摘要:目的:观察伴有抑郁症状的心力衰竭患者加用黛力新干预的疗效。方法: 65例用Zung抑郁自评量表检测评测诊断为抑郁症并心力衰竭患者,将患者分为黛力新治疗组及对照组,治疗组在常规治疗基础上加用黛力新(2片/d),治疗1个月后再行Zung抑郁自评量表粗分及24项症状统计,同时观察治疗前后患者心功能改善情况。结果: 35例治疗组患者心功能的改善及Zung抑郁自评量表检测粗分及24项症状改善明显优于对照组。〖HTH〗结论〖HTSS〗: 黛力新使心衰患者的抑郁症状很快得到改善,并提高了心力衰竭的疗效。Abstract: Objective: To observe the curative efficacy of deanxit to the patients suffering by heart failure with depression. Methods: Sixtyfive patients who were diagnosed as depression by Zung Selfrating Depression Scale are into deanxit treatment group and control group,and treatment group receive the treatment with two pieces of deanxit everyday besides the conventional therapy.After a month,we count the Zung selfrating depression scale score and study the24 symptoms,at the same time,we observed the change of cardiac function in the patients. Results:The curative efficacy in the treatment group is better than those in the control group with improvement in cardiac function and Zung selfrating depression scale score and the alleviation for 24 symptoms. Conclusion:Deanxit can alleviate symptoms of depression in patients with heart failure soon and increase the efficacy of heart failure.
Objective To evaluate the clinical effectiveness and safety of escitalopram in the treatment of major depression. Methods A randomized double-blind active-drug controlled trial was used to observe 56 patients with major depression. They were randomly divided into the treatment group (escitalopram, 28 patients) and the control group (citalopram, 28 patients). We used HAMD,CGI-I, and HAMA to evaluate clinical effectiveness and symptom-recording to evaluate safety. All outcomes were measured before treatment and at 14 days, 28 days and 42 days after treatment. Results According to an intention-to-treat (ITT) analysis in the Full Analysis Set with last observation carried forward (LOCF), the HAMD score decreased from baseline by 15.1±7.8 in the treatment group, and 12.1±7.7 in the control group. There was no significant difference between the two groups(t=1.42,P=0.1613). The rate of effectiveness, based on the percentage decrease of HAMD is 78.6% in the treatment group, and 67.9% in the control group(χ2 = 0.8195,P=0.3653). The HAMA score decreased from 15.1±3.7 to 3.3±4.5 in the treatment group, and from 14.0±4.1 to 5.0±3.7 in the control group(t=1.5756, P=0.1223). From the point of CGI, there was no significant difference between these two groups at any follow-up. At the end of the trial, the proportion of patients assessed to have a great improvement or more was 90.0% in the treatment group, and 87.8% in the control group (CMH=1.5013,P=0.2205). Side effects were recorded for 32.5% of the treatment group and 30.8% of the control group(χ2 =0.0770, P=0.7814). The most frequent side effects were nausea(11.7%), dry mouth(9.2%), dizziness(5.8%), insomnia(3.3%), hypodynamia(2.5%), transaminase elevation(1.7%), palpitation(1.7%), and constipation(1.7%). Conclusion The therapeutic action of escitalopram for the treatment of major depression is confirmed with less side effects than the well-proven antidepressant- citalopram.
Psilocybin is a hallucinogenic indole alkaloid derived from mushrooms, which is metabolized into psilocin in vivo and exerts biological effects. Clinical studies have shown that psilocybin has the effect of relieving anxiety and depression in cancer patients. Due to its fast onset, significant therapeutic effect, and low addictive nature, psilocybin has the potential to break through the bottleneck of slow action and poor efficacy of existing depression drugs, bringing new hope for the treatment of severe depression and refractory depression. This article will review the pharmacokinetics, antidepressant mechanisms, and research progress of psilocybin, providing a reference for subsequent research.
