Depression in postmenopause: interdisciplinary approach in management and perspectives for rehabilitation

Surgical and natural menopause is often associated with depression symptoms. Along with the postpartum period, perimenopause is a “window of vulnerability” for depression development, because decline in estrogen level accounts for extinction of reproductive function, emotional disorders, genitourinary menopausal syndrome, which are combined with non-endocrine risk factors, such as decreasing income levels, low social support, and stress. Although a direct relationship between blood estrogens level and depression has not been demonstrated, the relation between menopause symptoms and depression has been proven, i.e., the symptoms of menopause can be considered as risk factors. Here, we summarizes the current view on the correct counseling and routing of menopausal women with depression symptoms in primary health care facilities, the principles of managing patients with risk factors, including genitourinary menopausal syndrome, as well as methods of rehabilitation and informational support. This will aid to improve the quality of medical care for such patients.

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Early menopause and premature ovarian insufficiency: problems and perspectives

Obstetrics Gynecology and Reproduction ◽

10.17749/2313-7347/ob.gyn.rep.2020.173 ◽

2020 ◽

Vol 14 (3) ◽

pp. 328-345

Author(s):

D. V. Blinov ◽

P. L. Hasan ◽

A. N. Mnatsakanyan ◽

D. I. Korabelnikov ◽

A. T. Safarov ◽

...

Keyword(s):

Hormone Replacement ◽

Clinical Signs ◽

Reproductive Function ◽

Current Data ◽

Premature Ovarian Insufficiency ◽

Ovarian Insufficiency ◽

Menopausal Syndrome ◽

Natural Menopause ◽

Threatening Condition

In this review we summarize current data on prevalence, etiology and pathogenesis resulting in premature ovarian insufficiency (POI). In particular, genetic, autoimmune, metabolic, iatrogenic disorders as well as unfavorable impact of environmental factors represent key pathogenetic mechanisms underlying POI development. Clinical picture of this disease is mainly manifested by oligo- and amenorrhea as well as genitourinary menopausal syndrome (GUMS). Special attention is paid to a link between such clinical signs and psychosocial discomfort not being a life-threatening condition but still able to markedly lower quality of woman’s life and considered as a comorbidity with type 2 diabetes mellitus, osteoporosis and cardiovascular diseases. Hormone replacement therapy (HRT) serves as the first-line therapeutic approach for treating POI, which is performed according to the principles similar to those used to perform menopausal hormone therapy (MHT) in case of natural menopause that should be continued until reaching at least the average age for the onset of menopause. Topical estriol therapy eliminates GUMS symptoms, which in turn positively affects sexual function and woman’s psychosocial status and contributes to improved quality of life. The data from recent studies examining topical estriol therapy in POI demonstrated high efficacy and safety. Finally, we also discuss diverse strategies to support reproductive function in women with POI.

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Possibilities of correction of menopausal disorders in women with the use of medicine Menopace

HEALTH OF WOMAN ◽

10.15574/hw.2016.111.95 ◽

2016 ◽

pp. 95-100

Author(s):

G.I. Reznichenko ◽

◽

N.Yu. Reznichenko ◽

V.Yu. Potebnya ◽

K.I. Kovalenko ◽

...

Keyword(s):

General Condition ◽

Clinical Symptoms ◽

Average Score ◽

Control Group ◽

Climacteric Syndrome ◽

Basic Subgroup ◽

Menopausal Syndrome ◽

Natural Menopause ◽

Surgical Menopause ◽

Observation Period

The objective: to determine the efficacy of medicine «Menopace» in treatment of women with natural and surgical menopause. Patients and methods. 20 women (I group) with a natural menopause were examined (basic subgroup consisted of 10 patients who used Menopace for 3 months; control subgroup consisted of 10 patients). 20 women (II group) with surgical menopause were examined (basic subgroup consisted of 10 patients who received Menopace for 3 months; control subgroup consisted of 10 patients). Results. The average score of neurovegetative and emotional manifestations of climacteric syndrome during the observation period decreased in women with natural and surgical menopause who used Menopace, compared with subgroups of patients who had not used the medicine. Conclusions. 1. The use of the medicine Menopace in women with natural menopause after 3 months showed the disappearance of clinical symptoms of climacteric syndrome in 70% of the cases, and significant improvement in general condition in 30% of cases. 2. During surgical menopause after 1 month of treatment with Menopace manifestations of sweating were observed 4.5 times less often than in control group, tides were observed 7 times less often than in control group. Neurovegetative and psychoemotional symptoms of menopause were absent in 80% of women after 3 months of treatment and in 20% of cases significant improvement was shown. 3. The obtained results give grounds to recommend wide use of Menopace in practical work for the treatment of menopausal syndrome during natural and surgical menopause. Key words: menopause, therapy, Menopace.

