Depressive episode

抑郁发作
  • 文章类型: Journal Article
    尽管有有效的抗抑郁药策略,许多抑郁症患者仍未得到治疗。新冠肺炎大流行影响了医疗服务,尤其是精神卫生部门。这项研究旨在探讨西班牙普通人群抑郁症治疗的覆盖率以及新冠肺炎大流行的影响。
    我们使用了西班牙普通人群的纵向数据(2018年和2022年):大流行前n=1512;平均年龄=65.43岁±14.90;56%女性;大流行后n=909;平均年龄=68.00岁±14.24;54%女性。国际疾病分类第10版用于诊断终生抑郁发作和严重程度。我们通过对4个协变量(出生时分配的性别,教育水平,年龄,Covid-19大流行)用于诊断为抑郁症的参与者。
    大流行前和大流行后样本中抑郁症的治疗覆盖率为,分别,53.3%和51.9%。我们观察到重度抑郁症与治疗覆盖率之间存在关联(OR=2.77,95CI1.05至7.75)。我们发现COVID-19大流行与治疗覆盖率之间没有关联。
    药物治疗范围与严重类型的抑郁症有关。在COVID-19大流行前后,治疗覆盖率的患病率相似,这证明了西班牙精神卫生系统的韧性。
    UNASSIGNED: Despite the availability of effective antidepressant strategies, numerous people with depressive disorders remain untreated. The Covid-19 pandemic has affected healthcare services, especially the mental health sector. This study aims to explore the coverage of depression treatments in the general Spanish population and the impact of the Covid-19 pandemic.
    UNASSIGNED: We used longitudinal data (2018 and 2022) from the general Spanish population: pre-pandemic n = 1512; mean age = 65.43 years ± 14.90; 56 % females; post-pandemic n = 909; mean age = 68.00 years ± 14.24; 54 % women. The International Classification of Disease 10th edition was used to diagnose lifetime depressive episodes and severity. We explored psychological and pharmacological treatment coverage via multiple logistic regressions adjusted for 4 covariates (sex assigned at birth, education level, age, Covid-19 pandemic) for participants with a diagnosis of depression.
    UNASSIGNED: Treatment coverage for depression in the pre-pandemic and post-pandemic samples was, respectively, 53.3 % and 51.9 %. We observed an association between severe depression and treatment coverage (OR = 2.77, 95%CI 1.05 to 7.75). We found no association between the COVID-19 pandemic and treatment coverage.
    UNASSIGNED: The pharmacological treatment coverage was associated with severe types of depression. The prevalence rates of treatment coverage were similar in the pre- and post-COVID-19 pandemic attesting to the resilience of the mental health system in Spain.
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  • 文章类型: Journal Article
    如今,血清中的神经组织损伤蛋白被认为是有希望的药物靶标和情绪障碍的生物标志物。在一项横断面自然主义研究中,S100B,在两个诊断组之间比较血清中的MBP和GFAP水平(抑郁发作患者(DE,n=28)和复发性抑郁障碍患者(RDD,n=21)),和健康对照(n=25)。通过ROC分析评估血清标志物的诊断价值。在DE组中,我们没有发现S100B水平的变化,MBP和GFAP与对照组比较。在RDD组中,我们发现,与健康对照组相比,S100B水平降低(p=0.011),MBP水平升高(p=0.015).提供ROC分析表明MBP有助于DE的发展(AUC=0.676;95%Cl0.525-0.826;p=0.028),和S100B和MBP对RDD的发展有显着影响(AUC=0.732;95%Cl0.560-0.903;p=0.013和AUC=0.712;95%Cl0.557-0.867;p=0.015,相应)。对患有当前DE的患者的神经组织损伤的血清标志物的研究表明结构和功能关系解体的迹象,神经胶质传递功能障碍,和神经特异性蛋白质分泌受损。星形胶质细胞和少突胶质细胞的功能改变与RDD的病理生理学有关。
    Nowadays, nervous tissue damage proteins in serum are considered promising drug targets and biomarkers of Mood Disorders. In a cross-sectional naturalistic study, the S100B, MBP and GFAP levels in the blood serum were compared between two diagnostic groups (patients with Depressive Episode (DE, n = 28) and patients with Recurrent Depressive Disorder (RDD, n = 21)), and healthy controls (n = 25). The diagnostic value of serum markers was assessed by ROC analysis. In the DE group, we did not find changed levels of S100B, MBP and GFAP compared with controls. In the RDD group, we found decreased S100B level (p = 0.011) and increased MBP level (p = 0.015) in comparison to those in healthy controls. Provided ROC analysis indicates that MBP contributes to the development of a DE (AUC = 0.676; 95%Cl 0.525-0.826; p = 0.028), and S100B and MBP have a significant effect on the development of RDD (AUC = 0.732; 95%Cl 0.560-0.903; p = 0.013 and AUC = 0.712; 95%Cl 0.557-0.867; p = 0.015, correspondingly). The study of serum markers of nervous tissue damage in patients with a current DE indicates signs of disintegration of structural and functional relationships, dysfunction of gliotransmission, and impaired secretion of neurospecific proteins. Modified functions of astrocytes and oligodendrocytes are implicated in the pathophysiology of RDD.
