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Depression: HELP
Articles from Chile
Based on 193 articles published since 2008
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These are the 193 published articles about Depression that originated from Chile during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8
1 Editorial [The role of the paediatrician in post-partum depression]. 2016

Schonhaut Berman, Luisa / Podestá López, Loreto. ·Clínica Alemana de Santiago, Facultad de Medicina, Universidad del Desarrollo, Santiago, Región Metropolitana, Chile. · Instituto de Pediatría, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Región de los Ríos, Chile. Electronic address: loretopodesta@gmail.com. ·Rev Chil Pediatr · Pubmed #26971830.

ABSTRACT: -- No abstract --

2 Review [Psychosocial impact of type 1 diabetes mellitus in children, adolescents and their families. Literature review]. 2018

Henríquez-Tejo, Rocío / Cartes-Velásquez, Ricardo. ·Fundación Kimntrum, Chile. · Facultad de Odontología, Universidad Andres Bello, Concepción, Chile. ·Rev Chil Pediatr · Pubmed #29999147.

ABSTRACT: Type 1 diabetes mellitus is the most common chronic endocrine pathology among children. Treatment includes diet, physical activity, insulin medication, and proper self-control. This self-control may be difficult, resulting in children, adolescents and their families suffering diverse psychosocial complications. There is an inverse relationship between self-control and psychosocial complications, the main problems being anxiety and depression, where adolescents are 2.3 times more likely to have mental health problems. Families are initially affected, in the debut period by a state of shock, with feelings of distress and anger. The necesary changes in habits and lifestyles can lead to psychosocial problems, including anxiety, depression and eating disorders. Subsequently, the child or adolescent and his or her family group may move into new balance characterized by good self-control and adherence to tratment, or deepen individual and group disorders which may reappear, especially in adolescence. The comprehensive treatment of type 1 diabetes mellitus requires addressing these aspects through multidisciplinary teams which include medical and phychosocial professionals. This review analyses the main aspects related to the psychosocial impact of diabetes mellitus type 1 among children, adolescents and their families.

3 Review Internet-based interventions for the prevention and treatment of depression in people living in developing countries: A systematic review. 2018

Martínez, Pablo / Rojas, Graciela / Martínez, Vania / Lara, María Asunción / Pérez, J Carola. ·Escuela de Psicología, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile; Centro de Innovación en Tecnologías de la Información para Aplicaciones Sociales (CITIAPS), Universidad de Santiago de Chile, Santiago, Chile; Instituto Milenio para la Investigación en Depresión y Personalidad (MIDAP), Santiago, Chile. · Instituto Milenio para la Investigación en Depresión y Personalidad (MIDAP), Santiago, Chile; Departamento de Salud Mental y Psiquiatría, Hospital Clínico, Universidad de Chile, Santiago, Chile. · Instituto Milenio para la Investigación en Depresión y Personalidad (MIDAP), Santiago, Chile; CEMERA, Facultad de Medicina, Universidad de Chile, Santiago, Chile. · Departamento de Modelos de Intervención, Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México. · Instituto Milenio para la Investigación en Depresión y Personalidad (MIDAP), Santiago, Chile; Centro de Apego y Regulación Emocional, Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile. Electronic address: janetperez@udd.cl. ·J Affect Disord · Pubmed #29529553.

ABSTRACT: BACKGROUND: Internet-based interventions for depression may be a valuable resource to reduce the treatment gap for those living in developing countries. However, evidence comes mainly from developed countries. This systematic review summarized the evidence on preventive or therapeutic Internet-based interventions for depression for people who reside in developing countries. METHODS: CINAHL, EMBASE, PubMed, SciELO Citation Indexes, the Journal of Medical Internet Research, and the Telemedicine and e-Health journal, were searched up to June 2017, to identify feasibility or effectiveness studies of preventive or therapeutic Internet-based interventions for depression, with or without human support. Studies included subjects residing in developing countries, and were published in English or Spanish. Study protocols were included. Risk of bias and/or quality of the reporting of the studies included was assessed. RESULTS: Five feasibility studies, aimed at the prevention of depression, and a study protocol were included in this systematic review. Reports came mostly from the Americas (n = 4). Internet-based interventions aimed at the prevention of depression presented low levels of human support, were useful and acceptable to their users, and require further design refinements to improve their use and retention. LIMITATIONS: No gray literature was searched or included in this systematic review. Searches were limited to English and Spanish languages. DISCUSSIONS: Internet-based interventions aimed at the prevention of depression in people who reside in developing countries are in an early phase of development, limiting the generalizability of the results. Future studies must employ persuasive designs to improve user retention, incorporating larger samples and a control group to conclusively determine feasibility.

4 Review Is augmentation with folate effective for major depressive disorder? 2018

Trincado, Javier / Caneo, Constanza. ·Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos, Santiago, Chile. · Proyecto Epistemonikos, Santiago, Chile; Departamento de Psiquiatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. Email: cmcaneo@uc.cl. Address: Centro Evidencia UC, Pontificia Universidad Católica de Chile, Centro de Innovación UC Anacleto Angelini, Avda. Vicuña Mackenna 4860, Macul, Santiago, Chile. ·Medwave · Pubmed #29499033.

