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Wei J, Zhang Y, Lohman MC, Merchant AT. Supplemental Nutrition Assistance Program and depressive symptoms among adults with low family income in the U.S.: The National Health and Nutrition Examination Survey 2011-2018. J Affect Disord 2024; 362:828-834. [PMID: 39029691 DOI: 10.1016/j.jad.2024.07.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 06/28/2024] [Accepted: 07/14/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND The Supplemental Nutrition Assistance Program (SNAP) has been established to reduce food insecurity. Limited evidence is available on SNAP participation status over time and depressive symptoms. We aimed to examine the associations of SNAP status over time among low-income individuals, with depressive symptoms in the U.S. METHODS NHANES participants aged ≥20 years of low family income from 2011 to 2018 with information available on depressive symptoms and SNAP use were included in analysis. Depressive symptoms were assessed using 9-item Patient Health Questionnaire (PHQ-9), and PHQ-9 score ≥ 10 is indicative of significant depressive symptoms. Multivariable linear and logistic regressions models were conducted to examine the associations of SNAP participation status over time (never receiving SNAP, receiving SNAP prior to >12 months ago, current receiving SNAP, receiving SNAP in the last 12 months but not currently) with depressive symptoms and significant depressive symptoms. RESULTS Currently receiving SNAP (beta (β) = 0.17, 95 % CI: 0.10, 0.25; odds ratio (OR) = 1.52, 95 % confidence interval (CI): 1.16, 2.00) and receiving SNAP in the last 12 months but not currently (β = 0.24, 95 % CI: 0.04, 0.43; OR = 1.83, 95 % CI: 1.16, 2.89) were associated with higher depressive symptoms and higher prevalence of significant depressive symptoms. LIMITATIONS The cross-sectional design precludes causal interpretation, and key variables were measured with self-report. CONCLUSION Receiving SNAP in the last 12 months was associated with higher levels of depressive symptoms among individuals with low family income. Improvement on diet quality may be important for reducing depressive symptoms among SNAP users.
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Affiliation(s)
- Jingkai Wei
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America.
| | - Yanan Zhang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | - Matthew C Lohman
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
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Deason KG, Luchetti M, Karakose S, Stephan Y, O'Súilleabháin PS, Hajek A, Sutin AR, Terracciano A. Neuroticism, loneliness, all-cause and cause-specific mortality: A 17-year study of nearly 500,000 individuals. J Affect Disord 2024; 368:274-281. [PMID: 39288835 DOI: 10.1016/j.jad.2024.09.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 08/28/2024] [Accepted: 09/13/2024] [Indexed: 09/19/2024]
Abstract
BACKGROUND Neuroticism is related to mental and physical health. This study examined whether neuroticism and its underlying components were associated with risk of all-cause and cause-specific mortality. METHODS Community-dwelling adults (N = 491,323) in the UK Biobank completed a neuroticism scale between 2006 and 2010. Vital status was tracked up to December 2022 via linkage with the UK National Health Service. RESULTS Over 17 years of follow-up, 43,400 (8.8 %) participants died. Accounting for age, sex, and ethnicity, participants who scored 1 SD higher on neuroticism had a 10 % greater risk of dying (HR = 1.10, 95%CI = 1.09-1.11), an association that remained significant but was explained partly by socioeconomic status, health behaviors, and chronic conditions. Item-level analyses found that loneliness was the neuroticism item most predictive of mortality (HR = 1.46, 95%CI = 1.43-1.49), especially in males. Neuroticism and loneliness were more predictive of mortality among relatively younger adults and those with lower education. Among the causes of death, neuroticism and loneliness had the strongest association with deaths due to intentional self-harm, respiratory and digestive system diseases. LIMITATIONS Loneliness was assessed with a single item. The associations could be due to increases in neuroticism and loneliness approaching death. However, contrary to expectations from reverse causality, the associations were similar when excluding deaths within the first five or ten years of follow-up. Future research should examine whether findings from this high-income country replicate in middle- and lower-income communities. CONCLUSIONS Loneliness was the component of neuroticism most strongly associated with premature mortality, including from intentional self-harm, respiratory, and digestive system causes of death.