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  • 文章类型: Journal Article
    创伤后应激(PTSD)障碍是一种精神健康状况,可以在经历或目睹创伤事件后发生。2010年智利发生的27-F地震就是其中一个对人口心理健康产生重大影响的事件。进行了一项研究,以调查这次地震幸存者中PTSD的患病率及其相关因素。这项研究是纵向设计,涉及913名18至75岁的患者样本,他们在康塞普西翁的10个初级保健中心就诊,智利。综合国际诊断访谈(CIDI)用于评估地震前后的抑郁发作(DE)和PTSD。该研究还涉及使用参与者的唾液样本进行基因分型研究,特别关注Val66Met和5-HTTLPR多态性。进行统计分析以检查不同变量与PTSD存在之间的关联。这些变量包括人口因素,精神病家族史,DE,童年虐待经历,以及与地震有关的严重创伤事件。结果表明,震后PTSD的发生率为11.06%。在Val66Met或5-HTTLPR多态性方面,发生地震后PTSD的参与者之间没有发现显着差异。然而,发现伴随的DE诊断与震后PTSD的发展之间存在显着关联。DE的存在使发生地震后PTSD的风险增加了一倍。经历的创伤事件的数量与发生地震后PTSD的风险增加也具有统计学上的显着关联。该研究的局限性包括不同DE亚型的潜在干扰,量化每个人经历的地震暴露程度的复杂性,以及导致社会混乱的事件,比如抢劫,可以深刻地影响痛苦。总之,研究发现,智利27-F地震后的PTSD与伴随的DE诊断和所经历的创伤事件数量相关.该研究未发现PTSD与Val66Met或5-HTTLPR多态性之间存在显著关联。研究人员建议,精神卫生专业人员应优先考虑发现和治疗灾难幸存者中伴随的抑郁发作和严重创伤事件。他们还建议需要进一步的研究来更好地了解遗传因素与灾后创伤后应激障碍之间的关系。
    Post-traumatic stress (PTSD) disorder is a mental health condition that can occur after experiencing or witnessing a traumatic event. The 27-F earthquake that struck Chile in 2010 was one such event that had a significant impact on the mental health of the population. A study was conducted to investigate the prevalence of PTSD and its associated factors among survivors of this earthquake. The study was a longitudinal design, involving a sample of 913 patients aged 18 to 75 years who attended 10 Primary Care Centers in Concepción, Chile. The Composite International Diagnostic Interview (CIDI) was used to assess both depressive episodes (DE) and PTSD before and after the earthquake. The study also involved genotyping studies using saliva samples from the participants, specifically focusing on the Val66Met and 5-HTTLPR polymorphisms. Statistical analysis was performed to examine the association between different variables and the presence of PTSD. These variables included demographic factors, family history of psychiatric disorders, DE, childhood maltreatment experiences, and critical traumatic events related to the earthquake. The results showed that the incidence of post-earthquake PTSD was 11.06%. No significant differences were found between the groups of participants who developed post-earthquake PTSD regarding the Val66Met or 5-HTTLPR polymorphisms. However, a significant association was found between the concomitant diagnosis of DE and the development of post-earthquake PTSD. The presence of DE doubled the risk of developing post-earthquake PTSD. The number of traumatic events experienced also had a statistically significant association with an increased risk of developing post-earthquake PTSD. The study\'s limitations include the potential interference of different DE subtypes, the complexity of quantifying the degree of earthquake exposure experienced by each individual, and events entailing social disruption, such as looting, that can profoundly influence distress. In conclusion, the study found that PTSD following the 27-F earthquake in Chile was associated with a concomitant diagnosis of DE and the number of traumatic events experienced. The study did not find a significant association between PTSD and the Val66Met or 5-HTTLPR polymorphisms. The researchers recommend that mental health professionals should prioritize the detection and treatment of concomitant depressive episodes and exposure to critical traumatic events in survivors of disasters. They also suggest that further research is needed to better understand the relationship between genetic factors and post-disaster PTSD.