ABSTRACT: INTRODUCTION: Antidepressant treatment does not lead to a satisfactory response in a significant proportion of patients with depression. It has been postulated that co-administration of pharmacologically standardized nutrients (nutraceuticals), such as folate, would potentiate the effect of antidepressants. METHODS: To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS: We identified four systematic reviews including nine studies overall, of which eight were randomized trials. We concluded augmentation with folate for the treatment of major depressive disorder probably results in little or no difference in depressive symptoms. It would be interesting to evaluate the effects of specific presentation forms of folate or in population with objective folate deficit.

5 Review [Paternal postpartum depression: Why is it also important?] 2017

Pérez C, Francisca / Brahm M, Paulina. ·Facultad de Psicología, Universidad Alberto Hurtado, Santiago, Chile. · Departamento de Medicina Familiar, Pontificia Universidad Católica de Chile, Santiago, Chile. ·Rev Chil Pediatr · Pubmed #29546941.

ABSTRACT: Health supervision is a privileged opportunity to walk along with the new families during their transition to parenthood. This period is challenging for both mother and father, and there is the potential danger that demand surpasses the existing resources of the family. This imbalance may lead to mothers and fathers to develop depressive symptomatology. Postpartum depression may affect one to two out of ten men, and maternal depression is a major risk factor for developing it. The postpartum depression in the father impact all the family members, being the child development, the bonding, and the child´s mental health which can be disturb at a short, medium and long term. Therefore, it seems to be relevant to think about screening for post partum depression not only in mothers but also fathers, and give a first step to broaden the gaze from the dyad to the triad. The health supervision is a unique opportunity to be able to carry out this screening; however, the validation of a postpartum screening test for Chilean fathers is a pending task.

6 Review Direct comparison of tricyclic and serotonin-reuptake inhibitor antidepressants in randomized head-to-head trials in acute major depression: Systematic review and meta-analysis. 2017

Undurraga, Juan / Baldessarini, Ross J. ·1 International Consortium for Mood & Psychotic Disorder Research, Mailman Research Center, McLean Hospital, Belmont, USA. · 2 Department of Psychiatry, Faculty of Medicine, Clinica Alemana Universidad del Desarrollo, Santiago, Chile. · 3 Early Intervention Program, J Horwitz-Barak Psychiatric Institute, Santiago, Chile. · 4 Department of Psychiatry, Harvard Medical School, Boston, USA. ·J Psychopharmacol · Pubmed #28633600.

ABSTRACT: BACKGROUND: A comparison across trials conducted over several decades suggested superior efficacy of tricyclic antidepressants (TCAs) over selective serotonin-reuptake inhibitors (SSRIs). However, this outcome may reflect a selective secular decline of responses after randomization to placebo. Remaining uncertainty encouraged direct comparison of the drug-types in trials involving randomized, head-to-head comparisons. METHODS: We systematically identified reports of randomized trials of TCAs versus SSRIs for major depression in several digital databases, and applied standard meta-analytic and multiple-factor regression methods to analyze and pool the findings. RESULTS: In 89 head-to-head trials, there was no detectable overall difference in responder rates or percent-improvement between TCAs and SSRIs. In addition to non-difference between drug-types, outcomes were unrelated to reporting-year, trial-size or nominal duration, proportion of women participants, initial depression ratings, rating scales, subjects/arm, imipramine-equivalent mg/day drug dose, or dropout rate. Trial size and duration increased significantly over the years 1980-2016. CONCLUSIONS: Previous evidence suggesting superior benefits of TCAs over SSRIs for the treatment of acute major depression is probably an artifact of a selective secular decline in responses to placebo, as no difference was found in a large series of direct comparisons of these antidepressant-types.

7 Review Effects of exercise-based interventions on postpartum depression: A meta-analysis of randomized controlled trials. 2017

Poyatos-León, Raquel / García-Hermoso, Antonio / Sanabria-Martínez, Gema / Álvarez-Bueno, Celia / Cavero-Redondo, Iván / Martínez-Vizcaíno, Vicente. ·Virgen de la Luz Hospital, Cuenca, Spain. · Physical Activity, Sport and Health Sciences Laboratory, University of Santiago de Chile, USACH, Santiago, Chile. · Universidad de Castilla-La Mancha, Social and Health Care Research Center, Cuenca, Spain. · Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile. ·Birth · Pubmed #28589648.

ABSTRACT: BACKGROUND: There is inconsistent evidence about the effect of physical activity on the prevention and treatment of depression during the postnatal period. The aim of this meta-analysis was to determine the effect of physical activity interventions during pregnancy and the postpartum period for controlling postpartum depressive symptoms. METHODS: We systematically searched Cochrane Library Plus, Science Direct, EMBASE, CINAHL, PubMed, Web of Science, and Scopus, from January 1990 to May 2016, for randomized or nonrandomized controlled trials addressing the effect of physical activity on postpartum depression. The inverse variance-weighted method was used to compute pooled estimates of effect size and respective 95% confidence intervals (95% CI) for physical activity intervention on postpartum depression. Subgroup analyses were performed comparing women with and without postpartum depressive symptoms according to specific scales measuring this construct. Meta-regression and sensitivity analysis were computed to evaluate heterogeneity. RESULTS: Twelve studies were included in the meta-analysis. Effect size for the relationship between physical activity interventions during pregnancy and the postpartum period on postpartum depressive symptoms was 0.41 (95% CI 0.28-0.54). Heterogeneity was I CONCLUSION: Physical exercise during pregnancy and the postpartum period is a safe strategy to achieve better psychological well-being and to reduce postpartum depressive symptoms.

