Depression in the elderly represents a major public health problem, due to its high prevalence and its deleterious consequences in terms of morbidity and mortality, in particular by suicide.

1-Draw up the socio-demographic and clinical profile of elderly patients hospitalized in psychiatry for a major depressive episode 2-Determine the semiological and therapeutic characteristics of depression in the elderly.

Participants were outpatients of Psychiatry B department in Hedi chaker University Hospital Center in Tunisia, over the age of 65, hospitalized in psychiatry for a major depressive episode, recruted between 2000 and 2015. The data was collected using a pre-established sheet containing socio-demographic information, the clinical and evolutionary characteristics of the depressive episode and the therapeutic data concerning the depressive episode.

30 patients were included in this study with an average age (69 Y) and sex ratio (0.66). More than half (53.3%, 16 patients) had a history of chronic somatic disease. The average length of hospitalization was 26 days. The most frequent reason for hospitalization is sadness of mood (43.3%) with cognitive impairment as the predominant clinical symptomatology (40%). 93.3% of the population received as treatment an antidepressant mainly Fluoxetine (50%).

Depression and its different modes of expression in the elderly is a serious condition with direct effects on quality of life. Early detection is desirable in order to set up appropriate management, and thus prevent the occurrence of complications such as suicide.

Research has found that low mood including sadness and hopelessness is an important factor for decreased awareness in one’s oral health and lowered frequency of visit to the dental office, this relationship is not well studied in national representative samples. Poor mental wellbeing can lead to poor oral health.

Aim is to examine the relationship between feeling sad or hopeless and awareness for dental care.

Data were obtained from the Youth Risk Behavior Surveillance Survey (YRBS-CDC), USA, for years 2009-2017. All ages from 12 to 18 years, feeling sad or hopeless and dental visits were identified. Univariable relationship between feeling sad or hopeless (>2 weeks in the past year) and dental office visits for all dental care (during the past 12 months, 12-24 months, >24 months, and never) was evaluated using chi-square test.

Out of a total of 53,098 youths, 30.5% of youths were feeling sad or hopeless. Within the youths feeling sad or hopeless, the prevalence of youth who never received dental care was higher at 37.1% in comparison to youths who received dental care >24 months ago 36.4%,12-24 months 33.7%, and visited the dental office in the past 12 months 28.9%. (p<0.0001). In youths who had dental care in the last 12 months, the prevalence of sadness or hopelessness was lower at 65% vs 70%, while it was higher in youths who had never had dental care at 3.3% vs 1.7%.

Further research is warranted to evaluate reduced oral health care awareness among participants feeling sad or hopeless.

Functional recovery is the contemporary treatment goal in Major Depressive Disorder (MDD). Although consistency among physician and patient expectations may influence the therapeutic result (Demyttenaere K et al, 2011), patients’ perceptions are not always fully captured. Vortioxetine,a multimodal antidepressant, has shown encouraging data in achieving functional recovery, improving both mood and cognitive symptoms (Mahableshwarkar AR et al, 2015).

The aim of the study was to assess the effectiveness of vortioxetine on mood symptoms, cognitive symptoms and functionality, assessed by patient-rated tools, in MDD outpatients in Greece.

In this non-interventional study, vortioxetine was administered as flexible dosing (5-20 mg/d). Mood symptoms, cognitive symptoms and functioning were assessed by the patient-rated scales PHQ-9, PDQ-D and SDS respectively, at baseline, 1 and 3 months. Repeated measures analysis of variance and t-test were used for the statistical analyses.

336 patients participated in the study. PHQ-9 score ±SD decreased from 16.1±5.3, to 10.0±5.7 and 4.6±4.5, PDQ-D score ±SD decreased from 37.3±16.6 to 23.1±14.8 and 12.0±10.6, SDS Score ±SD decreased from 18.7±5.3 to 12.9±5.9 and to 7.8±6.5, at baseline, 1 and 3 months, respectively. The 3 SDS subscales: work/school life improved from 5.8±2.4 to 4.2±2.2 and 2.6±2.2, social life improved from 6.6±2.0 to 4.5±2.2 and 2.7±2.3 and family life improved from 6.3±2.0 to 4.3±2.1 and 2.6±2.3 -baseline, 1 and 3 months, respectively (p<0.001 for all paired comparisons).

