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Depressive symptoms in neurodegenerative diseases

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World Journal of Clinical Cases 2015年第8期3卷 682-693页

作者： Miquel Baquero Nuria Martín Servei de Neurologia Hospital Universitari i Politècnic La Fe

Depressive symptoms are very common in chronic conditions. This is true so for neurodegenerative diseases. A number of patients with cognitive decline and dementia due to Alzheimer's disease and related conditions like Parkinson's disease, Lewy body disease, vascular dementia, frontotemporal degeneration amongst other entities, experience depressive symptoms in greater or lesser grade at some point during the course of the illness. Depressive symptoms have aparticular significance in neurological disorders, specially in neurodegenerative diseases, because brain, mind, behavior and mood relationship. A number of patients may develop depressive symptoms in early stages of the neurologic disease, occurring without clear presence of cognitive decline with only mild cognitive deterioration. Classically, depression constitutes a reliable diagnostic challenge in this setting. However, actually we can recognize and evaluate depressive, cognitive or motor symptoms of neurodegenerative disease in order to establish their clinical significance and to plan some therapeutic strategies. Depressive symptoms can appear also lately, when the neurodegenerative disease is fully developed. The presence of depression and other neuropsychiatric symptoms have a negative impact on the quality-of-life of patients and caregivers. Besides, patients with depressive symptoms also tend to further decrease function and reduce cognitive abilities and also uses to present more affected clinical status, compared with patients without depression. Depressive symptoms are treatable. Early detection of depressive symptoms is very important in patients with neurodegenerative disorders, in order to initiate the most adequate treatment. We review in this paper the main neurodegenerative diseases, focusing in depressive symptoms of each other entities and current recommendations of management and treatment.

关键词： Depressive symptoms like Parkinson’s disease

Gastrointestinal symptoms and associated factors in Chinese patients with functional dyspepsia

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World Journal of Gastroenterology 2013年第32期19卷 5357-5364页

作者： Jiao Yu Shi Liu Xiu-Cai Fang Jun Zhang Jun Gao Ying-Lian Xiao Li-Ming Zhu Fen-Rong Chen Zhao-Shen Li Pin-Jin Hu Mei-Yun Ke Xiao-Hua Hou Division of Gastroenterology Union HospitalTongji Medical CollegeHuazhong University of Science and Technology Division of Gastroenterology Peking Union Medical College HospitalChinese Academy of Medical Sciences Division of Gastroenterology Second Affiliated Hospital of Medical CollegeXi’an Jiaotong University Division of Gastroenterology Changhai HospitalSecond Military Medical University Division of Gastroenterology First Affiliated Hospital of Sun Yat-sen University

AIM:To study the evolution of gastrointestinal symptoms and associated factors in Chinese patients with functional dyspepsia(FD).METHODS:From June 2008 to November 2009,a total of 1049 patients with FD(65.3%female,mean age42.80±11.64 years)who visited the departments of gastroenterology in Wuhan,Beijing,Shanghai,Guangzhou,and Xi’an,China were referred for this study.All of the patients fulfilled the RomeⅢcriteria for FD.Baseline demographic data,dyspepsia symptoms,anxiety,depression,sleep disorder,and drug treatment were assessed using self-report questionnaires.Patients completed questionnaires at baseline and after1,3,6 and 12 mo follow-up.Comparison of dyspepsia symptoms between baseline and after follow-up was explored using multivariate analysis of variance of repeated measuring.Multiple linear regression was done to examine factors associated with outcome,both longitudinally and horizontally.RESULTS:Nine hundred and forty-three patients(89.9%of the original population)completed all four follow-ups.The average duration of follow-up was12.24±0.59 mo.During 1-year follow-up,the mean dyspeptic symptom score(DSS)in FD patients showed a significant gradually reduced trend(Psymptoms(P<0.001).Multiple linear regression analysis showed that sex(P<0.001),anxiety(P=0.018),sleep disorder at 1-year follow-up(P=0.019),weight loss(P<0.001),consulting a physician(P<0.001),and prokinetic use during 1-year follow-up(P=0.035)were horizontally associated with DSS at 1-year followup.No relationship was found longitudinally between DSS at 1-year follow-up and patient characteristics at baseline.CONCLUSION:Female sex,anxiety,and sleep disorder,weight loss,consulting a physician and prokinetic use during 1-year follow-up were associated with outcome of FD.

