Na literatura encontramos trabalhos que revelam que em indivíduos tratados com antipsicóticos e antidepressivos há um aumento de cáries, gengivite, periodontite e estomatites. No entanto, além dessas propriedades anticolinérgicas, sabidamente as drogas antipsicóticas e, em menor intensidade, as drogas antidepressivas provocam ações no sistema muscular como um todo. O uso de drogas antipsicóticas é reconhecidamente associado com efeitos colaterais motores agudos e crônicos, como parkinsonismo, acatisia e discinesia tardia. Medicações antidepressivas, tanto as clássicas tricíclicas, quanto as de nova geração, como os inibidores seletivos de recapitulação de serotonina têm sido apontadas como causadoras de efeitos musculares colaterais semelhantes aos antipsicóticos. Tendo em vista o exposto, o objetivo deste trabalho foi analisar eletromiograficamente os músculos masseter e temporal, a força de mordida e a eficiência mastigatória em indivíduos tratados com antipsicóticos e antidepressivos, mais precisamente, pacientes com esquizofrenia e transtornos do humor, e comparar com o grupo controle, dada a importância destas funções dentro das ações do sistema estomatognático. / In the literature we found studies showing that individuals treated with antipsychotics and antidepressants are an increase of caries, gingivitis, periodontitis and stomatitis. However, besides these anticholinergic properties, known antipsychotic drugs, and less intensity, antidepressant drugs cause muscle actions in the system as a whole. The use of antipsychotic drugs is known to be associated with side effects engines acute and chronic conditions such as parkinsonism, akathisia and tardive dyskinesia. Antidepressant medications, tricyclic both classical, as the new generation, such as selective inhibitors of recapitulation of serotonin have been identified as causing muscle side effects similar to antipsychotics. Given the above, the objective was to analyze the electromyographically masseter and temporal muscles, bite force and masticatory efficiency in patients treated with antipsychotics and antidepressants, specifically, patients with esquizofrina and mood disorders, and compare with the group control, given the importance of these functions within the actions of the stomatognathic system.

A atividade física é considerada uma prática que traz benefícios para o corpo e a mente. Entretanto, se por um lado há evidências de que exercício físico moderado pode ajudar a saúde mental, também existem relatos de alterações de humor com características depressivas associadas ao treinamento de atletas de elite, podendo culminar com o aparecimento da chamada “síndrome de overtraining”. Este trabalho procurou avaliar estas alterações de humor associadas a atividade física intensa, focando-se em três pontos: 1) caracterização de suas manifestações psicológicas, 2) avaliação da especificidade da associação e 3) verificação da possibilidade de alguma vulnerabilidade constitucional influenciar as alterações. Os sujeitos se dividiram em três grupos: atletas (N = 56, 30 homens – 26 mulheres; idade média = 18,16 anos), vestibulandos (222, 120 – 102; 17,48) e universitários (446, 259 – 187; 22,08). Instrumentos de avaliação de humor (POMS e PANAS-X) foram aplicados em atletas e vestibulandos em três oportunidades, ao longo da preparação para a competição mais importante da temporada ou o vestibular. Universitários, submetidos a estresse físico e intelectual estável e relativamente menor, foram avaliados apenas uma vez. Foram estudadas as variações de estados afetivos de cada grupo e suas relações com a quantidade de treinamento / estudo e a proximidade da competição / vestibular. O grupo de atletas e uma amostra de vestibulandos, definida randomicamente, foram avaliados com um instrumento de diagnóstico psiquiátrico (SCAN). Foi estudado, utilizando-se sintomatologia psiquiátrica prévia ou “afeto negativo traço” como marcadores, se fatores de vulnerabilidade exerceram algum tipo de influência sobre as alterações de humor em estudo. Os resultados foram avaliados segundo os três grupos de sintomas de um modelo tripartide de ansiedade e depressão: 1) um fator geral de afeto negativo, que inclui sintomas não específicos; 2) um grupo de sintomas relativamente