Women's perinatal depression: Anhedonia-related symptoms have increased in the COVID-19 pandemic

Background: The prevalence of perinatal depression increased during the COVID-19 pandemic, which may be due to changes in the profile of specific depressive symptoms.Aims: To analyze the impact of the COVID-19 pandemic on the (1) prevalence and severity of specific depressive symptoms; and on the (2) prevalence of clinically significant symptoms of depression during pregnancy and postpartum.Methods: Pregnant and postpartum women recruited before (n = 2395) and during the COVID-19 pandemic (n = 1396) completed a sociodemographic and obstetric questionnaire and the Edinburgh Postnatal Depression Scale (EPDS). For each item, scores & GE;1 and & GE; 2 were used to calculate the prevalence and severity of depressive symptoms, respectively.Results: The prevalence and severity of symptoms of depression were significantly higher during the COVID-19 pandemic. The prevalence of specific symptoms increased by >30%, namely being able to laugh and see the funny side of things (pregnancy 32.6%, postpartum 40.6%), looking forward with enjoyment to things (pregnancy 37.2%, postpartum 47.2%); and feelings of sadness/miserable or unhappiness leading to crying during postpartum (34.2% and 30.2%, respectively). A substantial increase was observed in the severity of specific symptoms related to feelings that things have been getting on top of me during pregnancy and the postpartum period (19.4% and 31.6%, respectively); feeling sad or miserable during pregnancy (10.8%); and feeling scared/panicky during postpartum (21.4%).Conclusion: Special attention should be paid to anhedonia-related symptoms of perinatal depression to ensure that they are adequately managed in present and future situations of crisis.This study was and supported by the Psychology Research Centre (UID/PSI/01662/2013) , University of Minho, by the Portuguese Foundation for Science and Technology and the Portuguese Ministry of Education and Science through national funds and co-financed by FEDER through COMPETE2020 under the PT2020 Partnership Agreement, under the Grant No. POCI-01-0145-FEDER-007653. This research was supported by the FEDER Funds through the Programa Operacional Factores de Competitividade (COMPETE) and by National Funds through FCT (Fundacao para a Ciencia e a Tecnologia) under the Grant No. PTDC/SAU/SAP/116738/2010. Fundacao Bial, under the project with the reference 157/12 and by the FCT- Fundacao para a Ciencia e a Tecnologia, I.P., under the projects PTDC/PSI-PCL/119152/2010, HEI-Lab R & amp;D Unit UIDB/05380/2020, UIDB/04750/2020, and LA/P/0064/2020. It was supported by FEDER through COMPETE2020 under the PT2020 Partnership Agreement (POCI-01-0145-FEDER-007653) . Raquel Costa was supported by the FSE and FCT under the Post-Doctoral Grant SFRH/BPD/117597/2016 [RC] . Tiago Miguel Pinto [TMP] was supported by the FSE and FCT under the individual grant SFRH/BD/115048/2016. Ana Conde was supported a doctoral grant for Science in Measure IV.3 and co-funded under the 2010 Science and Innovation Operational Program (POCI 2010) from Science and Technology Foundation, Government of the Portuguese Republic (Ref. SFRH/BD/13768/2003) [AC] . The work developed by ProChild CoLAB was supported by: (i) NORTE-06-3559-FSE-000044, integrated in the invitation NORTE-59-2018-41, aiming to hire Highly Qualified Human Resources, co-financed by the Regional Operational Programme of the North 2020, thematic area of Competitiveness and Employment, through the European Social Fund (ESF) and (ii) Mission Interface Program from the Resilience and Recuperation Plan, notice no 01/C05-i02/2022, aiming to guarantee public core funding to strengthen the network of interface institutions, as defined in the legal regime in force, approved by Decree-Law no. 63/2019, of May 16th, as well as in its 1st review on 'Technology and Innovation Centres-CTI' and 'Collaborative Laboratories-CoLABs', approved by Decree-Law no. 126-B/2021, of December 31st. Ana Mesquita is supported from the Portuguese Foundation for Science and Technology (FCT) and from EU through the European Social Fund and from the Human Potential Operational Program-IF/00750/2015. This article is based upon work from COST Action CA18138 Research Innovation and Sustainable Pan-European Network in Peripartum Depression Disorder (Riseup-PPD) , supported by COST (European Cooperation in Science and Technology; https:// www.cost.eu/) . The funders had no role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication

Depression and anxiety in systemic lupus erythematosus: The crosstalk between immunological, clinical, and psychosocial factors

