***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES To determine the prevalence of anxiety and depressive disorders in patients referred to general neurology outpatient clinics , to compare disability and number of somatic symptoms in patients with and without emotional disorder , the relation to neurological disease , and assess the need for psychiatric treatment as perceived by patients and doctors . METHODS A prospect i ve cohort study set in a regional neurology service in Edinburgh , Scotl and . The subjects were 300 newly referred consecutive out patients who were assessed for DSM IV anxiety and depressive disorders ( PRIME-MD , and HAD ) , health status , and disability ( SF-36 ) , and patients ' , GPs ' and neurologists ' ratings of the need for patient to receive psychiatric or psychological treatment .  RESULTS Of 300 new patients , 140 ( 47 % ) met criteria for one or more DSM IV anxiety or depressive diagnosis . Major depression was the most common ( 27 % ) . A comparison of patients with and without emotional disorder showed that physical function , physical role functioning , bodily pain , and social functioning were worse in patients with emotional disorders ( p<0.0005 ) . The median number of somatic symptoms was greater in patients with emotional disorders ( p<0.0005 ) . These differences were independent of the presence of neurological disease . Few patients wished to receive psychiatric or psychological treatments . Both general practitioners and neurologists were more likely to recommend psychiatric treatment when the patients ' symptoms were medically unexplained . CONCLUSIONS Almost half of new referrals to general neurology clinics met criteria for a DSM IV psychiatric diagnosis . These patients were more disabled , and had more somatic symptoms . They expressed little enthusiasm for receiving psychiatric treatment Aim . The aim of the study is to compare the prevalence of depression in women surgically diagnosed with endometriosis according to the presence or absence of pelvic pain . Methods . This cross‐sectional prospect i ve study evaluated 100 women receiving care at the Out patients ’ Clinic for Endometriosis , Department of Obstetrics and Gynecology , Universidade Estadual de Campinas ( UNICAMP ) , Campinas , São Paulo , Brazil , equally divided into two groups : one suffering from chronic pelvic pain and the other pain‐free .  The Beck Depression Inventory  was used in order to measure depression . Results . Depression was detected in 86 and 38 % of the women with and without chronic pelvic pain , respectively . Complaints of depression , such as somatic concerns , work inhibition , dissatisfaction , and sadness , were observed at a significantly higher rate in the group with pain . A sensation of failure was the only variable observed more frequently in the pain‐free group . Conclusions . Depression is highly prevalent in women with endometriosis , especially those with pelvic pain . Careful evaluation can identify women with depression who may benefit from treatment OBJECTIVES /HYPOTHESIS Empty nose syndrome ( ENS ) is often associated with psychological symptoms . With the absence of psychiatric instruments utilized in the current literature , the assessment of psychological disorder is limited , and the effectiveness of surgical intervention in improving such disorders in ENS are not well understood . The aim of this study was to evaluate the change in depression and anxiety before and after surgical treatment for ENS STUDY DESIGN : Prospect i ve cohort study in a tertiary medical center . METHODS ENS patients indicated for surgical treatment were enrolled . The  Beck Depression Inventory II ( BDI-II ) and Beck Anxiety Inventory ( BAI ) question naires were completed by these patients before and after surgery to assess the level of depression and anxiety . RESULTS A total of 20 patients completed the BDI-II and BAI before and after surgical treatment . A majority of patients developed depression and anxiety prior to surgical treatment . The severity of depression and anxiety were significantly decreased following the surgery ; the mean scores of both the BDI-II and BAI improved from moderate severity to normal ( both P < .001 ) . The preoperative total score was found to be a powerful predictor for the postoperative improvement in both BDI-II and BAI ( P < .001 ) . Female patients had significantly worse preoperative scores ( P = .005 ) and greater postoperative improvement ( P = .012 ) in the BDI-II . CONCLUSIONS Depression and anxiety are psychological disorders prevalent among ENS patients .  