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Psychotropic medication in depression

Woon TH

Family Practitioner, 1973;1(1):13-16.

Matched MeSH terms: Depression
Postnatal depression and its associated factors in women from different cultures

Abdollahi F, Lye MS, Md Zain A, Shariff Ghazali S, Zarghami M

Iran J Psychiatry Behav Sci, 2011;5(2):5-11.
PMID: 24644441

OBJECTIVE: Postpartum depression (PPD) is a common health problem which affects women in the postpartum period. This is a brief note on its associated factors in women from different cultures.
METHODS: A literature review was performed in MEDLINE and Pubmed from 1991 to 2008 and Magiran from 1991 to 2009. Additional articles and book chapters were referenced from these sources.
RESULTS: The prevalence of postpartum depression has been reported to be from 0.5% to 60% globally, and from 3.5% to 63.3% in Asian countries, in which Malaysia and Pakistan had respectively the lowest and highest rates. One of the factors contributing to PPD in Asian societies can be that women may not have the empowerment to reject traditional rituals that are imposed on them by their caregivers. Unsatisfactory pre-existing relationships between the mothers and their caregivers resulting in mothers experiencing difficulties during their confinement period may be another factor. Thirdly, some features of these traditional rituals may be the cause of tension, stress and emotional distress. Emotional conflicts caused by insistence on practice of traditional rituals during the postpartum period may lead to mental breakdown.
CONCLUSION: Health care professionals should be aware that the phenomenon in Asian cultures is as prevalent as European cultures. Moreover, further research needs to be conducted on the global prevalence of the experiences of childbearing women with depressive symptoms.
KEYWORDS: Cultures; Postpartum depression; Risk factors

Matched MeSH terms: Depression, Postpartum*
Cross-cultural and social diversity of prevalence of postpartum depression and depressive symptoms

Halbreich U, Karkun S

J Affect Disord, 2006 Apr;91(2-3):97-111.
PMID: 16466664 DOI: 10.1016/j.jad.2005.12.051

BACKGROUND:
The prevalence of postpartum depression (PPD) is currently considered to be 10-15%. Most studies were performed with a brief unidimensional instruments (mostly the Edinburgh Postnatal Depression Scale-EPDS) with focus on depression and not on other symptoms and disorders. Most cited studies were conducted in Western economically developed countries.

METHODS:
We reviewed the literature on prevalence of postpartum depression and depressive symptoms in a wide range of countries.

RESULTS:
143 studies were identified reporting prevalence in 40 countries. It is demonstrated that there is a wide range of reported prevalence of PPD ranging from almost 0% to almost 60%. In some countries like Singapore, Malta, Malaysia, Austria and Denmark there are very few reports of PPD or postpartum depressive symptoms, whereas in other countries (e.g. Brazil, Guyana, Costa Rica, Italy, Chile, South Africa, Taiwan and Korea) reported postpartum depressive symptoms are very prevalent.

CONCLUSIONS:
We believe that the widely cited mean prevalence of PPD-10-15% is not representative of the actual global prevalence and magnitude of the problem, due to the wide range of reports. The variability in reported PPD might be due to cross-cultural variables, reporting style, differences in perception of mental health and its stigma, differences in socio-economic environments (e.g. poverty, levels of social support or its perception, nutrition, stress), and biological vulnerability factors. The elucidation of the underlying processes of this variability as well as the diversity of postpartum normal versus abnormal expressions of symptoms may contribute to better understanding of the diversified ante, peri- and postpartum phenomena.

Matched MeSH terms: Depression/diagnosis; Depression/epidemiology*; Depression/psychology; Depression, Postpartum/diagnosis; Depression, Postpartum/epidemiology*; Depression, Postpartum/psychology
Fulltext Emotional Intelligence and Depressive Symptoms as Predictors of Happiness Among Adolescents

Abdollahi A, Abu Talib M, Motalebi SA

Iran J Psychiatry Behav Sci, 2015 Dec;9(4):e2268.
PMID: 26834804 DOI: 10.17795/ijpbs-2268