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Affiliation(s)
| | | | - Selin Karakose
- Florida State University College of Medicine, Tallahassee, USA
| | - Yannick Stephan
- University of Montpellier, Euromov, UFRSTAPS, Montpellier, France
| | - Páraic S O'Súilleabháin
- University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Ireland
| | - Andre Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
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Mao Q, Zhu X, Kong Y. Sleep duration mediates the association between heavy metals and the prevalence of depression: an integrated approach from the NHANES (2005-2020). Front Psychiatry 2024; 15:1455896. [PMID: 39286395 PMCID: PMC11404323 DOI: 10.3389/fpsyt.2024.1455896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Accepted: 08/08/2024] [Indexed: 09/19/2024] Open
Abstract
Purpose This study investigates the association between heavy metal exposure and the prevalence of depression, with the mediating role of sleep duration. Method Our study investigated the association between heavy metal concentration and depression risk in the NHANES from 2005 to 2020. We used logistic regression analysis, WQS regression model and BKMR model to assess the association. Mediation analysis was performed to explore the role of sleep duration in heavy metal exposure-induced depression. Result Of the 10,825 individuals included in this study, 705 (6.85%) were diagnosed with depression. We found a positive association between the cadmium (Cd), cobalt (Co), lead (Pb), antimony (Sb), wolfram (W) concentration and the prevalence of depression. Moreover, heavy metals mixtures were positively correlated with the prevalence of depression, with Cd identified as the main contributor in the WQS regression model (0.4654). Furthermore, sleep duration mediated the association between Cd, molybdenum (Mo), Pb, Sb, W exposure and prevalence of depression, explaining 3.12%, 15.84%, 18.24%, 9.56%, 3.68% of the effect. Conclusion The findings affirm that heavy metal exposure is linked to higher depression incidence and that this relationship is partly mediated by sleep duration alterations. The study underscores the importance of environmental health monitoring and interventions aimed at reducing heavy metal exposure to mitigate its psychological impacts.
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Affiliation(s)
- Qingsong Mao
- Hepatobiliary Pancreatic Surgery, Banan Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoyi Zhu
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Yuzhe Kong
- Xiangya School of Medicine, Central South University, Changsha, China
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Su Y, Li M, Schmitz N, Meng X. The longitudinal patterns of depression subtypes and stressors in depression severity in the Canadian longitudinal study on aging (CLSA). Psychiatry Clin Neurosci 2024. [PMID: 39221760 DOI: 10.1111/pcn.13728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 07/28/2024] [Accepted: 07/31/2024] [Indexed: 09/04/2024]
Abstract
AIM The current study aims to characterize the longitudinal patterns of depression subtypes and investigate the associations among the stability of depression subtypes, COVID-19-related stressors, and depression severity. METHODS The study utilized data from the Canadian Longitudinal Study on Aging, which is a national, long-term study of Canadian adults aged 45 and older (n = 12,957). Latent profile analysis was used to identify latent depression subtypes. Latent transition analysis was then applied to assess the stability of these subtypes over time. Hierarchical multivariate linear regression was used to explore the relationships among these identified depression subtypes, COVID-19-related stressors, and depression severity among males and females, respectively. RESULTS Distinct depression subtypes were identified. Except for atypical depression, other depression subtypes showed greater stability over time. We also found that melancholic depression (B = 9.432) and typical depression (B = 6.677) were strongly associated with depression severity during the pandemic. Health-related stressors (B = 0.840), conflict (B = 3.639), difficulties accessing resources (B = 0.927), separation from family (B = 0.840), and caregiving experience (B = 0.764), were significantly associated with increased depression severity. Sex-specific analyses also revealed differences in the associations between stressors and depression severity between males and females. CONCLUSIONS This study contributes valuable insights into the latent clustering of depression subtypes and their stability. Stressors were associated with increased depression severity, with distinct associations observed among males and females. These findings have implications for targeted early interventions and integrated clinical management strategies by providing the evidence base for tailored mental health care during and after the pandemic.