específicos de depressão, o qual reflete falta de experiências emocionais positivas (chamado de afeto positivo), e 3) um grupo de sintomas relativamente específicos de ansiedade, o qual reflete manifestações de tensão somática. Foram encontradas alterações de humor entre os atletas. Suas características principais foram: aumento de fadiga, diminuição de afeto positivo e nenhuma alteração de afeto negativo (o que indica proximidade com o construto de depressão); associação com a quantidade e a intensidade de treinamento, mas não com a proximidade da competição; nenhuma influência de fatores de vulnerabilidade. Os vestibulandos também apresentaram alterações de humor, mas com características diferentes: aumento de fadiga, aumento do afeto negativo e nenhuma alteração do afeto positivo (o que indica proximidade com o construto de ansiedade); associação com a proximidade do vestibular (a associação com a quantidade de estudo não foi conclusiva); tendência de que fatores de vulnerabilidade ligados a sintomatologia psiquiátrica prévia influenciem sua intensidade. Esses resultados apontam para a especificidade da associação entre as alterações de humor encontradas entre os atletas e a atividade física intensa a qual se submetem. / Physical activity is considered to be beneficial to both body and mind and evidences that moderate intensity exercise can improve mental health are increasing. Nevertheless, there are also evidences that depressive mood alterations are associated with elite athletes training and that this training can lead to the so called “overtraining syndrome”. This work aimed to evaluate these mood alterations associated with intense physical activity considering three points: 1) characterization of its psychological manifestations, 2) association specificity, and 3) influence of some kind of constitutional vulnerability. Subjects were athletes (N = 56, 30 men – 26 women; mean age = 18,16 years), last year high school students (222, 120 – 102; 17,48) and college students (446, 259 – 187; 22,08). Athletes and high school students were evaluated with psychometric instruments (POMS and PANAS-X) three times during the preparation for the most important competition of the season or for the “vestibular” (Brazilian exam to enter college). College students, submitted to stable and relatively lower levels of physical and intellectual demands, were evaluated only once. Mood states fluctuations and their relation to training volume / hours of study and proximity to competition / “vestibular” were studied. The athletes and part of the high school students, randomly selected, were also evaluated with a psychiatric diagnostic instrument (SCAN). The influence of vulnerability factors over the mood alterations were studied, using previous psychiatric symptomatology or negative affect trait as markers. Results were evaluated according to the three groups of symptoms from a tripartite model of anxiety and depression: 1) a general negative affect factor, which includes nonspecific symptoms; 2) a relatively specific depression cluster of symptoms that reflects the absence of positive emotional experiences (called positive affect); and 3) a relatively specific anxiety cluster of symptoms that reflects the manifestations of somatic tension. Mood alterations were found among the athletes. Presence of fatigue, diminished positive affect and no alteration in negative affect (which points to proximity to the depression construct); association with training volume and intensity, but not with competition proximity; and no vulnerability factors (related to psychiatric history, trait negative affect and profile of affective traits) influence were the athlete mood alterations characteristics. The high school students showed mood alterations too, but with different characteristics: fatigue, increased negative affect and no alteration in positive affect (which points to proximity to the anxiety construct); association with “vestibular” proximity (the association with study volume was non conclusive); and a tendency that vulnerability factors (related to psychiatric history) influences their intensity. Results point to the specificity of the association between the athletes’ mood alterations and the intense physical activity performed by them.

