Introduction: Post-stroke depression (PSD) is a common mental health problem after cerebrovascular accidents. There are several treatments that have been shown to be effective in treating post-stroke depression. However, it is not clear which treatment is more effective.Methods: In this meta-analysis, an appropriate search strategy was used to search eligible randomized controlled trials (RCTs) on different treatments to treat patients with Post-stroke depression published up to December 2021 from the CNKI, PubMed, and Cochrane Library. We assessed the mean difference or odds ratio between each treatment and placebo and summarized them as the average and 95% confidence interval (CI) by conducting Bayesian network meta-analyses.Results: By constructing a Bayesian network meta-analysis, we found that acupuncture combined with fluoxetine (vs placebo MD, −8.9; 95% CI, [−15, −2.9]) or paroxetine (vs placebo MD,—8.5; 95% CI, [−15, −2.5]) was the most effective for change in Hamilton depression scale (HAMD) at the end of the 4th week. For change in Hamilton depression scale at the end of the 8th week, rTMS combined with paroxetine (vs placebo MD, −13; 95% CI, [−17, −7.9]) had the greatest amount of change. The efficacy of medication combined with adjuvant therapy was also superior for the percentage of patients with Hamilton depression scale change over 50%.Discussion: The combination of antidepressants with adjuvant therapy may enhance the efficacy of antidepressants and achieve better results than antidepressant monotherapy in both Hamilton depression scale changes at the end of week 4 or 8 and 50% Hamilton depression scale improvement rate. Acupuncture combined with fluoxetine treatment was more effective in the treatment of post-stroke depression at week 4, while rTMS combined with paroxetine was more effective at week 8. Further research is needed to determine whether acupuncture combined with fluoxetine is better than rTMS combined with paroxetine for post-stroke depression at week 8.

Spearman's rank correlation coefficients between branched-chain amino acids and Hamilton Depression Rating Scale (HAMD-17) and Beck Depression Inventory (BDI-II) scores.

HAMD = Hamilton Depression Rating Scale, DS = Depression subscale of the Depression and Somatic Symptoms Scale (DSSS), SS = Somatic subscale of the DSSS, HADS-D = Depression subscale of the Hospital Anxiety and Depression Scale (HADS), HADS-A = Anxiety subscale of the HADS*p < 0.05a Subjects with pharmacotherapy in the index follow-up month were categorized as the treated group and those without pharmacotherapy were categorized as the undertreated group.Demographic variables and psychometric scores (mean ± standard deviation) at baseline among the different groups.a

Severity and improvement percentage of depression in patients according to categorical variables a,b.

Relationship between HAMD score and TSH levels in Graves’ disease patients after 131I treatment.

Serum markers in patients with and without depression.

ABSTRACT Objective Estimate the prevalence of depressive symptoms in ambulatory of medical clinics at Lauro Wanderley University Hospital in 2018. Methods Application of a sociodemographic questionnaire and the Hamilton Depression Rating Scale in a 2-month period, where 101 patients were interviewed. Results It was observed that 61.4% of the sample is classified as mildly and severely depressed, with 78% of rheumatology patients, 63% of cardiology and 48% of endocrinology. Of the patients treated 34.6% practice physical activity at least three times a week, 53.5% use or had used sleeping medication, 25.7% have psychiatric treatment and 4.9% currently do, in contrast 29.7% use some psychotropic. Of the psychotropics, the most used was Diazepam (16.7%). The following associations were found: slightly depressed patients did not practice physical activities, were already receiving health treatment and had a history of psychiatric treatment; rheumatology showed more patients with some degree of depression. Of the 27 who reported poor sleep, 78% used sleeping medication and 63% psychotropic, 60% did not practice physical activity and 81% were slightly depressed. Somatic symptoms were the most reported on the Hamilton scale. Conclusion There is a high prevalence of depressive symptoms in patients of medical ambulatory services, especially cardiovascular, endocrinological and rheumatologic diseases. It is noticed that there was a great emphasis on somatic symptoms, which may explain the large number of respondents who are not accompanied by psychiatrist and treated only with symptomatic.