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Affiliation(s)
- Yingying Su
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Douglas Research Centre, Montreal, Quebec, Canada
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Muzi Li
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Douglas Research Centre, Montreal, Quebec, Canada
| | - Norbert Schmitz
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Douglas Research Centre, Montreal, Quebec, Canada
- Department of Population-Based Medicine, Tuebingen University, Tuebingen, Germany
| | - Xiangfei Meng
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Douglas Research Centre, Montreal, Quebec, Canada
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ontario, Canada
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Wang Y, Li X, Cao Z, Zhou Y. The impact of alcohol consumption on the relationship between depression and chronic diarrhea: a cross-sectional study analysis on NHANES (2005-2010). Front Psychiatry 2024; 15:1393546. [PMID: 39279809 PMCID: PMC11392863 DOI: 10.3389/fpsyt.2024.1393546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 07/30/2024] [Indexed: 09/18/2024] Open
Abstract
Background Alcohol consumption, depression, and chronic diarrhea are all public health issues of concern, with irreversible consequences for individual health and significant economic burdens on health care systems. Previous studies have shown that depression increases the risk of developing chronic diarrhea, but few studies have explored whether alcohol consumption has an effect on the relationship between depression and chronic diarrhea. Objective To explore the effect of alcohol consumption on the relationship between depression and chronic diarrhea. Methods 12,538 adults (≥20 years) in NHANES from 2005-2010 were analyzed. Participants were stratified according to drinking status, and differences between the risk of depression and chronic diarrhea among participants who drank alcohol or not were assessed using multiple regression analysis and likelihood ratio tests. Results In this cross sectional, after adding possible confounders, the prevalence of depression with chronic diarrhea was higher in the drinking population than in the non-drinking population (OR,2.34, 95%CI:1.84-2.98 and 1.26, 95%CI:0.85-1.86), with a likelihood ratio test of P=0.024. Conclusion Our findings suggest that there is a significant association between depression and chronic diarrhea and that alcohol consumption may increase the correlation between depression and chronic diarrhea. However, these findings require further prospective studies to provide more evidence.
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Affiliation(s)
- Yongsen Wang
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
- Gastroenterology Department, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xiaotong Li
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Zhiqun Cao
- Gastroenterology Department, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yongkun Zhou
- Gastrointestinal and Hernia Surgery, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
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Boschesi Barros V, Chiavegatto Filho ADP. Modifiable risk factors and excess mortality in depression: Data from the UK Biobank. Gen Hosp Psychiatry 2024; 91:11-17. [PMID: 39244951 DOI: 10.1016/j.genhosppsych.2024.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 08/19/2024] [Accepted: 08/19/2024] [Indexed: 09/10/2024]
Abstract
OBJECTIVE To study the role of modifiable risk factors in explaining the excess mortality associated with depression using data from the UK Biobank, a middle-aged and elderly cohort recruited in 2006-2010. METHODS We estimated the prevalence and relative mortality associated with modifiable risk factors and groups of risk factors (socioeconomic factors, diet and exercise, smoking and substance-related disorders, and cardiometabolic diseases) in a subsample of probable cases of lifetime/current depression (n = 51,302) versus non-cases. We also estimated the relative mortality associated with depression and the percentages of excess mortality associated with depression explained by modifiable risk factors in the total sample (499,762). RESULTS In our depression subsample, all modifiable risk factors were associated with increased prevalence and mortality. In our total sample, depression was associated with an age and sex-adjusted mortality hazard ratio of 1.63 (95% CI = [1.58-1.68]). Modifiable risk factors explained 70.5% [66.9%-75.0%] of the excess mortality associated with depression. CONCLUSIONS In the UK Biobank cohort, depression was associated with a higher prevalence of modifiable risk factors. These risk factors were associated with increased mortality in the depression subsample and explained most of the excess mortality risk associated with depression in the total sample.