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Risk factors for excessive gestational weight gain in a UK population: a biopsychosocial model approach

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03519-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

S. M. Garay ◽

L. A. Sumption ◽

R. M. Pearson ◽

R. M. John

Keyword(s):

Risk Factors ◽

Weight Gain ◽

Gestational Weight Gain ◽

Biopsychosocial Model ◽

Elective Caesarean Section ◽

Depression Symptoms ◽

Institute Of Medicine ◽

Contributing Factors ◽

Gestational Weight ◽

The Uk

Abstract Background Gestational weight gain (GWG) can have implications for the health of both mother and child. However, the contributing factors remain unclear. Despite the advantages of using a biopsychosocial approach, this approach has not been applied to study GWG in the UK. This study aimed to investigate the risk factors of excessive GWG in a UK population, employing a biopsychosocial model. Methods This study utilised data from the longitudinal Grown in Wales (GiW) cohort, which recruited women in late pregnancy in South Wales. Specifically, data was collected from midwife recorded notes and an extensive questionnaire completed prior to an elective caesarean section (ELCS) delivery. GWG was categorised according to Institute of Medicine (IOM) guidelines. The analysis was undertaken for 275 participants. Results In this population 56.0% of women had excessive GWG. Increased prenatal depression symptoms (Exp(B)=1.10, p=.019) and an overweight (Exp(B)=4.16, p<.001) or obese (Exp(B)=4.20, p=.010) pre-pregnancy BMI, consuming alcohol in pregnancy (Exp(B)=.37, p=.005) and an income of less than £18,000 (Exp(B)=.24, p=.043) and £25–43,000 (Exp(B)=.25, p=.002) were associated with excessive GWG. Conclusion GWG is complex and influenced by a range of biopsychosocial factors, with the high prevalence of excessive weight gain in this population a cause for concern. Women in the UK may benefit from a revised approach toward GWG within the National Health Service (NHS), such as tracking weight gain throughout pregnancy. Additionally, this research provides evidence for potential targets for future interventions, and potentially at-risk populations to target, to improve GWG outcomes.

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Risk factors associated with adverse reactions to antituberculosis drugs

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37132015000100010 ◽

2015 ◽

Vol 41 (1) ◽

pp. 77-89 ◽

Cited By ~ 7

Author(s):

Laíse Soares Oliveira Resende ◽

Edson Theodoro dos Santos-Neto

Keyword(s):

Risk Factors ◽

Adverse Reactions ◽

Scientific Evidence ◽

Acetylator Phenotype ◽

Health Care Facilities ◽

Public Health Care ◽

Antituberculosis Drugs ◽

Factors Associated ◽

Treatment Regimens ◽

Care Facilities

This review sought to identify the available scientific evidence on risk factors associated with adverse reactions to antituberculosis drugs. We performed a systematic review of studies published in the 1965-2012 period and indexed in the MEDLINE and LILACS databases. A total of 1,389 articles were initially selected. After reading their abstracts, we selected 85 studies. Of those 85 studies, 16 were included in the review. Risk factors for adverse reactions to antituberculosis drugs included age > 60 years, treatment regimens, alcoholism, anemia, and HIV co-infection, as well as sodium, iron, and albumin deficiency. Protective factors against hepatic adverse effects of antituberculosis drugs included being male (combined OR = 0.38; 95% CI: 0.20-0.72) and showing a rapid/intermediate N-acetyltransferase 2 acetylator phenotype (combined OR = 0.41; 95% CI: 0.18-0.90). There is evidence to support the need for management of adverse reactions to antituberculosis drugs at public health care facilities.