MDD patients in Greece treated with vortioxetine significantly improved on mood symptoms, cognitive symptoms and functioning, enriching the already published efficacy data which is mostly based on clinician-rated scales.

A. Galanopoulos and E. Papalexi are full-time employees in Lundbeck Hellas.

Esketamine had been rised as a potential treatment for Resistant Depression, becoming an alternative for the use of Electroconvulsive Therapy. In Spain since 2020, it has been applied for compassionate use but is not widely used. Although Esketamine is defined safe and effective in preliminary studies, there are common side effects which could reduce it use.

Increasing blood pressure has been found commonly in ederly population treated with Esketamine Nasal. Studies showed as very common side effect (10% or more) increasing systolic and diastolic blood pressure which is higher in elderly people. Our aim is to show that esketamine is well tolerated and safe in ederly people without increasing blood pressure, although is combinate with oral antidepressant therapy.

Presenting female 65-year-old with 4 years of treatment maintaining a moderate-severe symptoms. Althougt numerous pharmacological strategies have been attempted, with optimal time and maximum doses, which have been progressively withdrawing showing lack of efficacy or appearance of adverse effects. Among the drugs used we find; 11 antidepressants, 3 antipsychotics, benzodiazepines and even lithium, without response after 6 weeks of treatment. Futhermore, patient refusal to receive Electro-Convulsive Therapy. Treating with Esketamine nasal and applying the established guidelines.

Assess the response to Esketamine Nasal with Montgomery-Asberg depression scale (MADRS) we found that decrease the initial score in 26 points. Evaluating blood pressure before and after each time with no increased value.

Concluding esketamine is well tolerated and safe in ederly people without increasing blood pressure. These findings and results should be confirmed with futher studies.

MIJ821 is a novel N-methyl-D-aspartate (NMDA) receptor antagonist, with a potentially low rate of the psychotomimetic side effects that limit the therapeutic utility of ketamine in treatment-refractory depression (TRD).

To assess efficacy and safety of MIJ821.

Adults with TRD (>2 prior treatment failures; Montgomery-Asberg Depression Rating Scale [MADRS], >24) were eligible and were randomized (n=70) to low versus high doses of MIJ821, with two dosing regimens of weekly or biweekly, versus ketamine versus placebo. The primary outcome was change in MADRS total score at 24 hours and final follow up was at 6 weeks.

At 24 hours, adjusted mean differences (ΔAM) versus placebo were –8.25 (p=0.001), –5.71 (p=0.019) and –5.67 (p=0.046) and at 48 h were –7.06 (p=0.013), –7.37 (p=0.013), –11.02 (p=0.019) in the pooled MIJ821 low dose, high dose, and ketamine groups, respectively. At 6 weeks, ΔAM (80% CI) versus placebo on MADRS were –6.46 (–11.8, –1.15); p=0.059 for low dose MIJ821, –5.42 (–10.8, –0.02); p=0.099) for high dose MIJ821, and –5.24 (–10.4, –0.06); p=0.097 for ketamine. Further details on dosing, efficacy, and safety outcomes will be provided.

In this proof-of-concept study, MIJ821 was effective and tolerable in TRD. This study was funded by Novartis. Clinical trial.gov: NCT03756129

Employee of Novartis.

According to the World Health Organization (WHO, 2017) depressive disorder continues to be the most widespread and growing mental illness in the world, also assumes that in 2020 depression will have a prevalence equal to one in six individuals. Studies of neuroanatomy have highlighted structural alterations in the hippocampus, striatal nuclei and prefrontal cortex in patients with mood disorders. This alteration in depressed patients is closely related to the secretion of neurotrophic factors, in particular there is a reduction in BDNF (Brain Derived Neurotrophic Factor).

The objective of this study is to demonstrate which treatments are effective in reducing depressive symptoms that allow the increase of BDNF and consequently the structural homostaticity of the brain.

We have selected data from the literature of the last decade, collected on major search engines such as: Google Scholar, Research Gate, PubMed, Ebsco. Articles collected by selecting the following Keyword: depression, BDNF (Brain Derived Neurotrophic Factor), neuroimaging cognitive behavior therapy.