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Affiliation(s)
- Vivian Boschesi Barros
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil.
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Wang Y, Yang X, Zhou Y, Ruan W, Li H, Han Y, Wang H. High-level physical activity provides protection against all-cause mortality among U.S. adults with depression. J Affect Disord 2024; 358:458-465. [PMID: 38750801 DOI: 10.1016/j.jad.2024.05.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 04/09/2024] [Accepted: 05/12/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND Regular physical activity (PA) offers numerous benefits, decreasing all-cause mortality (ACM) among the general population. However, its impact on individuals with depression remains unknown. The present study aimed to investigate the correlation between various PA levels and ACM among adult patients with depression in the United States. METHODS Data from the National Health and Nutrition Examination Survey from 2007 to 2018, as well as relevant mortality data up to December 31, 2018 were extracted. 4850 adults with depression were incorporated into this cohort study. PA level was quantified based on weekly metabolic equivalent of task (MET-min/week) and categorized into four groups according to the Physical Activity Guidelines for Americans. Weighted Cox proportional-hazards models were leveraged to assess the association of different PA levels with ACM among adults with depression, and adjustments were made for various sociodemographic and health factors. RESULTS Among the 4850 patients with depression, 503 deaths were noted over a median follow-up of 6.6 years. The weighted Cox regression analysis showed that participants with high-level PA (>1200 MET-min/week) had a markedly lower risk of ACM (HR = 0.48, 95 % CI 0.33 to 0.68) compared to those with no PA (0 MET-min/week). The benefit conferred by the high-level PA group (HR = 0.65, 95CI 0.45 to 0.94) remained significant (p < 0.05) after adjustment for other confounders. LIMITATIONS PA and some covariates were assessed through self-reported questionnaires. CONCLUSION High-level PA has the most pronounced effect on reducing ACM among adult patients with depression, which should be recognized in clinical and public health guidelines.
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Affiliation(s)
- Yifei Wang
- College of Physical Education and Health, Guangxi Normal University, Guilin, Guangxi 541006, China
| | - Xin Yang
- College of Physical Education and Health, Guangxi Normal University, Guilin, Guangxi 541006, China
| | - Ying Zhou
- College of Physical Education and Health, Guangxi Normal University, Guilin, Guangxi 541006, China
| | - Weiqi Ruan
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China
| | - Honglei Li
- School of Chemistry and Chemical Engineering, Nanjing University, Nanjing, Jiangsu 210023, China
| | - Yanbai Han
- College of Physical Education and Health, Guangxi Normal University, Guilin, Guangxi 541006, China
| | - Hongli Wang
- College of Physical Education and Health, Guangxi Normal University, Guilin, Guangxi 541006, China.