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  • 文章类型: Journal Article
    抑郁症是全球残疾的主要原因。在高危人群中进行筛查对于确定最需要治疗的人群很重要。Pengpid等人报告了在泰国人群的流行病学研究中发现的抑郁症的高发生率和持续性症状及其与身体合并症的关系。然而,筛查有局限性,由于资源影响和诊断掩盖的风险。尽管筛查有助于从流行病学角度概述抑郁症状的患病率,将这种方法转化为临床环境可能存在合理的担忧。在提供进一步全面评估和治疗的资源可能不足的情况下尤其如此。临床上需要考虑一种更完整的筛查方法,该方法利用嵌入在更广泛的诊断方法中的筛查工具,该方法允许检测和管理其他混杂条件。
    Depression is a major cause of disability worldwide. Screening in at-risk populations is important in identifying those at most need of treatment. Pengpid et al report on high rates of incident and persistent symptoms of depression identified in an epidemiological study in a Thai population and their association with physical comorbidities. However, there are limitations to screening, due to both resource implications and the risk of diagnostic overshadowing. Although screening is useful in providing an overview of the prevalence of depressive symptoms from an epidemiological perspective, there may be justified concerns in translating this approach to clinical settings. This is especially true where the resources to provide further comprehensive assessment and treatment may be inadequate. Clinically there is a need to consider a more complete approach to screening that utilises screening tools embedded in a wider diagnostic approach which allows the detection and management of other confounding conditions.
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  • 文章类型: Journal Article
    背景:在美国,抑郁发作与死亡率增加有关。认识到抑郁症和身体健康之间的关系,了解促成因素,和解决差异对于降低死亡率和改善经历抑郁发作的个体的整体福祉至关重要。继续研究,公共卫生工作,合作方法对于有效解决这一复杂的公共卫生问题至关重要。研究抑郁发作的死亡率趋势以及其他相关因素将有助于增强对病情的了解,which,反过来,将有助于降低弱势群体的死亡率。研究了来自CDC广泛的流行病学研究在线数据(WONDER)数据库的潜在死亡原因的方法数据,以确定从1999年到2020年经历过与抑郁发作有关的致命结局的个体。WONDER数据库是指CDC使用的在线系统,用于使公众和公共卫生专家可以访问其各种资源。CDCWONDER提供更广泛的公共卫生信息。结果在1999年至2020年期间,共有13,290人死于抑郁发作。数据分析显示,在特定时期内,总死亡率为每100,000个人0.20。死亡率最高的是2003年(0.28),2001年(0.27),1999年(0.27)。分析显示,不同人口群体之间的死亡率存在显着差异。老年人,女性,特定种族群体,包括白人和非裔美国人,和特定的地理区域,包括中西部地区,东北,南,西方,表现出与抑郁发作相关的较高死亡率。结论研究发现,老年人,女性,Whites,非洲裔美国人,以及某些地理区域,表现出与抑郁发作相关的死亡可能性增加。这些发现强调了理解心理健康和死亡率之间复杂相互作用的重要性。研究结果强调了解决不同人口群体之间心理健康结果差异的重要性。确定弱势群体可以为有针对性的干预措施和资源提供信息,以解决死亡率上升的风险。
    Background Depressive episodes are associated with increased mortality rates across the United States. Recognizing the relationship between depression and physical health, understanding the contributing factors, and addressing disparities are critical in reducing mortality rates and improving the overall well-being of individuals experiencing depressive episodes. Continued research, public health efforts, and collaborative approaches are essential to tackle this complex public health concern effectively. Studying the mortality rate trends of depressive episodes along with other related factors will help enhance the understanding of the condition, which, in turn, will assist in reducing mortality rates in the vulnerable population. Methodology Data from the CDC Wide-Ranging Online Data for Epidemiologic Research (WONDER) database on the Underlying Cause of Death were examined to identify individuals who experienced fatal outcomes related to depressive episodes from 1999 to 2020. The WONDER database refers to the online system used by the CDC to make its various resources accessible to the public and public health experts. CDC WONDER offers access to a broader range of information on public health. Results A total of 13,290 individuals who died from depressive episodes between 1999 and 