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Pattern of adverse drug reactions of antitubercular drugs in tuberculosis patients with comorbidities and risk factors in South Indian government health-care facilities

National Journal of Physiology Pharmacy and Pharmacology ◽

10.5455/njppp.2021.11.07220202105072021 ◽

2021 ◽

pp. 1

Author(s):

Jayapriya B ◽

Lourdu Antony ◽

Balamurugan V ◽

Dinesh A

Keyword(s):

Risk Factors ◽

Health Care ◽

Adverse Drug Reactions ◽

Health Care Facilities ◽

Drug Reactions ◽

Indian Government ◽

Antitubercular Drugs ◽

Tuberculosis Patients ◽

South Indian ◽

Care Facilities

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Osteosarcopenia in chronic pancreatitis

Terapevticheskii arkhiv ◽

10.26442/00403660.2021.08.200971 ◽

2021 ◽

Vol 93 (8) ◽

pp. 869-875

Author(s):

Irina V. Kozlova ◽

Anna P. Bykova

Keyword(s):

Risk Factors ◽

Body Mass Index ◽

Chronic Pancreatitis ◽

Body Mass ◽

Assessment Tool ◽

Reproductive Function ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Colon Mucosa ◽

Traditional Risk Factors

Aim. To determine clinical features and some mechanisms of osteosarcopenia development in patients with chronic pancreatitis (CP). Materials and methods. A casecontrol study was conducted on the basis of the Saratov State Clinical Hospital 5 in 20152018 of patients with CP. In a study of 161 patients with CP included, the control group 30 healthy individuals. Patients were divided into groups according to the etiology of CP: 79 with toxic-metabolic CP, 82 with biliary CP. To determine the risks of low-energy fractures, 154 patients were tested with the Fracture risk assessment tool (FRAX). Along with the standard examination, 30 patients with CP dual-energy X-ray absorptiometry was performed. To assess the state of skeletal muscles, body mass index was determined, hand-held dynamometry was performed, and a set of Short Physical Performance Battery (SPPB) tests was used. Along with the assessment of traditional risk factors for osteosarcopenia gender, age, state of reproductive function in women, body mass index, functional state of the pancreas (pancreas) the quantitative content of interleukins (IL)-2, 6, 8 in in colonic biopsies was analyzed by enzyme-linked immunosorbent assay (ELISA). Results. Bone disorders, according to densitometry, was detected in 70.0% of patients with CP, in 13.3% of the control group. Presarcopenia was detected in 62 (38.5%) patients with CP, sarcopenia in 34 (21.1%), in the control group presarcopenia and sarcopenia were not detected. Sarcopenia was statistically significantly more common in toxic-metabolic CP than in biliary CP (2=11.6; p0.001). Correlations of the lumbar spine T-score and IL-6 (r=-0.29; p=0.03), IL-8 (r=-0.29; p=0.04) were revealed. Correlations between sarcopenia and the concentration of cytokines in the in the colon mucosa in CP were determined (IL-2: r=0.44; p0.001; IL-6: r=0.48; p0.001; IL-8: r=0.42; p0.001). Conclusion. The development of osteopenia and sarcopenia syndromes in CP is interrelated and associated with both traditional risk factors and an increased concentration of cytokines in the in the colon mucosa.

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Delayed access to treatment and frequency of acute respiratory infection as risk factors of severe pneumonia among children aged 12-59 months in Denpasar, Bali

Public Health and Preventive Medicine Archive ◽

10.15562/phpma.v5i1.45 ◽

2017 ◽

Vol 5 (1) ◽

pp. 61

Author(s):

Dewa Ayu Ketut Sri Abadi ◽

Dewa Nyoman Wirawan ◽

Anak Agung Sagung Sawitri ◽

I Gusti Ayu Trisna Windiani

Keyword(s):

Risk Factors ◽

Health Care ◽

Access To Health Care ◽

Respiratory Infections ◽

Severe Pneumonia ◽

Health Care Facilities ◽

First Episode ◽

Access To Treatment ◽

Healthcare Facilities ◽

Care Facilities

Background and purpose: Period prevalence of pneumonia among children in Indonesia increased from 2.1 in 2007 to 2.7 per 1000 children in 2013. The highest incidence was found among children aged 12-23 months. This study aims to examine association between delayed access to health care facilities and severity of children pneumonia.Methods: A case control study was conducted in Denpasar City. A total of 132 children were recruited to participate in this study, consisted of 44 cases and 88 controls. Cases were selected from 161 children with severe pneumonia who registered at Pulmonology Department of Sanglah General Hospital between January 2015 to April 2016. Controls were selected from 261 children aged 12-59 months with mild pneumonia who visited out-patient service at all community health centres in Denpasar City between January 2015 and April 2016. Cases and controls were matched by sex. Data were collected by interview with the parents in their houses. Data were analysed using multivariate analysis with logistic regression.Results: Risk factors associated to severity of pneumonia among children aged 12-59 months were delayed access to treatment for more than three days (AOR=2.15;95%CI: 1.39-3.32), non-health care facilities at first episode of illness (AOR=4.02; 95%CI: 1.53-10.61) and frequent episodes of respiratory infections (>4 times) over the last 6 months (AOR=5.45; 95%CI: 2.13-13.96).Conclusion: Delayed access to treatment, did not access healthcare facilities at first episode of illness, and high frequency of acute respiratory infections are risk factors of severe pneumonia among children.