8 Review [Heritability and genetic comorbidity of attention deficit disorder with hyperactivity]. 2017

Puddu, Giannina / Rothhammer, Paula / Carrasco, Ximena / Aboitiz, Francisco / Rothhammer, Francisco. ·Instituto de Alta Investigación, Universidad de Tarapacá, Arica, Chile. · Departamento de Psiquiatría y Centro de Investigaciones Médicas, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. · Servicio de Neurología y Psiquiatría, Hospital Luis Calvo Mackenna, Santiago, Chile. ·Rev Med Chil · Pubmed #28548194.

ABSTRACT: This review aims to summarize information about the genetic etiology of attention deficit disorder with hyperactivity (ADHD), with particular reference to the contributions of our research group. We also discuss the genetic comorbidity estimated from genome-wide single nucleotide polymorphisms (SNP´s) between ADHD and major psychiatric disorders such as schizophrenia (E), major depressive disorder (MDD), bipolar disorder (BD) and autism spectrum disorders (ASD). A high genetic comorbidity was found between E and BD (46%), a moderate comorbidity between MDD and E, MDD and BD and MDD and ADHD (18%, 22% and 10% respectively) and a low comorbidity between E and ASD (2.5%). Furthermore, we show evidence concerning the genetic determination of psychiatric diseases, which is significantly lower when it is estimated from genome-wide SNP´s rather than using traditional quantitative genetic methodology (ADHD = E = 23%, BD = 25%, MDD = 21% and ASD = 17%). From an evolutionary perspective, we suggest that behavioral traits such as hyperactivity, inattention and impulsivity, which play a role in ADHD and perhaps also other hereditary traits which are part of major psychiatric disorders, could have had a high adaptive value during the early stages of the evolution of Homo sapiens. However, they became progressively less adaptive and definitively disadvantageous, to the extreme that they are involved in frequently diagnosed major psychiatric disorders.

9 Review BDNF/NF-κB Signaling in the Neurobiology of Depression. 2017

Caviedes, Ariel / Lafourcade, Carlos / Soto, Claudio / Wyneken, Ursula. ·Facultad de Medicina, Universidad de los Andes, Monseñor Alvaro del Portillo 12.455, Santiago. Chile. · Dept of Neurology, University of Texas Medical School at Houston, Texas. United States. · Laboratorio de Neurociencias, Facultad de Medicina, Universidad de los Andes; Mons. Alvaro del Portillo 12.455, Las Condes; Santiago. Chile. ·Curr Pharm Des · Pubmed #28078988.

ABSTRACT: BACKGROUND: Mood disorders, consisting of unipolar and bipolar depression, are complex diseases characterized by depressed mood and anhedonia. These core symptoms are accompanied in a varying manner by anxiety, several neurovegetative symptoms and cognitive impairment. Mood disorders are characterized by decreases in neurogenesis, alteration in synaptic structure and synaptic transmission, all of them regulated by BDNF, a neurotrophin that performs multiple functions in the adult central nervous system. Many evidences show that BDNF is critically decreased in mood disorders and plays an essential role in most anti-depressant treatments. In turn, the transcription factor NF-kB has recently emerged as an important player in the pathophysiology of depression, with roles in neurogenesis, synaptic transmission and plasticity. METHODOLOGY: We review the bidirectional interactions between BDNF and NF-kB signaling pathways. RESULTS AND CONCLUSIONS: We discuss a potential beneficial effect of a positive feedback loop between BDNF and NF-kB activated pathways in antidepressant action. This could be transduced into the identification of downstream NF-kB gene targets able to potentiate antidepressant mechanisms, thus guiding the development of novel and faster acting antidepressant drugs.

10 Review Cortisol as a predictor of psychological therapy response in depressive disorders: systematic review and meta-analysis. 2017

Fischer, Susanne / Strawbridge, Rebecca / Vives, Andres Herane / Cleare, Anthony J. ·Susanne Fischer, PhD, Rebecca Strawbridge, MSc, Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Andres Herane Vives, MD, DPM, MSc, Universidad Católica del Norte, Coquimbo, Chile and Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Anthony J. Cleare, BSc, MBBS, FRCPsych, PhD, Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK susanne.fischer@kcl.ac.uk. · Susanne Fischer, PhD, Rebecca Strawbridge, MSc, Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Andres Herane Vives, MD, DPM, MSc, Universidad Católica del Norte, Coquimbo, Chile and Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Anthony J. Cleare, BSc, MBBS, FRCPsych, PhD, Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK. ·Br J Psychiatry · Pubmed #27908897.