BACKGROUND: Given that happiness is an important construct to enable adolescents to cope better with difficulties and stress of life, it is necessary to advance our knowledge about the possible etiology of happiness in adolescents.
OBJECTIVES:The present study sought to investigate the relationships of emotional intelligence, depressive symptoms, and happiness in a sample of male students in Tehran, Iran.
MATERIALS AND METHODS: This cross-sectional study was conducted on a sample of high school students in Tehran in 2012. The participants comprised of 188 male students (aged 16 to 19 years old) selected by multi-stage cluster sampling method. For gathering the data, the students filled out assessing emotions scale, Beck depression inventory-II, and Oxford happiness inventory. Data analysis was carried out using descriptive and analytical statistics in statistical package for social sciences (SPSS) software.
RESULTS: The findings showed that a significant positive association existed between high ability of emotional intelligence and happiness (P < 0.01). Conversely, the low ability of emotional intelligence was associated with unhappiness (P < 0.01), there was a positive association between non-depression symptoms and happiness (P < 0.05), and severe depressive symptoms were positively associated with unhappiness (P < 0.01). High ability of emotional intelligence (P < 0.01) and non-depression symptoms (P < 0.05) were the strongest predictors of happiness.
CONCLUSIONS: These findings reinforced the importance of emotional intelligence as a facilitating factor for happiness in adolescences. In addition, the findings suggested that depression symptoms may be harmful for happiness in adolescents.

KEYWORDS:
Depression; Emotional Intelligence; Iranian Students; Wellbeing

Matched MeSH terms: Depression*
The relationship between post-natal depression, somatization and behaviour in Malaysian women

Grace J, Lee KK, Ballard C, Herbert M

Transcult Psychiatry, 2001;38:27-34.
DOI: 10.1177/136346150103800103

This study evaluated the rate of post-natal depression (PND) in a Malaysian population, investigated the relationship between belief systems and PND, and examined the relationship between PND and somatization. The sample included 154 consecutive attendees for a 6-week post-natal check at a general hospital well-baby clinic in Kuala Lumpur. Patients were assessed using the Edinburgh Post-Natal Depression Score (EPNDS), the Bradford Somatisation Inventory (BSI), and a questionnaire to assess beliefs about pregnancy and childbirth. The rate of PND was 3.9%. EPNDS and BSI were moderately correlated. Women who practised specific post-natal practices had a higher EPNDS and BSI than those who did not. The rate of PND is lower than in Western studies but similar to that seen in other Asian countries. The correlation between BSI and EPNDS suggest that the BSI will not detect cases missed by the EPNDS. © 2001, Sage Publications. All rights reserved.

Matched MeSH terms: Depression; Depression, Postpartum
Fulltext A survey on burnout and depression risk among anaesthetists during COVID-19: the tip of an iceberg?

Tsan SEH, Kamalanathan A, Lee CK, Zakaria SA, Wang CY

Anaesthesia, 2021 03;76 Suppl 3:8-10.
PMID: 32776524 DOI: 10.1111/anae.15231
Matched MeSH terms: Depression/epidemiology
Fulltext Interpersonal psychotherapy for depression in the ageing – A case study. [Abstract]

Pereira XV

Malaysian Journal of Medicine and Health Sciences, 2019;15(102):30.
MyJurnal

ABSTRACTS FOR INTERNATIONAL HEALTH AND MEDICAL SCIENCES CONFERENCE 2019
IHMSC 2019. Accelerating Innovations in Translational and Precision Medicine. Held at Taylor’s University Lakeside Campus, Subang Jaya, Selangor, Malaysia, 8-9th March, 2019
Introduction: Depression is becoming increasingly prevalent as a mental health disorder worldwide. The prevalence of clinical depression is between about five and fifteen percent globally. Clinical depression has also increased in prevalence among the ageing. Some of the etiological factors associated with depression in the ageing include grief and loss, and role transitions. Interpersonal Psychotherapy (IPT), an evidenced based psychotherapy for clinical depression, has been proven to be effective for depression in the ageing. IPT addresses four main problem areas, namely - interpersonal disputes, grief and loss, role transitions and interpersonal sensitivity. The adaptation of IPT for the ageing is IPT for late-life depression or IPT – LLM which was utilized to treat the patient discussed in this case study. Methods: The patient was treated with 12 sessions of psychotherapy which is often the minimum number of sessions required in the treatment of depression with IPT. The initial sessions included the development of an Interpersonal Formulation and Interpersonal Inventory. Her problem areas were grief as her husband had passed away recently, and role transitions. The problem areas were addressed during the 8 middle IPT sessions. The final two sessions were utilized to conclude IPT treatment. Results: The patient was assessed to have a PHQ – 9 (Patient Health Questionnaire--9) score of 17 before treatment with IPT, indicating moderate depression. Her PHQ – 9 score after 12 sessions of IPT was 4 indicating minimal depression. Conclusion: This case study highlights that some of the factors that contribute to depression in the ageing are grief and role transitions, and that IPT is efficacious in the treatment of depression in the ageing.

