This case report is a unique case of solar retinopathy following antidepressant-induced mydriasis and highlights the need for comprehensive ophthalmic evaluation in patients treated with medications having mydriatic effects. A 49-year-old female patient who had received long-term antidepressant therapy presented with bilateral visual impairment after prolonged sun exposure. Fundoscopy confirmed solar retinopathy, which was attributed to drug-induced mydriasis. Medication adjustments and sun protection strategies led to full visual recovery, underscoring the importance of interdisciplinary awareness. This case emphasizes the challenges associated with the simultaneous management of psychiatric and ophthalmic conditions and highlights the need for routine ophthalmic evaluation of patients prescribed antidepressants with reported ocular side effects.
Background Pregnancy is associated with a number of physical, emotional, and biological changes that can exacerbate maternal psychological disturbances, such as body image concerns and depression. Sleep disturbances during pregnancy can also have adverse impacts. This study aimed to determine the prevalence of depression, sleep disturbances, and body image concerns among pregnant women. The study also examined the relationship between these factors and pregnancy-related variables, such as bad obstetric history and whether the pregnancies were unplanned.
Methods A cross-sectional study of 146 pregnant patients was conducted at a tertiary care center over 15 months. The patients were administered the Beck Depression Inventory, Pittsburgh Sleep Quality Index, and Body Image Concern Inventory questionnaires. Contingency tables, Fisher exact test, and Spearman correlation were used to identify underlying relationships.
Results The prevalence of depression was 22.6%. Although body image disturbance was noted in only 2.7% of patients, 46.6% had poor sleep quality. Poor sleep was associated with primigravida status. Bad obstetric history and unplanned pregnancy were associated with depression. Depression was found to be significantly correlated with body image disturbances and poor sleep quality.
Conclusion Psychiatric disorders were prevalent during pregnancy. This study highlights the importance of screening for depression in pregnant patients. Counselling and caregiver education can be useful for mitigating psychological disturbances. Management of pregnancies by multidisciplinary teams that include psychiatrists could be immensely useful in improving the pregnancy experiences of patients.
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Melatonin improves maternal sleep deprivation‐induced learning and memory impairment, inflammation, and synaptic dysfunction in murine male adult offspring Yue‐Ming Zhang, Ru‐Meng Wei, Zong‐Yin Li, Xue‐Yan Li, Kai‐Xuan Zhang, Yi‐Jun Ge, Xiao‐Yi Kong, Xue‐Chun Liu, Gui‐Hai Chen Brain and Behavior.2024;[Epub] CrossRef
Background This study assessed the psychological impact of the outbreak of coronavirus disease 2019 (COVID-19) on university hospital nurses. It provides an assessment of mental health issues, including depression, anxiety, distress, and burnout of nurses dealing directly and indirectly with COVID-19.
Methods In a web-based, cross-sectional study, 111 nurses from Daegu Catholic University Hospital in Korea were enrolled from August 4 to August 9, 2020. Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Impact of Event Scale-Revised, and Maslach Burnout Inventory were used to assess the psychological symptoms of depression, anxiety, psychological distress, and burnout among the study participants.
Results Of 111 nurses, 35 (31.5%), nine (8.1%), 26 (23.4%), and 49 (44.1%) experienced depression, anxiety, distress, and burnout, respectively. Nurses who performed COVID-19–related tasks were more likely to have moderate depression (related vs. unrelated, 52.0% vs. 25.6%; p=0.037). There were no differences in anxiety, distress, and burnout between nurses with and without COVID-19–related tasks. More than 50% of the participants showed receptive and positive attitudes toward caring for COVID-19 patients.
Conclusion Nurses who performed COVID-19–related tasks had a higher risk of depression. There were no significant differences in anxiety, distress, and burnout between the two groups. Since nurses who perform COVID-19–related tasks are more prone to psychological distress, continued psychiatric interventions are required for infectious disease outbreaks with a high mortality rate for healthcare workers who are emotionally vulnerable.