ABSTRACT: BACKGROUND: Many patients with depressive disorders demonstrate resistance to psychological therapy. A frequent finding is hypothalamic-pituitary-adrenal (HPA) axis alterations. As cortisol is known to modulate cognitive processes, those patients may be less likely to profit from psychological therapy. AIMS: To conduct a systematic review and meta-analysis on cortisol as a predictor of psychological therapy response. METHOD: The Cochrane Library, EMBASE, MEDLINE and PsycINFO databases were searched. Records were included if they looked at patients with any depressive disorder engaging in psychological therapy, with a pre-treatment cortisol and a post-treatment symptom measure. RESULTS: Eight articles satisfied our selection criteria. The higher the cortisol levels before starting psychological therapy, the more symptoms patients with depression experienced at the end of treatment and/or the smaller their symptom change. CONCLUSIONS: Our findings suggest that patients with depression with elevated HPA functioning are less responsive to psychological therapy.

11 Review Changes in neural circuitry associated with depression at pre-clinical, pre-motor and early motor phases of Parkinson's disease. 2017

Borgonovo, Janina / Allende-Castro, Camilo / Laliena, Almudena / Guerrero, Néstor / Silva, Hernán / Concha, Miguel L. ·Anatomy and Developmental Biology, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, PO Box 70031, Santiago, Chile; Biomedical Neuroscience Institute, Independencia 1027, Santiago, Chile; Center for Geroscience, Brain Health and Metabolism, Santiago, Chile. · Anatomy and Developmental Biology, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, PO Box 70031, Santiago, Chile; Biomedical Neuroscience Institute, Independencia 1027, Santiago, Chile. · Department of Psychiatry and Mental Health, Clinical Hospital, Universidad de Chile, Santiago, Chile. · Anatomy and Developmental Biology, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, PO Box 70031, Santiago, Chile; Biomedical Neuroscience Institute, Independencia 1027, Santiago, Chile; Center for Geroscience, Brain Health and Metabolism, Santiago, Chile. Electronic address: mconcha@med.uchile.cl. ·Parkinsonism Relat Disord · Pubmed #27889469.

ABSTRACT: Although Parkinson's Disease (PD) is mostly considered a motor disorder, it can present at early stages as a non-motor pathology. Among the non-motor clinical manifestations, depression shows a high prevalence and can be one of the first clinical signs to appear, even a decade before the onset of motor symptoms. Here, we review the evidence of early dysfunction in neural circuitry associated with depression in the context of PD, focusing on pre-clinical, pre-motor and early motor phases of the disease. In the pre-clinical phase, structural and functional changes in the substantia nigra, basal ganglia and limbic structures are already observed. Some of these changes are linked to motor compensation mechanisms while others correspond to pathological processes common to PD and depression and thus could underlie the appearance of depressive symptoms during the pre-motor phase. Studies of the early motor phase (less than five years post diagnosis) reveal an association between the extent of damage in different monoaminergic systems and the appearance of emotional disorders. We propose that the limbic loop of the basal ganglia and the lateral habenula play key roles in the early genesis of depression in PD. Alterations in the neural circuitry linked with emotional control might be sensitive markers of the ongoing neurodegenerative process and thus may serve to facilitate an early diagnosis of this disease. To take advantage of this, we need to improve the clinical criteria and develop biomarkers to identify depression, which could be used to determine individuals at risk to develop PD.

12 Review Epigenetic Modifications of Major Depressive Disorder. 2016

Saavedra, Kathleen / Molina-Márquez, Ana María / Saavedra, Nicolás / Zambrano, Tomás / Salazar, Luis A. ·Center of Molecular Biology and Pharmacogenetics, Scientific and Technological Bioresource Nucleus, Universidad de La Frontera, Temuco 4811230, Chile. kathleen.saavedra@ufrontera.cl. · Center of Molecular Biology and Pharmacogenetics, Scientific and Technological Bioresource Nucleus, Universidad de La Frontera, Temuco 4811230, Chile. anamariamolinamarquez@gmail.com. · Center of Molecular Biology and Pharmacogenetics, Scientific and Technological Bioresource Nucleus, Universidad de La Frontera, Temuco 4811230, Chile. nicolas.saavedra@ufrontera.cl. · Center of Molecular Biology and Pharmacogenetics, Scientific and Technological Bioresource Nucleus, Universidad de La Frontera, Temuco 4811230, Chile. tomas.zambrano@ufrontera.cl. · Center of Molecular Biology and Pharmacogenetics, Scientific and Technological Bioresource Nucleus, Universidad de La Frontera, Temuco 4811230, Chile. luis.salazar@ufrontera.cl. · Millennium Institute for Research in Depression and Personality (MIDAP), Universidad de La Frontera, Temuco 4811230, Chile. luis.salazar@ufrontera.cl. ·Int J Mol Sci · Pubmed #27527165.

ABSTRACT: Major depressive disorder (MDD) is a chronic disease whose neurological basis and pathophysiology remain poorly understood. Initially, it was proposed that genetic variations were responsible for the development of this disease. Nevertheless, several studies within the last decade have provided evidence suggesting that environmental factors play an important role in MDD pathophysiology. Alterations in epigenetics mechanism, such as DNA methylation, histone modification and microRNA expression could favor MDD advance in response to stressful experiences and environmental factors. The aim of this review is to describe genetic alterations, and particularly altered epigenetic mechanisms, that could be determinants for MDD progress, and how these alterations may arise as useful screening, diagnosis and treatment monitoring biomarkers of depressive disorders.

