comorbid depression and anxiety

  • 文章类型: Journal Article
    目的:探讨口腔健康与抑郁症的关系,英国生物银行队列中的焦虑及其合并症。
    方法:在基线时自我报告口腔健康问题。在一项横断面研究中,使用心理健康问卷(PHQ-4)评估了抑郁和焦虑的症状。在队列研究中,抑郁症和焦虑症的诊断基于医院记录.采用Logistic回归和Cox回归模型分析口腔健康与抑郁/焦虑的关系。
    结果:共有305,188名参与者被纳入横断面研究,多因素分析显示牙周病与抑郁和/或焦虑相关(比值比[OR]:1.79,95%置信区间[CI]:1.73~1.86).在涉及264,706名参与者的前瞻性队列研究中,牙周病与抑郁和/或焦虑风险增加显著相关(风险比[HR]:1.14,95%CI:1.10-1.19),抑郁(HR:1.19,95%CI:1.13-1.25)和焦虑(HR:1.13,95%CI:1.07-1.19)。牙周病也与抑郁和焦虑合并症显著相关(HR:1.27,95%CI:1.16-1.38)。使用基线炎症因子的多重中介分析显示,白细胞计数和C反应蛋白解释了牙周病与抑郁和焦虑之间的相关性的3.07%和3.15%,分别。然而,首次随访时炎性因子的纵向多重介导分析结果(N=10,673)不显著.
    结论:发现牙周病与抑郁症风险增加有关,焦虑和他们的共病。
    OBJECTIVE: To investigate the associations between oral health and depression, anxiety and their comorbidity in the UK Biobank cohort.
    METHODS: Oral health problems were self-reported at baseline. Symptoms of depression and anxiety were assessed using the Mental Health Questionnaire (PHQ-4) in a cross-sectional study. In the cohort study, diagnoses of depression and anxiety disorders were based on hospital records. Logistic regression and Cox regression models were used to analyse the association between oral health and depression/anxiety.
    RESULTS: A total of 305,188 participants were included in the cross-sectional study, and multivariate analysis showed that periodontal disease was associated with depression and/or anxiety (odds ratio [OR]: 1.79, 95% confidence interval [CI]: 1.73-1.86). In the prospective cohort study involving 264,706 participants, periodontal disease was significantly associated with an increased risk of depression and/or anxiety (hazard ratio [HR]: 1.14, 95% CI: 1.10-1.19), depression (HR: 1.19, 95% CI: 1.13-1.25) and anxiety (HR: 1.13, 95% CI: 1.07-1.19). Periodontal disease was also significantly associated with comorbid depression and anxiety (HR: 1.27, 95% CI: 1.16-1.38). Multiple mediation analysis using baseline inflammatory factors showed that white blood cell count and C-reactive protein explained 3.07% and 3.15% of the association between periodontal disease and depression and anxiety, respectively. However, the results of longitudinal multiple mediation analysis of inflammatory factors at first follow-up (N = 10,673) were not significant.
    CONCLUSIONS: Periodontal disease was found to be consistently associated with an increased risk of depression, anxiety and their comorbidity.