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Risk Factors for Postpartum Depression During COVID-19 Pandemic: A Systematic Literature Review

Journal of Primary Care & Community Health ◽

10.1177/21501327211059348 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110593

Author(s):

Sadia Usmani ◽

Elona Greca ◽

Sana Javed ◽

Medha Sharath ◽

Zouina Sarfraz ◽

...

Keyword(s):

Mental Health ◽

Risk Factors ◽

Literature Review ◽

Postpartum Depression ◽

Systematic Literature Review ◽

Adverse Outcomes ◽

Depression Symptoms ◽

Postpartum Women ◽

Negative Consequences ◽

Symptoms Of Depression

Introduction: The COVID-19 pandemic has had a devastating worldwide effect on mental health. Recent studies correlate the spreading of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with symptoms of depression, most prominent in postpartum women. Our systematic literature review scope is to identify the risk factors and predictors for postpartum depression (PPD) and describe the steps that should be taken to help postpartum women. This study will help clinicians, researchers, and policymakers to elucidate the predictors of PPD during this pandemic and prevent these adverse outcomes in future crises. Methods: We conducted a systematic search by employing databases PubMed, Google Scholar, Scopus, and Embase to identify articles published before March 2021. About 463 publications were generated during our search process and from those, 36 were reviewed, summarized, and synthesized. Studies qualified the criteria if they (1) utilized qualitative or quantitative design, (2) explored the risk factors for PPD, and (3) were written in English. Quality evaluation of each study was achieved by using criteria set by Lincoln and Guba. Results: Prevalence of depression symptoms ranged from 7% to 80.8% in postpartum women during the SARS-COV 2 pandemic. The risk factors for PPD were classified into 6 major categories: socio-demographic, psychological, pre-existing pathology, metabolic factors, previous events of miscarriage, and media misinformation. Conclusion: It is extremely vital to care for women’s mental health during pregnancy and after childbirth during these unprecedented times. This review urges the need to design adequate interventions for this vulnerable population to prevent negative consequences of PPD.

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Lower levels of directed exploration and reflective thinking are associated with greater anxiety and depression

10.31234/osf.io/3w4je ◽

2021 ◽

Author(s):

Ryan Smith ◽

Samuel Taylor ◽

Robert C Wilson ◽

Annie E. Chuning ◽

Michelle Persich ◽

...

Keyword(s):

Emotional Disorders ◽

Information Seeking ◽

Ambiguity Aversion ◽

Community Sample ◽

Well Being ◽

Anxiety And Depression ◽

Information Seeking Behavior ◽

Depression Symptoms ◽

Seeking Behavior ◽

Reflective Cognition

Anxiety and depression are often associated with strong beliefs that entering specific situations will lead to aversive outcomes – even when these situations are objectively safe and avoiding them reduces well-being. A possible mechanism underlying this maladaptive avoidance behavior is a failure to reflect on: 1) appropriate levels of uncertainty about the situation, and 2) how this uncertainty could be reduced by seeking further information (i.e., exploration). To test this hypothesis, we asked a community sample of 417 individuals to complete measures of reflective cognition, exploration, and symptoms of anxiety and depression. Consistent with our hypotheses, we found significant associations between each of these measures in expected directions (i.e., positive relationships between reflective cognition and strategic information-seeking behavior or “directed exploration”, and negative relationships between these measures and anxiety/depression symptoms). Further analyses suggested that the relationship between directed exploration and depression/anxiety was due to an ambiguity aversion promoting exploration in conditions where information-seeking was not beneficial (as opposed to under-exploration when more information would aid future choices). In contrast, reflectiveness was associated with greater exploration in appropriate settings and separately accounted for differences in reaction times, decision noise, and choice accuracy in expected directions. These results shed light on the mechanisms underlying information-seeking behavior and how they may contribute to symptoms of emotional disorders. They also highlight the possibility that reflectiveness and exploration could represent novel treatment targets for those who show low levels of these tendencies – consistent with the need to develop individualized precision medicine approaches within computational psychiatry.

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