Made available in DSpace on 2014-06-12T23:01:00Z (GMT). No. of bitstreams: 2 arquivo8618_1.pdf: 1604073 bytes, checksum: d9765092ab2a50cd8b1426f73b5ed129 (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2006 / Este estudo é uma revisão narrativa da literatura sobre os paradigmas computacionais, as modelagens naturais conexionistas e a investigação dos fenômenos psicopatológicos. O objetivo geral foi realizar uma coleta de informações sobre os trabalhos publicados, até então, que contemplassem os modelos de processamento de informações no cérebro humano, a analogia com Redes Neurais Artificiais e a aplicação de métodos investigativos nas psicopatologias. A seleção dos estudos foi baseada principalmente pesquisas em bancos de dados digitais: Medline, Períodos CAPES, MIT Search, Scholar Google e PsychInfo, usando os descritores neural networks, neurocomputation, psychopathology, connectionism, mood disorders, depression, cognition e artificial intelligence, em mecanismos de busca digital. Foram selecionados os estudos considerando os critérios de inclusão a partir dos descritores, o aspecto cronológico, a adequação e pertinência dos estudos e o impacto destes artigos na comunidade científica. A literatura clássica também foi incluída. O estudo buscou estabelecer relações entre as pesquisas que utilizaram ferramentas computacionais, visando a criação de modelos que simularam o funcionamento cognitivo do cérebro humano. Destes modelos, as Redes Neurais Artificiais Conexionistas (RNA) mostraram-se as mais promissoras dentre as demais. Conclui-se que as investigações dos fenômenos psicopatológicos baseadas em modelagem computacional conexionista constituem em uma importante estratégia para compreensão do funcionamento da mente humana e de como se processam as alterações psíquicas

Les troubles de l’humeur font partie des problèmes de santé majeurs dans le monde, du fait de leur forte incidence et récurrence dans la population générale, de la nuisance pour la qualité de vie des patients ainsi que la répercussion majeure sur les systèmes de santé. A ce jour, l’étiologie ainsi que les mécanismes biologiques sous-jacents les troubles de l’humeur sous encore très mal connus. Un nombre grandissant de preuves suggère qu’une interaction complexe entre les gènes et l’environnement serait a l’origine de la mise en place et évolution des épisodes dépressifs majeurs – un des troubles de l’humeur les plus répandus. Par conséquent, des régulations épigénétiques complexes, qui consistent en des mécanismes clefs par lesquels l’environnement induit des changements persistant sur l’expression des gènes (sans modifier le code génétique), joueraient un rôle prépondérant dans la pathophysiologie de la dépression. De manière plus spécifique, la répression épigénétique du gène codant pour le brain-derived neurotrophic factor (BDNF) – un facteur de croissance impliqué dans la plasticité neuronale et développement du système nerveux central – serait un mécanisme clef dans la mise en place de la dépression et autres troubles de l’humeur. Dans ce contexte, les travaux de recherche présentés dans cette thèse visent à explorer le rôle des régulations épigénétiques au niveau de la signalisation BDNF/TrkB dans la physiopathologie et traitement des troubles de l’humeur. Les résultats montrent que les régulations épigénétiques au niveau de la signalisation BDNF/TrkB sont fortement impliquées dans la mise en place et maintenance de la plasticité neuronale. De plus, les variations environnementales, particulièrement au cours du développement, sont capables d’induire une reprogrammation épigénétique stable et persistante au niveau du complexe BDNF/TrkB ainsi qu’une altération de la neuroplasticité, conduisant à une augmentation de la vulnérabilité au stress et troubles de l’humeur. De manière intéressante, la signalisation du récepteur TrkB est nécessaire pour les effets neurobiologiques et comportementaux des antidépresseurs. De ce fait, une approche pharmocologique ciblée sur le complexe BDNF/TrkB et ses régulations épigénétiques sous-jacentes apparaît comme stratégie thérapeutique prometteuse pour le traitement des troubles de l’humeur tel que la dépression. / Mood disorders are among the major health problems worldwide due to the high prevalence and recurrence in the general population, and the significant burden for individual life quality and the repercussion on healthcare systems and society. Up to date, the etiology and biological mechanisms underlying mood disorders are still poorly understood. Mounting evidences suggest that a complex interaction between genes and environment might account in the development and course of major depression i.e. one of the most prevalent affective disorders. Accordingly, complex epigenetic regulations - consisting of key mechanisms by which environmental factors induce enduring changes in gene expression without altering the DNA code - have been suspected to plays a pivotal role in the pathophysiology of depression. More specifically, epigenetic repression of the gene encoding for brain-derived neurotrophic factor (BDNF) - a small-secreted growth factor implicated in brain development and neuronal plasticity - may have a preponderant role in the onset of depression and other mood disorders. In this context, the research presented in this thesis aimed at exploring the role of BDNF signaling and its downstream epigenetic regulations in the pathophysiology and treatment of mood disorders. Our findings indicate that epigenetic regulation at BDNF/TrkB signaling is critically important in the establishment and maintenance of neuronal plasticity. Moreover, environmental variations, especially when occurring in development, are able to induce stable and enduring epigenetic reprogramming involving aberrant BDNF/TrkB signaling and impaired neuroplasticity, thereby increasing vulnerability to stress and mood disorders. Interestingly, antidepressants require TrkB to exert some of their neurochemical and behavioral effects. Hence, targeting the BDNF receptor TrkB to restore a normal epigenetic regulation and neuronal functioning appears to be a promising strategy for the treatment of mood disorders.