2020 were identified. Data analysis revealed an overall mortality rate of 0.20 per 100,000 individuals during the specified period. The highest mortality rates were observed in the years 2003 (0.28), 2001 (0.27), and 1999 (0.27). The analysis revealed significant disparities in mortality rates among different demographic groups. Older adults, females, specific racial groups, including Whites and African Americans, and specific geographic areas, including the Midwest, Northeast, South, and West, exhibited higher mortality rates associated with depressive episodes. Conclusions The study identified that older individuals, females, Whites, and African Americans, as well as certain geographic regions, exhibited an increased likelihood of mortality related to depressive episodes. These findings highlight the importance of understanding the complex interplay between mental health and mortality. The findings emphasize the importance of addressing disparities in mental health outcomes among different demographic groups. Identifying vulnerable populations can inform targeted interventions and resources to address the elevated mortality risk.
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  • 文章类型: Journal Article
    塞来昔布对广泛的情绪障碍和炎症参数的影响尚未得到全面评估。这项研究的目的是系统地总结有关该主题的可用知识。分析了临床前和临床研究的数据,考虑到塞来昔布治疗情绪障碍的疗效和安全性,以及炎症参数与塞来昔布治疗效果的相关性。纳入了44项研究。我们发现有证据支持塞来昔布的抗抑郁疗效,剂量为400毫克/天,持续6周作为重性抑郁症的附加治疗(SMD=-1.12[95%Cl:-1.71,-0.52],p=0.0002)和躁狂症(SMD=-0.82[95%CI:-1.62,-0.01],p=0.05)。塞来昔布在上述剂量中作为单独治疗的抗抑郁疗效也在患有躯体合并症的抑郁症患者中得到证实(SMD=-1.35[95%CI:-1.95,-0.75],p<0.0001)。我们没有发现塞来昔布治疗双相抑郁的有效性的确凿证据。塞来昔布在400mg/d的剂量下使用长达12周似乎是情绪障碍患者的安全治疗方法。尽管在临床前研究中发现了塞来昔布反应与炎症参数之间的关联,这一点尚未在临床试验中得到证实。需要进一步的研究来评估塞来昔布在双相抑郁中的疗效,以及评估塞来昔布治疗复发性情绪障碍的安全性和有效性的长期研究,涉及治疗耐药人群的研究,并评估塞来昔布治疗与炎症标志物的相关性。
    The effects of celecoxib on a broad spectrum of mood disorders and on inflammatory parameters have not yet been comprehensively evaluated. The aim of this study was to systematically summarize the available knowledge on this topic. Data from both preclinical and clinical studies were analyzed, considering the efficacy and safety of celecoxib in the treatment of mood disorders, as well as the correlation of inflammatory parameters with the effect of celecoxib treatment. Forty-four studies were included. We found evidence supporting the antidepressant efficacy of celecoxib in a dose of 400 mg/day used for 6 weeks as an add-on treatment in major depression (SMD = -1.12 [95%Cl: -1.71,-0.52], p = 0.0002) and mania (SMD = -0.82 [95% CI:-1.62,-0.01], p = 0.05). The antidepressant efficacy of celecoxib in the above dosage used as sole treatment was also confirmed in depressed patients with somatic comorbidity (SMD = -1.35 [95% CI:-1.95,-0.75], p < 0.0001). We found no conclusive evidence for the effectiveness of celecoxib in bipolar depression. Celecoxib at a dose of 400 mg/d used for up to 12 weeks appeared to be a safe treatment in patients with mood disorders. Although an association between celecoxib response and inflammatory parameters has been found in preclinical studies, this has not been confirmed in clinical trials. Further studies are needed to evaluate the efficacy of celecoxib in bipolar depression, as well as long-term studies evaluating the safety and efficacy of celecoxib in recurrent mood disorders, studies involving treatment-resistant populations, and assessing the association of celecoxib treatment with inflammatory markers.