The results show that in patients treated with a single drug treatment or vagus nerve stimulation, repetitive transcranial magnetic stimulation (Lang et al., 2008) or electroconvulsive therapy had improvements in BDNF levels, although compared to drug treatment there are problems of no responders, no compliance and lack of effectiveness in reducing vulnerability to relapse. In addition, the study has shown that patients treated with cognitive behavioral therapy have reported greater changes in the frontal and temporal cortex reducing both depressive symptoms and the risk of relapse.

Underlines the importance of an integrated approach

Pathological kinking of the internal carotid arteries (PK ICA) is a controversial issue of angioneurology. Patients with PK ICA often present a variety of complaints, such as headache, dizziness, decreased concentration, memory impairment, and general weakness [1].

To study the prevalence of anxiety and depression in patients with PK ICA.

We studied 132 patients who had PK ICA (main group) and 86 patients without brachiocephalic artery pathology (control group). Hospital Anxiety and Depression Scale (HADS) was used to evaluate anxiety and depression, considering depression or anxiety if the score was ≥10. Statistical analysis was performed with SPSS software, p-value<0.05 was considered statistically significant.

The mean age of the patients in the main group was 38.4±5.2 years, in patients of the control group 41.2±4.8 years, respectively. Anxiety disorders were detected significantly more frequently in the main group of patients than in the control group (35.7% and 10.2%, p=0.017 respectively). The frequency of depressive disorders was comparable in both groups – 13.6% and 14.3%, p=0.061, respectively. The level of anxiety was also significantly higher in the group of patients with PK compared to the control group (14.2±4.3 and 9.7±3.1 points, p=0.019). patients with PK ICA with anxiety are more likely suffered from depression (10.2% and 5.8%, p<0.001).

Anxiety disorders were present in one-third of patients with PK ICA, while depressive disorders were not typical for this group. In patients with PK ICA, in addition to collecting complaints, anamnesis, and evaluating the neurological status, it is advisable to conduct neuropsychological testing. References:1.Medvedeva LA, Zagorulko OI.Korsakov Journal 2019

Attributional style (AS) indicates cognitive dispositions for explaining positive and negative events. People with pessimistic АS explain failure with stable and global causes. Previous studies and meta-analyses (Hu et al., 2015; Peterson et al., 1985; Zhang et al., 2014) showed that pessimistic AS for failures is a reliable predictor of depression and ill-being, but the possible mediators of such relations are understudied.

Our main objective was to analyse relations of pessimistic AS for success and failure with mental health. We hypothesized that pessimistic AS would be a predictor of low mental health mediated by self-esteem, dispositional optimism, and gratitude.

A cross-sectional study was conducted on a sample of 261 adults (MA=32.09, SD=12.53, 13% male) using a 24-item attributional style questionnaire (SFASQ, Gordeeva et al., 2009), mental well-being scale (Tennant et al., 2007), self-esteem scale (Rosenberg, 1965), gratitude questionnaire (McCullough et al., 2002), and LOT (Scheier, Carver, 1985).

A path model of effects of pessimistic AS in positive and negative situations on mental ill-being was developed. The model with three mediators fits the data very well: CFI=0.990; RMSEA=0.048. The pessimistic attributional style for positive events was a significant predictor of mental ill-being mediated by self-esteem, dispositional optimism, and gratitude while the indirect effect of pessimistic AS for failures on mental ill-being (controlling for age) was not significant.

Only the pessimistic AS for successes but not for failures was a significant predictor of mental ill-being which underline the importance of stable and global attributions of positive life events for mental health.

Previous studies suggest that one of the possible depression pathophysiological pathways is autoimmune inflammation increasing inflammatory mediators’ levels and thus affecting mood.

To compare depression and anxiety symptoms among inflammatory bowel disease patients receiving TNF-α inhibitors and those receiving treatment as usual (TAU).

Instruments: Ulcerative colitis activity index, Crohn’s disease activity index, the subscale of neurovegetative symptoms of the Beck depression inventory, Hospital anxiety and depression scale. Active ulcerative colitis or Chron‘s disease patients not using antidepressants were included in the study and divided into an experimental group (receiving TNF-α inhibitors) and control group (receiving TAU).