Mental illness among college students is a significant public health concern. Among mental health issues, one of the most prevalent and impairing is depression. Although many students experience depression, the majority do not seek help. Past research has shown that stigma beliefs are associated with help-seeking, but interventions targeting stigma have been unsuccessful at increasing help-seeking prompting the need to explore alternative models. Currently, there has been little research evaluating the role of threat-based beliefs related to help-seeking processes. As well, it remains unclear how different threat-based beliefs may interact and be related to help-seeking intentions. The purpose of these studies was to develop new measures that assess threat-based beliefs based on facilitating threats, as defined by perceived severity, mortality, loss of functioning, and loss of control threats and obstructing threats, as defined by general stigma, interpersonal rejection, and workplace rejection beliefs. As well, it was hypothesized that facilitating threats would be positively associated with help-seeking intentions and that this relationship would be moderated by obstructing threats such that higher levels of obstructing threats would attenuate the relationship between facilitating threats and help-seeking. Data were analyzed using structural equation modeling. The measurement development phase (N = 240) supported the proposed factor structure with the exclusion of the stigma and severity threat measures. When testing the moderation hypothesis (N = 212), results did not support the hypothesized relationships between facilitating threats, obstructing threats, and help-seeking intentions. The implications of these results for future research, theory, and prevention program directions are discussed.

Bipolar disorder (BD) and major depressive disorder (MDD) are characterised by a fundamental disturbance of mood, with strong support for overlapping causal pathways. Structural brain and neurocognitive abnormalities have been associated with mood disorders, but it is unknown whether these reflect early adverse effects predisposing to mood disorders or emerge as a consequence of illness onset. The Bipolar Family Study is well-suited to examine the origin of structural brain and neuropsychological abnormalities in mood disorders further. The volumes of subcortical brain regions, cortical thickness and surface area measures of frontal and temporal regions of interest and neuropsychological performance over a two-year time interval was compared at baseline and longitudinally between three groups: young individuals at high risk of mood disorders who subsequently developed MDD during the follow-up period (HR-MDD), individuals at high risk of mood disorders who remained well (HR-well), and healthy control subjects (HC). The longitudinal analysis of cortical thickness revealed significant group effects for the right parahippocampal and right fusiform gyrus. Cortical thickness in both of these brain regions across the two time points was reduced in both high-risk groups relative to controls, with the HR-MDD group displaying a thinner parahippocampus gyrus than the HR-well group. Moreover, a significant interaction effect was observed for the left inferior frontal and left precentral gyrus. The HR-well subjects had progressive thickness reductions in these brain regions relative to controls, while the HR-MDD group showed cortical thickening of these areas. Finally, longitudinal analyses of neuropsychological performance revealed a significant group effect for long delay verbal memory and extradimensional set-shifting performance. Reduced neurocognitive performance during both tasks across the two time points was found in the HR-well group relative to controls, with the HR-MDD group displaying decreased extradimensional set-shifting abilities as compared to the HC group only. These findings indicate, that reduced left parahippocampal and fusiform thickness constitute a familial trait marker for vulnerability to mood disorders and may thus form potential neuroanatomic endophenotypes. Particularly strong thickness reductions of the parahippocampal gyrus appear be linked to an onset of MDD. Moreover, progressive thickness reductions in the left inferior frontal and precentral gyrus in early adulthood form a familial trait marker for vulnerability to mood disorders, potentially reflecting early neurodegenerative processes. By contrast, an absence of cortical thinning of these brain regions in early adulthood appears to be linked to the onset of MDD, potentially reflecting a lack or delay of normal synaptic pruning processes. Reduced long delay verbal memory and extradimensional set-shifting performance across time constitute a familial trait marker for vulnerability to mood disorders, likely representing disturbances of normal brain development predisposing to illness. These findings advance our understanding of the origin of structural brain and neurocognitive abnormalities in mood disorders.

