的腹外侧前额叶皮质(vlPFC)活动减少相关,但ST患者的vlPFC活性更高。此外,较少的基线dlPFC活动对应于更大的自我报告的重新评估改进轨迹,不管治疗的手臂。
    结论:如果重复,研究结果表明,在重新评估期间,大脑反应的个体差异可能与症状严重程度的治疗依赖性改善相关,但是心理治疗后主观重新评估的改善,更广泛的。
    BACKGROUND: Cognitive behavioral therapy (CBT) is an effective treatment for patients with social anxiety disorder (SAD) or major depressive disorder (MDD), yet there is variability in clinical improvement. Though prior research suggests pre-treatment engagement of brain regions supporting cognitive reappraisal (e.g. dorsolateral prefrontal cortex [dlPFC]) foretells CBT response in SAD, it remains unknown if this extends to MDD or is specific to CBT. The current study examined associations between pre-treatment neural activity during reappraisal and clinical improvement in patients with SAD or MDD following a trial of CBT or supportive therapy (ST), a common-factors comparator arm.
    METHODS: Participants were 75 treatment-seeking patients with SAD (n = 34) or MDD (n = 41) randomized to CBT (n = 40) or ST (n = 35). Before randomization, patients completed a cognitive reappraisal task during functional magnetic resonance imaging. Additionally, patients completed clinician-administered symptom measures and a self-report cognitive reappraisal measure before treatment and every 2 weeks throughout treatment.
    RESULTS: Results indicated that pre-treatment neural activity during reappraisal differentially predicted CBT and ST response. Specifically, greater trajectories of symptom improvement throughout treatment were associated with less ventrolateral prefrontal cortex (vlPFC) activity for CBT patients, but more vlPFC activity for ST patients. Also, less baseline dlPFC activity corresponded with greater trajectories of self-reported reappraisal improvement, regardless of treatment arm.
    CONCLUSIONS: If replicated, findings suggest individual differences in brain response during reappraisal may be transdiagnostically associated with treatment-dependent improvement in symptom severity, but improvement in subjective reappraisal following psychotherapy, more broadly.
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  • 文章类型: Journal Article
    与精神健康有关的疾病和障碍像其他慢性疾病一样在世界各地蔓延。考虑到食物在预防和治疗这些疾病中的作用,包括重度抑郁症,调查不同食物模式与这种疾病之间的关系尤为重要。这项研究的目的是比较重度抑郁症患者与健康个体的荷兰健康饮食和健康饮食指数以及人体测量学。
    在本病例对照研究中,对年龄范围为20~30岁的67名男性和111名女性进行了最终分析.高度(cm),重量(kg),食物频率问卷(FFQ),身体活动(MET-min/周),对所有参与者进行人口统计学和PHQ-9问卷调查.在下文中,提取所有食品成分及其成分并用于计算HEI-2015和DHD。统计学分析采用SPSS软件进行独立t检验,Logistic回归和卡方。
    研究发现,在这项研究中,患有重度抑郁症的人大多是女性,并且被占领。健康人群和重度抑郁症患者的平均HEI-2015分别为58和54.3。此外,这些人的平均DHD分别为60.5和55。HEI-2015和DHD与抑郁评分呈显著负相关(r=-0.16,p值=0.03)(r=-0.19,p值=0.01)。此外,在逻辑回归模型中,在调整混杂因素之前甚至之后,HEI-2015和DHD在患有严重抑郁症的人中的比值比降低。两组在身高的平均因素上没有显著差异,体重和体重指数(BMI)。
    似乎HEI2015和DHD在减少重度抑郁症方面有显着关系。然而,由于这方面的研究数量很少,尤其是在DHD领域,似乎有必要进行更多的研究。
    UNASSIGNED: Diseases and disorders related to mental health are spreading like other chronic diseases all around the world. Considering the role of food in the prevention and treatment of these disorders, including major depression, investigating the relationship between different food patterns and this disorder is of particular importance. The aim of this study was to compare Dutch healthy eating and healthy eating indexes and anthropometry in patients with major depression with healthy individuals.
    UNASSIGNED: In this case-control study, the final analysis was performed on 67 men and 111 women with an age range of 20-30 years. Height (cm), weight (kg), food frequency questionnaire (FFQ), physical activity (MET-min/week), demographic and PHQ-9 questionnaires were taken from all participants. In the following, all the food ingredients and their components were extracted and used to calculate HEI-2015 and DHD. Statistical analysis was performed using SPSS software with independent t-test, logistic regression and chi-square.
    UNASSIGNED: It was found that people with major depression in this study were mostly women and occupied. The average HEI-2015 in healthy people and those with major depression was 58 and 54.3, respectively. Also, the average DHD in these people was 60.5 and 55, respectively. HEI-2015 and DHD had a significant negative correlation with depression score (r = -0.16, p-value = 0.03) (r = -0.19, p-value = 0.01). Also, in the logistic regression model, before and even after adjusting confounders, HEI-2015 and DHD had a reduced odds ratio in people suffering from major depression. The two groups did not differ significantly in terms of the average factors of height, weight and body mass index (BMI).
    UNASSIGNED: It seems that HEI2015 and DHD have a significant relationship in reducing major depression. However, due to the small number of studies in this regard, especially in the field of DHD, the need for more studies seems necessary.
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