BackgroundDrug efficacy generally varies with different durations. There is no systematic review analyzing the effect of selegiline for Parkinson's disease (PD) on different treatment duration. This study aims to analyze how the efficacy and safety of selegiline changes for PD over time.MethodsPubMed, the Cochrane Library, Embase, China National Knowledge Infrastructure and Wanfang Database were systematically retrieved for randomized controlled trials (RCTs) and observational studies of selegiline for PD. The search period was from inception to January 18th, 2022. The efficacy outcomes were measured by the mean change from baseline in the total and sub Unified Parkinson's Disease Rating Scale (UPDRS), Hamilton Depression Rating Scale (HAMD) and Webster Rating Scale (WRS) scores. The safety outcomes were measured by the proportion of participants having any adverse events overall and that in different system organ classes.ResultsAmong the 3,786 studies obtained, 27 RCTs and 11 observational studies met the inclusion criteria. Twenty-three studies reported an outcome which was also reported in at least one other study, and were included in meta-analyses. Compared with placebo, selegiline was found with a stronger reduction of total UPDRS score with increasing treatment duration [mean difference and 95% CIs in 1 month: −3.56 (−6.67, −0.45); 3 months: −3.32 (−3.75, −2.89); 6 months: −7.46 (−12.60, −2.32); 12 months: −5.07 (−6.74, −3.41); 48 months: −8.78 (−13.75, −3.80); 60 months: −11.06 (−16.19, −5.94)]. A similar trend was also found from the point estimates in UPDRS I, II, III, HAMD and WRS score. The results of observational studies on efficacy were not entirely consistent. As for safety, compared with placebo, selegiline had higher risk of incurring any adverse events [rate: 54.7% vs. 62.1%; odd ratio and 95% CIs: 1.58 (1.02, 2.44)], with the excess adverse events mainly manifested as neuropsychiatric disorders [26.7% vs. 31.6%; 1.36 (1.06, 1.75)] and no significant change over time. The statistically difference in overall adverse event between selegiline and active controls was not found.ConclusionSelegiline was effective in improving total UPDRS score with increasing treatment duration, and had a higher risk of incurring adverse events, especially the adverse events in the neuropsychiatric system.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier: PROSPERO CRD42021233145.

Multiplex cytokine comparisons between patients with major depressive disorder (MDD) and healthy controls.

Paired T-Tests for depression and HRV indices at intake and discharge of psychotherapy.

HAMD = Hamilton Depression Rating Scale, DS = Depression subscale of the Depression and Somatic Symptoms Scale (DSSS), SS = Somatic subscale of the DSSS, HADS-D = Depression subscale of the Hospital Anxiety and Depression Scale (HADS), HADS-A = Anxiety subscale of the HADS* p < 0.017 for the no migraine subgroup vs. the inactive migraine subgroup.†p < 0.017 for the no migraine subgroup vs. the active migraine subgroup.‡p < 0.017 for the inactive migraine subgroup vs. the active migraine subgroup.a Headache intensity was measured by visual analog scale.b Headache frequency was calculated from the number of headache days in the past month.c Patients without migraine at baseline were categorized as the no migraine group. Patients with migraine diagnosed at baseline and with no headache or mild headache at follow-up were categorized as the inactive migraine group. Patients with migraine diagnosed at baseline and with moderate or severe headache at follow-up were categorized as the active migraine group.d Subjects with pharmacotherapy in the index follow-up month were categorized as the treated group and those without pharmacotherapy were categorized as the undertreated group.The scores of the three scales (mean ± standard deviation) and headache indices among different subgroups at baseline and at the two-year follow-up.c,d

Legend: HAM, 17-item Hamilton Depression Rating Scale; BDI, 21-item Beck Depression Inventory; CORE, Core Assessment of Psychomotor change. The items that did not enter the models by Uher and Parker are coded in the “none” item dimension category.Exploratory Factor Analysis six-factor solution.

