Peran Brain Stimulation TMS Pada Prajurit Penderita Depresi Yang Penugasan di Kapal Perang

Personel militer mempunyai resiko yang tinggi menderita depresi karena sifat pekerjaan dan latihannya, perpisahan dengan keluarga, melaksanakan misi militer , berpindah-pindah tugas, penugasan di tempat yang sempit (kapal perang) dan terpapar dengan peristiwa maupun peralatan yang berbahaya. Pada penelitian oleh Al-Amri et al., di Arab Saudi dengan mengambil 357 sampel secara acak, didapatkan hasil prevalensi depresi sebesar 17,1% disuatu daerah operasi militer di Timur Tengah. PDSKJI (2017) melaporkan 3,7% dari populasi di Indonesia menderita gangguan depresi. Studi ini merupakan case report pre dan post test design sebanyak 4 pasien prajurit angkatan laut yang sudah didiagnosis menderita gangguan depresi berat yang akan mendapatkan terapi standar berupa antidepresan dan psikoterapi . Pertama-tama dilakukan assesment tingkat depresi dengan memakai BDI (Beck Depression Inventory) dan HDRS (Hamilton Depression Rating Scale). Terapi standar depresi diberikan terhadap kedua kelompok dan satu kelompok ditambah terapi augmentasi TMS , power disesuaikan dengan RMT ( resting motoric threshold), protokol terapi TMS dengan amplitudo 100% figh frequency 18 Hz , 2 sec dengan interval inter train 20 sec , 55 dan 59 train selama 20 menit sebanyak 5 X seminggu . Dari hasil studi ini, secara klinis seluruh pasien yang mendapat augmentasi TMS menunjukkan hasil perbaikan klinis yang lebih baik mulai minggu I terapi dengan penurunan skor BDI 15 poin dan HDRS 14 poin. Penurunan skore dengan selisih 6-8 poin pada skala BDI dan selisih 5-7 pada skala HDRS pada pasien yang mendapat terapi standar dibandingkan dengan yang mendapat terapi standar dan augmentasi TMS.

Prevalence and severity of depression in patients with the consequences of ischemic strokes and in patients with chronic brain ischemia

The aim of our study was to investigate the prevalence and severity of depression in patients with the consequences of ischemic strokes and in patients with chronic brain ischemia. Material and Methods. We examined 100 patients with consequences of ischemic strokes and 17 patients with chronic cerebral ischemia. The Hamilton Depression Rating Scale was used to assess the presence and degree of depression. Conclusions. Slightly less than half of the patients with chronic cerebral ischemia (47.1%) had no depression, 42.1% had mild depression, and only 11.8% of the patients had moderate and severe depression. A different situation was observed in the group of patients with the consequences of ischemic strokes. Among them, only 22.0% of patients had no depression, 44.0% had mild depression, and 34.0% of patients had moderate, severe, and extremely severe depression (p < 0.05).

Studying the relationship between tobacco use and depression between Egyptian patients

Background Although much attention has been drawn to trends in smoking and smoking related diseases in the general population, increasing evidence suggests that patients with mental illness are at a high risk for tobacco use and nicotine addiction. Cigarette smokers usually state the antidepressant and anxiolytic effects of smoking, but evidence reports that cigarette smoking may promote negative effect, so that the causal direction of this association still mysterious. It was reported that there is a cause effect relationship between cigarette smoking and depression as multiple studies mentioned that tobacco use increases the risk of symptoms of depression. The relationship between smoking and depression was attributed to genetic predisposition, low level of dopamine, low self-esteem, and coping styles. Aim of the Work The current study aimed to study the pattern of tobacco use among patients with depression, to study the degree of motivation to quit in patients with depression, and to assess severity of suicidal behavior among patients with depression using tobacco. Patients and Methods This is a case control study conducted in patients with the diagnosis of depression attending the outpatient clinic or inpatient of the institute of psychiatry Ain Shams University Hospitals during the academic year 2018-2019. The sample size was consisted of 100 patients and the patients were selected randomly. The relationship between tobacco use and depression between Egyptian patients was assessed using Socioeconomic status scale (SES), Hamilton Rating scale for Depression (HRSD), FagerströmTest for Nicotine Dependence (FTND), Lebanon Waterpipe Dependence Scale-11 (LWDS-11), Reason for quitting scale (RFQ), Columbia–Suicide Severity Rating Scale (C-SSRS), and ICD-10 symptom checklist for mental disorders. Results The present study showed a statistical significant association between the following scales; Fagerstrom Test for Nicotine Dependence (FTND) and Hamilton depression rating scale (HDRS), Difference score of Reason for quitting scale (RFQ) and Hamilton depression rating scale (HDRS), and Fagerstrom Test for Nicotine Dependence (FTND) and Columbia–Suicide Severity Rating Scale (CSSRS). Conclusion Compared to non-depressive persons, the results showed that depressive groups were less desired for quitting smoking.