Orientadores: Paulo Dalgalarrondo, Luiz Fernando Longuim Pegoraro / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-28T00:08:45Z (GMT). No. of bitstreams: 1 Brito_MairaEsteves_M.pdf: 2518848 bytes, checksum: eb0a3cb981b7d8de253ad554f28d7f73 (MD5) Previous issue date: 2015 / Resumo: Existem muitas teorias sobre o papel da personalidade nos transtornos do humor. Investigar os traços de personalidade destes pacientes pode contribuir para evidenciar especificidades importantes e para que estratégias mais eficazes de tratamento sejam adotadas no contexto clínico. Objetivos: O objetivo deste estudo foi avaliar e comparar os traços de personalidade e qualidade de vida em pacientes com diagnóstico de transtorno afetivo bipolar (TAB) e transtorno depressivo, e em indivíduos sem transtornos mentais (controles), além de verificar se existem diferenças nos traços de personalidade de pacientes com e sem tentativas de suicídio. Métodos: A amostra foi composta por 90 indivíduos, sendo 30 com TAB, 30 com transtorno depressivo e 30 controles saudáveis do ponto de vista psiquiátrico. Todos foram inicialmente avaliados pelo instrumento M.I.N.I. Plus, para confirmar ou descartar diagnósticos. Para investigar a presença de sintomas depressivos e maníacos, no momento da avaliação, foram aplicadas duas escalas: a Escala Avaliação para Depressão de Montgomery e Asberg e a Escala de Avaliação de Mania de Young. A personalidade foi avaliada pelo Personality Inventory for DSM-5 (PID-5), um instrumento que foi desenvolvido para identificar traços desadaptativos da personalidade e que faz parte do modelo alternativo para Transtornos de Personalidade que consta na seção III do DSM-5. A qualidade de vida foi avaliada por meio do Whoqol-Bref. Foram feitas análises estatísticas utilizando os programas o Statistical Package for Social Sciences (SPSS) for Windows e o Statistical Analysis System (SAS) for Windows. Resultados: o domínio Distanciamento evidenciou diferenças entre os três grupos, sendo que os pacientes com transtorno depressivo apresentaram as maiores pontuações. Os pacientes com transtorno de humor obtiveram escores superiores nos domínios Afetividade Negativa, Desinibição e Psicoticismo quando comparados aos controles, mas não foram encontradas diferenças significativas entre unipolares de bipolares. Em relação à dimensão Antagonismo, os bipolares se diferenciaram dos demais com escores elevados. Encontrou-se que o aumento na dimensão Desinibição elevou a chance do indivíduo pertencer a um dos grupos com transtorno de humor, e o aumento na faceta Anedonia elevou a chance de pertencer ao grupo com transtorno depressivo. Pacientes com tentativas prévias de suicídio apresentam maiores escores no domínio Distanciamento e nas facetas Anedonia, Tendência à Depressão, Hostilidade e Impulsividade. Sobre a qualidade de vida, o grupo controle teve escores significativamente superiores aos dos pacientes com transtornos do humor em todos os domínios avaliados. As dimensões Distanciamento e Afetividade Negativa apresentaram as correlações negativas mais importantes com a qualidade de vida geral nos pacientes com transtornos do humor. Conclusões: Os pacientes com transtorno do humor apresentaram perfil de personalidade diferente dos controles, sendo que os traços avaliados se mostraram mais acentuados nos grupos diagnósticos. O grupo com transtorno depressivo, além de ter apresentado escores elevados na maioria das facetas, também mostrou piores resultados em qualidade de vida e número superior de tentativas de suicídio, variáveis que mostraram associação importante com alguns dos domínios investigados / Abstract: There are many theories about the role of personality in affective disorders. To study the personality profiles of these patients can contribute to evidence important specificities as well to ensuring more efficacious strategies for the treatment adopted in the clinical context. Objective: The study aimed to assess and compare the personality traits and quality of life of individuals with a diagnosis of bipolar disorder, depression and a