Impact of Psychological Disorders on Clinical Presentation of Pediatric Patients Following a Concussion

ObjectiveTo examine differences in clinical symptom measures between pediatric patients with a history of depression and/or anxiety and no history of psychological disorders (PD) following a concussion.BackgroundLimited information exists regarding impact of pre-existing psychological disorders on initial clinical presentation in pediatric patients following concussion.Design/MethodsData were prospectively collected from participants aged 5–18 diagnosed with a concussion between August 2015 and March 2020. Demographics and clinical measures from initial presentation were reviewed, including SCAT-5 Symptom, Patient Health Questionnaire (PHQ-8), Generalized Anxiety Disorder (GAD-7) scale, and Brief Resiliency Scale (BRS). Participants were separated into 4 groups based on self-reported prior diagnosis: depression, anxiety, both, and no PD.ResultsOne thousand seven hundred seventy participants included: 50 depression, 82 anxiety, 84 both, and 1,554 no PD history. There was no significant difference in age, sex, prior concussion history, or time to presentation between the depression and no PD group, or the anxiety and no PD group. The both group was older, had more females and prior concussions, and presented later than the no PD group. The depression, anxiety, and both groups had higher rates of learning disorders than the no PD group (40%, 47.6%, 46.4% vs 16.4%, all p < 0.001). Each PD group had higher symptom severity scores than the no PD group. The PD groups all reported higher GAD-7 and PHQ-8 scores and lower BRS scores compared to the no PD group. The both group had the highest symptom severity, GAD-7, and PHQ-8 scores along with the lowest BRS score. All findings p = 0.001.ConclusionsDifferences were seen in participants with a history of depression and/or anxiety at initial clinical presentation, including history of learning disability, symptom severity scores, and screening tests for depression, anxiety, and resiliency compared to those without a history of PD. Understanding differences at initial presentation may urge providers to engage multidisciplinary teams in facilitating patient recovery.

Mental health and conspirasism in health care professionals during the spring 2020 COVID-19 lockdown in Greece

Introduction: The aim of the study was to investigate mental health and conspiracy theory beliefs concerning COVID-19 among Health Care Professionals (HCPs). Material and Methods: During lockdown, an online questionnaire gathered data from 507 HCPs (432 females aged 33.86±8.63 and 75 males aged 39.09±9.54). Statistical Analysis: A post-stratification method to transform the study sample was used; descriptive statistics were calculated. Results: Anxiety and probable depression were increased 1.5-2-fold and were higher in females and nurses. Previous history of depression was the main risk factor. The rates of the believing in conspiracy theories concerning the COVID-19 were alarming with the majority of individuals (especially females) following some theory to at least some extend. Conclusions: The current paper reports high rates of depression, distress and suicidal thoughts in the HCPs during the lockdown, with a high prevalence of beliefs in conspiracy theories. Female gender and previous history of depression acted as risk factors while the belief in conspiracy theories might act as a protective factor. The results should be considered with caution due to the nature of the data (online survey on a self-selected but stratified sample)

Incidence and Risk Factors for Postpartum Depression among Women with Preterm Prelabor Rupture of Membranes

Objective Patients admitted for preterm prelabor rupture of membranes are more likely to have risk factors for postpartum depression, including preterm delivery, low-birthweight infants, and a stressful life event. However, there is a paucity of data characterizing the development of postpartum depression in this population. We aim to evaluate the incidence of and describe risk factors for postpartum depression among patients admitted with preterm prelabor rupture of membranes. Study Design This is a retrospective cohort study of patients admitted for preterm prelabor rupture of membranes in a single health system between 2013 and 2019. Patients who developed depression were compared with patients who did not develop depression. Demographic, antepartum/intrapartum/postpartum, and neonatal characteristics were compared. Bivariate statistics were used to compare outcomes and logistic regression was used to estimate adjusted odds ratios. Results Of 132 included patients with preterm prelabor rupture of membranes, 25 (18.9%) had postpartum depression. Factors significantly (p < 0.05) associated with postpartum depression included history of depression, anxiety, or any prior mental health condition. Earlier admission gestational age, rupture of membranes < 28 weeks, earlier delivery gestational age, neonatal morbidity, and neonatal necrotizing enterocolitis also were significantly associated with postpartum depression. Latency, maternal postpartum length of stay, and neonatal intensive care unit length of stay were not significantly associated. In regression models, only a history of depression (odds ratio [OR], 11.89; 95% confidence interval [CI], 2.78–50.95) and neonatal morbidity (OR, 5.01; 95% CI, 1.15–21.89) remained associated with postpartum depression. Conclusion Postpartum depression occurred in nearly one in five patients with preterm prelabor rupture of membranes. Pre-existing depression and adverse neonatal outcomes strongly predicted postpartum depression. There is an urgent need to prioritize maternal mental health among patients with preterm prelabor rupture of membranes in the peripartum period. Further research is needed to identify optimal resources for mitigating the risk of postpartum depression in this cohort. Key Points