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  • 文章类型: Journal Article
    抑郁症发病率的持久性在双相情感障碍中很常见,这种症状的药理学管理往往缺乏有效性。本系统综述旨在总结截至2022年4月发表的关于双相抑郁药物治疗的自然主义观察研究的结果。根据GRADE方法对证据的确定性进行评估。总之,关于抗惊厥药的16项研究,20非典型抗精神病药,2在锂上,28抗抑郁药,并发现了9种其他化合物。拉莫三嗪,喹硫平,阿立哌唑,氯胺酮是研究最多的化合物。总的来说,结果支持关于拉莫三嗪和喹硫平有效性的建议.与目前的建议相比,阿立哌唑被证明是有效的,并且通常耐受性良好。此外,SSRIs被证明是有效的,但是,因为它们与可能更高的转换风险有关,它们应用作情绪稳定剂的辅助疗法。锂只在两个试验中进行了研究,但被证明是有效的,尽管血清浓度水平与临床反应无关。最后,氯胺酮显示出不同的反应率,证据的确定性较低,到目前为止,不清楚的长期影响。诊断中的异质性,样本大小,研究设计,报告偏见,和副作用限制了头对头比较的可能性。
    The persistence of depressive morbidity is frequent in bipolar disorder, and the pharmacological management of this symptomatology often lacks effectiveness. This systematic review aimed to summarize the results of the naturalistic observational studies on the pharmacological treatment of bipolar depression published through April 2022. The certainty of evidence was evaluated according to the GRADE approach. In sum, 16 studies on anticonvulsants, 20 on atypical antipsychotics, 2 on lithium, 28 on antidepressants, and 9 on other compounds were found. Lamotrigine, quetiapine, aripiprazole, and ketamine were the most investigated compounds. Overall, the results support the recommendations regarding the effectiveness of lamotrigine and quetiapine. In contrast to the current recommendations, aripiprazole was shown to be effective and generally well tolerated. Additionally, SSRIs were shown to be effective, but, since they were associated with a possibly higher switch risk, they should be used as an adjunctive therapy to mood stabilizers. Lithium was only studied in two trials but was shown to be effective, although the serum concentrations levels were not associated with clinical response. Finally, ketamine showed divergent response rates with a low certainty of evidence and, so far, unclear long-term effects. Heterogeneity in diagnosis, sample sizes, study designs, reporting of bias, and side effects limited the possibility of a head-to-head comparison.
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  • 文章类型: Journal Article
    抑郁症在双相情感障碍II(BDII)患者中很常见,可能需要使用抗抑郁药。由于缺乏高质量的证据,关于在BDII中使用抗抑郁药存在争议。目的比较文拉法辛和安非他酮治疗BDⅡ期抑郁发作的疗效。
    这项随机三盲临床试验研究是针对BDII抑郁发作的患者(基于疾病的诊断和统计手册[DSM-V]标准)进行的,该患者被转诊至Golestan医院的专门诊所。将40例患者随机分为两组,分别接受文拉法辛(75mg/天)或安非他酮(100mg/天)治疗4周。在干预结束时,使用汉密尔顿抑郁量表(HDRS)评估治疗效果.