Depression and anxiety cause severe loss of quality of life for patients with systemic lupus erythematosus. The causes and factors that contribute to these psychological manifestations in lupus are difficult to disentangle. This study compared clinical, psychological, and demographic factors between lupus patients, depressed patients, and rheumatoid arthritis patients to discover lupus-specific contributors to depression. Lupus-specific manifestations of depression were also investigated. Physiological, clinical, and psychosocial data were collected from 77 patients. ELISA was used to measure cytokine levels. Univariate and Multivariate analyses were used to compare the patient populations and identify correlations between key physical and psychological indicators. The prevalence of depression in the SLE cohort was 6 times greater than the healthy control subjects. Pain, IL-6, and Pittsburgh Sleep Quality index values were all significantly higher in SLE patients compared with the healthy control group (P < .001, P = .038, and P = .005, respectively). Anxiety levels were significantly higher in SLE patients compared to healthy and RA control patients (P = .020 and .011, respectively). Serum IL-10 concentrations, relationship assessment scale, and fatigue severity scale values were found to be correlated with depression among the SLE patients (P = .036, P = .007, and P = .001, respectively). Relationship assessment and fatigue severity scale scores were found to be the best indicators of depression for the SLE patients (P = .042 and .028, respectively). Fatigue Severity, relationship satisfaction, and IL-10 concentrations are indicators of depression in lupus patients. Despite also suffering from the pain and disability that accompanies chronic autoimmune disease, the rheumatoid arthritis patients had less anxiety and better relationship scores.The authors thank the Portugal Fulbright Commission for funding Dr. Pool

Influence of Biological Therapeutics, Cytokines, and Disease Activity on Depression in Rheumatoid Arthritis

Purpose: Rheumatoid arthritis (RA) is an often debilitating autoinflammatory disease. Patients with rheumatoid arthritis are often troubled by co-occurring depression or other psychological manifestations. RA patients have a variety of treatment options available, including biologicals that inhibit cytokines or immune cells. If these cytokines influence the psychological symptoms, then the use of cytokine inhibitors should modulate these symptoms.Methods: A cohort of 209 individuals was recruited. This group included 82 RA patients, 22 healthy subjects, 32 depressed control subjects, and 73 subjects with systemic lupus erythematosus. Of the RA patients, 51% were on a biological therapeutic. ELISA was used to measure cytokine levels. A variety of psychological assessments were used to evaluate depression, anxiety, sleep, fatigue, and relationship status. Clinical values were obtained from medical records.Results: IL-10 concentration was associated with depressive symptoms in the RA patients, healthy controls, and the lupus patients. In the patients with primary depression, depressive symptoms were associated with IL-6 and TNF-alpha. In RA patients, Tocilizumab use was associated with decreased depressive symptoms. 14 RA patients who were not using biologicals began using them by a one-month follow-up. In these patients, there was no significant change to any value except for fatigue.Conclusions: A variety of both biological and social factors influences depressive symptoms in RA. IL-10 and IL-6 are likely to be involved, since IL-10 concentration was associated with depression and Tocilizumab decreased depressive symptoms in the RA patients. The roles of these cytokines are different in RA and lupus, as high IL-10 in RA is associated with increased depressive symptoms, but high IL-10 in the lupus patients is associated with decreased depression. IL-6 was also associated with depressive symptoms in the patients with primary depression. These results strongly indicate that disease activity, including cytokine levels, has a strong impact on depressive symptoms.This study was supported by Portugal Fulbright Commission (Dr. Brian D. Poole)

Feasibility and acceptability of psychosocial care forunsuccessful fertility treatment

Introduction Many people undergo fertility treatment to have biological children, but around four in ten patients complete all treatment cycles without having the children they desire. This triggers intense grief from which patients report taking on average 2 years to recover. Fertility guidelines and regulators stress the need to support patients through this process, but there is a scarcity of evaluated interventions to this end and evidence about when and how to offer care is lacking. This study explored patients' and healthcare professionals' (HCPs) experiences of and views about provision of psychosocial care (to patients facing unsuccessful fertility treatment, i.e., care provided by a mental health professional to address the emotional, cognitive, behavioural, relational and social needs that patients have at this stage of treatment). Methods Five qualitative online focus groups were conducted with Portuguese participants: three with patients waiting to initiate or undergoing their last cycle of in vitro fertilization/intracytoplasmic sperm injection or having completed it within the last 2 months without achieving a pregnancy and two with HCPs working at fertility clinics. Focus groups were recorded and transcribed verbatim, and data were analysed with Framework Analysis. Results Thirteen patients and nine HCPs participated. Analysis resulted in 1293 codes, systematically organized into 13 categories, 4 themes and 1 metatheme. The latter showed high consensus about the need for psychosocial care for unsuccessful treatment, but perceived challenges in its implementation. Themes reflected (1) consensual demand for psychosocial care at all stages of treatment but particularly at the end, (2) high perceived acceptability of integrating preventive care initiated during treatment with early psychosocial care only for those patients who experience unsuccessful treatment, (3) perceived challenges of implementing psychosocial care for unsuccessful treatment at clinics and (4) suggestions to promote its acceptability and feasibility. Conclusion Patients and HCPs perceive that clinics should improve care provision across the whole treatment pathway and in particular for unsuccessful fertility treatment. Suggestions were made to inform future research focusing on the development and evaluation of psychosocial interventions to this end. Patient or Public Contribution Patients and HCPs participated in the focus groups. Two HCPs also revised the manuscript.Thanks are due to nurse Cláudia Coelho for supporting this project and to patients and healthcare professionals who participated in the focus groups. The authors are also grateful to the European Social Fund and Portuguese Foundation for Science and Technology, I.P. (FCT; Fundação para a Ciência e a Tecnologia) for supporting the present study, through the Portuguese State Budget. Mariana Sousa-Leite has a doctoral fellowship (SFRH/BD/144429/2019), Raquel Costa has a postdoctoral fellowship (SFRH/BPD/117597/2016), and the EPI Unit, ITR and CIPsi (PSI/01662) are also funded by FTC, in the scope of the projects UIDB/04750/2020, LA/P/0064/2020 and UIDB/PSI/01662/2020, respectively

