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1.
Systematic review and meta-analysis of omega-3-fatty acids in elderly patients with depression.
Bae, JH, Kim, G
Nutrition research (New York, N.Y.). 2018;:1-9
Abstract
One of the typical symptoms of a psychological crisis is depression, an increasing concern in the elderly population. Although omega-3-polyunsaturated fatty acids (PUFAs) are reported to be promising nutrients for treating depression, currently, there are no systematic reviews or meta-analyses of randomized control trials that provide critical evidence regarding the potential benefits of omega-3 fatty acids in elderly patients with depression. This analysis was conducted to provide evidence for the clinical application of omega-3 fatty acids in the treatment of depressive symptoms of elderly subjects older than 65 years. Seven databases were searched from their inception date until September 2016. Following this search, 6 studies were selected, which included 4605 patients (mean age, 76.97 years; male-female ratio=3752:853; mean dose of omega 3 intake, 1.3 g/d). These results were divided into 2 categories: well-being mental health group and depressive group. In the well-being mental health group, the Hedges g was 0.12 (95% confidence interval, -0.05 to 0.29), which indicated no significant effect of n-3 PUFA supplementation on depressed mood compared with placebo. In the depressive group, the pooled Hedges g was -0.94 (95% CI, -1.37 to -0.50]) for the random-effects model, which indicated a large effect of n-3 PUFA supplementation on those with depressed mood compared with placebo. Although this review shows that omega-3 fatty acids are effective in the treatment of elderly depressed patients, the benefits of omega-3 fatty acid supplementation were significant only in the elderly patients with mild to moderate depression.
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2.
Improving cardiometabolic and mental health in women with gestational diabetes mellitus and their offspring: study protocol for MySweetHeart Trial, a randomised controlled trial.
Horsch, A, Gilbert, L, Lanzi, S, Gross, J, Kayser, B, Vial, Y, Simeoni, U, Hans, D, Berney, A, Scholz, U, et al
BMJ open. 2018;(2):e020462
Abstract
INTRODUCTION Gestational diabetes mellitus (GDM) carries prenatal and perinatal risk for the mother and her offspring as well as longer-term risks for both the mother (obesity, diabetes, cardiovascular disease) and her child (obesity, type 2 diabetes). Compared with women without GDM, women with GDM are twice as likely to develop perinatal or postpartum depression. Lifestyle interventions for GDM are generally limited to physical activity and/or nutrition, often focus separately on the mother or the child and take place either during or after pregnancy, while their results are inconsistent. To increase efficacy of intervention, the multifactorial origins of GDM and the tight link between mental and metabolic as well as maternal and child health need to be heeded. This calls for an interdisciplinary transgenerational approach starting in, but continuing beyond pregnancy. METHODS AND ANALYSIS This randomised controlled trial will assess the effect of a multidimensional interdisciplinary lifestyle and psychosocial intervention aimed at improving the metabolic and mental health of 200 women with GDM and their offspring. Women with GDM at 24-32 weeks gestational age who understand French or English, and their offspring and partners can participate. The intervention components will be delivered on top of usual care during pregnancy and the first year postpartum. Metabolic and mental health outcomes will be measured at 24-32 weeks of pregnancy, shortly after birth and at 6-8 weeks and 1 year after childbirth. Data will be analysed using intention-to-treat analyses. The MySweetHeart Trial is linked to the MySweetHeart Cohort (clinicaltrials.gov/ct2/show/NCT02872974). ETHICS AND DISSEMINATION We will disseminate the findings through regional, national and international conferences and through peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT02890693; Pre-results.
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3.
Herbal and Holistic Solutions for Neurodegenerative and Depressive Disorders: Leads from Ayurveda.