    这项研究的结果表明,治疗前(P=0.43)和治疗后(P=0.15)的HDRS评分在两组之间没有显着差异。4周后两组HDRS评分均显著降低(P<0.0001)。尽管文拉法辛比安非他酮降低抑郁评分的比率更高,这些差异并不显著(%36.7±21.8vs.%45.3±17.9,P值=0.17)。
    我们的研究表明,文拉法辛和安非他酮的短期(4周)治疗同样有效,可能是BDII重性抑郁症的安全有效的抗抑郁单一疗法。建议以更大的样本量和更长的时间以多中心的方式进行更多的研究。
    UNASSIGNED: Depressive disorders are common among those with bipolar disorder II (BD II) and may necessitate the use of antidepressants. Because of the lack of quality evidence, there is controversy about the use of antidepressants in BD II. The aim was to compare the efficacy of venlafaxine and bupropion in the treatment of depressive episode in BD II.
    UNASSIGNED: This randomized triple-blind clinical trial study was conducted on patient with depressive episode of BD II (based on diagnostic and statistical manual of disorders [DSM-V] criteria) referred to the specialized clinic of Golestan Hospital. A total of 40 patients were randomly divided into two groups of receiving venlafaxine (75 mg/day) or bupropion (100 mg/day) for 4 weeks. At the end of the intervention, the effectiveness of treatment was assessed using the Hamilton Depression Rating Scale (HDRS).
    UNASSIGNED: The results of this study showed that the HDRS score before treatment (P = 0.43) and after treatment (P = 0.15) was not significantly different between the two groups. HDRS score in both groups significantly decreased after 4 weeks (P < 0.0001). Although the rate of decrease in depression score was more in venlafaxine than in bupropion, these differences were not significant (% 36.7 ± 21.8 vs. % 45.3 ± 17.9, P value = 0.17).
    UNASSIGNED: Our study showed that short-term (4-weeks) treatments of venlafaxine and bupropion were equally effective and could be a safe and effective antidepressant monotherapy for BD II major depression. It is suggested that more studies be conducted with larger sample size and over longer periods of time in a multicenter manner.
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  • 文章类型: Journal Article
    UNASSIGNED:针对患有单相抑郁症(UD)和双相抑郁症(BD)的年轻人的相关研究有限。本研究旨在调查UD和BD年轻人的童年创伤和人格特征。
    UNASISIGNED:在第一次抑郁发作(诊断为UD和BD)中的二百三十五名患者,16-25岁,从湘雅二医院招募。从社区招募79名健康对照(HC)组成对照组。通过儿童创伤问卷(CTQ)测量患者的儿童创伤,人格由艾森克人格量表(EPI)测量。Kruskal-Wallis测试用于比较抑郁症,焦虑,CTQ,和EPI得分在HC(n=79)之间,UD(n=131),和BD(n=104)组。使用二元逻辑回归分析确定与情绪障碍和BD独立相关的因素。
    UNASSIGNED:与HC相比,情绪障碍有更严重的焦虑和抑郁症状,和更高的CTQ。情绪虐待(OR=1.47;95%CI=1.08-2.01),情感忽视(OR=1.24;95%CI=1.05-1.46),和神经质(OR=1.25;95%CI=1.16-1.35)与情绪障碍的几率显着增加相关。然而,更高的外向性评分是心境障碍的保护因素.与UD相比,BD有更严重的焦虑症状,和更高的CTQ,而不是外向性和神经质人格得分。焦虑(OR=1.06;95%CI=1.02-1.08)和外向性(OR=1.05;95%CI=1.03-1.09)与BD几率显著增加相关。
    未经评估:预防儿童创伤的干预措施可能会改善年轻人的心理健康。使用儿童创伤和人格来预测BD和UD,为患有抑郁症的年轻人创造了更准确的治疗方法。
    Relevant research focusing on young adults with Unipolar Depression (UD) and Bipolar Depression (BD) is limited. The current research aims to investigate childhood trauma and personality traits in young adults with UD and BD.
    Two hundred and thirty-five patients in a first depressive episode (diagnosed UD and BD), 16-25 years old, were recruited from Second Xiangya Hospital. And 79 healthy controls (HC) were recruited from the community to form the comparison group. Patients\' childhood trauma was measured by the Childhood Trauma Questionnaire (CTQ), and personality was measured by Eysenck Personality Inventory (EPI). The Kruskal-Wallis test was used to compare depression, anxiety, CTQ, and EPI scores between the HC (n = 79), UD (n = 131), and BD (n = 104) groups. Factors independently associated with mood disorders and BD were determined using binary logistic regression analyses.