Surgical treatment for ENS is effective in improving depression and anxiety . Patients with worse preoperative BDI-II and BAI scores as well as female patients may be better c and i date s for surgical intervention . LEVEL OF EVIDENCE 4 Laryngoscope , 126:1284 - 1289 , 2016 The prevalence of postpartum depression is approximately 13 % . Postpartum depression is associated with a higher maternal morbidity and mortality , and also with pervasive effects on the emotional , cognitive and behavioral development of the child . The aim of our study was to identify socio-demographic , psychosocial and obstetrical risk factors of postpartum depression in a middle class community sample , using a prospect i ve design . We enrolled consecutively 312 pregnant out patients in a single maternity unit . The first assessment was conducted between 32 and 41 weeks gestation , and a second time between 6 and 8 weeks after delivery . Depressive symptoms were measured using the French version of the  Edinburgh Postnatal Depression Scale ( EPDS ) . A cut-off score of 12/30 or above was considered as indicative of Major Depression . Of the initial sample of 312 women , 264 ( 84.6 % ) were followed-up between 6 and 8 weeks after delivery and considered for analysis . Depression during pregnancy , migrant status , and physical abuse by the partner were independently associated with postpartum depression when considered together , whereas physical complications were significantly associated with postpartum depression only when adjusting for antenatal depression . Depression during pregnancy , history of physical abuse , migrant status and postpartum physical complications are four major risk factors for postpartum depression Objective : Past studies of psychiatric disorders in primary care in developing countries have utilized measures to determine conspicuous psychiatric morbidity ( CPM ) rather than diagnoses . Our goal was to determine the prevalence of DSM-III major depression ( DEP ) , panic disorder ( PD ) , and generalized anxiety disorder ( GAD ) in an outpatient clinic in Lesotho , Africa . Methods : As part of a larger community study , we utilized a translated version of the N.I.M.H. Diagnostic Interview Schedule to determine the prevalence of DEP , PD , and GAD in 126 r and omly selected out patients ( response rate = 77 % ) attending a general hospital clinic . We compared these data to information about demographics and symptom presentation . Results : We found twenty-nine ( 23 % ) patients with DEP , thirty ( 24 % ) with PD , and thirty-six ( 29 % ) with GAD . Forty-six ( 36 % ) had either DEP or PD , with thirteen ( 45 % ) having concurrent illness . Patients with DEP and /or PD presented with a significantly higher number of physical symptoms , and a higher percentage of symptoms that were pain or autonomic nervous system related than patients with no disorder ever . Conclusion : There is significant psychiatric morbidity of common diagnoses in outpatient clinic in Lesotho , and patients present primarily with somatic symptoms , as in developed countries . There is a need for better elucidation of cross-cultural phenomenology , medical co-morbidity as a con-founder , and help-seeking and treatment patterns in the developing world Background : In a previous prospect i ve study of 300 consecutive new attenders at neurology outpatient clinics , depressive disorders were diagnosed in 119 patients ( 40 % ) and major depressive disorder in 77 ( 26 % ) . Objective : To describe the eight month outcome of depression in this cohort . Methods : Patients were reinterviewed eight months after their baseline assessment .  Mental state was examined using the primary care evaluation of mental disorders ( PRIME-MD ) interview and the hospital anxiety and depression ( HAD ) self rating scale . Health status was measured using the medical outcome study 36 item short form scale ( SF-36 ) . Results : Of the original cohort of 300 , 226 ( 75 % ) participated in the follow up . Among them , 88 had a depressive disorder at baseline and 69 ( 78 % ) of those were still depressed at follow up ; 54 had major depression at baseline and 46 ( 85 % ) of those still had a major depressive disorder at follow up . Among the 138 patients who had no depression at baseline , 20 new major depressive disorders had developed by the time of follow up . Resolution of major depressive disorders was associated with an improvement in health status . Conclusions : Most depressive disorders detected in neurology out patients persist at an eight month follow up , and a substantial number of new cases arise . Resolution of depressive disorders , particularly major depressive disorder , is associated with an improvement in health status PURPOSE To determine the feasibility of screening for depression , dementia , and functional impairment in an ophthalmology outpatient clinic . DESIGN Prospect i ve pilot survey study . PARTICIPANTS Fifty consecutive ophthalmology clinic out patients . METHODS Consecutive patients more than 64 years of age with