Matched MeSH terms: Depression*
Depression Following Major Life Transitions in Women: A Review and Theory

Moustafa AA, Crouse JJ, Herzallah MM, Salama M, Mohamed W, Misiak B, et al.

Psychol Rep, 2020 Oct;123(5):1501-1517.
PMID: 31470771 DOI: 10.1177/0033294119872209

Depression can occur due to common major life transitions, such as giving birth, menopause, retirement, empty-nest transition, and midlife crisis. Although some of these transitions are perceived as positive (e.g., giving birth), they may still lead to depression. We conducted a systematic literature review of the factors underlying the occurrence of depression following major life transition in some individuals. This review shows that major common life transitions can cause depression if they are sudden, major, and lead to loss (or change) of life roles (e.g., no longer doing motherly or fatherly chores after children leave family home). Accordingly, we provide a theoretical framework that explains depression caused by transitions in women. One of the most potential therapeutic methods of ameliorating depression associated with life transitions is either helping individuals accept their new roles (e.g., accepting new role as a mother to ameliorate postpartum depression symptoms) or providing them with novel life roles (e.g., volunteering after retirement or children leave family home) may help them overcome their illness.

Matched MeSH terms: Depression/etiology*; Depression/epidemiology*; Depression/psychology; Depression, Postpartum/etiology; Depression, Postpartum/epidemiology; Depression, Postpartum/psychology
Fulltext Prediction of incidence and bio-psycho-socio-cultural risk factors of post-partum depression immediately after birth in an Iranian population

Abdollahi F, Zarghami M, Sazlina SG, Zain AM, Mohammad AJ, Lye MS

Arch Med Sci, 2016 Oct 1;12(5):1043-1051.
PMID: 27695496

INTRODUCTION: Post-partum depression (PPD) is the most prevalent mental problem associated with childbirth. The purpose of the present study was to determine the incidence of early PPD and possible relevant risk factors among women attending primary health centers in Mazandaran province, Iran for the first time.
MATERIAL AND METHODS: A longitudinal cohort study was conducted among 2279 eligible women during weeks 32-42 of pregnancy to determine bio-psycho-socio-cultural risk factors of depression at 2 weeks post-partum using the Iranian version of the Edinburgh Postnatal Depression Scale (EPDS). Univariate and hierarchical multiple logistic regression models were used for data analysis.
RESULTS: Among 1,739 mothers whose EPDS scores were ≤ 12 during weeks 32-42 of gestation and at the follow-up study, the cumulative incidence rate of depression was 6.9% (120/1,739) at 2 weeks post-partum. In the multivariate model the factor that predicted depression symptomatology at 2 weeks post-partum was having psychiatric distress in pregnancy based on the General Health Questionnaire (GHQ) (OR = 1.06, (95% CI: 1.04-1.09), p = 0.001). The risk of PPD also lower in those with sufficient parenting skills (OR = 0.78 (95% CI: 0.69-0.88), p = 0.001), increased marital satisfaction (OR = 0.94 (95% CI: 0.9-0.99), p = 0.03), increased frequency of practicing rituals (OR = 0.94 (95% CI: 0.89-0.99), p = 0.004) and in those whose husbands had better education (OR = 0.03 (95% CI: 0.88-0.99), p = 0.04).
CONCLUSIONS: The findings indicated that a combination of demographic, sociological, psychological and cultural risk factors can make mothers vulnerable to PPD.
KEYWORDS: depression; incidence; post-partum

