Current Psychiatry Research and Reviews - Volume 20, Issue 3, 2024

Background: Despite the huge global socioeconomic burden of depressive disorders, depression is often underreported and undertreated due to a lower level of awareness from both healthcare providers and payers in many countries. The lack of an evidence-based approach to care delivery has resulted in the inequitable allocation of health resources, causing resource scarcity issues in Argentina. Objective: The aim of this paper is to identify the gaps in evidence related to patients’ journeys and barriers in the existing care ecosystem contributing to poor access to quality care for depression in an Argentine context. Methods: A semi-systematic review of the literature was performed from 2012 to 2021 using Medline, Embase and Biosis and other unstructured sources (Google Scholar, the World Health Organization (WHO) website, Argentina Ministry of Health website, and Incidence and Prevalence Database (IPD) on awareness, screening, diagnosis, treatment, adherence and/or control of depression amongst adults (≥18 years). Any identified data gaps were supplemented with anecdotal data from local experts. Results: Low percentages of adult patients with depression awareness (<25%), screening (<10%), diagnosis (37.5%), received treatment (41.9%), adherence to treatment (37.5%), and control (37.5%) were observed. Conclusion: Ensuring a care continuum while considering full clinical remission with functional recovery as a therapeutic goal and advocacy for patient-centric adjustments in existing mental health policies would be key drivers for improving the depression care scenario.

In this revisited review, the authors aimed to discuss the general prevalence and burden of depression in patients diagnosed with heart failure. The postulated mechanisms of depression in patients with heart failure, the diagnostic approaches, methods as well as treatment options were all discussed. The safety of depression medications in heart failure patients was also discussed. Through the review of the updated literature and current guidelines, the authors concluded that a team approach is the best way to manage those types of patients.

Background: Serotonin is a neurotransmitter that regulates neuronal activity and a variety of cognitive functions, and medicines that target serotonin receptors are frequently utilized in psychiatry and neurology. Clinical and preclinical research on the role of serotonin in major depressive disorder is growing. These findings demonstrate the intricacy of serotonin transmission across multiple receptors, in a variety of brain areas, and across the lifespan. The serotonin transporter's significance in major depressive disorder has been highlighted in geneenvironment association studies, as well as its participation in the mechanism of the most successful antidepressant medications, selective serotonin reuptake inhibitors. While most of the 15 known serotonin receptors have been linked to depression or depressive-like behaviour, the serotonin 1A (5-HT) and 1B (5-HT) receptors have received the most attention. Objectives: The primary goal of this study is to review the antidepressant effect of herbal medications by modifying serotonin receptors in the future. Result: Human brain imaging and genetic studies suggest that 5-HT and 5-HT receptors play a role in major depressive disorder and antidepressant treatment response. The availability of tissue-specific and inducible knockout mice lines in rodents has allowed for the detection of 5- HT and 5-HT receptor involvement throughout development and in cell-type specific ways. It may be found that herbal drugs will be effective as the serotonin reuptake inhibitors. Conclusion: This and other future preclinical pharmacology studies show that these receptors' autoreceptor and heteroreceptor populations play different roles in modulating depressionrelated behaviour and antidepressant responses, as well as having different functions during early postnatal development versus adulthood. According to analysis of our research findings, alkaloids may have some therapeutic promise as natural antidepressants. Given their widespread distribution in nature, alkaloids might be a cheap way to treat depression.

Background: Due to the high transmission rate of COVID-19, the high prevalence of the disease, the high mortality rate, and its effects on mental health, we aimed to assess the current status of psychiatric symptoms. Methods: In this observational study, we have assessed various psychiatric presentations and disorders before and after the COVID-19 pandemic within the same time limit. Data have been obtained from the psychiatric interview performed by an attending physician in psychiatry. Results: The following features have been observed after the pandemic: increased depressed mood, irritability, crime trend, physical violations, personality disorders along with improved family support, and decreased suicidal ideation. No significant difference has been observed in the rate of response to psychotherapy and psychiatric medications before and after the time of the pandemic. Conclusion: Increased physical threat and aggression, substance use, and symptoms of psychosis were more frequently observed in the time of the pandemic. The physical threat was mainly committed by younger patients with psychiatric illnesses.

Introduction: Substance use disorders (SUDs) contribute to one-fifth of all disability- adjusted life years caused by psychiatric illnesses. They have a high treatment gap. Stigma affects the lives of people with SUDs and is shown to impede the pursuit of valued life goals and recovery from addiction. We studied stigma and QOL in patients with Alcohol Use disorders (AUD). Methods: Participants between 18 and 65 years with a clinical diagnosis of AUD were included (inpatients and outpatients). Demographic and clinical data were recorded using a semistructured questionnaire. ISMIS & WHOQOL-Bref questionnaires were used to assess internalized stigma and quality of life. Results: Of the 141 participants, 89(63.10%) patients had severe self-stigma, 31(22.10%) patients had moderate self-stigma, and 21(14.90) patients had mild self-stigma. In ISMIS, stigma due to alienation (3.22) was higher than social withdrawal, discrimination, stereotype, and stigma resistance. In the WHOQOL-Bref questionnaire, the mean score of social domain (9.45) was the lowest compared to the other domains of the quality of life scale. A significant association was found between the education and the duration of substance use with ISMI grades with people with up to 10th standard education (p-value - 0.002*), living in urban areas (p-value - 0.022*), and ten or more years of substance use (p-value - 0.00002). Conclusion: The various domains of quality of life generally negatively correlated with the internalized stigma score, suggesting that a greater degree of self-stigma is associated with poorer quality of life.