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Key predictors of psychological distress and wellbeing in Australian frontline healthcare workers during COVID-19 (Omicron wave) Brian En Chyi Lee, Mathew Ling, Leanne Boyd, Craig A. Olsson, Jade Sheen Frontiers in Psychology.2023;[Epub] CrossRef
Depression and burnout among Chinese nurses during COVID-19 pandemic: a mediation and moderation analysis model among frontline nurses and nonfrontline nurses caring for COVID-19 patients Jingjun Wang, Xia Huang, Mengmeng Wang, Lei Huang, Ya Wang BMC Psychiatry.2023;[Epub] CrossRef
Frontline nurses' burnout and its associated factors during the COVID-19 pandemic in South Korea Eun-Young Noh, Yeon-Hwan Park, Young Jun Chai, Hyun Jeong Kim, Eunjin Kim Applied Nursing Research.2022; 67: 151622. CrossRef
Characteristics of Occupational Burnout among Nurses of Various Specialties and in the Time of the COVID-19 Pandemic—Review Robert Ślusarz, Klaudia Cwiekala-Lewis, Mariusz Wysokiński, Karolina Filipska-Blejder, Wiesław Fidecki, Monika Biercewicz International Journal of Environmental Research and Public Health.2022; 19(21): 13775. CrossRef
Serotonin syndrome (SS) is a potentially life-threatening condition that is caused by the administration of drugs that increase serotonergic activity in the central nervous system. We report a case of serotonin syndrome in a patient with chronic pain who was taking analgesic drugs. A 36-year-old female with chronic pain in the lower back and right buttock area had been taking tramadol hydrochloride 187.5 mg, acetaminophen 325 mg, pregabalin 150 mg, duloxetine 60 mg, and triazolam 0.25 mg daily for several months. After amitriptyline 10 mg was added to achieve better pain control, the patient developed SS, which was mistaken for psychogenic nonepileptic seizure. However, her symptoms completely disappeared after discontinuation of the drugs that were thought to trigger SS and subsequent hydration with normal saline. Various drugs that can increase serotonergic activity are being widely prescribed for patients with chronic pain. Clinicians should be aware of the potential for the occurrence of SS when prescribing pain medications to patients with chronic pain.
There is considerable overlap in the clinical presentations of apathy and depression. However, differential diagnosis between apathy and other psychiatric conditions, including depression and dementia, is important. In this report, we present the case of a 67-year-old woman with a history of receiving selective serotonin reuptake inhibitor (SSRI) treatment for depression. Differential diagnosis between treatment-resistant depression and SSRI-induced apathy syndrome was required. The symptoms of her apathy syndrome were relieved after the discontinuation of SSRIs and the addition of olanzapine, methylphenidate, and modafinil. Furthermore, we briefly review related literature in this article.
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Apathy associated with antidepressant drugs: a systematic review Vasilios G. Masdrakis, Manolis Markianos, David S. Baldwin Acta Neuropsychiatrica.2023; 35(4): 189. CrossRef
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Investigation of the efficiency of various antidepressant replacement regimens in the development of SSRI-induced apathy syndrome V. E. Medvedev, R. A. Kardashyan, V. I. Frolova, A. M. Burno, S. V. Nekrasova, V. I. Salyntsev Neurology, Neuropsychiatry, Psychosomatics.2020; 12(2): 48. CrossRef
Background Brain volume is associated with dementia and depression in the elderly. An easy way to predict relative brain volume is to measure head circumference. In this study, we investigated the relationship between head circumference and cognition as well as depression in a non-demented elderly community.
Methods Baseline and follow-up surveys were conducted in 2007 and 2010. At baseline, community residents aged 65 years or over (n=382) within a rural area of South Korea were screened for dementia and symptoms of depression and were followed using the same screening battery after 3 years (n=279). Data from anthropometric measurements (head circumference, height, and body weight), demographics, and blood tests were gathered. Neuropsychological tests, including the Korean version of mini-mental state examination (K-MMSE), clinical dementia rating (CDR) including the CDR-sum of boxes, the Korean version of instrumental activities of daily living, and geriatric depression scale (GDS), were performed. None of the 279 subjects followed were demented.