关键词： Functional dyspepsia Gastrointestinal symptoms Dyspeptic symptom score Helicobacter pylori infection Postprandial distress syndrome Epigastric pain syndrome RomeⅢcriteria

An association between the location of white matter changes and the behavioral and psychological symptoms of dementia in Alzheimer's disease patients

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Translational Neuroscience and Clinics 2016年第1期2卷 8-16页

作者： Tzuchou Lin Yihui Lin Linli Kao Yihui Kao Yuanhan Yang Pingsong Chou Mengni Wu Department of Neurology Kaohsiung Medical University Hospital Department of Neurology "National Taiwan University Hospital Yun-Lin Branch" Department of Neurology Kaohsiung Municipal Ta‐Tung Hospital Kaohsiung Medical University Department of Master’s Program in Neurology Faculty of Medicine Kaohsiung Medical University

Objective:The frontal lobe may be involved in circuits associated with depression,apathy,aggression,and other psychiatric symptoms.Although white matter changes(WMC)are related to the severity of behavioral and psychological symptoms of dementia(BPSD)in patients with Alzheimer’s disease(AD),it is unclear which part of the WMC may play the most important role in BPSD.This study was designed to investigate the relationship between the location of WMC and the severity of BPSD in AD patients.Methods:Among patients diagnosed with Alzheimer’s disease between 2009 and2014,387 patients were retrospectively reviewed after those with pre‐existing organic brain syndrome,psychiatric diseases,or toxic‐metabolic encephalopathy were excluded.Patients’demographic and laboratory data,WMC measured with brain computed tomography and scored using the age‐related white matter changes(ARWMC)scale,and neuropsychological tests,including the cognitive abilities screening instrument(CASI),the Mini‐Mental State Examination(MMSE),the clinical dementia rating scale with sum‐box(CDR‐SB),and the neuropsychiatric inventory(NPI)were analyzed.Results:There was no significant difference in the NPI between patients with and without a history of stroke,hypertension,and diabetes.No significant difference in the NPI was identified between different sexes or different Apolipoprotein E(APOE)alleles.The NPI score was significantly correlated with the duration of education(r=–0.4515,P=0.0172),CASI(r=–0.2915,P<0.0001),MMSE(r=–0.8476,P<0.0001),and CDR‐SB(r=2.2839,P<0.0001).WMC in the right frontal lobe showed a significant difference in NPI in comparison to those without WMC(P=0.0255).After adjusting for age,duration of education,and CASI,WMC in the right frontal lobe remained significantly associated with the NPI score(β=3.8934,P=0.042).Conclusions:WMC involving the right frontal lobe may play an important role in the BPSD in AD patients during their dementia diagnosis.Further studies are necessary to confirm whether controlling the risk factors of WMC can

关键词： Alzheimer’s diseas white matter changes leukoaraiosis behavioral and psychological symptoms of dementia

Acute Stress symptoms in Families of Patients Admitted to the Intensive Care Unit during the First 24 Hours Following Admission in Japan

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Open Journal of Nursing 2015年第4期5卷 325-335页

作者： Miyuki Komachi Kiyoko Kamibeppu Department of Nurse Practitioner Training Division of Healthcare Graduate School of Medical Welfare International University of Health and Welfare Tokyo Japan Department of Family Nursing Division of Health Sciences & Nursing Graduate School of Medicine University of Tokyo Tokyo Japan

Families of patients in the intensive care unit often experience sever stress. Understanding their experience is important for providing family-centered care during this difficult period. Little is known about the experience of families of patients admitted to the intensive care unit (ICU). To evaluate the prevalence and factors associated with acute stress symptoms among families of patients admitted to the ICU, we carried out a cross-sectional study at a teaching and advanced treatment hospital. The mean total Impact of Event Scale-Revised (IES-R) score differed significantly between planned and unplanned ICU admissions (t = 4.03, p symptoms (B = 18.09, β = 0.47, p symptoms associated with acute stress symptoms of family members more than did getting support from nurses, being the patient’s spouse, or the severity of illness of the patient.

