Objective To observe the serum levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), platelet 5-HT and blood platelet count, emotion and burn injury healing of patients with moderate and severe burn injury and anxiety-depression symptoms. Methods In-patients with moderate and severe burn injury were selected from 2003.4 to 2005.2 and then divided into anxiety-depression group and control group according to their anxiety-depression scores by Hamilton Rating Scale for Depression (HAMD ) and Hamilton Rating Scale for Anxiety (HAMA) 3 days after being burnt. Routine therapy was given to two groups, which lasted 1 month. Their scores of anxiety and depression and the degree of injury healing were observed, and the serum levels of TNF-α and IL-6, platelet 5-HT and blood platelet count were measured in the two groups. Results Fifty-one in-patients with moderate and severe burn injury were divided into the anxiety-depression group (24 cases) and the control group (27 cases). After 30-day treatment, the depression scores did not decrease in the anxiety-depression group (P=0.12), but the anxiety scores decreased (P=0.00). In the anxiety-depression group, the burn injury healing time was postponed (P=0.00), the serum levels of TNF-α increased (P=0.00), and the platelet 5-HT levels decreased (P=0.04) before and after treatment. Conclusion Depressive reaction occurs in patients with moderate and severe burn injury, which is a continuously negative emotion. It can lead to high levels of serum TNF-α, reduction in platelet 5-HT, and delayed burn injury healing time. Due to the limited sample size and different location of patients, there may be some bias in this conclusion. We are prepared to increase the sample size and select patients in the same region in further relevant studies.
Objective To assess the effectiveness of psychotherapy for depression in older patients. Methods We searched the Cochrane Central Register of Controlled Trials (1990 to August 2007), MEDLINE (1966 to August 2007), EMbase (1980 to August 2007), and CMB-disk (1990 to August 2007) to collect randomized controlled trials (RCTs) in which psychotherapy was used to treat depression in older patients. We screened the retrieved studies according to the predefined inclusion and exclusion criteria, evaluated the quality of included studies, and performed meta-analyses by using The Cochrane Collaboration’s RevMan 4.2 software. Results Ten RCTs were included. Compared with placebo, psychotherapy was more effective in decreasing depression score (SMD 0.63, 95%CI – 0.84 to – 0.42). Subgroup analysis showed that cognitive-behavioral therapy, reminiscence therapy, and general psychological therapy were more effective than placebo (SMD – 0.70, 95%CI – 1.12 to – 0.27; SMD – 0.54, 95%CI – 0.81 to – 0.26; SMD – 0.84, 95%CI – 1.34 to – 0.34, respectively). However, psychotherapy as an adjunct treatment could not significantly improve the effectiveness of antidepressant medication (SMD – 0.35, 95%CI – 0.74 to 0.05). There was no significant difference between cognitive-behavioral therapy and reminiscence therapy in improving depression symptoms (SMD 0.13, 95%CI – 0.30 to 0.56). The dropout rate was similar between patients treated with or without psychotherapy (RR 1.03, 95%CI 0.55 to 1.94). Conclusion Various kinds of psychotherapy are effective for depression in older patients. But psychotherapy as an adjunct treatment could not significantly improve the effectiveness of antidepressant medication.
ObjectiveTo systematically review the effect of different psychological intervention methods on depressive symptoms in patients with inflammatory bowel disease. MethodsPubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect randomized controlled trials(RCTs) on psychological interventions on depression of patients with inflammatory bowel disease from inception to January 12, 2023. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Network meta-analysis was then conducted by using software Stata and GeMTC. ResultsA total of 18 articles, 1 567 patients and 6 psychological intervention methods were included. The results of the network meta-analysis showed that, compared with conventional nursing, music therapy, mindfulness therapy and cognitive behavioral therapy had statistically significant differences in the intervention effect of depression in patients with inflammatory bowel disease (P<0.05); Among the six psychological intervention methods included, there was a statistically significant difference in relaxation therapy compared with music therapy, writing expression and mindfulness therapy (P<0.05); The difference between cognitive behavioral therapy and music therapy and mindfulness therapy was statistically significant (P<0.05), while there was no statistically significant difference in other interventions (P>0.05). The SUCRA ranking probability chart showed that music therapy was the best intervention method for depression in patients with inflammatory bowel disease, followed by mindfulness therapy and cognitive behavioral therapy. ConclusionThe current evidence suggests that music therapy has an advantage in relieving depression in patients with inflammatory bowel disease, followed by mindfulness therapy or cognitive behavioral therapy. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo compare the anxiety, depressive and personality characteristics between diabetes mellitus patients with or without diabetic retinopathy (DR), and look for psychological treatment and corresponding prevention measures. Methods435 diabetic patients were enrolled in this study from April to November 2014 in our hospital, including 178 DR cases (group A) and 257 cases without retinopathy (group B). All the patients completed a questionnaire, the Self-Rating Anxiety (SAS), the Self-Rating Depression Scale (SDS) and the big five personality scale (NEO-FFI), and were scored by eye doctors. According to the score, SAS can be divided into mild anxiety, moderate anxiety, and severe anxiety. SDS is divided into depression, mild depression, moderate depression and major depression. NEO-FFI was scored from emotional stability, outgoing, openness, easy-going and sense of responsibility. Multiple linear regression analysis was used to analyze the DR risk factors in those scores and education level, high blood pressure, age, alcohol consumption, occupation and other factors. ResultsThere were 110 cases of mild anxiety, 57 cases of moderate anxiety, 11 cases of severe anxiety; 74 cases without depression, 53 cases of mild depression, 31 cases of moderate depression, 20 cases with major depression in group A. There were 181 cases of mild anxiety, 53 cases of moderate anxiety, 23 cases of severe anxiety; 177 cases without depression, 44 cases of mild depression, 25 cases of moderate depression, 11 cases with major depression in group B. Group A patients had higher SAS, SDS scores than group B, the difference was statistically significant (P=0.035). Group B patients had higher NEO-FFI score in outgoing, easygoing, responsibility (P=0.022), lower NEO-FFI score in emotional stability (P=0.014) and same NEO-FFI score in openness(P=0.210)compare to Group A patients. Multiple linear regression analysis results showed that education level, high blood pressure, age, weight, drinking, occupation can affect the degree of changes in the retina (P=0.019). ConclusionsCompared with those without retinopathy, DR patients were more prone to anxiety and depression. They also had low score in personality characteristics of outgoing, easygoing, responsibility.
ObjectiveTo systematically evaluate the effects of cognitive behavioural therapy (CBT) on improving depression, medication adherence and quality of life in people living with HIV/AIDS (PLHIV). MethodsWe searched The Cochrane Library (Issue 4, 2013), Ovid-JBI, PubMed, EMbase, PsycARTICLES, CBM and CNKI to collect randomized controlled trials (RCTs) on improving depression, medication adherence and quality of life in PLHIV from the establishment dates to April 30th 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality. Meta-analysis was conducted using RevMan 5.2. ResultsA total of 17 RCTs were included, involving 2 163 patients. The results of meta-analysis showed that CBT significantly improved PLHIV's depression (SMD=-0.26, 95%CI-0.41 to-0.10, P=0.001), and quality of life (SMD=-0.57, 95%CI-1.04 to-0.11, P=0.02) in 6 months. Meanwhile, CBT significantly improved PLHIV's medication adherence (WMD=3.98, 95%CI 1.67 to 6.30, P=0.000 8) in the long term. ConclusionCBT is efficacious in improving PLHIV's depression and quality of life in the short term, and improving medication adherence in the long term, compared to standard care.
ObjectiveTo investigate the current status and influencing factors of self-care behavior of non-dialysis patients with chronic kidney disease (CKD).MethodsA total of 336 patients with CKD were investigated by a general data questionnaire, the CKD Self-care Behavior Scale, Social Support Scale, Generalized Anxiety Self-assessment Scale, and 9-item Patients Health Questionnaire through WeChat platform, and the influencing factors of self-care behavior were explored by binary logistic regression analysis.ResultsThe median score of self-care behavior of CKD patients without dialysis was 60, and the patients with median and high level of self-care behavior accounted for 97.6%. The score of self-care behavior of CKD patients without dialysis was positively correlated with the total score of social support (r=0.210, P<0.001), objective support score (r=0.127, P=0.020), subjective support score (r=0.195, P<0.001), and social support utilization score (r=0.164, P=0.002), and negatively correlated with the anxiety score (r=–0.132, P=0.015), depression score (r=–0.230, P<0.001), body mass index (r=–0.181, P=0.001), and systolic blood pressure (r=–0.168, P<0.001). The results of binary logistic regression analysis showed that the influencing factors of non-dialysis CKD patients’ self-care behavior were gender [(odds ratio, OR)=2.179, 95% confidence interval, CI (1.134, 4.187), P=0.019], systolic blood pressure [OR=0.967, 95%CI (0.947, 0.987), P=0.002], and depression score [OR=0.844, 95%CI (0.765, 0.931), P=0.001].ConclusionsThe self-care behavior of CKD patients without dialysis is at the median and high level. Healthcare workers can improve the self-care behavior of CKD patients by reducing their negative emotions such as depression, and guiding patients to carry out blood pressure management, to delay the progress of the disease.