Matched MeSH terms: Depression, Postpartum*
Fulltext A Microbial-Based Approach to Mental Health: The Potential of Probiotics in the Treatment of Depression

Johnson D, Letchumanan V, Thum CC, Thurairajasingam S, Lee LH

Nutrients, 2023 Mar 13;15(6).
PMID: 36986112 DOI: 10.3390/nu15061382

Probiotics are currently the subject of intensive research pursuits and also represent a multi-billion-dollar global industry given their vast potential to improve human health. In addition, mental health represents a key domain of healthcare, which currently has limited, adverse-effect prone treatment options, and probiotics may hold the potential to be a novel, customizable treatment for depression. Clinical depression is a common, potentially debilitating condition that may be amenable to a precision psychiatry-based approach utilizing probiotics. Although our understanding has not yet reached a sufficient level, this could be a therapeutic approach that can be tailored for specific individuals with their own unique set of characteristics and health issues. Scientifically, the use of probiotics as a treatment for depression has a valid basis rooted in the microbiota-gut-brain axis (MGBA) mechanisms, which play a role in the pathophysiology of depression. In theory, probiotics appear to be ideal as adjunct therapeutics for major depressive disorder (MDD) and as stand-alone therapeutics for mild MDD and may potentially revolutionize the treatment of depressive disorders. Although there is a wide range of probiotics and an almost limitless range of therapeutic combinations, this review aims to narrow the focus to the most widely commercialized and studied strains, namely Lactobacillus and Bifidobacterium, and to bring together the arguments for their usage in patients with major depressive disorder (MDD). Clinicians, scientists, and industrialists are critical stakeholders in exploring this groundbreaking concept.

Matched MeSH terms: Depression/drug therapy
Marital conflict, trauma exposure, posttraumatic stress disorder, and depressive symptoms among Malaysian firefighters

Majani AF, Ghazali SR, Yoke Yong C, Pauzi N, Adenan F, Manogaran K

Psychol Rep, 2023 Aug;126(4):1605-1619.
PMID: 35084251 DOI: 10.1177/00332941221075246

Multiple exposures to life-threatening events may lead to various mental health issues and indirectly affect the marriage of those affected. Very few studies have investigated trauma exposure, posttraumatic stress disorder (PTSD), depressive symptoms, and marital conflicts among firefighters, a group that faces such exposure occupationally. The present study explores the relationship between trauma exposure, PTSD, and depression in relation to marital conflicts among firefighters in Sarawak, adopting a cross-sectional research design. Different marital status reported significant PTSD and depressive symptoms. The widowed scored higher PTSD and depressive symptoms than the married and single groups. Firefighters with PTSD and depressive symptoms reported having more problems in aggression family history of distress, sexual dissatisfaction, and problem solving communication than those without. Regression analysis showed that problem solving communication (t (212) = 2.59, p = .01) and global distress scores (t (212) = 2.17, p < .05) in type of marital conflicts served as a significant predictor for depressive symptoms. The present study suggests that proper planning for treatment and intervention is needed to improve psychological well-being among firefighters and other high-risk professions following multiple exposures to traumatic events in carrying their job duty. Proper intervention programs also should be initiated for spouses of firefighters dealing with traumatized partners.

Matched MeSH terms: Depression/epidemiology
Fulltext Age-friendliness of city, loneliness and depression moderated by internet use during the COVID-19 pandemic

