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Major depressive disorder (MDD) is an incapacitating condition characterized by loss of interest, anhedonia and low mood, which affects almost 4% of people worldwide. With rising prevalence, it is considered a public health issue that affects economic productivity and heavily increases health costs alone or as a comorbidity for other pandemic non-communicable diseases (such as obesity, cardiovascular disease, diabetes, inflammatory bowel diseases, etc.). What is even more noteworthy is the double number of women suffering from MDD compared to men. In fact, this sex-related ratio has been contemplated since men and women have different sexual hormone oscillations, where women meet significant changes depending on the age range and moment of life (menstruation, premenstruation, pregnancy, postpartum, menopause…), which seem to be associated with susceptibility to depressive symptoms. For instance, a decreased estrogen level promotes decreased activation of serotonin transporters. Nevertheless, sexual hormones are not the only triggers that alter neurotransmission of monoamines and other neuropeptides. Actually, different dietary habits and/or nutritional requirements for specific moments of life severely affect MDD pathophysiology in women. In this context, the present review aims to descriptively collect information regarding the role of malnutrition in MDD onset and course, focusing on female patient and especially macro- and micronutrient deficiencies (amino acids, ω3 polyunsaturated fatty acids (ω3 PUFAs), folate, vitamin B12, vitamin D, minerals…), besides providing evidence for future nutritional intervention programs with a sex-gender perspective that hopefully improves mental health and quality of life in women.

Background Patients with bipolar disorder, even euthymic, could suffer an impairment in their quality of life compared to healthy controls. Since no previous systematic review and meta-analysis has been conducted, the aim of the current study is to conduct a systematic review and meta-analysis of cross-sectional case-controlled studies on quality of life in adult euthymic Bipolar Disorder patients. Methods A systematic review and meta-analysis that followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) was conducted. Major electronic databases were searched on August 2018 to assess the variables associated with quality of life in euthymic bipolar disorder patients. After selecting case-control studies, data collection, quality assessment and subsequently statistical analysis were done. Results 66 studies were finally selected for systematic review and meta-analysis. Four different quality of life instruments were used among the different studies. Effect size analysis showed that there were significant differences in quality of life outcomes between euthymic bipolar disorder patients and healthy controls (d=−0.922; SE=0.316; 95%CI=−1.541–−0.303; p=.004), with lower quality of life in the euthymic patients. Furthermore, time since euthymia explained 15.62% of variability, and age of control group explained 29.6% of variability. No other moderators were statiscally significant. Limitations The instruments used were heterogeneous. Moreover, the role of other clinical moderators could not be included due to the lack of this information in most of the articles. Conclusions Quality of life is lower in euthymic bipolar patients than in healthy controls. However, longer time in euthymia is associated with better outcomes.

Resumen Se trata de un estudio descriptivo, transversal y multicentrico realizado mediante encuestas autoadministradas para recoger de forma concurrente las opiniones de dos grupos de estudio (psiquiatras y pacientes) y analizar sus discordancias. El ambito de estudio lo constituyen servicios hospitalarios, centros ambulatorios, consultas profesionales individuales y cualquier otro dispositivo asistencial, publico o privado, donde se presta atencion psiquiatrica en Espana. En el presente estudio participaron 319 psiquiatras y 957 pacientes diagnosticados de depresion, de procedencia estratificada por comunidades autonomas. Las poblaciones a las que se pretenden inferir los resultados de este estudio son el conjunto de pacientes diagnosticados de depresion y en tratamiento antidepresivo, y el colectivo de especialistas en psiquiatria responsables de su seguimiento clinico, a nivel estatal. En la muestra de estudio, los sintomas depresivos relacionados con los ritmos circadianos resultan muy comunes: son percibidos por mas del 65% de los pacientes encuestados, excepto el «insomnio de despertar precoz» (54%) y la «fatiga, anergia y apatia» (37%). En general, y refrendando la hipotesis de estudio, la prevalencia de la practica totalidad de los sintomas depresivos analizados es significativamente infravalorada por los psiquiatras, respecto a la percepcion de los propios pacientes. Solo la presencia de «fatiga, anergia y apatia» es mas frecuentemente considerada por los profesionales que por los pacientes, quiza por resultar sintomas de especial caracter somatico que pueden indicar al clinico la necesidad de descartar la presencia de una afeccion organica subyacente. A la luz de los resultados presentados, cabe concluir que los trastornos de los ritmos circadianos son aspectos nucleares de la depresion y causa frecuente de sintomas clave y sintomas residuales de los pacientes en tratamiento. Estos trastornos parecen insuficientemente considerados por los profesionales y solo parcialmente resueltos con los farmacos antidepresivos actuales.

In wireless positioning systems, the transmitter’s power is usually fixed. In this paper, we explore the use of varying transmission powers to increase the performance of a wireless localization system. To this extent, we have designed a robot positioning system based on wireless motes. Our motes use an inexpensive, low-power sub-1-GHz system-on-chip (CC1110) working in the 433-MHz ISM band. Our localization algorithm is based on a particle filter and infers the robot position by: (1) comparing the power received with the expected one, and (2) integrating the robot displacement. We demonstrate that the use of transmitters that vary their transmission power over time improves the performance of the wireless positioning system significantly, with respect to a system that uses fixed power transmitters. This opens the door for applications where the robot can localize itself actively by requesting the transmitters to change their power in real time.

This is a descriptive, transversal and multicenter study using self-administered surveys concurrently to collect the opinions of two groups (psychiatrists and patients) and discuss their disagreements. The scope of study are hospital services, outpatient centers, individual professional consultation and other assistance system, public or private, which provides psychiatric care in Spain. Participated in this study 319 psychiatrists and 957 patients with the diagnosis of depression, stratified by autonomous communities. The populations they are intended to infer the results of this study were all patients diagnosed with depression and antidepressant treatment, and the group of specialists in psychiatry responsible for clinical monitoring at the national level. In the study sample, depressive symptoms related to circadian rhythms are very common: they are perceived by more than 65% of patients surveyed, except the «early morning awakening insomnia» (54%) and «fatigue, anergy and unresponsiveness» (37%). In general, and endorsing the study hypothesis, the prevalence of almost all analyzed depressive symptoms is significantly underestimated by psychiatrists about the perception of the patients themselves. Only the presence of «fatigue, anergy and unresponsiveness» is more often observed by professionals than by patients, perhaps by nature be of particular somatic symptoms that may suggest to the clinician to rule out underlying organic pathology. In light of the results presented it is concluded that disturbances in circadian rhythms are core aspects of depression and frequent cause of key symptoms and residual symptoms of patients in treatment. These disorders appear to be underestimated by professionals and only partially solved with existing antidepressant drugs.