13 Review Healthcare team training programs aimed at improving depression management in primary care: A systematic review. 2016

Vöhringer, Paul A / Castro, Ariel / Martínez, Pablo / Tala, Álvaro / Medina, Simón / Rojas, Graciela. ·Department of Psychiatry and Mental Health, Clinical Hospital, Universidad de Chile, Santiago, Chile; Millennium Institute for Depression and Personality Research (MIDAP), Santiago, Chile; Mood Disorders Program, Tufts Medical Center, Tufts University, Boston, USA. · Clinical Hospital, Universidad de Chile, Santiago, Chile. · Department of Psychiatry and Mental Health, Clinical Hospital, Universidad de Chile, Santiago, Chile; Millennium Institute for Depression and Personality Research (MIDAP), Santiago, Chile; School of Psychology, Faculty of Humanities, Universidad de Santiago de Chile, Santiago, Chile. Electronic address: pablo88.martinezdiaz@gmail.com. · Department of Psychiatry and Mental Health, Clinical Hospital, Universidad de Chile, Santiago, Chile. · School of Medicine, Faculty of Medicine, Universidad de Chile, Santiago, Chile. · Department of Psychiatry and Mental Health, Clinical Hospital, Universidad de Chile, Santiago, Chile; Millennium Institute for Depression and Personality Research (MIDAP), Santiago, Chile. ·J Affect Disord · Pubmed #27136411.

ABSTRACT: BACKGROUND: Although evidence from Latin America and the Caribbean suggests that depression can be effectively treated in primary care settings, depression management remains unevenly performed. This systematic review evaluates all the international evidence on healthcare team training programs aimed at improving the outcomes of patients with depression. METHODS: Three databases were searched for articles in English or Spanish indexed up to November 20, 2014. Studies were included if they fulfilled the following conditions: clinical trials, meta-analyses, or systematic reviews; and if they evaluated a training or educational program intended to improve the management of depression by primary healthcare teams, and assessed change in depressive symptoms, diagnosis or response rates, referral rates, patients' satisfaction and/or quality of life, and the effectiveness of treatments. RESULTS: Nine studies were included in this systematic review. Five trials tested the effectiveness of multi-component interventions (training included), and the remaining studies evaluated the effectiveness of specific training programs for depression management. All the studies that implemented multi-component interventions were efficacious, and half of the training trials were shown to be effective. LIMITATIONS: Contribution of training programs alone to the effectiveness of multi-component interventions is yet to be established. The lack of specificity regarding health providers' characteristics might be a confounding factor. CONCLUSIONS: The review conducted suggests that stand-alone training programs are less effective than multi-component interventions. In applying the evidence gathered from developed countries to Latin America and the Caribbean, these training programs must consider and address local conditions of mental health systems, and therefore multi-component interventions may be warranted.

14 Review Discriminating Between Bipolar Disorder and Major Depressive Disorder. 2016

Vöhringer, Paul A / Perlis, Roy H. ·Department of Psychiatry, Tufts University School of Medicine, 800 Washington Street, Boston, MA 02111, USA; Department of Psychiatry, University of Chile, Av. Independencia 1027, Santiago 8071146, Chile. · Department of Psychiatry, Center for Experimental Drugs and Diagnostics, Massachusetts General Hospital, Harvard Medical School, 185 Cambridge Street, Boston, MA 02114, USA. Electronic address: rperlis@mgh.harvard.edu. ·Psychiatr Clin North Am · Pubmed #26876315.

ABSTRACT: Rates of misdiagnosis between major depressive disorder and bipolar disorder have been reported to be substantial, and the consequence of such misdiagnosis is likely to be a delay in achieving effective control of symptoms, in some cases spanning many years. Particularly in the midst of a depressive episode, or early in the illness course, it may be challenging to distinguish the 2 mood disorders purely on the basis of cross-sectional features. To date, no useful biological markers have been reliably shown to distinguish between bipolar disorder and major depressive disorder.

15 Review Diabetes and Quality of Life: Initial Approach to Depression, Physical Activity, and Sexual Dysfunction. 2016

Pozzo, M Josefina / Mociulsky, Juliana / Martinez, Esteban T / Senatore, Guido / Farias, Javier M / Sapetti, Adrian / Sanzana, M Gabriela / Gonzalez, Patricia / Cafferata, Alberto / Peloche, Andrea / Lemme, Liliana. ·1German Hospital, Buenos Aires, Argentina; 2Dr Alberto Cormillot Nutrition and Health Clinic, Buenos Aires, Argentina; 3University of Buenos Aires School of Medicine, Buenos Aires, Argentina; 4Bayer Argentina, Buenos Aires, Argentina; 5Güemes Hospital, Buenos Aires, Argentina; 6Medical Center for Sexology, Buenos Aires, Argentina; 7University of Chile Clinical Hospital, Santiago, Chile; 8FLENI Institute, Buenos Aires, Argentina; and 9UCUDAL, Montevideo, Uruguay. ·Am J Ther · Pubmed #24858335.