Ng SI, Lim XJ, Hsu HC, Chou CC

Health Promot Int, 2023 Jun 01;38(3).
PMID: 35437585 DOI: 10.1093/heapro/daac040

The purpose of this study was to examine the association between age-friendliness of a city, loneliness and depression moderated by internet use among older people during the coronavirus disease 2019 (COVID-19) pandemic. The survey was from 'The 2020 Survey of Needs Assessment for a Safe Community and Age-Friendly City' in Xinyi District, Taipei, which was conducted by face-to-face interviews with community-based older adults who were aged 65 and above from one district of Taipei City from May to June 2020 (n = 335). Partial least square structural equation modeling and the SPSS PROCESS macro were used for data analysis. Two domains of an age-friendly city (housing and community support and health services) were found to be associated with reduced loneliness, while one (respect and social inclusion) was associated with decreased depression. The age-friendliness of cities mitigates depression through moderator (internet use) and mediation (loneliness) mechanisms. Although some age-friendly domains of the city reduced loneliness and depression directly, the age-friendliness-loneliness-depression mechanism held true only for older adults who used the internet and not for nonusers. Maintaining the age-friendliness of an environment is beneficial to mental health, and internet use is a necessary condition to gain optimum benefits from age-friendly initiatives. Policy suggestions are discussed.

Matched MeSH terms: Depression/epidemiology
State of the Science on postpartum depression: what nurse researchers have contributed--part 1

Beck CT

MCN Am J Matern Child Nurs, 2008 Mar-Apr;33(2):121-6.
PMID: 18327112 DOI: 10.1097/01.NMC.0000313421.97236.cf

Postpartum depression has been described as a thief that steals motherhood. It can result in tragedy and sometimes in headline-gripping maternal suicide or infanticide. Because one of the highest priorities for nursing is to continually advance the knowledge that underlies nursing practice, it is essential that we understand what nurse researchers have done to advance the knowledge base of postpartum depression. This integrative review is a two-part series for MCN that summarizes 141 postpartum depression studies conducted by nurse researchers from around the globe, including United States, Australia, Canada, China (Hong Kong, Taiwan), Finland, Iceland, Sweden, Turkey, and Malaysia. Specific areas of postpartum depression to which nurse researchers have devoted their primary attention include epidemiology, risk factors, transcultural perspectives, instrument development, screening, interventions, and mother-infant interactions.

Matched MeSH terms: Depression, Postpartum/ethnology; Depression, Postpartum/nursing; Depression, Postpartum/prevention & control*; Depression, Postpartum/psychology
Fulltext Managing depression in primary care

Ng CW, How CH, Ng YP

Singapore Med J, 2017 08;58(8):459-466.
PMID: 28848991 DOI: 10.11622/smedj.2017080

Major depression is common in the primary care setting. In the final article of this series, we illustrate the approach to the management of depression in primary care. Psychotherapy has been shown to be as effective as antidepressants for mild to moderate major depression. The common myth that antidepressants are addictive should be addressed. Antidepressants should be started at a subtherapeutic dose to assess tolerability, then gradually increased until a minimally effective dose is achieved. Apart from pharmacotherapy and psychotherapy, management of depression should include managing stressors, engaging social and community support, dealing with stigma and discrimination, and managing concomitant comorbidities. A strong therapeutic relationship and empathic listening are important between the primary care physician and patient.

Matched MeSH terms: Depression/drug therapy; Depression/therapy*
Effect of mindfulness intervention on anxiety, distress, and depression for chronic diseases: a scoping review

Mansor M, Chong MC, Chui PL, Hamdan M, Lim CC

Psychol Health Med, 2023 Jul;28(6):1549-1561.
PMID: 36120729 DOI: 10.1080/13548506.2022.2124288

This scoping review describes the research-based mindfulness intervention on anxiety, distress, and depression. The search strategy retrieved articles published in English from 2014 to 2019 and were retrieved across Scopus, Web of Science, Science Direct, CINAHL, and Google Scholar. The PRISMA-Scr checklist is a tool to evaluate the quality of the articles. The selection criteria initially included all original articles in English, with 1,527 that were related to mindfulness intervention for anxiety, distress, and depression. A total of 490 full texts were retrieved, and after the abstracts were reviewed, 124 full-text articles were included for eligibility, and the final eight studies were determined. The articles were reviewed and screened for relevance to mindfulness intervention in reducing anxiety, distress, and depression among those with chronic diseases. The results have shown that mindfulness intervention reduces anxiety, distress, and depression among patients with chronic diseases. The review contributes further insight into the fact that mindfulness intervention is also appropriate for other conditions to facilitate reducing psychological symptoms.