Results Baseline performance on the K-MMSE and GDS was poorer for participants with smaller head circumferences. Follow-up performance on the MMSE was also poorer for participants with smaller head circumferences. Interestingly, participants with smaller head circumference showed worse GDS scores at baseline but on follow-up examination, participants with larger head circumference showed rapid worsening than those with smaller head circumference with marginal significance by ANOVA test. In regression coefficient analysis, GDS decline showed significant difference.
Conclusion Head circumference was not associated with cognitive change but was associated with symptoms of depression in non-demented community residents.
Diabetes and depression are serious chronic conditions. As a result of their increasing prevalence, diabetes and depression, together with population growth and aging, are public health issues. The rate of depression in adults with either type 1 diabetes or type 2 diabetes is high relative to the general population. The coexistence of diabetes and depression has attracted much interest. Although it is unclear whether diabetes and depression are causally linked, most studies have shown that the association between diabetes and depression might be bidirectional. Currently, emotional well-being is becoming an increasingly important aspect of diabetes care and self-management. Psychiatric disorders and diabetic distress among people with diabetes may increase the risk of diabetes complication and mortality. Thus, assessment and appropriate management of depression in people with diabetes should be considered to achieve psychological well-being and optimize medical outcomes.
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In Korea, cases of direct insertion of foreign bodies into the rectum are rare in the literature. Most cases of rectal insertion of foreign bodies are associated with sexual acts and psychiatric disorder such as schizophrenia. Objects inserted into the anus are usually blunt and shaped like the male genitalia. The removal method can be varied depending on the size and shape of the foreign object, its anatomical location, and the accompanying complications. In cases wherein attempts to remove the object fail or there are rectal perforation and peritonitis complications, immediate laparotomy may be required in order to prevent serious complications such as sepsis. Here, we report on a case of rectal perforation and peritonitis due to insertion of a foreign body in a middle-aged patient, with a literature review. He inserted a sharp pig backbone in his rectum and he only had depression. The patient underwent a Hartmann's operation as well as psychiatric counseling and treatment. Thus, after removal of foreign bodies, psychiatric counseling and treatment should be carried out in order to prevent similar accidents and to minimize the need for trauma medicine.
Background :This study performed to evaluate the patterns and prevalence of depression in patients with schizophrenia and to identify risk factors, using subjective and objective forms of depression scales.
Materials and Methods:Demographic data and psychiatric history were obtained from the 139 participants with schizophrenia. The Beck Depression Inventory, Zung Self-Rating Depression Scale, Hamilton Rating Scale for Depression, and Calgary Depression Scale for Schizophrenia were applied to the participants to evaluate depression.
Results :Thirty percent of all the participants had significant degree of depression, more in participants of outpatient unit and with earlier onset. Schizophrenic participants had more subjective feeling of depression than objective evaluation, performed by independent evaluators.
Conclusion :Many schizophrenic patients have significant degree of depression. In treating schizophrenic patients, depression should be considered as an important target and variable of treatment.
PURPOSE: This study was conducted to investigate the prognostic factors of postpsychotic depressive symptoms in patients with schizophrenia. MATERIALS AND METHODS: Eighty patients were selected based on the diagnostic criteria from the DSM-IV, PANSS and ESRS. For all patients information was collected on demographic and clinical characteristics. The subjective depressive symptoms and the objective depressive symptoms, as well as patients insight regarding psychosis were evaluated. The subjective depressive symptoms were evaluated by BDI and ZDS; the objective depressive symptoms were evaluated by HDRS and CDSS, and patient insight into the psychosis was evaluated by KISP. RESULTS: The comparisons using demographic and clinical characteristics showed that HDRS and CDSS had significant difference with regard to gender and suicide attempts; the BDI was associated with difference in education level and age of onset. The patients with scores above cuff-off score for each scale were 20 (25.0%) for the BDI, 16 (20.0%) for the ZDS, 18 (22.5%) for the CDSS and 6 (7.5%) for the HDRS. The results of the stepwise multiple regression analysis showed that the scores for the KISP, education levels, gender and suicide attempts were the main prognostic factors in patients with the psychotic depressive disorder of schizophrenia. CONCLUSION: The main prognostic factors in psychotic depressive disorder of schizophrenia included: insight into psychosis, suicidal attempts. Insight into the psychosis was the most reliable prognostic factor but this characteristic had a negative relationship to the with depressive symptoms.