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  • 文章类型: Journal Article
    抑郁和焦虑并存会对老年人造成严重的心理和生理损害。这项研究旨在确定中国老年人群抑郁和焦虑(CDA)的异质性类别,并确定潜在类别成员资格的预测因素。从中国纵向健康长寿调查中提取了10919例的横截面数据。潜在特征分析(LPA)用于识别共病抑郁症(通过流行病学研究中心10项抑郁量表测量)和焦虑(通过广泛性焦虑症7项量表测量)的症状模式。双变量分析后的多项逻辑回归用于探索派生类别与个人和社会水平因素之间的关系。确定了CDA的四种模式:抑郁和焦虑的低症状(30.52%;n=3333),仅轻度抑郁症(53.26%;n=5815),中度抑郁和焦虑(13.82%;n=1509),和严重的抑郁和焦虑(2.40%;n=262)。老年人是男性,患有多种疾病,缺乏健康的生活方式更有可能出现有问题的症状。虽然与伴侣和孩子的亲密关系显着预测CDA模式,兄弟姐妹关系的影响,日常生活,来自社区的情感支持微不足道。LPA在中国老年人的代表性样本中确定了四种不同的CDA模式。当不安的睡眠,缺乏积极的情绪,无用,弱浓度在所有剖面中都很突出,“难以放松”在焦虑中突出。除了个人层面的变量,社会层面的因素,特别是与伴侣和孩子的亲密关系,而不是与兄弟姐妹或社区的一般联系,在关系的文化背景下,对中国老年人是否以及在多大程度上遭受CDA的影响不可忽视,父权制,和孝道。
    Comorbid depression and anxiety causes serious psychological and physiological damage for older people. This study aimed to identify heterogeneous classes of comorbid depression and anxiety (CDA) among older people in China and to ascertain predictors of latent class membership. Cross-sectional data of 10,919 cases were extracted from the Chinese Longitudinal Healthy Longevity Survey. Latent profile analysis (LPA) was used to identify symptom patterns of comorbid depression (measured by the 10-item Center for Epidemiologic Studies Depression Scale) and anxiety (measured by the Generalized Anxiety Disorder 7-item Scale). Multinomial logistic regressions following bivariate analyses were used to explore the relationship between the derived classes and individual- and social-level factors. Four patterns of CDA were identified: low symptoms of depression and anxiety (30.52%; n = 3333), mild depression only (53.26%; n = 5815), moderate depression and anxiety (13.82%; n = 1509), and severe depression and anxiety (2.40%; n = 262). Older people who are male, suffer from multimorbidity, and lack a healthy lifestyle are more likely to have problematic symptom profiles. While intimate relationships with partners and children significantly predicted CDA patterns, the effects of sibling relationships, daily life, and emotional support from the community were insignificant. LPA identified four distinct CDA patterns among a representative sample of older Chinese people. While restless sleep, lack of positive emotions, uselessness, and weak concentration are salient across all profiles, \"difficult to relax\" is prominent in profiles high in anxiety. In addition to individual-level variables, social-level factors, especially intimate relationships with partners and children rather than general links to siblings or the community, have unneglectable impacts on whether and to what extent older Chinese adults suffer from CDA in the cultural context of relationism, patriarchy, and filial piety.
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  • 文章类型: Journal Article
    这项流行病学研究描述了仅在患有抑郁症的大学生中,当前基于药物和/或心理治疗的治疗利用的估计患病率的变化。只有焦虑,或并存的抑郁和焦虑。
    通过2013-2019年健康思想研究问卷收集了190,500个加权响应的样本。仅对抑郁症的年度患病率估计,只有焦虑,或共病抑郁和焦虑被计算。目前使用的疗法,药理服务,或双重治疗的学生抑郁和/或焦虑通过描述性统计进行了检查。
    仅抑郁症筛查呈阳性的大学生的估计患病率,只有焦虑,从2013年到2018-2019年,抑郁和焦虑共病升级。当单独评估时,目前使用任何精神病药物的比率,参与治疗,在患有抑郁症和/或焦虑症的学生中,同时从事药物和治疗服务的人数显着增加。然而,目前仅在患有抑郁症的年轻人中使用特定类别的精神病药物的时间趋势,只有焦虑,或并存的抑郁和焦虑因药物类别而异。
    这项研究无法评估精神病处方的做法,抑郁症或焦虑症的诊断,和之前的心理健康治疗。
    在比较2013年至2018-19年的比率时,越来越多的大学生报告抑郁和/或焦虑症状以及药物和/或心理治疗服务利用率。尽管这可能表明公开和寻求治疗有问题的症状的可接受性增加,需要对大学人群进行持续监测,以确定有不良精神健康结果风险的学生,特别是在2019年冠状病毒疾病大流行期间。
    This epidemiological study described changes in the estimated prevalence of current pharmacological and/or psychotherapy-based treatment utilization among college students with depression only, anxiety only, or comorbid depression & anxiety.