Matched MeSH terms: Depression/psychology; Depression/therapy
Relationship Between Post-Traumatic Stress Symptoms and Caregiver Burden In Breast Cancer Patients: The Mediating Role of Anxiety and Depression

Wang S, Zhang Q, Goh PH, Hu J, Liu X, Du J, et al.

J Clin Psychol Med Settings, 2023 Sep;30(3):645-653.
PMID: 36385422 DOI: 10.1007/s10880-022-09927-z

Breast cancer impacts not only the physical and mental health of patients but also the people around them-especially their caregivers. This study examined the relationship between post-traumatic stress symptoms (PTSS) and caregiver burden in breast cancer patients through the mediating pathway of anxiety and depression.
METHODS: A total of 236 breast cancer patients from China completed the Chinese Version of the Posttraumatic Stress Disorder Symptom Scale (PSS), the Chinese version of the Patient Health Questionnaire (PHQ-9), the Chinese version of the General Anxiety Symptoms Scale (GAD-7). In addition, caregivers of these breast cancer patients were surveyed by the Caregiver Self-Assessment Questionnaire (CSAQ).
RESULTS: Structural equation model showed that our model fitted well [χ2 /df = 1.966, TLI = 0.959, CFI = 0.994, RMSEA (90% CI) = 0.065 (0-0.12)] and revealed that anxiety, but not depression, mediated the relationship between PTSS in breast cancer patients and caregiver burden.
CONCLUSION: The level of PTSS was positively correlated with anxiety and depression in breast cancer patients, and the level of anxiety and depression was positively related to caregiver burden. The PTSS of patients positively predicted caregiver burden and this relationship appears to be mediated by the patient's anxiety.

Matched MeSH terms: Depression/etiology; Depression/psychology
Depression and Severity of Glaucoma Among Older Adults in Urban and Suburban Areas

Tharmathurai S, Muhammad-Ikmal MK, Razak AA, Che-Hamzah J, Azhany Y, Fazilawati Q, et al.

J Glaucoma, 2021 May 01;30(5):e205-e212.
PMID: 33710066 DOI: 10.1097/IJG.0000000000001830

PRCIS: Depression increases with severity of visual field defect in older adults with primary open-angle glaucoma (POAG).
PURPOSE: This study aimed to determine the prevalence of depression among patients with POAG and examine the relationship between depression and the severity of POAG in older adults.
MATERIALS AND METHODS: Three hundred and sixty patients with POAG aged 60 years or above were recruited from 2 tertiary centers located in an urban and suburban area. The participants were stratified according to the severity of their glaucoma based on the scores from the modified Advanced Glaucoma Intervention Study (AGIS) to mild, moderate, severe, and end stage. Face-to-face interviews were performed using the Malay Version Geriatric Depression Scale 14 (mGDS-14) questionnaire. Depression is diagnosed when the score is ≥8. One-way analysis of variance was used to compare the subscores between the groups. Multifactorial analysis of variance was also applied with relevant confounding factors.
RESULTS: Depression was detected in 16% of older adults with POAG; a higher percentage of depression was seen in those with end stage disease. There was a significant increase in the mean score of mGDS-14 according to the severity of POAG. There was evidence of an association between depression and severity of visual field defect (P<0.001). There was a significant difference in mGDS-14 score between the pairing of severity of POAG [mild-severe (P=0.003), mild-end stage (P<0.001), moderate-severe (P<0.001), and moderate-end stage (P<0.001)] after adjustment to living conditions, systemic disease, and visual acuity.
CONCLUSION: Ophthalmologists should be aware that older adults with advanced visual field defects in POAG may have depression. The detection of depression is important to ensure adherence and persistence to the treatment of glaucoma.

Matched MeSH terms: Depression/diagnosis; Depression/epidemiology
Consensus-based recommendations for the diagnosis and treatment of anxiety and depression in children and adolescents with epilepsy: A report from the Psychiatric Pediatric Issues Task Force of the International League Against Epilepsy

Valente KD, Reilly C, Carvalho RM, Smith ML, Mula M, Wirrell EC, et al.