ABSTRACT: The different aspects that contribute to quality of life in patients with diabetes mellitus, such as mood, are of great importance for the treatment of this disease. These aspects not only influence the well-being of patients but also influence treatment adherence, therefore affecting the course of the disease. A panel of experts from Argentina, Chile, and Uruguay performed a review of the main aspects affecting quality of life in patients with diabetes: physical activity, mood disorders, and sexual activity. The consensus of the panel was that physical activity is important in the treatment of patients with diabetes because it reduces morbidity, mortality, and disease complications, and it should be performed on a regular basis, bearing in mind the patient's characteristics. Increased physical activity is associated with better glycemic control, and in individuals with glucose intolerance, it delays progression toward diabetes. In patients with diabetes, there is a high prevalence of depression, which can influence treatment adherence. Therefore, early detection of depression is essential to improve the course of diabetes. Regarding sexual activity, erectile dysfunction may be a significant sign in the case of suspected diabetes and the early diagnosis of vasculopathy in patients with diabetes. In conclusion, greater emphasis should be placed on improving patient knowledge, early detection, and multidisciplinary approaches to deal with the aspects of diabetes that affect patients' quality of life.

16 Review Inflammation and clinical response to treatment in depression: A meta-analysis. 2015

Strawbridge, R / Arnone, D / Danese, A / Papadopoulos, A / Herane Vives, A / Cleare, A J. ·Affective Disorders Research Group, Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, King׳s College London, London, UK. Electronic address: Becci.strawbridge@kcl.ac.uk. · Affective Disorders Research Group, Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, King׳s College London, London, UK. · Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, King׳s College London, London, UK; Department of Child & Adolescent Psychiatry, Institute of Psychiatry, King׳s College London, London, UK. · Affective Disorders Research Group, Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, King׳s College London, London, UK; Psychiatric University Clinic, University of Chile, Santiago, Chile. · Affective Disorders Research Group, Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, King׳s College London, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King׳s College London, London, UK. ·Eur Neuropsychopharmacol · Pubmed #26169573.

ABSTRACT: The depressive state has been characterised as one of elevated inflammation, which holds promise for better understanding treatment-resistance in affective disorders as well as for future developments in treatment stratification. Aiming to investigate alterations in the inflammatory profiles of individuals with depression as putative biomarkers for clinical response, we conducted meta-analyses examining data from 35 studies that investigated inflammation before and after treatment in depressed patients together with a measure of clinical response. There were sufficient data to analyse IL-6, TNFα and CRP. Levels of IL-6 decreased with antidepressant treatment regardless of outcome, whereas persistently elevated TNFα was associated with prospectively determined treatment resistance. Treatment non-responders tended to have higher baseline inflammation, using a composite measure of inflammatory markers. Our findings suggest that elevated levels of inflammation are contributory to treatment resistance. Combining inflammatory biomarkers might prove a useful tool to improve diagnosis and detection of treatment refractoriness, and targeting persistent inflammation in treatment-resistant depression may offer a potential target for the development of novel intervention strategies.

17 Review Differential typology of delusions in major depression and schizophrenia. A critique to the unitary concept of 'psychosis'. 2015

Stanghellini, Giovanni / Raballo, Andrea. ·"G. d'Annunzio" University, Chieti, Italy; "D. Portales" University, Santiago, Chile. · Department of Mental Health and Pathological Addiction, AUSL Reggio Emilia - Reggio Emilia, Italy. ·J Affect Disord · Pubmed #25443763.

ABSTRACT: It is a current trend in psychiatry to discard the Kraepelinian dichotomy schizophrenia vs. manic-depressive illness and use the overinclusive label 'psychosis' to broadly indicate the whole spectrum of severe mental disorders. In this paper we show that the characteristics of psychotic symptoms vary across different diagnostic categories. We compare delusions in schizophrenia and major depression and demonstrate how these phenomena radically differ under these two psychopathological conditions. The identification of specific types of delusions is principally achieved through the differential description of subjective experiences. We will use two general domains to differentiate schizophrenic and depressive delusions, namely the intrinsic and extrinsic features of these phenomena. Intrinsic features are the form and content of delusions, extrinsic ones include the background from which delusions arise, that is, changes in the field of experience, background feelings, ontological framework of experience, and existential orientation. This kind of systematic exploration of the patients' experience may provide a useful integration to the standard symptom-based approach and can be used to establish a differential typology of the clinical manifestation of psychosis based on the fundamental alterations of the structures of subjectivity characterizing each mental disorder, particularly with respect to the Kraepelinian dichotomy schizophrenic vs. manic-depressive illness.

18 Review Causal effects of retirement timing on subjective physical and emotional health. 2013

Calvo, Esteban / Sarkisian, Natalia / Tamborini, Christopher R. ·Public Policy Institute, School of Business and Economics, Universidad Diego Portales, AV. Ejercito Libertador 260, Santiago, Chile. esteban.calvo@udp.cl ·J Gerontol B Psychol Sci Soc Sci · Pubmed #23149431.

