Objective To conduct a systematic review and meta‐analysis of studies that measured cytokine and chemokine levels in individuals with major depressive disorder (MDD) compared to healthy controls (HCs). Method The PubMed/MEDLINE, EMBASE, and PsycINFO databases were searched up until May 30, 2016. Effect sizes were estimated with random‐effects models. Result Eighty‐two studies comprising 3212 participants with MDD and 2798 HCs met inclusion criteria. Peripheral levels of interleukin‐6 (IL‐6), tumor necrosis factor (TNF)‐alpha, IL‐10, the soluble IL‐2 receptor, C‐C chemokine ligand 2, IL‐13, IL‐18, IL‐12, the IL‐1 receptor antagonist, and the soluble TNF receptor 2 were elevated in patients with MDD compared to HCs, whereas interferon‐gamma levels were lower in MDD (Hedge's g = −0.477, P = 0.043). Levels of IL‐1β, IL‐2, IL‐4, IL‐8, the soluble IL‐6 receptor (sIL‐6R), IL‐5, CCL‐3, IL‐17, and transforming growth factor‐beta 1 were not significantly altered in individuals with MDD compared to HCs. Heterogeneity was large (I2: 51.6–97.7%), and sources of heterogeneity were explored (e.g., age, smoking status, and body mass index). Conclusion Our results further characterize a cytokine/chemokine profile associated with MDD. Future studies are warranted to further elucidate sources of heterogeneity, as well as biosignature cytokines secreted by other immune cells.
Mounting evidence suggests that aberrations in immune-inflammatory pathways contribute to the pathophysiology of major depressive disorder (MDD), and individuals with MDD may have elevated levels of predominantly pro-inflammatory cytokines and C-reactive protein. In addition, previous meta-analyses suggest that antidepressant drug treatment may decrease peripheral levels of interleukin-1 beta (IL-1β) and IL-6. Recently, several new studies examining the effect of antidepressants on these cytokines have been published, and so we performed an updated meta-analysis of studies that measured peripheral levels of cytokines and chemokines during antidepressant treatment in patients with MDD. The PubMed/MEDLINE, EMBASE, and PsycInfo databases were searched from inception through March 9, 2017. Forty-five studies met inclusion criteria (N = 1517). Peripheral levels of IL-6, tumor necrosis factor-alpha (TNF-α), IL-1β, IL-10, IL-2, IL-4, interferon-γ, IL-8, the C-C motif ligand 2 chemokine (CCL-2), CCL-3, IL-1 receptor antagonist, IL-13, IL-17, IL-5, IL-7, and the soluble IL-2 receptor were measured in at least three datasets and thus were meta-analyzed. Antidepressant treatment significantly decreased peripheral levels of IL-6 (Hedges g = -0.454, P <0.001), TNF-α (g = -0.202, P = 0.015), IL-10 (g = -0.566, P = 0.012), and CCL-2 (g = -1.502, P = 0.006). These findings indicate that antidepressants decrease several markers of peripheral inflammation. However, this meta-analysis did not provide evidence that reductions in peripheral inflammation are associated with antidepressant treatment response although few studies provided separate data for treatment responders and non-responders.
Although accuracy properties of the three screening instruments did not consistently differ in mental health care services, the HCL-32 was more accurate than the MDQ for the detection of type II BD. More studies in other settings (for example, in primary care) are necessary.
Our data indicated that SOC is an important construct, as it influences psychological distress and has significant albeit indirect effects on several HRQoL domains in IBD.
ABSTRACT:Introduction: breast cancer is one of the main causes of death among women in Brazil and worldwide. The diagnosis of breast neoplasms usually represents an emotional burden, and it may lead to adjustment reactions and even be the trigger for affective disorders (mainly depression), anxiety or psychosis. The Beck Depression Inventory (BDI) is one of the most used mechanisms for the evaluation of depression in research and in clinics. Depression prevalence in patients with cancer varies from 3% to 55% among different studies. Methodological variation, different instruments to assess depression and different cut-off points for diagnosis contribute to the huge discrepancy in current findings. In general, the more specifically depression is defined and evaluated, the lower the rates of prevalence are reported. Many articles fail to demonstrate a statistical significance in the relationship between depression and cancer-specific factors. This suggests that risk factors for depression in those patients are more related to the patient as contextual variables and premorbid factors of personality -and not to the cancer or its treatment. Objective: to determine the prevalence of major depression in women with breast cancer. Methods: a cross-sectional study was conducted in women with breast cancer. The sample consisted of 51 patients who answered the Beck Depression Inventory (BDI). The presence of depression was considered in cases where the scores were above 20. A questionnaire with additional data about the patients such as age, marital status, ethnicity, education, family income, family history of depression and breast cancer, and cancer-related variables including staging, months since diagnosis, treatment modality, type of surgery, alopecia occurring were used. Descriptive analysis and test of association (chi-square) were conducted. Results: the prevalence of major depression was 5.9%, similar to that observed in community samples. Subsyndromal depressive symptoms had a score of 21.6% (BDI scores from 16 to 20). Chi-square test was conducted and showed no statistically significant relationship between the classification of BDI and the variables tested (characteristics related to patient and cancer-specific). This indicates that the isolated context of the variables does not influence the event of depression. Conclusion: the prevalence of major depression in women with breast neoplasms was 5.9%.
Objective: Inflammatory bowel disease (IBD) is associated with elevated levels of anxiety and depression and a reduction in health-related quality of life (HRQoL). Nonadherence to treatment is also frequent in IBD and compromises outcomes. Religious coping plays a role in the adaptation to several chronic diseases. However, the influence of religious coping on IBD-related psychological distress, HRQoL, and treatment adherence remains unknown. Method: This cross-sectional study recruited 147 consecutive patients with either Crohn's disease or ulcerative colitis. Sociodemographic data, disease-related variables, psychological distress (Hospital Anxiety and Depression Scale), religious coping (Brief RCOPE Scale), HRQoL (WHOQOL-Bref), and adherence (8-item Morisky Medication Adherence Scale) were assessed. Hierarchical multiple regression models were used to evaluate the effects of religious coping on IBD-related psychological distress, treatment adherence, and HRQoL. Results: Positive RCOPE was negatively associated with anxiety (b = -0.256; p = 0.007) as well as with overall, physical, and mental health HRQoL. Religious struggle was significantly associated with depression (b = 0.307; p o 0.001) and self-reported adherence (b = -0.258; p = 0.009). Finally, anxiety symptoms fully mediated the effect of positive religious coping on overall HRQoL. Conclusion: Religious coping is significantly associated with psychological distress, HRQoL, and adherence in IBD.
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PSICOLOGIA SOCIAL Transtornos mentais comuns e associação com variáveis sociodemográficas e estressores ocupacionais: uma análise de gênero Common mental disorders and its association with sociodemographic variables and occupational stressors: a gender analysis Trastornos mentales comunes y asociación con variables sociodemográficas y estresores ocupacionales: un análisis de género
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