46 patients’ data were analyzed. Between the experimental group and the control group, the disease activity index was not significantly different (Chron’s disease 3.54 ±4.20; ulcerative colitis 5.70 ±5.00; p > 0.05) as well as the mean scores of the neurovegetative depression symptoms subscale of the Beck depression inventory (2.52 experimental ±3.91 control; p > 0.05). The mean score of the hospital anxiety and depression scale were significantly different between both groups (5.22 ±8.13; p < 0.05). The mean anxiety subscale scores’ p=0,06, which shows trend for significance. The mean depressive subscale score was significantly different in the control group (1.43 ±2.65; p < 0.05).

Patients treated with biological therapy experienced fewer depression symptoms than patients showing similar disease activity, but receiving TAU.

Psychiatric symptoms associated with Primary hyperparathyroidism (PHPT) involved several presentations; the most characteristic is depression. However, PHPT remains often overlooked by physicians when making differential diagnosis for patients with psychiatric disorders, particularly in the elderly.

We proposed to describe the clinical and therapeutic characteristics of major depression secondary to PHPT.

We report a case of PHPT revealed by depression. Then, we conducted a literature review using “PubMed” database and keywords “primary Hyperparathyroidism”, “depression”.

A 73-year-old man presented with a 3-month history of depressed mood, loss of interest, clinophilia, poor concentration, and weight loss. These symptoms were associated with epigastralgia and constipation not responding to symptomatic treatment. The etiological assessment was normal. The diagnosis of major depression was established, and the patient was treated with Sertraline (25 mg/day). After one month of treatment, somatic and psychiatric symptoms worsened. Physical examination revealed a deteriorated general condition, dehydration, and cardiac arrhythmia. Blood analysis revealed renal failure, hypercalcemia (4.2mmol/L), hypophosphatemia (0.4mmol/L), and increased parathyroid hormone level (180 pg/ml). The patient was hospitalized in intensive care unit. Cervical echography showed 2 hyperparathyroid adenomas, and diagnosis of PHPT was established. Under symptomatic treatment, the patient’s somatic and psychiatric condition improved. An hyperparathyroidectomy is undergone soon.

This case highlighted the importance of considering a primary psychiatric disorder as a diagnosis of exclusion, especially in the elderly. PHPT is one of differential diagnoses for psychiatric symptoms, like depression, whose management is conditioned by that of the somatic disease.

Screening for psychiatric disorders is the job of primary care providers. As such, general practice residents spend one month on psychiatry rotation. During which, they need to familiarize with the diagnostic and treatment of mental disorders. Since depressive disorders in early stages can be easily overlooked by the untrained eye, we set out to analyse the demographic particularities of our patients.

The objective of our study was to analyze demographic characteristics of patients hospitalised on Acute Inpatient Psychiatry Ward with unipolar depression and to identify the specific warning signs, later to be used for an awareness campaign addressed to family medicine residents.

Data was collected from Acute Inpatient Psychiatry Ward of Arad County Emergency Clinical Hospital (Romania) between 1th January 2019 and 30th September 2020. We included every patient who was discharged with unipolar depression diagnosis according to ICD-10 criterias(F32-F33). Every patient was included only once. In cases of multiple hospitalisations, we included the most severe episode. If the severity of episodes was similar, the longest hospitalisation from the selected period. The data analysis accomplished in Microsoft Excel2010.

A number of 344 patients were included in our analysis (175 male, 169 female). Their presumptive diagnosis upon hospitalisation: Depressive Episode(F32)-32.3%, Recurring Depression(F33)-32,3%, Alcohol Use Disorder(F10)-23,8%, Suicid Attempt(X61-80)-7,0%, Other Psychiatric Disorders(F06,F20-23), Other Substance Use Disorder(F19)-0,6%. From 82 patients with presumptive diagnosis of Alcohol Use Disorder and definitive diagnosis of Depressive Disorder, 90,2% were male.

In primary practice alcohol misuse can be objectively spotted. Awareness is needed to investigate a possibly underlying depressive disorder.