ObjectiveTo explore the distribution pattern of respiratory symptoms and relevant factors in patients with pulmonary nodules. MethodsDemographic and clinical information were collected from patients who visited the Thoracic Surgery Outpatient Clinic of Guangdong Provincial People’s Hospital from January 2021 to January 2022. Hospital Anxiety and Depression Scale (HADS) was used to assess their anxiety and depression level. ResultsA total of 1173 patients were enrolled, including 449 males and 724 females, with an average age of 46.94±11.43 years. Among the patients with pulmonary nodules, 37.7% of them had at least one respiratory symptom; 24.4% had cough, 14.0% had expectoration, 1.3% had hemoptysis and 14.9% had chest pain. Old age, male, exposure to second-hand smoking or environmental smoke, hair coloring and history of tuberculosis were major risk factors for respiratory symptoms (P<0.05). Middle age, old age, male, exposure to environmental smoke were major risk factors for cough (P<0.05); old age, smoking, larger maximum nodules diameters, exposure to environmental smoke and history of pneumonia were major risk factors for expectoration (P<0.05); male, multiple nodules, hair coloring, exposure to second-hand smoking and history of tuberculosis were major risk factors for chest pain (P<0.05). Symptomatic patients showed generally higher HADS scores than asymptomatic patients (P<0.001). ConclusionCough, expectoration and chest pain are the predominant respiratory symptoms for patients with pulmonary nodules. The presentation of respiratory symptoms increases patients' anxiety and depression.
In order to explore effective ways to reduce non-suicidal self-injury (NSSI) among female adolescents, a total of 45 female adolescent patients with NSSI in West China Hospital of Sichuan University and Guizhou Second Provincial People's Hospital from June 2021 to June 2024 were selected randomly that divided into groups A, B and C, with 15 cases in each group. Group A was treated with repeated transcranial magnetic stimulation (rTMS) and bipolar depression triple therapy, and group B was treated with bipolar depression triple therapy to compare the effectiveness and safety. Group C received bipolar depression triple therapy combined with sham stimulation which only produced stimulating sounds but no stimulating magnetic field as a control in the study. After treatment, the Hamilton Anxiety Score (HAMA), Hamilton Depression Score (HAMD) and Nurses’ Global Assessment of Suicide Risk (NGASR) in group A were significantly lower than those in group B and C (P < 0.01). rTMS combined with bipolar depression triple therapy has a definite effect on reducing NSSI in female adolescents, which can reduce the incidence rate of short-term NSSI behavior in patients.
Objective To study the effect of surgical treatment with core depression and allo-fibular grafting on osteonecrosis of the femoral head in early stages. Methods From June 1998 to August 2004, 22patients with necrosis of the femoral head (39 hips) were treated with core depression and allo-fibular grafting, indluding 17 males and 5 females. Necrosis was classified as Stages Ⅰ-Ⅲ according to ARCO classification system. Their ages ranged from 22 to 60 years and pain duration was 2 to 12 months preoperatively (6.5 months on average). The regular examinations of joint function, X-ray, ECT,CT and MRI were conducted before surgerg and after 15 days, 3 months, and 6 months of surgery. Results All patients were followed up for 3 to 74 months (31.4 months on average). Symptoms 17 of the patients were relievedevidently. Harris hip score from 78 points preoperatively to 91.6 points.The X-ray films 18 of the patients showed that the geography of the hip joint kept intact with no deterioration. Osteogenesis was observed by regular examinations. Two cases (4 hips, 10.25%) were revised by total hip replacement, and 3 cases (4hips, 10.25%) without THR worsened postoperatively. Conclusion The method is less traumatic than common procedures. The joint function can berecovered within 2.4 weeks. Clinical symptoms are greatly improved. This method is effective at least in short term and the long-term effect needs further study.
Anxiety is a strong behavioral and psychological reaction with fear components, while depression is a mental disorder dominated by high or low mood, both of which are accompanied by cognitive and behavioral changes, and are common comorbidities in patients with heart disease. Cardiac surgery is one of the important factors which trigger specific emotional and physiological reactions of patients. Persistent or initial depression and anxiety after surgery will not only increase surgical complications, short- or long-term mortality and medical costs, but also seriously affect patients' social function and quality of life. With the transformation of bio-psycho-social medical model, it is necessary to evaluate the perioperative psychological state and biological risk of patients undergoing cardiac surgery. This article reviews the characteristics, related mechanisms and therapeutic interventions of anxiety and depression in patients undergoing cardiac surgery.