healthy control group, and to identify whether there are differences in personality traits of patients with and without suicide attempts. Methods: The sample was composed of 90 individuals, 30 with bipolar disorder, 30 with depression and 30 psychiatrically-healthy subjects. They were assessed using the M.I.N.I. Plus to confirm or to exclude possible mental disorders. Two scales were used to assess depressive and manic symptoms at the time of the evaluation: the Montgomery and Asberg Depression Rating Scale and the Young Mania Rating Scale. To evaluate personality was used the Personality Inventory for DSM-5 (PID-5), it is an instrument that was developed as a measure of the maladaptive personality trait proposed by the alternative model for Personality Disorders, included within Section III of the DSM-5. Quality of life was assessed using the test Whoqol-Bref. All statistical analyses were performed using SPSS Statistical Package and SAS (Statistical Analysis System). Results: The domain Detachment showed differences among the three groups, patients with depression present the highest scores in this domain. Patients with mood disorders presented significantly higher scores in the domains of Negative Affectivity, Disinhibition and Psychoticism when compared to the control subjects. In relation to Antagonism, the bipolar patients stood out from the rest with their high scores. An increase in the domain Disinhibition was shown to increase the chances of an individual having a mood disorder and the increase in the trait Anhedonia raises the chances of depression. Patients with previous suicide attempts presented higher scores in the dimension Detachment and in the traits Anhedonia, Depressivity, Hostility and Impulsivity. In relation to the quality of life, the healthy control presented significantly higher scores when compared to patients in all domains. Negative correlation between the domains Detachment and Negative Affectivity and general quality of life were found in the patients with mood disorders. Conclusions: Patients with mood disorders presented different personality profile when compared to healthy control group and the evaluated traits were higher in the sample of patients. The depressive group, not only exhibited higher scores in the majority facets, but also showed worse results in quality of life and more suicide attempts. These variables presented significant association with some personality domains assessed / Mestrado / Ciencias Biomedicas / Mestra em Ciências Médicas

Les troubles de l’humeur sont des troubles psychiatriques fréquents et constituent un ensemble hétérogène caractérisés par un fardeau personnel, sanitaire et social considérable. Le pronostic de ces troubles est aggravé par un risque suicidaire accru, la présence de comorbidités psychiatriques et somatiques. Dans une démarche préventive, il parait essentiel d’identifier des facteurs biologiques ou psychologiques pouvant prédire l’aggravation du pronostic de ces troubles. Cette thèse porte sur des éléments majeurs du pronostic des deux principaux troubles de l’humeur à savoir, le trouble dépressif caractérisé et le trouble bipolaire. Dans un premier temps, nous avons tenté d’identifier un biomarqueur du risque suicidaire chez les patients dépressifs à partir d’une approche gène-candidat. Nous avons montré que l’expression génétique de l’ARN messager de SLC6A4 obtenu à partir du sang périphérique, permet de prédire l’aggravation des idées suicidaires au cours du suivi de patients souffrant d’un épisode dépressif majeur. Dans un second temps, nous avons exploré les facteurs cliniques et neuropsychologiques associés à une faible qualité de l’observance médicamenteuse chez les patients bipolaires euthymiques. Les résultats de notre étude suggèrent que les patients bipolaires auraient plus de risque de rencontrer des problèmes d’observance lorsqu’ils rapportent de nombreux effets indésirables liés aux traitements et un faible nombre d’hospitalisations antérieures. De plus, chez les patients bipolaires les plus âgés uniquement, la qualité de