Clinical and laboratorial diversity in the bantu haplotype of sickle cell anemia

Several factors have been identified as possibly being responsible for the diversity of sickle cell anemia patients symptoms, including gender, age, haplotypes and hemoglobin F levels. The aim of this paper is to verify the clinical and laboratorial diversity of the Bantu haplotype. A descriptive study was performed of eighteen children and adolescents with sickle cell anemia and homozygous for the Bantu haplotype. Gender and age were assessed in respect to clinical and laboratorial features. Statistical analysis of the results was achieved using the EPIINFO program version 6.04. Children from 1 to 11 years old had more infections than adolescents from 12 to 19 and higher levels of hemoglobin F. The hematocrit was higher in girls. Higher levels of hemoglobin A2 were related to more infections, and higher levels of hemoglobin F were related to hematocrit values and lower numbers of infections and periods in hospital. This study suggests that there is diversity within the Bantu haplotype, which is possibly related to gender, age and hemoglobin A2 and hemoglobin F levels of patients.Muitos fatores são responsáveis pela diversidade de sintomas nos pacientes de anemia falciforme, entre eles: sexo, idade, haplótipos e nível de hemoglobina fetal. O objetivo deste estudo foi verificar a diversidade clínica e laboratorial dentro do haplótipo bantu. Realizou-se um estudo descritivo onde foram avaliados 18 crianças e adolescentes portadores de anemia falciforme e homozigóticos para o haplótipo bantu, relacionando sexo e idade com as características clínicas e laboratoriais, além de relacioná-las diretamente entre si. As amostras foram do tipo casuais simples. O tamanho da amostra teve uma variação de freqüência para o evento de 30% a 65% e nível de confiança de 99,9%. As análises estatísticas foram realizadas através do programa EPIINFO, versão 6.04b, com erro a de 5%. A faixa etária de 01 a 11 anos teve um maior número de infecções que a faixa de 12 a 19, além de níveis mais altos de hemoglobina fetal. Os valores do hematócrito foram maiores no sexo feminino. Níveis mais elevados de hemoglobina A2 foram relacionados com maior número de infecções, enquanto níveis mais elevados de hemo&shy;globina fetal foram relacionados com maiores valores de hematócrito e menor número de crises álgicas/ano de acompanhamento. O número de transfusões/ano teve correlação positiva com o número de crises álgicas, de infecções e de inter&shy;namentos. Este estudo sugere que há uma diversidade clínica e laboratorial dentro do haplótipo bantu e possivelmente está relacionado com o sexo, a idade e os níveis de hemoglobina fetal e A2 dos pacientes.Fundação Universitária de Ciências da Saúde de Alagoas Departamento de PediatriaUniversidade Federal de Alagoas Departamento de Clínica MédicaUniversidade Federal de Sergipe Departamento de PediatriaUniversidade Federal de São Paulo (UNIFESP) Departamento de Clínica MédicaUNIFESP, Depto. de Clínica MédicaSciEL

Biological and economic performance of animal genetic groups under different diets.

A grazing trial to evaluate biological and economic efficiencies for rearing young animals exclusively on pasture from weaning at 7 months of age, with average initial weight of 220 ± 12 kg, to slaughter was conducted from May 2006 to October 2007. Two levels of combined supplementation during the first dry period and four genetic groups (F1 Angus-Nellore; ½Braford-¼Angus-¼Nellore; ½Brahman-¼Angus-¼Nellore; and Charolais- Nellore) were used following a 4 by 2 factorial arrangement and eight replications in a completely randomized design. During both dry periods, eight paddocks of deferred Brachiaria brizantha were utilized. During the first dry period, concentrated mix (CM) and protein-mineral mixture (PMM) were provided in quantities of 0.8% and 0.2% of body weight (BW), respectively, for 142 days. During the subsequent rainy period, the animals were transferred to eight guinea grass paddocks for 197 days. During the second dry period, the animals were allocated to the same eight palisade grass paddocks used during the previous dry season. Steers had received supplementary diet with the same CM used before at 0.8% of BW. Animals supplemented with CM gained more BW than those supplemented with PMM; however, during the rainy season, steers supplemented with PMM performed better than those receiving CM during the preceding dry period. Using concentrate since the first dry season is a risky option in economic terms, as only the Angus-Nellore group showed a positive but small gain.Título em português: Desempenho biológico e econômico de grupos genéticos animais sob diferentes dietas