Sharma, R, Kabra, A, Rao, MM, Prajapati, PK
Current pharmaceutical design. 2018;(22):2597-2608
Abstract
Neuropsychiatric and neurodegenerative disorders such as Alzheimer's disease, Parkinson's disease, schizophrenia, epilepsy, depression and anxiety pose a sizable global health problem, accompanying substantial burden of disorders, suicides, physical comorbidities, high fiscal expenses, and poor quality of life. There is a recent upsurge in global interest toward the area of traditional therapies and phytomedicines are widely admired by researchers owing to their natural source and fewer side effects. On the contrary, conventional synthetic drugs have been reported with undesirable but inevitable ill effects having poor patient compliance. Thus, herbal medicines are being preferred over synthetic drug therapies as an effective remedy for many brain disorders. Ayurveda provides a holistic approach to treatment along with several nootropic herbs having multi-dimensional bioactivities in various disorders. Scattered information is available pertaining to traditional Ayurvedic remedial options for various mental disorders. Present review encompasses: (i) common brain disorders and the associated changes (ii) Ayurvedic holistic approach to manage neurodegenerative and depressive disorders, and (iii) important Ayurvedic single herbs and polyherbal formulations with description of their traditional usage and administration. Concomitantly, it opens up for future investigations and standardization on Ayurvedic nootropic herbs.
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4.
Efficacy and Safety of Xiaoyao Formula as an Adjuvant Treatment for Post-Stroke Depression: A Meta-Analysis.
Jin, X, Jiang, M, Gong, D, Chen, Y, Fan, Y
Explore (New York, N.Y.). 2018;(3):224-229
Abstract
OBJECTIVE To systematically evaluate the efficacy and safety of Xiaoyao formula (XYF) as an adjuvant treatment of post-stroke depression (PSD) by conducting a meta-analysis. METHODS Pubmed, Embase, Cochrane Library, CNKI, VIP, and Wanfang databases were searched up to May 2016. Randomized controlled trials investigating XYF plus antidepressants versus antidepressants alone for patients with PSD were considered. RESULTS A total of 607 PSD patients were identified from 7 trials. Adjuvant treatment with XYF had additional benefits in terms of improved total response rates (risk ratio [RR] 1.21; 95% confidence interval [CI]: 1.12-1.30), reduced Hamilton's depressive scale (weighted mean difference [WMD] -5.21; 95% CI: -7.48 to -2.95), and decreased Scandinavian Stroke Scale (WMD -6.35; 95% CI: -8.27 to -4.43). No serious adverse events were observed in any of the included trials. CONCLUSIONS Adjuvant treatment with XYF appears to have additional benefits in the treatment of PSD, without increasing serious adverse events.
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5.
Inflammatory theory of depression.
Gałecki, P, Talarowska, M
Psychiatria polska. 2018;(3):437-447
Abstract
Brain diseases are one of the most socially and economically burdening diseases in Europe. Among all brain diseases, more than 60% of social and economic costs are generated by mental disorders (mainly depressive disorders and anxiety disorders). Recurrent depressive disorders have been a significant civilizational problem in recent times. Among the biological and psychological theories explaining the causes of depression, the hypothesis involving an active inflammatory process taking place in a human organism is becoming increasingly important. The following are considered inflammation markers: inflammatory enzymes (e.g., manganese superoxide dismutase (MnSOD), myeloperoxidase (MPO), inducible nitric oxide synthase), proinflammatory and anti-inflammatory cytokines, and the phenomenon of oxidative stress. Through the kynurenine pathway, these factors lead to a deficit in serotonin and melatonin, which is considered one of the main reasons of depression. We can consider depression to be a chronic cold of the organism, which develops in response to the action of greater or smaller everyday stressors. This paper presents results of recent studies regarding this matter.
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6.
Dietary education with customised dishware and food supplements can reduce frailty and improve mental well-being in elderly people: A single-blind randomized controlled study.
Wu, SY, Hsu, LL, Hsu, CC, Hsieh, TJ, Su, SC, Peng, YW, Guo, TM, Kang, YW, Pan, WH
Asia Pacific journal of clinical nutrition. 2018;(5):1018-1030
Abstract
BACKGROUND AND OBJECTIVES The elderly population is increasing rapidly worldwide, and frailty is a common geriatric syndrome. Comprehensive dietary management strategies may have beneficial effects on frailty prevention and reversal. This 3-month single-blind, paralleled, randomized controlled trial compared the effects of micronutrients and/or protein supplements, and a personalised diet on frailty status in elderly individuals. METHODS AND STUDY DESIGN Between 2014 and 2015, 40 prefrail or frail subjects aged >=65 years were recruited at Miaoli General Hospital, Taiwan. Of these, 37 completed the study, and 36 were included in the analysis. Participants were randomly assigned to one of four treatment groups: (1) the control (2) multiple micronutrient supplements, (3) multiple micronutrients plus isolated soy protein supplement, and (4) individualised nutrition education with customised dishware and food supplements (mixed nuts and skimmed milk powder). Dietary intake, protein biomarkers, frailty score, and geriatric depression score were assessed. RESULTS Individualised nutrition education with customised dishware and food supplements significantly increased the participants' intake of vegetables, dairy, and nuts, in addition to increasing the concentration of urinary urea nitrogen. It yielded a significant reduction in frailty score (p<0.05) and a borderline reduction (p=0.063) in geriatric depression score. No significant beneficial changes were observed for the other two intervention groups. CONCLUSIONS Our study indicated that a dietary approach with easy-to-comprehend dishware and food supplements to optimize the distribution of the consumption of six food groups improved frailty status and, potentially, psychological well-being in elderly people.