ABSTRACT: OBJECTIVES: This article explores the effects of the timing of retirement on subjective physical and emotional health. Using panel data from the Health and Retirement Study (HRS), we test 4 theory-based hypotheses about these effects-that retirements maximize health when they happen earlier, later, anytime, or on time. METHOD: We employ fixed and random effects regression models with instrumental variables to estimate the short- and long-term causal effects of retirement timing on self-reported health and depressive symptoms. RESULTS: Early retirements--those occurring prior to traditional and legal retirement age--dampen health. DISCUSSION: Workers who begin their retirement transition before cultural and institutional timetables experience the worst health outcomes; this finding offers partial support to the psychosocial-materialist approach that emphasizes the benefits of retiring later. Continued employment after traditionally expected retirement age, however, offers no health benefits. In combination, these findings offer some support for the cultural-institutional approach but suggest that we need to modify our understanding of how cultural-institutional forces operate. Retiring too early can be problematic but no disadvantages are associated with late retirements. Raising the retirement age, therefore, could potentially reduce subjective health of retirees by expanding the group of those whose retirements would be considered early.

19 Review [An update on neuropsychiatric lupus with emphasis in cognitive dysfunction]. 2012

León, Tomás / Henríquez, Carla / Calderón, Jorge / Massardo, Loreto. ·Departamentos de Inmunología Clínica y Reumatología y Psiquiatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. ·Rev Med Chil · Pubmed #23559293.

ABSTRACT: BACKGROUND: Patients with systemic lupus erythematosus (SLE) suffer from a number of neuropsychiatric (NP) symptoms throughout their disease affecting them both physically and psychologically. We review herein the nomenclature and case definitions for neuropsychiatric lupus syndromes proposed by the American College of Rheumatology in 1999. We emphasize cognitive dysfunction and discuss etiological hypotheses, especially those related to the presence of antineuronal autoantibodies.

20 Review Communication between gastrointestinal bacteria and the nervous system. 2012

Bravo, Javier A / Julio-Pieper, Marcela / Forsythe, Paul / Kunze, Wolfgang / Dinan, Timothy G / Bienenstock, John / Cryan, John F. ·Instituto de Química, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile. javier.bravo@ucv.cl ·Curr Opin Pharmacol · Pubmed #23041079.

ABSTRACT: In the past few years, intestinal microbiota has emerged as a novel target for the treatment of gut-brain axis alterations. These include functional gastrointestinal disorders, such as irritable bowel syndrome (IBS), which can be comorbid with stress-related psychiatric conditions. Thus, modulation of the microbiota (e.g. with the use of probiotics) could be proposed as a novel strategy not only for the treatment of IBS but also as an adjuvant for psychiatric treatment of anxiety and depression.

21 Review Solving the antidepressant efficacy question: effect sizes in major depressive disorder. 2011

Vöhringer, Paul A / Ghaemi, S Nassir. ·Facultad de Medicina, Hospital Clinico, Universidad de Chile, Santiago, Chile. ·Clin Ther · Pubmed #22136980.

ABSTRACT: BACKGROUND: Numerous reviews and meta-analyses of the antidepressant literature in major depressive disorders (MDD), both acute and maintenance, have been published, some claiming that antidepressants are mostly ineffective and others that they are mostly effective, in either acute or maintenance treatment. OBJECTIVE: The aims of this study were to review and critique the latest and most notable antidepressant MDD studies and to conduct our own reanalysis of the US Food and Drug Administration database studies specifically analyzed by Kirsch et al. METHODS: We gathered effect estimates of each MDD study. In our reanalysis of the acute depression studies, we corrected analyses for a statistical floor effect so that relative (instead of absolute) effect size differences were calculated. We also critiqued a recent meta-analysis of the maintenance treatment literature. RESULTS: Our reanalysis showed that antidepressant benefit is seen not only in severe depression but also in moderate depression and confirmed a lack of benefit for antidepressants over placebo in mild depression. Relative antidepressant versus placebo benefit increased linearly from 5% in mild depression to 12% in moderate depression to 16% in severe depression. The claim that antidepressants are completely ineffective, or even harmful, in maintenance treatment studies involves unawareness of the enriched design effect, which, in that analysis, was used to analyze placebo efficacy. The same problem exists for the standard interpretation of those studies, although they do not prove antidepressant efficacy either, since they are biased in favor of antidepressants. CONCLUSIONS: In sum, we conclude that antidepressants are effective in acute depressive episodes that are moderate to severe but are not effective in mild depression. Except for the mildest depressive episodes, correction for the statistical floor effect proves that antidepressants are effective acutely. These considerations only apply to acute depression, however. For maintenance, the long-term efficacy of antidepressants is unproven, but the data do not support the conclusion that they are harmful.

22 Review [Psychiatric and cognitive problems associated to hepatitis C and its treatment with interferon]. 2010

Caneo R, Constanza / González T, Matías / Repetto L, Paula B / Soza R, Alejandro. ·Unidad de Enlace y Medicina Psicosomática, Departamento de Psiquiatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Temuco, Chile. ·Rev Med Chil · Pubmed #21279258.

ABSTRACT: This article is a literature search about the psychopathology related to hepatitis C and its treatment with interferon. An overview of the methodology of the available studies is presented. New theories for a better understanding and diagnosis of the psychiatric alteration associated to hepatitis C or interferon treatment are proposed, to improve future research. We discuss neurobiological aspects, clinical manifestations, psychosocial features and pharmacotherapy of the psychiatric manifestations of hepatitis C and its treatment with interferon.