关键词： Intensive Care Unit Families within 24 Hours Acute Stress symptoms Post-Traumatic Stress Disorder

Breast cancer-related lymphedema: symptoms, diagnosis, risk reduction, and management

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World Journal of Clinical Oncology 2014年第3期5卷 241-247页

作者： Mei R Fu College of Nursing New York UniversityNew YorkNY 10003United States

The global burden of breast cancer continues to increase largely because of the aging and growth of the world population. More than 1.38 million women worldwide were estimated to be diagnosed with breast cancer in 2008, accounting for 23% of all diagnosed cancers in women. Given that the 5-year survival rate for breast cancer is now 90%, experiencing breast cancer is ultimately about quality of life. Women treated for breast cancer are facing a life-time risk of developing lymphedema, a chronic condition that occurs in up to 40% of this population and negatively affects breast cancer survivors' quality of life. This review offers an insightful understanding of the condition by providing clinically relevant and evidence based knowledge regarding lymphedema symptoms, diagnosis, risk reduction, and management with the intent to inform health care professionals so that they might be better equipped to care for patients.

关键词： Lymphedema Breast cancer symptoms Diagnosis Risk reduction Management

Investigation of the incidences of non-mo-tor symptoms in siblings and spouses of patients withParkinson's disease

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China Medical Abstracts(Internal Medicine) 2018年第4期35卷 237-238页

作者：刘姜冰 Dept Neurol Affil Hosp Yangzhou Univ

Objective Non-motor symptoms are important prodromal characteristics of Parkinson's disease(PD).The siblings and the spouses of PD patients do not have classic motor symptoms.This study aimed to investigate if they have PD prodromal symptoms.Methods A total of 98 PD patients from the Affiliated Hospital of Yangzhou University were recruited between January 2015 and August 2017;256 siblings of these patients were included in a siblings group,87 spouses of PD patients were included in a spouses group and 250 healthy individuals were included in a control group.Various scales were used to assess non-motor symptoms,including depression,anxiety,cognitive function,sleep status,constipation,daytime sleepiness,subjective olfactory disorder,rapid-eye-movement sleep behavior disorder(RBD),and restless legs syndrome(RLS).Results The incidence of anxiety(OR=3.06,95% CI 1.86-5.05,Psymptoms between the spouses group and the control group,except that the mild depression(OR=2.58,95% CI 1.07-6.20,P=0.03)in the spouses group was more obvious.Conclusion The siblings of PD patients are more likely to have PD prodromal symptoms compared with those without PD family history,perhaps because PD patients and their siblings have common pathogenic genetic factors and early living environment for neurode-generation.There are no obvious non-motor symptoms in the spouses of PD patients.It can be concluded that the onset of PD is not related to the family life environment in adulthood.

关键词： Non-motor symptoms important prodromal characteristics

Association of Erectile Dysfunction and Hypogonadism with Metabolic Syndrome in Men with Lower Urinary Tract symptoms of Younger and Older Age Groups

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Advances in Sexual Medicine 2014年第4期4卷 55-64页

作者： Elena Novikova Vera Selyatitskaya Igor Mitrofanov Boris Pinkhasov Ani Karapetyan Siberian Branch of Russian Academy Medical Sciences Scientific Centre of Clinical and Experimental Medicine Novosibirsk Russia Department of Urology Regional Medical and Diagnostic Center Novosibirsk Russia

The aim of this study was to evaluate the incidence and severity of erectile dysfunction (ED) and hypogonadism in 193 men presenting with lower urinary tract symptoms (LUTSs) in the younger (20 - 39 years old) and older (40 - 60 years old) age groups depending on the presence of metabolic syndrome (MetS). Triglycerides, glucose and high-density lipoprotein cholesterol, serum total testosterone (TT), sex hormone-binding globulin, prostate-specific antigen, pituitary hormones levels were measured in serum. Standardized criteria (2009) were used to determine the prevalence of MetS. Patients were assessed based on the International Prostate Symptom Score (IPSS) and the IPSS-Quality of Life (IPSS-QoL) for LUTSs and the International Index of Erectile Function (IIEF) for ED. Hypogonadism was determined in accordance with the ISA, ISSAM, EAU, EAA and ASA recommendations. In men with MetS in the younger age group the incidence of ED was 2.4 times higher, and that of low TT level and hypogonadism was 8.4 times higher compared to men without the syndrome. In the older age group, an increased incidence of ED and low TT level in men with MetS compared to men without the syndrome was on the trend level, but the incidence of hypogonadism was for sure higher (by 1.6 times). In conclusion, the study showed that ED and hypogonadism are associated with MetS by a high degree of certainty in young men with LUTSs. In men of the older age group with LUTSs, the presence of MetS is not so clearly associated with ED and hypogonadism due to the fact that the incidence of these urogenital diseases is also high in men without MetS.