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7.
Prevalence of depression and anxiety among participants with glaucoma in a population-based cohort study: The Gutenberg Health Study.
Rezapour, J, Nickels, S, Schuster, AK, Michal, M, Münzel, T, Wild, PS, Schmidtmann, I, Lackner, K, Schulz, A, Pfeiffer, N, et al
BMC ophthalmology. 2018;(1):157
Abstract
BACKGROUND To investigate the prevalence of depression and anxiety among subjects with self-reported glaucoma and the association between self-reported glaucoma and depression respectively anxiety in a European cohort. METHODS A study sample of 14,657 participants aged 35 to 74 years was investigated in a population-based cohort study. All participants reported presence or absence of glaucoma. Ophthalmological examinations were carried out in all participants and demographic and disease related information were obtained by interview. Depression was assessed with the Patient Health Questionnaire (PHQ-9), and generalized anxiety with the two screening items (GAD-2) of the short form of the GAD-7 (Generalized Anxiety Disorder-7 Scale). Prevalence of depression and generalized anxiety were investigated for subjects with and without self-reported glaucoma. Logistic regression analyses with depression, respectively anxiety as dependent variable and self-reported glaucoma as independent variable were conducted and adjusted for socio-demographic factors, systemic comorbidities (arterial hypertension, myocardial infarction, stroke, diabetes mellitus, chronic obstructive pulmonary disease, cancer), ocular diseases (cataract, macular degeneration, corneal diseases, diabetic retinopathy), visual acuity, intraocular pressure, antiglaucoma eye drops (sympathomimetics, parasympathomimetics, carbonic anhydrase inhibitors, beta-blockers, prostaglandins) and general health status. RESULTS 293 participants (49.5% female) reported having glaucoma. Prevalence of depression among participants with and without self-reported glaucoma was 6.6% (95%-CI 4.1-10.3) respectively 7.7% (95%-CI 7.3-8.2), and for anxiety 5.3% (95%-CI 3.1-8.7) respectively 6.6% (95%-CI 6.2-7.1). Glaucoma was not associated with depression (Odds ratio 1.10, 95%-CI 0.50-2.38, p = 0.80) or anxiety (1.48, 95%-CI 0.63-3.30, p = 0.35) after adjustment for socio-demographic factors, ocular/systemic diseases, ocular parameters, antiglaucoma drugs and general health status. A restriction to self-reported glaucoma cases either taking topical antiglaucoma medications or having a history of glaucoma surgery did not alter the result. CONCLUSIONS This is the first study analyzing both depression and anxiety among glaucoma patients in a European cohort. Subjects with and without self-reported glaucoma had a similar prevalence of depression and anxiety in our population-based sample. Self-reported glaucoma was not associated with depression or anxiety. A lack of a burden of depressive symptoms may result from recruitment from a population-based sample as compared to previous study groups predominantly recruited from tertiary care hospitals.
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8.
Metabolic Syndrome and Symptom Resolution in Depression: A 5-Year Follow-Up of Older Adults.