Objectives To evaluate the effectiveness of different antidepressant drugs in addition to standard clinical care in the prevention of postnatal depression. To compare the effectiveness of different antidepressant drugs and with any other form of intervention for postnatal depression i.e. hormonal, psychological or social support. To assess any adverse effects of antidepressant drugs in either the mother or the foetus/infant.Methods The register of clinical trials maintained and updated by the Cochrane Depression, Anxiety and Neurosis Group and the Cochrane Pregnancy and Childbirth Group.Randomised studies of antidepressants alone or in combination with another treatment, compared with placebo or a psychosocial intervention in non-depressed pregnant women or women who had given birth in the previous six weeks (i.e. women at risk of postnatal depression). Data were extracted independently from the trial reports by the authors.Missing information was requested from investigators wherever possible. Data were sought to allow an intention to treat analysis.Results Two trials fullled the inclusion criteria for this review. Both looked at women with a past history of postpartum depression.Nortriptyline (n=26) did not show any benefit over placebo (n=25). Sertraline (n=14) reduced the recurrence of postnatal depression and the time to recurrence when compared with placebo (n=8). Intention to treat analyses were not carried out in either trial.Conclusions It is not possible to draw any clear conclusions about the effectiveness of antidepressants given immediately postpartum in preventing postnatal depression and, therefore, cannot be recommended for prophylaxis of postnatal depression, due to the lack of clear evidence. Larger trials are needed which also include comparisons of antidepressant drugs with other prophylactic treatments to reect clinical practice, and examine adverse effects for the foetus and infant, as well as assess womens’ attitudes to the use of antidepressants at this time.
Objective To investigate the current situation of anxiety and depression in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and analyze the related influencing factors. Methods A questionnaire survey was conducted among AECOPD patients admitted to the Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Anhui Medical University from August 2022 to October 2023. The survey included basic demographic information, anxiety and depression scores, quality of life and dyspnea symptoms in the AECOPD patients. The clinical data of patients in the electronic medical record system were also collected. According to the anxiety score or depression score, the patients were divided into an anxiety group and a non-anxiety group, or a depression group and a non-depression group. The indicators between two groups were compared and the influencing factors were analyzed. Results Among the 164 patients with AECOPD, 123 patients (75.0%) were complicated with anxiety, 125 patients (76.2%) were complicated with depression, and 105 patients (64.0%) were complicated with anxiety and depression. Education level, place of residence, monthly income, smoking index, and chronic obstructive pulmonary disease assessment test (CAT) score were associated with AECOPD and anxiety (P<0.05). Higher CAT score was an independent risk factor for anxiety in the patients with AECOPD. Residence, monthly income, smoking index, CAT score, modified British Medical Research Council (mMRC) dyspnea questionnaire rating, actual bicarbonate, neutrophilic granulocyte percentage (NEU%), lymphocyte percentage (LYM%), basophile percentage (BASO%), alkaline phosphatase, total carbon dioxide concentration, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were associated with AECOPD and depression (P<0.05). Among them, higher CAT score and PLR value were independent risk factors of AECOPD and depression. Conclusion Anxiety and depression have higher prevalence in AECOPD patients, and the influencing factors include quality of life, dyspnea symptoms, education level, place of residence, monthly income, smoking index, acid base balance, NEU%, LYM%, BASO%, NLR和PLR, etc.
Objective To evaluate the effectiveness and safety of both olanzapine combined with fluoxetine (combination therapy) and fluoxetine (monotherapy) for refractory depression. Methods According to the computer retrieval from PubMed (1966 to September 2009), Cochrane Library (Issue 3, 2009), EMbase (1974 to September 2009), SCI (1974 to September 2009), CNKI (1994 to September 2009), CBM (1978 to September 2009), CSJD (1989 to September 2009) and Wanfang Database (1997 to September 2009), and the manual retrieval from related journals and conference proceedings were conducted, to include randomized controlled trials of comparison in between olanzapine combined with fluoxetine and fluoxetine in treating refractory depression. We collected the valid data after assessing the methodology quality of included studies on the basis of Jadad scoring standard, and conducted meta-analysis with RevMan 5.0 software. Results A total of 7 studies with 1 230 patients were included. The meta-analysis showed that, there was no significant difference between two groups about the scores of HAMA (Hamilton Anxiety Scale) at the end of the 1st week, but the olanzapine combined with fluoxetine in trial group was much better for relieving anxiety situation compared to fluoxetine in control group at the end of the 2nd, 4th, 8th and 12th week. In accordance with the scores of CGI (Clinical Global Impression Scale), there was no significant difference at the end of 2nd and 4th week after treatment, but there was a significant difference at the end of 8th and 12th week. As to the changes of MADRS (Montgomery and Asberg Depression Rating Scale), the trial group was much distinct than control group at the end of the 1st, 2nd, 4th and 8th week. In summary, the clinical effect of trial group was superior to that of control group, and there was no significant difference in adverse reactions between two groups (RR=1.10, 95%CI 0.99 to 1.23). Conclusion Current evidence shows that, the clinical effect and safety of olanzapine combined with fluoxetine in treating refractory depression is obviously superior to that of fluoxetine.