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Giraldo-Rodríguez L, Torres-Castro S, Roa-Rojas PA, Alvarez-Cisneros T. Demographic, socioeconomic and health determinants of depressive symptoms in adults 50 years and older from Mexico: a secondary data longitudinal analysis from the Mexican Health and Aging Study. BMJ Open 2024; 14:e075035. [PMID: 39002968 PMCID: PMC11253772 DOI: 10.1136/bmjopen-2023-075035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 06/06/2024] [Indexed: 07/15/2024] Open
Abstract
BACKGROUND Depression in ageing adults is a public health problem. Worldwide studies have identified social and health risk factors for depressive symptoms. However, little is known about their longitudinal determinants in Mexico. OBJECTIVES AND SETTING To find the prevalence of depressive symptoms and their longitudinal individual and contextual risk factors in Mexican adults aged 50 and older. DESIGN Secondary data of 6460 persons aged 50 years and older from the Mexican Health and Aging Study were analysed using a 'between-within' panel data analysis approach. RESULTS The prevalence of depressive symptoms increased from 35% in 2003 to 38% in 2015. The significantly longitudinal factors associated with these symptoms were getting older (OR 1.02, 95% CI 1.01 to 1.03), being a woman (OR 2.39, 95% CI 2.16 to 2.64), less time spent in formal education (0 years and less than 6 years OR 1.52, 95% CI 1.32 to 1.75 and OR 1.33, 95% CI 1.19 to 1.50, respectively), lower net worth (OR 1.13, 95% CI 1.08 to 1.17), being recently unemployed (OR 1.25, 95% CI 1.10 to 1.25), increased (OR 1.17, 95% CI 1.10 to 1.25) or increasing number (OR 1.23, 95% CI 1.15 to 1.31) of chronic conditions, poor (OR 4.68, 95% CI 4.26 to 5.15) or worsened (OR 1.71, 95% CI 1.61 to 1.81) self-rated health and having impairments on instrumental activities of daily living (IADLs) (OR 2.94 95% CI 2.35 to 3.67) or a new IADL impairment (OR 1.67, 95% CI 1.48 to 1.89), as well as having impairments on ADLs (OR 1.51, 95% CI 1.23 to 1.86) or a new ADL impairment (OR 1.34, 95% CI 1.21 to 1.48). CONCLUSIONS The prevalence of depressive symptoms in Mexican adults aged 50 and older is high. Our findings show that they are longitudinally associated with the individual's demographic, socioeconomic, health and disability characteristics. Efforts in public policy should focus on preventing chronic conditions and disability, as well as fighting inequalities to reduce the prevalence of depressive symptoms.
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Affiliation(s)
- Liliana Giraldo-Rodríguez
- Demographic and Determinants of Health Research, Instituto Nacional de Geriatria, Mexico City, Mexico
| | - Sara Torres-Castro
- Demography and Determinants of Health Research, Instituto Nacional de Geriatria, Mexico City, Mexico
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Rodrigues MF, Quagliato L, Appolinario JC, Nardi AE. Online mindfulness-based cognitive therapy for treatment-resistant depression: a parallel-arm randomized controlled feasibility trial. Front Psychol 2024; 15:1412483. [PMID: 39021648 PMCID: PMC11252472 DOI: 10.3389/fpsyg.2024.1412483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 06/10/2024] [Indexed: 07/20/2024] Open
Abstract
Introduction Treatment-resistant depression (TRD) presents a significant challenge, affecting approximately 30% of individuals diagnosed with major depressive disorder and leading to poor treatment responses. Innovations in digital mental health, especially online mindfulness-based cognitive therapy (eMBCT), offer promising avenues for enhancing access to effective mental health care for individuals with TRD in a clinical setting. Objective The aim of this study was to examine the feasibility of eMBCT in an individual clinical context to decrease depressive symptoms for TRD. Methods Conducted at the Institute of Psychiatry of the Federal University of Rio de Janeiro, Brazil, this parallel-arm, randomized controlled feasibility trial involved outpatients diagnosed with TRD, aged 18 and above. Of the 39 outpatients invited, 28 were randomized into two groups: an intervention group receiving the eMBCT program (n = 15) and a control group (n = 13). The intervention, consisting of an 8-week course, was delivered via live video sessions. Following the assessment period, participants in the control group were offered the eMBCT intervention. Assessments using standardized questionnaires were conducted at the start and end of the study. Results Within the eMBCT group, improvements were observed in depression symptoms (Z = -3.423; p = 0.001; effect size r = 0.78), anxiety symptoms (Z = -3.361; p = 0.001; effect size r = 0.77), with no significant changes in the control group. Comparatively, the eMBCT group showed significant reductions in depression symptoms and improvements in clinical global impressions over the control group (BDI2: U = 30.5; p = 0.015; effect size r = 0.47, CGI1: U = 21.0; p = 0.004; effect size r = 0.56). Conclusion eMBCT in an individual format combined with medication, appears to be a feasible treatment for TRD, decreasing symptoms of depression. In a future trial the control group may have a manualized intervention. Clinical trial registration The Brazilian Clinical Trials Registry: (https://ensaiosclinicos.gov.br/rg/RBR-6zndpbv) and RBR-6zndpbv.