ObjectivesTo systematically review the prevalence of depression in the elderly in China.MethodsPubMed, Web of Science, CBM, CNKI, WanFang Data and VIP databases were electronically searched to collect cross-sectional studies on the prevalence of depression of Chinese elderly from January 2010 to July 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 22 cross-sectional studies involving 12 656 patients were included. Meta-analysis showed that the overall prevalence of depression in Chinese elderly was 25.55% (95%CI 19.81% to 31.29%). Subgroup analysis showed that the prevalence of females was higher than that of males; the prevalence in the north was higher than that in the south; the prevalence in rural areas was higher than that in cities; the prevalence of CES-D assessment scale was higher than that of GDS-30; the prevalence of depression increased annually of data collection.ConclusionThe prevalence of depression in the elderly (aged 60 years and above) in China is high. More attention should be paid to this situation and more psychological intervention should be provided to the elderly. Due to the limited quantity and quality of the included studies, more high-quality studies are required to verify the above conclusion.
Objective To investigate the effect of music therapy plus selective serotonin reuptake inhibitors （SSRIs） on emotion and bum wound healing in bum patients. Methods Moderate and severe bum inpatient.s, aged 12-60 years were selected. Emotional problems were then measured by the Hamilton Rating Scale for Depression and Hamilton Rating Scale for Anxiety within three days after bum injury. Bum patients with depression and anxiety were randomly allocated into the trial group （28 patients） and the control group （27 patients）. Music therapy and SSRIs plus conventional burn care Were applied to the trial group, and conventional bum care to the control group, both for 30 days. The scores of anxiety, depression and the degree of bum wound healing were assessed. Results The differences of depression score and anxiety score before and after treatment were 13. 7 ±6.43 and 6.43 ±2.72 respectively in the trial group, and 4. 74 ±6.75 and 4.44 ±3.36 respectively in the control group. This showed both scores significantly improved compared with the control group （P 〈0. 05）. The time for burn wound healing was shortened in the treatment group （P 〈0. 05）. The anxiety score was positively correlated with bum index, and so was the depression score （P 〈 0.05 ）. Conclusions The anxiety and depression scores are positively correlated with the burn index. Music therapy plus SSrIs can ameliorate the emotional problems （ depression and anxiety）, and shorten the time for burn wound heating.
ObjectiveTo evaluate the reasonableness of anticoagulation management strategy in patients after mechanical heart valve replacement. MethodsAll patients were followed and registered continually at outpatient clinic from July 2011 to February 2013, with a minimum of 6 months after surgery. Targeted international normalized rate (INR) 1.60 to 2.20 and warfarin weekly dosage adjustment were used as the strategy of anticoagulation management. Except bleeding, thrombogenesis and thromboembolism, time in therapeutic range (TTR) and fraction of TTR (FTTR) were adopted to evaluate the quality of anticoagulation management. ResultsA total 1 442 patients and 6 461 INR values were included for data analysis. The patients had a mean age of 48.2±10.6 years (14-80 years) and the following up time were 6 to 180 months (39.2±37.4 months) after surgery. Of these patients, 1 043 (72.3%) was female and 399 (27.7%) was male. INR values varied from 0.90-8.39 (1.85±0.49) and required weekly doses of warfarin were 2.50-61.25 (20.89±6.93 mg). TTR of target INR and acceptable INR were 51.1% (156 640.5 days/306 415.0 days), 64.9% (198 856.0 days/306 415.0 days), respectively. FTTR of target INR and acceptable INR were 49.4% (3 193 times/6 461 times), 62.6% (4 047 times/6 461 times). There were 8 major bleeding events, 7 mild bleeding events, 2 thromboembolism events, and 2 thrombogenesis in the left atrium. ConclusionIt is reasonable to use target INR 1.60-2.20 and warfarin weekly dosage adjustment for patients after mechanical heart valve replacement.
ObjectiveTo evaluate the influence of personalized nursing intervention on the negative emotions after occupational exposure for nurses in the Emergency Department, in order to provide effective nursing intervention methods for relieving nurses' negative emotions after occupational exposure. MethodsTwenty nurses with occupational exposure between January and September 2013 were chosen to be the control group, and another 20 nurses with occupational exposure between October 2013 and October 2014 were designated as the personalized nursing group. The level of depression and anxiety was compared between the two groups by using the self-rating depression scale (SDS) and self-rating anxiety scale (SAS) on the exposure day and 5 weeks after the exposure. ResultsBefore intervention, SDS score of the control group was 0.65±0.04 and of the personalized nursing group was 0.63±0.05, and there was no statistically significant difference between the two groups (t=0.59, P=0.44); SAS score of the control group was 51.98±6.77 and of the personalized nursing group was 50.73±10.03, and there was no statistically significant difference between the two groups (t=0.37, P=0.70). After the intervention, personalized nursing group had lower scores of SDS and SAS than the control group. SDS score was 0.64±0.11 in the control group and 0.50±0.09 in the personalized nursing group with a significant difference (t=5.11, P < 0.01); SAS score was 49.53±9.49 in the control group and 42.66±9.53 in the personalized nursing group, and the difference was statistically significant (t=4.10, P < 0.01). ConclusionThe personalized nursing intervention can effectively alleviate negative emotions after occupational exposure for nurses in the Emergency Department.