visits to the comprehensive eye clinic and the neuroophthalmology clinic at the University of Iowa were assessed . Suitable subjects were asked to complete a short question naire on instrumental activities of daily living , to answer a single question on depression , and to complete a clock drawing task in the office waiting room or examination room . RESULTS The 50 question naires review ed showed that most respondents were functional ( 94 % ) in instrumental activities of daily living , had normal clock drawing results ( 80 % ) , and were not depressed ( 80 % ) . A significant minority , however , were identified by the screening to have functional impairment ( 6 % ) , abnormal clock drawing results ( 20 % ) , or depression ( 20 % ) , and these patients were offered geriatric assessment . The tests were rapid ( fewer than 5 minutes to perform ) and easy to administer . CONCLUSIONS Screening for geriatric syndromes in the eye clinic was rapid , easy to perform , and detected a significant number of patients with functional disability , depression , and possible dementia OBJECTIVE To evaluate the impact of minimal depression on subjective and objective vision function measures in age-related macular degeneration ( AMD ) . DESIGN Prospect i ve cross-sectional study . PARTICIPANTS Two hundred six out patients with newly diagnosed neovascular AMD in one eye and preexisting AMD in the fellow eye . METHODS Structured clinical evaluations of visual acuity ( VA ) , contrast sensitivity , vision function , and depression . MAIN OUTCOME MEASURES The  17-item National Eye Institute Visual Function Question naire ( NEI VFQ 17 ) , Melbourne Low-Vision Index ( MLVI ) , Chronic Disease Score , and Hamilton Depression Rating Scale . RESULTS Minimally depressed subjects had significantly worse vision function on both the NEI VFQ 17 and performance-based tasks of the MLVI than nondepressed subjects , independent of severity of VA , contrast sensitivity , and medical status . CONCLUSIONS Minimally depressed patients with AMD , who would not be considered depressed according to current diagnostic st and ards , suffer decrements in vision function that can not be accounted for by the severity of their eye disease or general medical problems . These data emphasize the need to assess depressive symptoms in research studies that use vision function outcome measures and in clinical practice to identify excess vision-related disability in patients with AMD OBJECTIVE Our objective is to measure the prevalence and correlates of major depressive disorder ( MDD ) among Chinese breast cancer patients after surgery , which is essential for analyzing the service needs and allocating mental health re sources . METHODS A total of 505 patients were r and omly recruited from 1580 post-surgery breast cancer out patients from one tertiary hospital in Shanghai , and the  Mini International Neuropsychiatric Interview  was used to assess 1-month prevalence of MDD according to the Diagnostic and Statistical Manual Fourth Edition ( DSM-IV ) in a two-phase design . RESULTS The adjusted 1-month prevalence of MDD was 20.59 % ( 95 % CI 17.06 - 23.82 ) . The risk for depression within the first year was two times as higher as that in more than 1 year . Patients within 1 year after surgery , with lower income , disrupted marriage or being single , recurrent breast cancer and psychiatric history were more likely to have MDD . There was no significant association between depression and disease stage , type of surgery , receptor status and cancer treatment . CONCLUSIONS Depression is quite common in Chinese breast cancer patients and survivors . A more sensitive and responsive mental health service is recommended for this population OBJECTIVE To examine ( 1 ) the prevalence of depressive disorders in community-dwelling adults with advanced age-related macular degeneration ( AMD ) and ( 2 ) the relationship in this population between depression , visual acuity , the number of comorbid medical conditions , disability caused by vision loss as measured by the National Eye Institute-Vision Function Question naire ( NEI-VFQ ) and the  vision-specific Sickness Impact Profile ( SIPV ) , and disability caused by overall health status as measured by the Sickness Impact Profile-68 ( SIP ) . DESIGN Analysis of cross-sectional baseline data from a r and omized clinical trial . PARTICIPANTS Participants were 151 adults aged 60 and older ( mean age , 80 years ) with advanced macular degeneration whose vision was 20/6 
    Output:
    
Our study provides evidence that a significant proportion of out patients experience depression or depressive symptoms , highlighting the importance of developing effective management strategies for the early identification and treatment of these conditions among out patients in clinical practice .