Association between depression and the risk of Alzheimer’s disease using the Korean National Health Insurance Service-Elderly Cohort

In this cohort study, we assessed the association between depression and the risk of Alzheimer’s disease from data obtained from the 2002 to 2013 Korean National Health Insurance Service-Elderly Cohort Database, which accounts for 10% of the South Korean population aged > 60 years. A total 518,466 patients were included in the analysis and followed up, unless they were excluded due to death or migration. Patients who sought treatment for depression or dementia within 1 year of the washout period and who were diagnosed with dementia within the 1-year period of the diagnosis of depression were excluded from the study. The risk of dementia was analysed using Cox proportional hazards models. Patients with a history of depression during the follow-up period were at a higher risk of Alzheimer’s disease than those without a history of depression (HR 3.35, CI 3.27–3.42). The severe-depression group exhibited the highest risk of Alzheimer’s disease (HR 4.41, CI 4.04–4.81), while the mild-depression group exhibited a relatively lower risk of Alzheimer’s disease (HR 3.31, CI 3.16–3.47). The risk of Alzheimer’s disease was associated with depression history and an increased severity of depression increased the risk of Alzheimer’s disease.

Delirium, depression, and long-term cognition

ABSTRACT Objectives: We examined whether preadmission history of depression is associated with less delirium/coma-free (DCF) days, worse 1-year depression severity and cognitive impairment. Design and measurements: A health proxy reported history of depression. Separate models examined the effect of preadmission history of depression on: (a) intensive care unit (ICU) course, measured as DCF days; (b) depression symptom severity at 3 and 12 months, measured by the Beck Depression Inventory-II (BDI-II); and (c) cognitive performance at 3 and 12 months, measured by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) global score. Setting and participants: Patients admitted to the medical/surgical ICU services were eligible. Results: Of 821 subjects eligible at enrollment, 261 (33%) had preadmission history of depression. After adjusting for covariates, preadmission history of depression was not associated with less DCF days (OR 0.78, 95% CI, 0.59–1.03 p = 0.077). A prior history of depression was associated with higher BDI-II scores at 3 and 12 months (3 months OR 2.15, 95% CI, 1.42–3.24 p = <0.001; 12 months OR 1.89, 95% CI, 1.24–2.87 p = 0.003). We did not observe an association between preadmission history of depression and cognitive performance at either 3 or 12 months (3 months beta coefficient −0.04, 95% CI, −2.70–2.62 p = 0.97; 12 months 1.5, 95% CI, −1.26–4.26 p = 0.28). Conclusion: Patients with a depression history prior to ICU stay exhibit a greater severity of depressive symptoms in the year after hospitalization.

Lifetime Prevalence and Risk Factors for Perinatal Depression in a Large Cohort of Women with Depression