BACKGROUND This study assessed the mental health, in order to determine the effect of the subject's spiritual well-being on anxiety depression and quality of life in active old people, and to verify whether or not spiritual well-being is a new factor for comprehensive health in old people. MATERIALS AND METHODS: This study selected 184 old people aged over 65 years. The subject's spiritual well-being was assessed by the Korean Spiritual Well-Being Scale (SWS) that was composed of the Religious Well-being Scale (RWS) and Existential Well-being Scale (EWS). The quality of life was assessed using Quality of Life Scale, which was composed of the subjective feeling about life and the subject's satisfaction of their whole life. RESULTS: Among the psychosocial factors, the educational level and physical health, showed significant discriminative score in the SWS. A prior medical history was associated with a significantly low SWS score. Satisfaction with life was associated with a significantly high SWS score. These factors a showed significant discriminative EWS score rather than a RWS. Among the religion factors, the satisfaction with their religion showed significant difference in the SWS. The SWS score especially the EWS affected the anxiety and depression of the Korean Combined Anxiety and Depression Scale (CADS). The subjective feeling of life score was associated with a significantly EWS low score and the subject's satisfaction with their whole life score was associated with a significantly high EWS score. CONCLUSION: Spiritual well being has significantly effects on anxiety depression and the quality of life in active old age people, and the subject; s spiritual well-being might be a new factor for assessing health in old age.
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In order to survey the reality of anxiety and depression among the Koreans residing in china, a study was conducted between January and March of 1991, on the residents of Yun-Kil city, with subjects of 472 Koreans and 479 Chinese. The evaluation was based on the questionnaires, named Combined self-rating anxiety depression scale (CADS), distributed among the subjects. ANOVA and t-test were applied for data processing. The results were as follows: There was not significant difference in the mean of total scores between the two groups. The scores of Koreans were 29.70±7.03, while those of Chinese were 29.45±9.01. The score of the CADS above 50 (clinically significant level) was seen in 12 (2.54%) Koreans and 21 (4.38%) Chinese. The anxiety-depression scores relating to the items of indigestion and decreased appetite, sleep disturbance, apprehension, decreased libido were relatively high among the Koreans. The items appeared low in scores among the Koreans were faintness, fear, suicidal rumination, hopelessness, paresthesias. The highs among the Chinese were facial flushing, anxiousness, dissatisfaction, suicidal rumination. The items appeared low among the Chinese were fear, faintness, paresthesias, weight loss, suicidal rumination. In the compatison of evaluation by items between the two groups, the items placing the Koreans significantly higher over the Chinese are indigestion & decreased appetite, sleep disturbance, apprehension, decreased libldo. The Chinese marked significantly higher in facial flushing, anxiousness, dissastisfaction, suicidal rumination. Those in the case of female (p<0.01 respectively), less than twenty years old (p<0.01 respectively), dissatisfied with family relationship (p<0.01 respectively), with past history of psychiatric hospitalization (Koreans p<0.01, Chinese p<0.05), pessimistic toward future, present, past self image (p<0.01 respectively) had significantly higher scores in both groups. In religion, neither group showed significant difference. In religion, neither group showed significant difference. In marital status, the Koreans showed a higher degree of divorce and separation and the Chinese in singleness (p<0.01 respectively). The Korean were higher in illiteracy and the Chinese had more college education (p<0.01 respectively). In place of growth, The Koreans showed not much difference in the areas while more Chinese grew up un large cities (p<0.01). More Koreans lived in the dormitory while the Chinese were engaged more in self-cooking (p<0.01 respectively), In pocket money per mouth, more Koreans were less than 1 dollar while the Chinese were between 7 and 10 dollars (p<0.01 respectively). There were no significant difference between two groups about religion.