Epilepsia, 2024 Nov;65(11):3155-3185.
PMID: 39320421 DOI: 10.1111/epi.18116

The Psychiatric Pediatric Issues Task Force of the International League Against Epilepsy (ILAE) aimed to develop recommendations for the diagnosis and treatment of anxiety and depression in children and adolescents with epilepsy. The Task Force conducted a systematic review and identified two studies that assessed the accuracy of four screening measures for depression and anxiety symptoms compared with a psychiatric interview. Nine studies met the eligibility criteria for treatment of anxiety and depressive disorders or symptoms. The risk of bias and certainty of evidence were assessed. The evidence generated by this review followed by consensus where evidence was missing generated 47 recommendations. Those with a high level of agreement (≥80%) are summarized. Diagnosis: (1) Universal screening for anxiety and depression is recommended. Closer surveillance is recommended for children after 12 years, at higher risk (e.g., suicide-related behavior), with subthreshold symptoms, and experiencing seizure worsening or therapeutic modifications. (2) Multiple sources of ascertainment and a formal screening are recommended. Clinical interviews are recommended whenever possible. The healthcare provider must always explain that symptom recognition is essential to optimize treatment outcomes and reduce morbidity. (3) Questioning about the relationship between symptoms of anxiety or depression with seizure worsening/control and behavioral adverse effects of antiseizure medications is recommended. Treatment: (1) An individualized treatment plan is recommended. (2) For mild depression, active monitoring must be considered. (3) Referral to a mental health care provider must be considered for moderate to severe depression and anxiety. (4) Clinical care pathways must be developed. (5) Psychosocial interventions must be tailored and age-appropriate. (6) Healthcare providers must monitor children with epilepsy who are prescribed antidepressants, considering symptoms and functioning that may not improve simultaneously. (7) Caregiver education is essential to ensure treatment adherence. (8) A shared-care model involving all healthcare providers is recommended for children and adolescents with epilepsy and mental health disorders. We identified clinical decisions in the management of depression and anxiety that lack solid evidence and provide consensus-based guidance to address the care of children and adolescents with epilepsy.

Matched MeSH terms: Depression/diagnosis; Depression/therapy
Fulltext A cross-sectional study on the impact of the COVID-19 pandemic on psychological outcomes: Multiple indicators and multiple causes modeling

Aljaberi MA, Alareqe NA, Alsalahi A, Qasem MA, Noman S, Uzir MUH, et al.

PLoS One, 2022;17(11):e0277368.
PMID: 36350838 DOI: 10.1371/journal.pone.0277368

Although the psychological impact of coronavirus disease 2019 (COVID-19) has been evaluated in the literature, further research is needed, particularly on post-traumatic stress disorder (PTSD) and psychological outcomes, is needed. This study aims to investigate the effect of the COVID-19 pandemic on psychological outcomes (depression, anxiety, and insomnia). A cross-sectional study using an online survey was conducted using the following instruments: Impact of Event Scale-Revised (IES-R), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder (GAD-7), and Insomnia Severity Index (ISI). Confirmatory factor analysis (CFA), structural equation model (SEM), multiple indicators and multiple causes (MIMIC) modeling, and differential item functioning (DIF) were performed to analyze the collected data. According to the results, participants with PTSD (n = 360) showed a higher level of depression, anxiety, and insomnia than those without PTSD (n = 639). Among the participants, 36.5% experienced moderate to severe symptoms of depression, and 32.6% had mild depressive symptoms. Moreover, 23.7% of participants experienced moderate to severe anxiety symptoms, and 33.1% had mild anxiety symptoms. In addition, 51.5% of participants experienced symptoms of insomnia. In conclusion, the PTSD caused by COVID-19 is significantly associated with depression, anxiety, and insomnia at the level of latent constructs and observed variables.

Matched MeSH terms: Depression/epidemiology; Depression/psychology
Clinical and economic impact of non-adherence to antidepressants in major depressive disorder: A systematic review

Ho SC, Chong HY, Chaiyakunapruk N, Tangiisuran B, Jacob SA

J Affect Disord, 2016 Mar 15;193:1-10.
PMID: 26748881 DOI: 10.1016/j.jad.2015.12.029

Medication non-adherence is one of the major challenges in treating patients with depression. This systematic review aims to determine the clinical and economic outcomes of non-adherence in depression.

Matched MeSH terms: Depression

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