ObjectivesAmongst women with a history of depression, this study sought to identify risk factors associated with reporting perinatal depression (PND)). Lifetime prevalence, length and severity of PND were evaluated, as well as the effect of PND onset either after previous depression episodes, or as the first episode of depression.SettingThe Australian Genetics of Depression Study (AGDS), an online case cohort study of the etiology of depression.ParticipantsIn a large sample of parous women who met DSM criteria for major depressive disorder (MDD) (n=7,182), we identified two subgroups of PND cases (Edinburgh Postnatal Depression Scale score >= 13) with and without prior depression history (n=2,261; n=878 respectively). For a range of risk factors, both subgroups were compared to women with MDD who did not report depressive symptoms in the perinatal period (non-perinatal depression (NPD) cases). PND cases with prior depression history were compared to NPD cases with depression onset before their first pregnancy (n=672). PND cases without prior depression history were compared to all NPD cases (n=2,124).Primary and secondary outcome measuresDescriptive measures reported lifetime prevalence, length, and severity of PND. Logistic regression compared a range of characteristics of PND cases to those of the comparison group of NPD cases.ResultsOf women who experienced depression prior to first pregnancy, PND cases were significantly more likely to report more episodes of depression (OR=1.1 per additional depression episode, CI=[1.1-1.1], P=1.9e-13), non-European ancestry (OR=1.5, CI=[1.0-2.1], P=3.4e-02), severe nausea during pregnancy (OR=1.3, CI=[1.1-1.6], P=6.6e-03) and emotional abuse (OR=1.4, CI=[1.1-1.7], P=5.3e-03). Women without any depression before their first perinatal episode were significantly more likely to report emotional abuse (OR=1.3, CI=[1.1-1.6], P=1.0e-02) than women with NPD.ConclusionsThe majority of parous women in this study experienced PND, associated with more complex, severe depression. Results highlight the importance of perinatal assessments of depressive symptoms, particularly for women with a history of depression or childhood adverse experiences.

Association between Toxoplasma gondii Infection in Brain and a History of Depression in Suicide Decedents: A Cross-Sectional Study

We assessed the association between Toxoplasma gondii (T. gondii) infection of the central nervous system and suicide correlates in suicide decedents. Eighty-seven decedents who died by suicide received in a forensic setting for medico-legal autopsies in Mexico City were studied. Two samples of brain (amygdala and prefrontal cortex) from each decedent were examined for detection of T. gondii using immunohistochemistry. Correlates of suicide including a history of previous suicide attempts, co-morbid mental disorder, consumption of alcohol or tobacco, irritability and aggression, economic problems, presence of drugs or alcohol in blood and suicide method were obtained and analyzed for their association with T. gondii infection. T. gondii immunohistochemistry was positive in prefrontal cortex sections in 6 decedents and in an amygdala section in one decedent. Thus, the prevalence of T. gondii infection in brain in suicide victims was 8.0% (7/87). Bivariate and logistic regression analysis of suicide correlates showed that only a history of depression was associated with T. gondii infection of the brain in suicide victims (OR: 12.00; 95% CI: 2.26–63.46; p = 0.003). Our results provide evidence that T. gondii infection in brain is associated with a history of depression in suicide decedents.

Domperidone Withdrawal in a Nursing Female with Pre-existing Psychiatric Illness: Case Report

Background: In this report, we describe a case of domperidone withdrawal in a woman with a history of major depressive disorder and obsessive-compulsive disorder (OCD) who experienced a recurrence of these disorders after stopping domperidone. Case presentation: The symptoms improved after the restarting of domperidone and disappeared gradually as the drug was tapered and discontinued. Clinicians should consider domperidone withdrawal a differential diagnosis in women with a history of depression or anxiety who present with an acute onset of these symptoms following the abrupt discontinuation of domperidone. Conclusion: A gradual taper off of the drug may be effective in minimizing withdrawal symptoms and obviate the need for psychotropic drug use.

An exploration of the sociodemographic and health conditions associated with self-rated wellbeing for Aboriginal and Torres Strait Islander adults

Objective To identify sociodemographic factors and health conditions associated with self-rated wellbeing for Aboriginal and Torres Strait Islander adults. Participants were recruited via investigator networks and an online panel provider with an established nationwide panel of Aboriginal and Torres Strait Islander adults. Those interested were invited to complete a survey that included an assessment of wellbeing using a visual analogue scale. Data was collected from October–November 2019 and August–September 2020. Exploratory analyses were conducted to ascertain factors associated with self-rated wellbeing for Aboriginal and Torres Strait Islander adults. Results Having more than enough money to last until next pay day, full-time employment, completion of grade 12, having a partner, and living with others were significantly associated with higher wellbeing among Aboriginal and Torres Strait Islander adults. A self-reported history of depression, anxiety, other mental health conditions, heart disease, or disability were associated with lower self-rated wellbeing scores. Our findings indicate a need for further investigation among these socioeconomic and patient groups to identify how to improve and support the wellbeing of Aboriginal and Torres Strait Islander adults.