Depression is a heterogeneous syndrome linked to significant structural brain abnormalities, such as volumetric reductions in the hippocampus, anterior cingulate cortex and prefrontal cortex, as well as compromised white matter integrity. Recent growing evidence suggests that exercise is a promising and compelling treatment for depression in adults, showing effects that are comparable to other first-line treatments for depression.

This review aims to improve our understanding of the biological pathways involved in both the pathophysiology of depression and the antidepressant effects of exercise.

This literature review considers the latest available scientific research addressing a comprehensive analysis of the antidepressant effect of physical exercise and the biological pathways involved.

Physical activity has been shown to have a multimodal effect that stimulates biochemical pathways and restores neuronal structures disturbed in depression. Experimental evidence supports exercise-induced increases in hippocampal, anterior cingulate cortex and prefrontal cortex volume, suggesting that exercise and antidepressant medication may alleviate depression through common neuromolecular mechanisms. However, the benefits of exercise may also persist beyond the end of treatment, unlike antidepressant medication.

Given the undeniable scientific evidence favoring physical exercise in alleviating depression, it is of crucial importance to recommend this treatment in adjunct to psychotherapy and medication. Individuals at risk for depression also greatly benefit from it’s neuroprotective effects and should prioritize lifestyle changes. In older adults, there is a greater need for non-pharmaceutical treatments for depression due to limited efficacy of pharmaceutical treatments in this population.

The current treatment goal in Major Depressive Disorder (MDD) is functional recovery (Zimmerman M et al, 2012). However, finding the “right dose for the right patient” may be challenging and the dose-response relationship for antidepressant efficacy remains controversial (Hieronymus F et al, 2016). Efficacy evaluated by MADRS increases with higher vortioxetine doses, based on meta-analysis data (Thase ME et al, 2016).

The aim of this exploratory analysis was to assess the impact of different doses on vortioxetine effectiveness in clinical practice in Greece.

In this non-interventional study, open-label vortioxetine was administered at a flexible dosage (5-20 mg/d). Patients receiving 5/10 mg vortioxetine (group A), at the end of the study, were compared to patients receiving 15/20mg vortioxetine (group B). At baseline, 1 and 3 months, depressive symptoms and functioning were assessed by MADRS and SDS. Multiple regression was used for the statistical analyses.

The study included 336 MDD patients. At the end of the study, 64.3% (n=200) of patients were receiving 15/20 mg vortioxetine. Higher vortioxetine dose at month 3 was significantly correlated with higher MADRS total score at baseline (p<0.001). SDS total score change from baseline to month 3 was significantly associated with vortioxetine dose (p<0.001), with group A and group B showing improvements of -9.2±8.2 and -12.1±6.0, respectively- whereas such association was not observed for MADRS total score.

In conclusion, patients with more severe depressive symptoms were treated with higher antidepressant doses. However, beyond symptom improvement, vortioxetine effectiveness on patient functioning seems to increase with higher doses.

A. Galanopoulos and E. Papalexi are full-time employees in Lundbeck Hellas. A. Ettrup is a full-time employee in H. Lundbeck A/S.

Unipolar depression is daily encountered in psychiatry.

To describe the socio-demographic and clinical characteristics of patients with unipolar depression.

This is a cross-sectional, descriptive study carried out at the psychiatric department of the University Hospital of Mahdia. We have included patients with unipolar depression. The data were collected from patients’ medical files using a pre-established 37-item questionnaire.

We have collected 53 patients. The mean age was 44 years. The majority of patients were female (56.6%) and unemployed (70%). 47.2% of patients were married. 72% of patients had a low socio-economic level. They were smokers in 45.3% of cases. Alcohol consumption was found in 24.5% of cases. A family history of mood disorder and suicide or attempted suicide were present in 7% and 13.2% of the cases respectively. 7% of the patients had a history of a postpartum thymic episode. The mean number of depressive episodes was 2.5. Personal history of suicide attempts was found in 40% of cases. The mean age of the first thymic episode was 35 years. At the psychiatric examination, psychomotor retardation was present in 64% of cases, anxiety distress in 58.5% of cases, psychotic, melancholic and atypical characteristics in 30%, 13.2% and 5.7% of cases respectively. 81% of patients were treated with anxiolytic drugs in combination with an antidepressant. Antipsychotic treatment was combined in 45% of cases and electro-convulsive therapy in 9.4% of cases.