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Wu S, Zhong X, Gong Y, Yao Y, Shirai K, Kondo K, Wang X, Guan L, Chen Q, Liu K, Li Y. Depression and the Risk of Dementia and All-Cause Mortality Among Japanese Older Adults: A 9-Year Longitudinal Study From JAGES. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae084. [PMID: 38778797 DOI: 10.1093/geronb/gbae084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND This study aims to investigate the association and dose-response relationship between depression, dementia, and all-cause mortality based on a national cohort study of older adults in Japan. METHODS We conducted a longitudinal study of 44,546 participants ≥65 years from 2010-2019 Japanese Gerontological Evaluation Study. The Geriatric Depression Scale-15 was used to assess depressive symptoms and the long-term care insurance was used to assess dementia. Fine-Gray models and Cox proportional hazard models were used to explore the effect of depression severity on the incidence of dementia and all-cause mortality, respectively. Causal mediation analysis were used to explore the extent of association between dementia-mediated depression and all-cause mortality. RESULTS We found that both minor and major depressive symptoms were associated with the increased cumulative incidence of dementia and all-cause mortality, especially major depressive symptoms (p < .001). The multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for dementia were 1.25 (1.19-1.32) for minor depressive symptoms and 1.42 (1.30-1.54) for major depressive symptoms in comparison to non-depression; p for trend < .001. The multivariable-adjusted HRs and 95% CIs for all-cause mortality were 1.27 (1.21-1.33) for minor depressive symptoms and 1.51 (1.41-1.62) for major depressive symptoms in comparison to non-depression; p for trend < .001. Depression has a stronger impact on dementia and all-cause mortality among the younger group. In addition, dementia significantly mediated the association between depression and all-cause mortality. DISCUSSION Interventions targeting major depression may be an effective strategy for preventing dementia and premature death.
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Affiliation(s)
- Shan Wu
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Xiangbin Zhong
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Yajie Gong
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Yao Yao
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Kokoro Shirai
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Center for Well-being and Society, Nihon Fukushi University, Aichi, Japan
| | - Xinlei Wang
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Liqi Guan
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Qiqing Chen
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Keyang Liu
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yuting Li
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
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Kreppke JN, Cody R, Beck J, Brand S, Donath L, Eckert A, Imboden C, Hatzinger M, Holsboer-Trachsler E, Lang UE, Mans S, Mikoteit T, Oswald A, Rogausch A, Schweinfurth-Keck N, Zahner L, Gerber M, Faude O. Cardiorespiratory fitness, perceived fitness and autonomic function in in-patients with different depression severity compared with healthy controls. J Psychiatr Res 2024; 175:437-445. [PMID: 38797040 DOI: 10.1016/j.jpsychires.2024.05.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 03/26/2024] [Accepted: 05/20/2024] [Indexed: 05/29/2024]
Abstract
Over 300 million individuals worldwide suffer from major depressive disorder (MDD). Individuals with MDD are less physically active than healthy people which results in lower cardiorespiratory fitness (CRF) and less favorable perceived fitness compared with healthy controls. Additionally, individuals with MDD may show autonomic system dysfunction. The purpose of the present study was to evaluate the CRF, perceived fitness and autonomic function in in-patients with MDD of different severity compared with healthy controls. We used data from 212 in-patients (age: 40.7 ± 12.6 y, 53% female) with MDD and from 141 healthy controls (age: 36.7 ± 12.7 y, 58% female). We assessed CRF with the Åstrand-Rhyming test, self-reported perceived fitness and autonomic function by heart rate variability (HRV). In specific, we used resting heart rate, time- and frequency-based parameters for HRV. In-patients completed the Beck Depression Inventory-II (BDI-II) to self-assess the subjectively rated severity of depression. Based on these scores, participants were grouped into mild, moderate and severe MDD. The main finding was an inverse association between depression severity and CRF as well as perceived fitness compared with healthy controls. Resting heart rate was elevated with increasing depression severity. The time-based but not the frequency-based autonomic function parameters showed an inverse association with depression severity. The pattern of results suggests that among in-patients with major depressive disorder, those with particularly high self-assessed severity scores show a lower CRF, less favorable perceived fitness and partial autonomic dysfunction compared to healthy controls. To counteract these conditions, physical activity interventions may be effective.