    Compared with HC, mood disorders had more severe anxiety and depression symptoms, and higher CTQ. Emotional abuse (OR = 1.47; 95% CI = 1.08-2.01), emotional neglect (OR = 1.24; 95% CI = 1.05-1.46), and neuroticism (OR = 1.25; 95% CI = 1.16-1.35) were associated with significantly increased odds of mood disorders. Whereas, higher extraversion scores were a protective factor for mood disorders. Compared with UD, BD had more severe anxiety symptoms, and higher CTQ, than extraversion and neuroticism personality scores. Anxiety (OR = 1.06; 95% CI = 1.02-1.08) and extraversion (OR = 1.05; 95% CI = 1.03-1.09) were associated with significantly increased odds of BD.
    Interventions to prevent childhood trauma may improve young adults\' mental health. Using childhood trauma and personality to anticipate BD and UD creates more accurate treatment for young adults with first depression.
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  • 文章类型: Journal Article
    本研究旨在利用事件相关电位探讨双相情感障碍(BD)抑郁情绪患者的奖赏相关神经机制。尚不清楚BD抑郁症和重度抑郁症(MDD)中抑郁症状的神经生物学标志物是否不同。
    纳入24例BD抑郁症患者和20例健康对照者。参与者接受了快乐时间体验量表(TEPS)的评估,其次是经典的赌博范式,同时接受64通道脑电图检查。在参与者收到有关损失或收益的反馈后,从250-350ms时间窗口中提取反馈相关的负性(FRN)波形。使用时频分析获得事件相关电位数据集。
    (1)患者TEPS评分明显低于对照组[t(42)=5.16,p<0.01]。(2)丢失事件在患者中引起比对照组更深的FRN[t(42)=2.19,p<0.05],而在增益事件中没有观察到差异(t(42)=1.12,p>0.05)。(3)FRN患者的Theta功率损失明显高于增益[F(1,42)=30.32,p<0.01]。(4)方差分析(ANOVA)说明了θ功率在两组之间的增益/损失中的交互作用[F(1,42)=3.59,p=0.06]。
    我们的研究没有分析可能影响我们结果的不同药物的作用。
    负反馈的增强反射与负偏置一致,冲动控制障碍,和在双相情感障碍谱中观察到的情绪失调。我们认为,前扣带回(ACC)产生的极θ功率可能是异常FRN的主要成分。
    This study aimed to explore the reward-related neural mechanism in patients with depressive mood in bipolar disorder (BD) using event-related potentials. It remains unknown whether or not different neurobiological markers underlying depression symptoms in BD depression and major depression disorder (MDD).
    24 patients with BD depression and 20 healthy controls were included. Participants underwent evaluation with the Temporal Experience of Pleasure Scale (TEPS), followed by the classical gambling paradigm, while undergoing 64-channel electroencephalography. The waveform of feedback-related negativity (FRN) was extracted from the 250-350 ms time-window after participants received feedback regarding loss or gain. Event-related potential datasets were obtained using time-frequency analysis.
    (1) The TEPS scores of the patients were significantly lower than those of the controls [t(42) = 5.16, p < 0.01]. (2) The event of loss elicited a deeper FRN in patients than that in controls [t(42) = 2.19, p < 0.05], while no difference was observed in the event of gains (t(42) = 1.12, p > 0.05). (3) Theta power rooted in FRN in patients was significantly higher in loss than in gain [F(1,42) = 30.32, p < 0.01]. (4) Analysis of Variance (ANOVA) illustrated the interaction effect of theta power in gain/loss between two groups [F(1,42) = 3.59, p = 0.06].
    Our study did not analyze the effect of different drugs which might affect our results.
    The enhanced reflection of negative feedback was consistent with the negative bias, impulse control impairment, and emotional dysregulation observed in the bipolar disorder spectrum. We suggested that the extreme theta power generated from the anterior cingulate gyrus (ACC) might be the main component of abnormal FRN.
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