This survey was conducted from January 1991 to May 1991. Two hundred and eight residents in 4 government supported homes for the aged and hundred and eleven living in the community in Taegu, Korea, were examined to evaluate the depression and the anxiety of the aged with combined anxiety and depression scale (CADS) and somatization symptom check list (SCL). There are no significant differences between residents in the home for the aged and those living in the community on the total scores of CADS and SCL. However, in the case of the total score of CADS of the female subjects in the home for the aged were significantly higher than those of the community residents. The elderly in the home for the aged tended to have pure depression, while community residents were likely to have anxiety and depression. Fifty-two subjects of home for the aged and sixty-nine of the community scored over 50 points of CADS, which indicates considerable depression or anxiety. In psychosocial factors, the subjects who in the following situations had statistically significant higher scores than others. The results were as follow. Poor health, unhappiness, unsatisfaction to the past occupation, pessimistic thought in future view for both group and unsatisfaction of the relationship with familiar people for the elderly in the community. The SCL scores of two groups subgrouped by under 49 and 50 on CADS showed significant differences between each subgroup on all of the SCL items. It could be suggested that somatic symptoms for the aged is a sign of depression.
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The author studied the mental status of 497 patients admitted in non-psychiatric wards and 42 patients diagnosed as mental disorders by DSM-III-R criteria and admitted in three general hospitals located in Pusan city, using NADS and PSCS. The assessment were obtained from October, 1991 to March, 1992 and the results as follows: The mean±SD of Anxiety-Depression scores were 34.4±10.4 in non-psychiatric patients and 50.0±18.3 in psychiatric patients. The psychiatric group had significantly higher scores than non-psychiatric group. The mean±SD of Psychosis scores were 3.9±4.4 in non-psychiatric patients and 20.3±9.8 in psychiatric patients. The psychiatric group had significantly higher scores than non-psychiatric group. In the psychosocial factors, dissatisfaction in family atmosphere and acquaintanceship with parents (P<0.001, relatively), pessimistic in future, present and past self-images (P<0.001, relatively), and yes in previous psychiatric treatment of admission (p<0.01, relatively) had common significant relationships to Anxiety-Depression and Psychosis scores. There were correlationships between NADS scores and PSCS scores (γ=0.74), past and present self-images (γ=0.45), present and future self images (γ=0.45), past and future self-images (γ=0.34) and family atmosphere and acquaintanceship with parents (γ=0.49) The regression analysis revealed that present self-image, acquaintanceship with parents, future self-image, past self-image, and family atmosphere, in order of significance were to be descriptive or predicable variances for Anxiety-Depression status. The discriminant analysis according to Anxiety-Depression scores showed that the cases of incorrect classification were 22 for non-psychiatric patient group and 2 for psychiatric patient group.
Pre-surgical and post-surgical change in adult clef lip and palate patient following Le Fort I advancement osteotomy combined with bone graft was evaluated clinically and cephalometically. We obtained a successful function and esthetic improvement. The bone graft of alveolo-palatal clefts provides a stable bone support to the adjacent teeth of the cleft area, and well union of adjacent bone tissue, the closure of oronasal fistula and improvement of speech problem. Le Fort I osteotomy following the ostectomy of nasal septum for advancement of the maxilla was obtained relative improvement of esthetics and functional occlusion. 1. The orthodontic correction was required before and after surgery. 2. In this case, there was a limited range of anterior advancement of the Premaxillary-segment due to the scar tissue. 3. After 8 months of operation, we could show the new bone deposition on the cleft sites in dental radiograph and then the prosthetic treatment to the missing teeth was done.