l’observance semble également associée aux capacités cognitives des patients et plus spécifiquement au fonctionnement exécutif. / Mood disorders are frequent and heterogeneous psychiatric illnesses associated to a huge functional, social and economic burden. Different factors such as a higher risk of suicide, the higher frequency of psychiatric and somatic comorbidities are worsening the prognosis of these diseases. Within a preventive approach, it is essential to identify biological, psychological or environmental factors that might influence or predict such prognosis. This thesis focused on major elements of the prognosis of the two main mood disorders: major depression and bipolar disorder. Firstly, using a candidate-gene approach, we have tried to identify a biomarker of suicide risk in patients with a major depressive episode. We have found that SLC6A4 (gene coding for the serotonin transporter protein) mRNA expression levels extracted from the peripheral blood was able to predict the worsening of suicidal ideation in a 30 weeks follow-up. Secondly, we explored the clinical and neuropsychological factors associated to medication adherence in euthymic bipolar patients. The results of our study highlighted that bipolar patients who experienced a higher number of adverse side effects and a smaller number of previous hospitalizations are more likely to be low adherent. Moreover, in the older bipolar patients only, poor executive functioning predicted low adherence.

Previous research suggests that lung cancer patients are at an increased risk for depressive symptomatology; however, little is known about the possible etiology or correlates of depression among these patients. This study examined the relationship between perceived stigma and depressive symptomatology among lung cancer patients, and sought to find potential mediators of this relationship. It was hypothesized that more perceived stigma would be related to greater depressive symptomatology and that perceived stigma would contribute unique variance to depressive symptomatology above and beyond that contributed by clinical, demographic, and psychosocial variables. A sample of 95 participants receiving chemotherapy for stage II-IV non-small cell lung cancer was recruited during routine outpatient chemotherapy visits. A medical chart review was conducted to assess clinical factors and participants completed a standard demographic questionnaire as well as measures of perceived stigma, depressive symptomatology, and other psychosocial variables. As hypothesized, there was a positive association of perceived stigma to depressive symptomatology. Perceived stigma contributed significant unique variance to depressive symptomatology. In addition dyadic adjustment and dysfunctional attitudes mediated this relationship. Future research should aim to replicate and extend these findings in longitudinal analyses and attempt to ameliorate lung cancer patients' depressive symptomatology by targeting perceived stigma.

This study examined the associations of polysubstance use, mood disorders, and chronic conditions with the history of anxiety disorder among patients with opioid use disorder (OUD). We performed a secondary analysis of the baseline data from a clinical trial including 1,645 individuals with OUD, of which 513 had anxiety disorder. Substance use disorders (SUDs) included alcohol, amphetamines, cannabis, cocaine, and sedative use disorders. Mood disorders included major depressive disorder (MDD) and bipolar disorder (BD). Chronic conditions were allergies, gastrointestinal problem(s), skin problem(s), and hypertension. Sedative use disorder, MDD, BD, skin problems, and hypertension were significantly associated with anxiety disorder (p < 0.05). Additionally, more than two SUDs, two mood disorders, and more than two chronic conditions were significantly associated with anxiety disorder (p < 0.05). These findings highlight the comorbid mental health and physical health problems in individuals with OUD, as well as the need for integrated multidisciplinary treatment plans.