关键词： Erectile Dysfunction Testosterone Hypogonadism Metabolic Syndrome Men of Younger and Older Age Groups Lower Urinary Tract symptoms

Depressive symptoms and Food Intake among Weight-Preoccupied Women: Do Eating Behaviors and Attitudes or BMI Mediate This Association?

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Health 2014年第20期6卷 2802-2813页

作者： Julie Maltais-Giguère Catherine Bégin Marie-Pierre Gagnon-Girouard Mélodie Daoust Véronique Provencher Institute of Nutrition and Functional Foods Université Laval Québec Canada School of Psychology Université Laval Québec Canada Department of Psychology Université du Québec à Trois-Rivières Trois-Rivières Canada

Associations between depressive symptoms, dysfunctional eating behaviors and attitudes, higher food intake and body mass index (BMI) have been previously observed. However, few studies have assessed these variables in the same study. The first objective is to compare, in a natural setting environment, the profile of women reporting lower or higher levels of depressive symptoms in terms of food intake, eating behaviors and attitudes, and BMI. The second objective is to test mediational models for which the link between depressive symptoms and food intake would be mediated by eating behaviors and attitudes or BMI. Weight-preoccupied women were recruited (n = 323), and their level of depressive symptoms was assessed using the Beck Depression Inventory. The median score was used to create two groups (lower ≤ 13;higher > 13). A web-based food-frequency questionnaire, the Three-Factor Eating Questionnaire, and the Intuitive Eating Scale were completed. BMI was calculated from reported body weight and height. Compared to women with a lower level of depressive symptoms, those with a higher level of depressive symptoms reported a higher energy intake (p = 0.02), and a higher consumption of savoury foods (p = 0.02). These women also had higher scores of disinhibition (p p = 0.0002), ate less intuitively (p p = 0.005). Association between depressive symptoms and energy intake was mediated by disinhibition, susceptibility to hunger and eating for physical rather than emotional reasons, while the role of BMI was less clear. Regarding another component of food intake, association between depressive symptoms and consumption of savoury foods was mediated by disinhibition and eating for physical rather than emotional reasons. In summary, it seems essential to be aware of the presence of depressive symptoms and to pay attention to eating behaviors and attitudes in interventions among weight-preoccupied women.

关键词： Depressive symptoms Food Intake Eating Behaviors and Attitudes Body Mass Index Women

Perception of Menopausal symptoms among Educated versus Non Educated Women by Using Menopausal Rating Scale (MRS)

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Open Journal of Nursing 2014年第8期4卷 602-607页

作者： Syeda Fakhar Batool Yasmeen Saggu Mansoor Ghani Univrsity of Health Sciences Lahore Lahore Pakistan

Background: A cross sectional comparative study was conducted in a well populated city named Rawalpindi, which is located in the Northern part of Pakistan. Objectives: This study was aimed to document the comparison of menopausal-related symptoms among educated and non educated women of Rawalpindi, Pakistan. Methods: MRS was used to measure the intensity of menopausal symptoms. 100 educated and 100 uneducated women were selected for study purpose. Pakistan Institute of Medical Sciences, Military Hospital and Combined Military Hospital were selected as a study setting. Findings: Correlation & Fisher exact test was applied for statistical analysis. The intensity of symptoms reported by Educated women as: sleeping problems (93.0%);heart discomfort (80.0%);hot flushes and sweating (70.0%);joint and muscular pain (52.0);depressive mood (63.0%);irritability (42%);anxiety (60.0%). physical and mental exhaustion;(48.0%);sexual problem (61.0%);dryness of vagina (57.0%);and bladder problem (65.0%). The severity of symptoms in uneducated women;sleeping problems (77.0%);heart discomfort (73.0%);hot flushes (69.0%);joint and muscular pain (66.0);depressive mood (71.0%);irritability (58%);anxiety (80.0%). physical and mental exhaustion (70.0%);sexual problem (66.0%);dryness of vagina (70.0%);and bladder problem (83.0%). Conclusions: Somatic symptoms were high in educated women as compare to uneducated women while the prevalence of psychological and Urogenital symptoms were high in uneducated women as compare to educated women.

关键词： Perception Menopause symptoms Educated Non Educated