23 Review [Bipolar depression and unipolar depression: differential diagnosis in clinical practice]. 2010

Leyton, Fanny / Barrera, Alvaro. ·Facultad de Medicina (Campus Sur), Universidad de Chile. Santiago de Chile. fanny.leyton@gmail.com ·Rev Med Chil · Pubmed #20919490.

ABSTRACT: When assessing a patient with depression it is crucial not to miss a diagnosis of bipolar depression. In this review we suggest that it can be achieved, first, by consistently usingstandardised diagnostic criteria (e.g., DSM-IV-TR or ICD 10) and, second, by ascertaining the presence of some clinical features. The latter include previous episodes of mood elevation, current or past episodes of psychotic depression, onset of recurrent depressive disorder before the age of 25, a strong family history of mood disorder and suicide, lack of response or "wearing off" of response to well conducted antidepressant treatment, and an unusually fast response to antidepressants with features of elation. Although more and better research is required to establish the validity, sensitivity, specificity, and predictive value of each one of these features we suggest that from a practical point of view they would increase clinicians' awareness of bipolar depression.

24 Review [Depression in HIV infection: prevalence, risk factors and management]. 2010

Wolff L, Claudia / Alvarado M, Rubén / Wolff R, Marcelo. ·Escuela de Salud Pública, Universidad de Chile, Santiago, Chile. clausiwola@msn.com ·Rev Chilena Infectol · Pubmed #20140318.

ABSTRACT: Depression is one of the main psychiatric co-morbidities in HIV infection, presenting with a significantly higher prevalence than in the general population (around 35%). Its presence has been associated with poor quality of life, HIV disease progression and poor adherence to antiretroviral therapy. Although antidepressive treatment has demonstrated effectiveness on the management of depressive symptoms, improvement of clinical and laboratory parameters, and enhancement of antiretroviral adherence, depression is frequently under diagnosed and under treated in these patients. We analyzed the main international findings on depression prevalence, risk factors, con-sequences and management in people with HIV disease.

25 Clinical Trial Adjunctive Lanicemine (AZD6765) in Patients with Major Depressive Disorder and History of Inadequate Response to Antidepressants: A Randomized, Placebo-Controlled Study. 2017

Sanacora, Gerard / Johnson, Michael R / Khan, Arif / Atkinson, Sarah D / Riesenberg, Robert R / Schronen, Juan P / Burke, Michael A / Zajecka, John M / Barra, Luis / Su, Hong-Lin / Posener, Joel A / Bui, Khanh H / Quirk, Michael C / Piser, Timothy M / Mathew, Sanjay J / Pathak, Sanjeev. ·Yale University School of Medicine, New Haven, CT, USA. · Sarkis Clinical Trials, Gainesville, FL, USA. · Northwest Clinical Research Center, Bellevue, WA, USA and Department of Psychiatry, Duke University School of Medicine, Durham, NC, USA. · Finger Lakes Clinical Research, Rochester, NY, USA. · Atlanta Center for Medical Research, Atlanta, GA, USA. · Welgemoed Medical Centre, Cape Town, South Africa. · iResearch Atlanta, Decatur, GA, USA. · Rush University Medical Center, Chicago, IL, USA. · Universidad de Antofagasta, Antofagasta, Chile. · AstraZeneca Pharmaceuticals LP, Wilmington, DE, and Cambridge, MA, USA. · Baylor College of Medicine, Houston and Michael E. Debakey VA Medical Center, Houston, TX, USA. ·Neuropsychopharmacology · Pubmed #27681442.

ABSTRACT: The objective of this study was to investigate the efficacy and safety of adjunctive lanicemine (NMDA channel blocker) in the treatment of major depressive disorder (MDD) over 12 weeks. This phase IIb, randomized, parallel-arm, double-blind, placebo-controlled study was conducted at 49 centers in four countries between December 2011 and August 2013 in 302 patients aged 18-70 years, meeting criteria for single episode or recurrent MDD and with a history of inadequate treatment response. Patients were required to be taking an allowed antidepressant for at least four weeks prior to screening. Patients were randomized equally to receive 15 double-blind intravenous infusions of adjunctive lanicemine 50 mg, lanicemine 100 mg, or saline over a 12-week course, in addition to ongoing antidepressant. The primary efficacy end point was change in Montgomery-Åsberg Depression Rating Scale (MADRS) total score from baseline to week 6. Secondary efficacy outcome variables included change in MADRS score from baseline to week 12, response and remission rates, and changes in Clinical Global Impression scale, Quick Inventory of Depressive Symptomology Self-Report score, and Sheehan Disability Scale score. Of 302 randomized patients, 240 (79.5%) completed treatment. Although lanicemine was generally well tolerated, neither dose was superior to placebo in reducing depressive symptoms on the primary end point or any secondary measures. There was no significant difference between lanicemine and placebo treatment on any outcome measures related to MDD. Post hoc analyses were performed to explore the possible effects of trial design and patient characteristics in accounting for the contrasting results with a previously reported trial.

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