Background: The medical staff who fought on the front line against the COVID- 19 pandemic were more affected by its physical and psychological dangers than others. Objective: This study aimed to investigate the level of depression, stress, anxiety, and job burnout of the medical staff in the COVID-19 wards of Hamedan Hospitals. Methods: In this cross-sectional study, the study population consisted of all medical staff working in educational and treatment centers affiliated with Hamedan University of Medical Sciences in 2019, of which 173 were medical staff in COVID-19 wards, and 173 were medical staff included by systematic random sampling from other wards. Data were collected using a demographic information checklist, Beck Depression Inventory, Beck Anxiety Inventory, perceived stress scale, and Maslach Burnout Inventory. The data were analyzed with chi-square coefficient tests and one-way analysis of variance (ANOVA) with SPSS-22 software. Results: About 26.9% of medical staff in COVID-19 wards had high job burnout, significantly different from those in non-COVID-19 wards (p < 0.05). The incidence of depression was 67.5% among the medical staff in COVID-19 wards, including twenty-nine people (18.5%) with mild depression, forty-two (26.7%) with moderate depression, and thirtyfive (22.3%) with severe depression. Thirty people (19.1%) had mild anxiety, forty-three (27.4%) had moderate anxiety, and three (3.3%) had severe anxiety. In addition, the prevalence of perceived stress was 94.3%. A statistically significant difference was observed between depression, anxiety, perceived stress, and job burnout in the medical staff of COVID-19 wards and other wards (p < 0.05). Conclusions: Stress, anxiety, depression, and job burnout among staff working in COVID- 19 wards differ significantly from other hospital wards employees. In similar circumstances to this pandemic, paying extra attention to medical staff is essential due to their role and the effect of their health on society’s health.

Background: The current article reports on the findings from a cross-sectional survey conducted among college students on a subjectively reported and objectively measured smartphone screen time (ST) and its relation to mental well-being. Methods: We explored the magnitude of discrepancy between subjectively reported and objectively measured smartphone ST. Moreover, we assessed the interaction of mental well-being with personality traits among subjects with a discrepancy between the subjectively reported and objectively measured smartphone ST. The mental health of study participants was assessed using the WHO well-being index. Personality was assessed using the Big Five Inventory (BFI)- 10. A total of 202 students shared screenshots of the phone ST function and were included in the analysis. Results: A total of 145 (71.8%) participants underestimated their daily smartphone ST, whereas 56 (27.7%) of them overestimated ST. In the regression analysis, the predicted odds of poor mental well-being were 1.43 times greater for subjects with higher neuroticism scores in the overall sample. Moreover, the predicted odds of poor mental well-being were 1.593 times greater for subjects with higher neuroticism scores among the study subjects who underestimated their ST. Conclusions: The findings of the current study suggested that the magnitude of discrepancy between the subjectively estimated and objectively estimated ST varies across college students, with the discrepancy being significantly higher among those who overestimated their ST. The predicted odds of poor mental well-being were about one and a half times greater for subjects with higher neuroticism scores among college students who underestimated their ST.

Background: Diosmin has already been described and documented to be neuroprotective, antioxidant and anti-inflammatory. It may possess or hold depressionalleviating activity. Therefore, the purpose of the current research protocol is to investigate the depression-relieving proficiency of diosmin in stressed and unstressed mice. Methods: Male mice (Swiss albino) were imperiled to an unpredictable chronic stress paradigm every day for three sequential weeks, and depression-resembling behavioral despair was induced. Imipramine 15 mg/kg and diosmin (25, 50 and 100 mg/kg) were dispensed for 21 successive days to discrete groups of stressed and unstressed mice. Results: Both diosmin (100 mg/kg) and 15 mg/kg imipramine administration for 3 consecutive weeks substantially or significantly diminished the immobility period of mice imperiled to stress in comparison to stressed mice gauzed with the vehicle. Diosmin (25, 50 and 100 mg/kg) and imipramine considerably reinstated the diminished sucrose proclivity (sucrose preference percentage; %) in stressed mice, demonstrating their considerable or substantial depression-relieving effects. The locomotor activities of mice were not considerably altered by these drugs. Antidepressant-like activity of diosmin for immobility periods and preference for sucrose was observed to be analogous to imipramine. Diosmin (100 mg/kg) and imipramine substantially quashed CUMS- persuaded escalation of plasma corticosterone and nitrite levels, malondialdehyde levels and MAO-A activity in the brain of stressed mice. Both drugs also substantially reversed CUMS-prompted reduction in catalase activity and brain glutathione levels. Conclusion: Accordingly, diosmin revealed significant anti-depressive activity in mice imperiled to chronic mild unpredictable stress paradigm conceivably via mitigation of nitrosative and oxidative stress, reticence of brain MAO-A action, and sink drop of plasma corticosterone degrees.

Although the related dimensions of professional quality of life, secondary traumatic stress, and emotion regulation have been widely investigated in the field of helping and healthcare professionals, these dimensions combined have scarcely been explored in the field of workers with forced migrants. The aims of the present study are twofold. First, it aims to investigate the prevalence of secondary traumatic stress levels, emotion regulation, burnout, and compassion satisfaction in professionals working with forced migrants in Italy. Second, it aims to explore the associations between some socio-demographic and work-related characteristics and the psychological health and professional well-being status of professionals. An online survey was administered via Google Modules to the Italian associations and Third Sector entities working in the field of forced migration from May 2021 to March 2022. A total of 264 professionals (mean age: 39.9; 76.1% females) responded to the survey. On the background of good levels of psychological health and professional well-being, significant differences emerged in mental health status and professional quality of life related to professional roles, age, gender, and geographic provenience. Understanding the psychological health and professional well-being of those working with asylum seekers and refugees is crucial in providing appropriate supportive healthcare interventions which might be able to take care of professionals’ well-being as well as of their beneficiaries themselves.