PENGARUH PEMBERIAN TERAPI ANTIPSIKOTIK KOMBINASI TERHADAP TINGKAT DEPRESI PASIEN SKIZOFRENIA DI UPT PUSKESMAS TALUN KABUPATEN BLITAR

Skizofrenia merupakan penyakit psikiatrik kronis yang banyak menimbulkan masalah psikologis. Penatalaksanaannya dengan memberikan obat antipsikotik, diberikan dalam bentuk kombinasi. Penggunaan yang tidak tepat dapat menyebabkan terjadinya depresi dan kemungkinan mengalami efek samping terapi. Oleh karena itu perlu diukur efektifitas terapi yang diukur melalui tingkat depresi meliputi depresi ringan, sedang, berat, sangat berat.Penelitian ini merupakan penelitian observasional dengan pendekatan cross sectional. Penelitian ini melibatkan 58 responden. Pengambilan data dilakukan dengan cara retrospektif, kemudian dilanjutkan dengan wawancara terstruktur oleh peneliti dibantu oleh asisten peneliti dengan instrument kuesioner Hamilton Depression Rating Scale (HDRS). Penelitian ini dilakukan pada penderita skizofrenia di UPT Puskesmas Talun Kabupaten Blitar pada bulan April-Juli 2020. Dilakukan uji validitas dan reliabilitas pada kuesioner Hamilton Depression Rating Scale (HDRS). Pengaruh pemberian terapi antipsikotik kombinasi terhadap tingkat depresi dilakukan menggunakan uji Kruskal Wallis, dan didapatkan bahwa probabilitas > alpha (5%), tidak terdapat perbedaan yang signifikan pada pemberian antipsikotik kombinasi, dan dilaporkan pula efek samping berupa ekstrapiramidal ringan, ekstrapiramidal berat dan tremor. Pada kombinasi I dilaporkan terjadi efek samping ektrapiramidal ringan 1 pasien, berat 1 pasien, tremor 1 pasien. Pada kombinasi II dilaporkan terjadi efek samping ekstrapiramidal ringan 2 pasien dan pada kombinasi III dilaporkan tidak ada kejadian efek samping.

Niveles de ansiedad y depresión en directivos escolares de las regiones Altoandinas del Perú

La nueva COVID-19 ejerció una influencia adversa en los sistemas educativos del mundo, especialmente desde que se comenzó con el cierre de las escuelas. El objetivo de este estudio fue evaluar la prevalencia de ansiedad y depresión en directivos de escuelas de las provincias de Puno y San Román de la región de Puno-Perú. Se aplicaron encuestas en línea de HARS (Hamilton Anxiety Rating Scale) y HDRS (Hamilton Depression Rating Scale) durante los meses de septiembre y octubre de 2020 a 326 directivos: varones (184) y mujeres (142) cuyas edades oscilaban entre 35 a 63 años (Edad promedio = 45,65 ± 7,54 años). Los resultados indican que la prevalencia de ansiedad y depresión fue mayor para directoras que para directores. En conclusión, la prevalencia global de ansiedad en los directivos de dichas provincias, fue de 15,34%, con mayor prevalencia de ansiedad para las directoras (16,90%) que para los directores (14,13%); mientras que la prevalencia global de depresión fue de 16,87% con mayor prevalencia para las directoras (19,01%) que para los directores (15,22%). La prevalencia de ansiedad y depresión están asociadas con la edad, el sexo y la ubicación de la escuela donde labora el directivo (todos con P < 0,0005).

The Relationship between Menopause and Depression in Padang

Objectives: to analyze the relationship between menopause and depression in PadangMethods : This type of research is an analytical observational with a comparative cross sectional approach that looks at the relationship between menopause and depression incidence. The research was conducted in the working area of the Padang City Health Center from April to June 2020. The instrument used in this study was the Hamilton Depression Rating Scale (HDRS / Ham-D) which was used to measure the level of depression and a questionnaire to ask questions related to the characteristics of the respondents.Results: A study was conducted on 170 people consisting of 85 respondents who had menopause and 85 respondents who had not yet menopause. Conclusion: As many as 50 (58.8%) menopausal respondents experienced depression and 35 (41.2%) respondents did not experience depression. There is a relationship between menopause and depression (p <0.05). There was a relationship between age, current medical history, income, occupation, and education level with the incidence of depression (p <0.05). There is no relationship between menopause duration, marital status, and BMI with depression incidence (p> 0.05)Keywords: depression, Hamilton Depression Rating Scale , menoupause

Personality changes with subcallosal cingulate deep brain stimulation in patients with treatment-resistant depression

Background: Deep brain stimulation (DBS) is a promising investigational approach for treatment-resistant depression. However, reports suggesting changes in personality with DBS for movement disorders have raised clinical and ethical concerns. We prospectively examined changes in personality dimensions and antidepressant response to subcallosal cingulate (SCC)-DBS for treatment-resistant depression. Methods: Twenty-two patients with treatment-resistant depression underwent SCC-DBS. We used the NEO Five-Factor Inventory for personality assessment at baseline and every 3 months until 15 months post-DBS. We assessed depression severity monthly using the Hamilton Depression Rating Scale. Results: We found a significant decrease in neuroticism (p = 0.002) and an increase in extraversion (p = 0.001) over time, showing a change toward normative data. Improvement on the Hamilton Depression Rating Scale was correlated with decreases in neuroticism at 6 months (p = 0.001) and 12 months (p < 0.001), and with an increase in extraversion at 12 months (p = 0.01). Changes on the Hamilton Depression Rating Scale over time had a significant covariate effect on neuroticism (p < 0.001) and extraversion (p = 0.001). Baseline openness and agreeableness predicted response to DBS at 6 (p = 0.006) and 12 months (p = 0.004), respectively. Limitations: Limitations included a small sample size, a lack of sham control and the use of subjective personality evaluation. Conclusion: We observed positive personality changes following SCC-DBS, with reduced neuroticism and increased extraversion related to clinical improvement in depression, suggesting a state effect. As well, pretreatment levels of openness and agreeableness may have predicted subsequent response to DBS. The NEO Five-Factor Inventory assessment may have a role in clinical decision-making and prognostic evaluation in patients with treatment-resistant depression who undergo SCC-DBS.