    A sample of 190,500 weighted responses was collected through the 2013-2019 Healthy Minds Study questionnaires. Annual prevalence estimates of depression only, anxiety only, or comorbid depression & anxiety were computed. Current use of therapy, pharmacological services, or dual treatment among students with depression and/or anxiety were examined via descriptive statistics.
    Estimated prevalence of college students who screened positive for depression only, anxiety only, and comorbid depression & anxiety escalated from 2013 to 2018-2019. When assessed individually, rates of currently using any psychiatric medication, participating in therapy, and engaging in concurrent medication & therapy services significantly rose among students with depression and/or anxiety. However, temporal trends in the current use of specific classes of psychiatric medications among young adults with depression only, anxiety only, or comorbid depression & anxiety differed by medication class.
    This study was unable to assess psychiatric prescribing practices, depression or anxiety diagnoses, and prior mental health treatment.
    An increasing proportion of college students are reporting depression and/or anxiety symptoms as well as pharmacological and/or psychotherapy service utilization when comparing rates from 2013 to 2018-19. Although this may indicate increasing acceptability to disclose and seek treatment for problematic symptomology, continued surveillance of college populations is needed to identify students at risk for adverse psychiatric health outcomes, especially during the coronavirus disease 2019 pandemic.
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  • 文章类型: Journal Article
    BACKGROUND: Depression and anxiety are common psychiatric sequelae of traumatic brain injury (TBI). However, there is lack of data on comorbid depression and anxiety, and depression and anxiety in TBI patients were often evaluated using non-validated diagnostic tools. This study aims to determine the rates, their comorbidity, and factors associated with depressive and anxiety disorders in TBI patients.
    METHODS: In this cross-sectional study, 101 TBI patients were interviewed using the Structured Clinical Interview for DSM-IV Axis I Disorders to assess the rates of depressive and anxiety disorders after TBI. The association of socio-demographic and clinical factors with depressive and anxiety disorders were determined using Pearson\'s Chi-Square test.
    RESULTS: A total of 25% of TBI patients (n = 25/101) were diagnosed with depressive disorders, of which 15% had major depressive disorder (n = 15/101) and 10% had minor depression (n = 10/101). Fourteen percent of TBI patients had anxiety disorders (n = 14/101), of which post-traumatic stress disorder (PTSD) was the commonest anxiety disorder (9%, n = 9/101). Seven percent of TBI patients (n = 7/101) had comorbid depressive and anxiety disorders. The only factor associated with depressive disorder was the duration of TBI (≥ 1 year) while the only factor associated with anxiety disorder was the mechanism of trauma (assault).
    CONCLUSIONS: Major depressive disorder, minor depression and PTSD are common psychiatric complications of TBI. Clinicians should screen for depressive and anxiety disorders in TBI patients, particularly those with ≥1 year of injury and had sustained TBI from assault.
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  • 文章类型: Journal Article
    Temperament and mental illness are thought to represent varying degrees along the same continuum of neurotransmitter imbalances. A taxonomy of temperament could provide the basis for a new taxonomy of mental illness. Most popular models of temperament, being based heavily on emotionality traits, show very poor ability to discriminate between mental disorders. The main goal of this study was to examine whether a temperament model based on modern neurophysiology and possessing an extensive set of non-emotionality traits provides better discrimination between Major Depression (MD), Generalized Anxiety (GAD) and Comorbid MD and GAD, in comparison to emotionality-based temperament models.
    Using the Structure of Temperament Questionnaire, the temperament profiles of 687 individuals (396 clients of private psychiatric and psychological practice, and 291 control subjects) were compared across four adult age groups (18-24, 25-45, 46-65, 66-84).
    MD and GAD appear to be accurately distinguished by the traits of Motor Endurance and Motor Tempo (much lower values in depression), and Neuroticism (much higher value in anxiety). Comorbids can be distinguished based on a significant decrease in the traits of Plasticity, Intellectual Endurance, Sensitivity to Probabilities, and increased Impulsivity. These effects seemed independent of age and gender.
    The results suggest the benefits of including non-emotionality-related traits and the usefulness of a functional approach to both taxonomy of temperament and classification of mental disorders.
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