ObjectiveMajor depressive disorder (MDD) has a relapse rate that cannot be ignored and places a tremendous burden on the patient in the prevention and treatment process. Yoga, a combination of physical and mental exercises, is effective and acceptable for the adjunctive treatment of MDD. This study aimed to explore further the evidence of yoga’s efficacy for patients with MDD.MethodsPubMed, Embase, Cochrane library, PsycINFO, SinoMed, CNKI, Wanfang, and VIP databases from their inception to 13 October 2022 were searched by a pre-defined search strategy. RCTs of patients with MDD who met diagnostic criteria for yoga treatment were included. RoB2.0 was used to evaluate the quality of the literature. Improvement in depressive symptoms was assessed by the Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HAMD), or other scales were used as primary outcome indicators, and improvement in anxiety was assessed by the Hamilton Anxiety Scale (HAMA) and State–Trait Anxiety Inventory (STAI) scale as secondary outcome indicators. RR and Cohen’s d at 95% CI were used as effect size estimates, and Q and I2 were used to evaluate the size of heterogeneity, with a p-value less than 0.05 indicating statistical significance.ResultsThirty-four RCT studies, including 1,269 patients in the treatment group and 1,072 patients in the control group, 48.4% of whom were women, were included in the study. Compared to the control group, the BDI-II results yielded a moderate effect of yoga on the improvement of depressive symptoms (Cohen’s d = −0.60; 95% CI: −1.00 to −0.21; p 

Executive dysfunctions frequently occur in patients with Major Depressive Disorder and have been shown to improve during effective antidepressant treatment. However, the time course of improvement and its relationship to treatment outcome is unknown. The aim of the study was to assess the test performance and clinical outcome by repetitive assessments of executive test procedures during antidepressant treatment. Executive test performance was assessed in 209 –patients with Major Depressive Disorder (mean age 39.3 ± 11.4 years) and 84 healthy controls five times in biweekly intervals from baseline to week 8. Patients were treated by a defined treatment algorithm within the early medication change study (EMC trial; ClinicalTrials.gov NCT00974155), controls did not receive any intervention. Cognitive domains were processing speed, cognitive flexibility, phonemic and semantic verbal fluency. Intelligence was assessed at baseline. Depression severity was tested once a week by the Hamilton Depression Rating Scale (HAMD17). 130 patients (62%) showed executive dysfunctions in at least one of four tests at baseline. Linear mixed regression models revealed that the course of depression severity was associated to the course of cognitive flexibility (p = 0.004) and semantic verbal fluency (p = 0.020). Cognitive flexibility and semantic verbal fluency may be candidates easily to apply for therapy response prediction in clinical routine, which should be tested in further prospective studies.Trial registration: ClinicalTrials.gov NCT00974155EudraCT: 2008-008280-96

Clinical demographics of Graves’ disease patients.

Nearly one third of the population diagnosed with major depressive disorder (MDD) fail to respond to two or more antidepressant drugs of adequate dose and duration. This necessitates identification of confounding psychological and physiological factors that could contribute to treatment resistant depression (TRD). The present longitudinal study investigated the influence of behavioural inhibition system (BIS) and behavioural approach system (BAS) in treatment resistance. Further, the association of depression severity with physiological factors contributing to arterial stiffness was also investigated. Baseline data was acquired from 101 middle-aged (36–56 years) patients on immediate diagnosis with MDD using DSM-V criteria. Follow ups were conducted at 06 months and 12 months during treatment. Psychological assessment battery at baseline and follow ups comprised of Hamilton depression rating (HAM-D) for depression severity, WHODAS-2 and BIS-BAS score. Atherosclerosis and central arterial stiffness were measured by intima-media thickness of internal carotid artery and brachial-ankle pulse wave velocity. Physiological factors influencing central vascular function viz., body-mass index, estimated glomerular filtration rate, HbA1c, central systolic and diastolic blood pressure, heart rate and tetrahydrobiopterin were also investigated. Our results show lower reward responsiveness (BAS-RR) and higher BIS scores in TRD patients along with differentially higher intima-media thickness of left internal carotid artery. Higher depression severity at all stages of the study was correlated with lower tetrahydrobiopterin and BAS-RR scores. We, therefore, suggest that vascular depression resulting due to increased intima-media thickness of left carotid artery and lower tetrahydrobiopterin could be contributing factors for treatment resistance in middle-aged MDD patients.

Independent variables predicting the severity and improvement percentage of depression at the two-year follow-up point a,b.

HAMD = Hamilton Depression Rating ScaleFactors associated with full remission of depression at follow-up.

1 RM-Anova: [before, during IFN-α therapy]Means and standard deviations of Hamilton Depression Rating Scale (HAMD-17) scores, indoleamine 2,3-dioxygenase (IDO) activity, kynurenine and quinolinic acid concentrations before, during and after IFN-α therapy.