Our patients presented predictive criteria of bipolarity. Therefore, vigilance is necessary in their medical management.

A family history (FH) of mood disorders is an important clinical feature that affects the risk of depression and its clinical manifestations during the course of the disease.

To assess the impact of FH in patients with depression on the presence of concomitant psychiatric disorders.

This cross-sectional study included 172 patients with depression (64.5% women; age - 40,87±15,86 years). The M.I.N.I. was conducted to verify the diagnosis of psychiatric disorders. FH is based on indirect reports of patients.

The most prevalent concomitant psychiatric diagnoses in patients with depression were generalized anxiety disorder (GAD; 26,2%), panic disorder (24,4%) and social anxiety disorder (13,4%). FH was recorded in 52 (30.2%) patients with depression. Patients with depression and FH more often had concomitant GAD (with FH - 20 (38,5%), without FH - 25 (20,8%); p=0.016). Women with depression and FH showed a higher rate of early onset (before age 18) of depression (with FH - 10 (32,3%), without FH - 10 (12,5%); p=0.015). Men with depression and FH more often had concomitant GAD (with FH - 10 (47,6%), without FH - 8 (20%); p=0.025). Logistic regression revealed that FH was associated with GAD in patients with depression (p=0.019).

FH of mood disorders in patients with depression is associated with specific concomitant psychopathology. Further genetic studies are needed to explain this comorbidity.

Major depression (MD) is associated with cognitive and behavioral alterations in many domains. It is not well clear what cortical structures and functional alterations characterize MD patients during resting state, a condition during which mind wandering process is prevailing.

In MD patients with severe levels of depression we expected, during resting state, an altered asymmetry of cortical activity in the EEG bands that generally mark neurological impairment, i.e. Delta and Theta EEG bands.

30 MD patients under pharmacological treatment and 32 matched controls underwent an EEG recording (38 scalp sites) during 5 min resting state with open eyes. Eye movements were corrected by ICA modeling and the 5 min recording was divided in 2 sec epochs from which Delta and Theta spectral powers were extracted.

Spectral analysis of the 5 min resting state revealed a significant difference between the two groups at the level of left temporal lobe. MD patients showed larger Delta and Theta spectral power in the left superior temporal gyrus at the level of Brodmann’s Areas 22 and 42.

Results evidenced a cortical inhibition (greater EEG Delta and Theta activity) in left temporal linguistic areas in severe depression, a result pointing to a different mind wandering process and thought architecture in MD patients during resting state.

Abdominal obesity is currently a growing problem in public health and has a high comorbidity with depressive and anxiety disorders. Obesity significantly decreases life quality, causes disability and decreases life expectancy.

The objective of this study was to examine anxiety and depressive symptoms among women, who received individual or group psychotherapy sessions due to obesity control.

577 women aging from 18 to 65 were examined. Height and weight were measured, Body mass index (BDI) was calculated based on received data. Depressive symptoms were determined with the PHQ-9 questionnaire [Kroenke K, Spitzer RL, Williams JB]. Anxiety symptoms were determined with the GAD-7 questionnaire. The level of social adaptation was examined.

The prevalence of mild depression in our sample of women with obesity was 31.5%, 19.1% - moderate depression, 1% - severe depression, 48.4% had no depression symptoms. Anxiety symptoms were found in 38.2% of examined women, 61.8% showed no anxiety symptoms. Furthermore, when patients were divided into subgroups accordingly to BMI, anxiety was mostly registered among ones with normal BMI. An average correlation between indicators of anxiety and depressive symptoms was identified (r=0,62, p<0,05). Average correlation between indicators of anxiety and depression and the level of social adaptation (r=0,59 and r=0,48 relatively, p<0,05). Anxiety and depressive symptoms’ dependency on BMI was not established.

The received data showed that anxiety and depression have high prevalence among women with obesity. The study will help medical specialists draw attention to high comorbidity between abdominal obesity and anxiety-depressive disorders.