Virtanen, M, Ferrie, JE, Akbaraly, T, Tabak, A, Jokela, M, Ebmeier, KP, Singh-Manoux, A, Kivimäki, M
The Journal of clinical psychiatry. 2017;(1):e1-e7
Abstract
OBJECTIVE Although metabolic syndrome is associated with the incidence of depression, little is known about its contribution to the course of depression. We examined whether metabolic syndrome and its components are associated with long-term symptom resolution in older adults with depressive symptoms. METHODS Data from 965 participants in the Whitehall II cohort study (mean age = 62 years at baseline) were used to generate 1,172 person-observations of metabolic syndrome and its components (abdominal obesity, low level of high-density lipoprotein [HDL] cholesterol, high level of triglycerides, hypertension, and elevated fasting glucose or diabetes). All participants were depression cases at the beginning of 2 consecutive follow-up cycles: from 2002-2004 to 2007-2009 and from 2007-2009 to 2012-2013 (mean follow-up = 4.6 years). Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression scale caseness at the beginning and the end of the 2 cycles. RESULTS In multivariable adjusted analyses, metabolic syndrome per se was not associated with symptom resolution. Of its components, low HDL cholesterol (risk ratio [RR] = 0.82; 95% CI, 0.68-1.00; P = .045) and high triglyceride levels (RR = 0.81; 95% CI, 0.70-0.95; P = .007) were associated with a lower likelihood of symptom resolution. These findings were replicated in a subpopulation without coronary heart disease and stroke (RR = 0.77 [95% CI, 0.63-0.95; P = .015] for low HDL cholesterol; RR = 0.79 [95% CI, 0.67-0.94; P = .006] for high triglycerides). CONCLUSIONS Low HDL cholesterol and high triglyceride levels are associated with lower likelihood of long-term symptom resolution in depression. These data suggest that an adverse lipid profile, but not other components of metabolic syndrome, may delay recovery from depression.
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9.
The epidemiology of PTSD and depression in refugee minors who have resettled in developed countries.
Reavell, J, Fazil, Q
Journal of mental health (Abingdon, England). 2017;(1):74-83
Abstract
BACKGROUND With an increasing number of refugees migrating across continents, the crisis is very apparent. AIM: A literature review of patterns, risk factors and effects of post-traumatic stress disorder (PTSD) and depression in refugee minors was carried out involving those who have resettled in different developed countries. METHODS Papers were narrowed down by reading the abstracts and methods to ascertain whether the refugee children had resettled in developed countries and to ensure that they had not just been internally displaced. RESULTS High incidences of PTSD and depression were found in refugee minors and poorer mental health was correlated with increased exposure to violence. Factors such as social support and family security were important in reducing the rates of PTSD and depression, whereas the implications of age and gender were unclear. Long-term effects from these mental illnesses indicated scholastic issues, but no further worsening of symptoms. CONCLUSIONS Further research is needed regarding the follow-up of refugee minors with PTSD and depression to allow the establishment of more effective support systems, as long-term outcomes become more clearly understood. Few papers discuss the influence of religion, which may be an interesting line of future research as refugees move to more secular societies.
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10.
Association of Mood Disorders with Serum Zinc Concentrations in Adolescent Female Students.
Tahmasebi, K, Amani, R, Nazari, Z, Ahmadi, K, Moazzen, S, Mostafavi, SA
Biological trace element research. 2017;(2):180-188
Abstract
Among various factors influencing mood disorders, the impact of micronutrient deficiencies has attracted a great attention. Zinc deficiency is considered to play a crucial role in the onset and progression of mood disorders in different stages of life. The main objective of this study was to assess the correlation between serum zinc levels and mood disorders in high school female students. This cross-sectional study was conducted on a random sample of 100 representative high school female students. The participants completed 24-h food recall questionnaires to assess the daily zinc intakes. Serum zinc status was assessed using flame atomic absorption spectrometry, and zinc deficiency was defined accordingly. Mood disorders were estimated by calculating the sum of two test scores including Beck's depression inventory (BDI) and hospital anxiety depression scale (HADS) tests. General linear model (GLM) and Pearson's regression test were applied to show the correlation of serum zinc levels and mood disorder scores and the correlation between zinc serum levels and BDI scores, respectively. Dietary zinc intake was higher in subjects with normal zinc concentrations than that of zinc-deficient group (p = 0.001). Serum zinc levels were inversely correlated with BDI and HADS scores (p < 0.05). Each 10 μg/dL increment in serum zinc levels led to 0.3 and 0.01 decrease in depression and anxiety scores, respectively (p < 0.05). Serum zinc levels were inversely correlated with mood disorders including depression and anxiety in adolescent female students. Increasing serum levels of zinc in female students could improve their mood disorders.