The relationship between epilepsy and depression has been recognized for a long time. In fact, the presence of depression could worsen the disease outcome.

we aimed to study the prevalence of depression in patients with epilepsy and to assess the determinant factors of its genesis.

54 patients with epilepsy, aged more than 18 years, attending the neurology department of Habib Bourguiba Hospital, Sfax, Tunisia, were enrolled for the study. All patients were administered Mini-International Neuropsychiatric Interview (MINI) for evalution of psychiatric comorbid disorders especially depression. Socio-demographic and clinical data were collected.

A total of 54 patients were included, of whom 63% (n =34) were men. Mean duration of epilepsy was 20.13 years. The most frequent type of seizure was generalized 72.7%. Depression was present in 7.3 % of patients. Alcoholism (p=0.027) was significantly associated with occurrence of depression. Drug resistence (p = 0.03) and longer duration of epilepsy (p = 0.046) were significantly associated with occurrence of depression. No significant association was found between type of seizure, seizure frequency, medication compliance and depression. Depression wasn’t associated with anti-epileptic drug. We didn’t find any association between depression and other psychiatric comorbidities.

Depression wasn’t frequent in our study contrary to literature. The possible explanations are the reduced simple size and the sensitivity of the used tool to assess depression in epilepsy. Pursuant to literature, we found significant association between Alcoholism, drug resistance and long duration of epilepsy.

Major depression (MD) and anxiety symptoms (AS) are frequent cardiovascular diseases satellites (CVD).

To examine features of comorbid physical and mental disorders considering age and sex variability.

Cross-sectional study 146 patients with СVD were examined in cardiologic department of the Medical Centre. Of these, 51 (60.0%) are women and 34 (40.0%) are men. Patients assessed the intensity of pain or its absence using Visual Analog Scale. Anhedonia was determined by the Snatch-Hamilton Pleasure Scale - SHAPS. A hospital scale, HADS, was used to assess anxiety and depression. The final clinical diagnosis of MD was carried out according to the DSM-V criteria. Quantitative and ordinal signs are presented in the form Me-Median (Q1; Q3) - the first and third quartiles, respectively.

The degree of MD among male and female p=0,17; in “A” and “B” groups р=0,4912. Among patients of “A” age group is 2 (Q1 1 ; Q3 4) p=0,1777 had no difference. Patients of group “B” scored 3 (Q1 1,0; Q3 5,0) р=0,0019. Anxiety among female is 9 (Q1 6,0; Q3 11,0), among male 7 (Q1 3,5; Q3 9,0) р=0,0006. In the group of patients under 60 years anxiety score is 8 (Q1 4,0; Q3 9,0), group above 60 - 8 (Q1 6,0; Q3 11,0) р=0,0045. Pain intensity scored 3 (Q1 1,0; Q3 5,0) among male, 5 (Q1 3,0; Q3 7,0) among female p=0,0009.

Despite invariability of main depression symptoms among sex and partly age, pain and anxiety symptoms prevailed in elderly male and female.

The diagnosis of depression and identifying the factors affecting it in patients with high levels of hospitalization is necessary. Evaluating the prevalence of depression in this population is difficult, because some of the symptoms in depression and medical illness are similar and it is probable the diagnosis of depression to be missed in this patients.

The purpose of this study was to investigate the prevalence of depression and factors affecting it in patientsadmitted to the CCU of the Persian Gulf hospital in BandarabbasCity.

This study was performed on 133 patients admitted to the Persian Gulf Hospital. After obtainingconsent from patients, depression was recorded based on Beck questionnaire (BDI-II). Demographic data was registered from hospital chart review, and patient interview. Chi-Square and Mann-Whitney tests were used to compare the data.

Our results showed that the prevalence of depressionwas significant in CCU patients. 14.3% of CCU patients had moderate to severe depression and 54.59% had mild depression and only 30.8% were normal. Our study also demonstrated that there was a direct and significant relationship between depression and age, low education level, unemployment and length of hospitalization. (P <0.05)

Considering the high prevalence of depression in CCU patients, it is necessary to identify and perform therapeutic measures in patients at high risk for mental illness.