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Affiliation(s)
- Jan-Niklas Kreppke
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland.
| | - Robyn Cody
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | | | - Serge Brand
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland; Adult Psychiatric Clinics (UPKE), University of Basel, Basel, Switzerland; Substance Use Prevention Research Center and Sleep Disorder Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah 6715847141, Iran; School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran; Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran
| | - Lars Donath
- German Sport University Cologne, Department of Intervention Research in Exercise Training, Cologne, Germany
| | - Anne Eckert
- Adult Psychiatric Clinics (UPKE), University of Basel, Basel, Switzerland
| | - Christian Imboden
- Private Clinic Wyss, Münchenbuchsee, Switzerland; University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Martin Hatzinger
- Psychiatric Services, Solothurn, and Medical Faculty, University of Basel, Switzerland
| | | | - Undine E Lang
- Adult Psychiatric Clinics (UPKE), University of Basel, Basel, Switzerland
| | - Sarah Mans
- Private Clinic Wyss, Münchenbuchsee, Switzerland
| | - Thorsten Mikoteit
- Psychiatric Services, Solothurn, and Medical Faculty, University of Basel, Switzerland
| | - Anja Oswald
- Psychiatric Clinic Sonnenhalde, Riehen, Switzerland
| | | | | | - Lukas Zahner
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Markus Gerber
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Oliver Faude
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland
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12
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Li G, Ji H, Jiang Q, Cao H, Wang Z, Liu S. Association between physical activity and depression in adult prescription opioid users: A cross-sectional analysis based on NHANES 2007-2018. Gen Hosp Psychiatry 2024; 89:1-7. [PMID: 38579547 DOI: 10.1016/j.genhosppsych.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 03/27/2024] [Accepted: 03/30/2024] [Indexed: 04/07/2024]
Abstract
OBJECTIVE This study was designed to examine the association between physical activity (PA) and depression among adult prescription opioid users. METHOD Data of adults who recently took prescription opioids were collected from NHANES 2007-2018. Participants were divided into two groups according to whether PA in each domain was ≥600 MET-min/week. According to weekly activity frequency, recreational physical activity (RPA) was divided into inactivity, insufficient activity, weekend warrior (WW), and regular activity. PHQ-9 scores ≥10 were identified as depression. RESULTS RPA of ≥600 MET-min/week was associated with a 40% (OR: 0.60, 95%CI: 0.38-0.96, P = 0.032) reduction in the risk of depression. Restricted Cubic Spline plots found a nonlinear dose-response relationship between RPA and depression (P = 0.045), and the turning point of depression risk was around 600 MET-min/week. There was no significant difference in the risk of depression between the WW and inactivity groups (OR: 0.65, 95%CI: 0.25-1.72, P = 0.382). The regular activity group had an 45% (OR: 0.55, 95%CI: 0.31-0.99, P = 0.046)lower risk for depression than the inactivity group. CONCLUSION Only regular RPA is associated with a reduced risk of depression, and RPA showed a nonlinear dose-response relationship. The antidepressant effect of the WW is not significant.
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Affiliation(s)
- Gang Li
- Department of Anesthesia, The Chenggong Hospital Affiliated to Xiamen University, Xiamen, Fujian, PR China
| | - Hongxiang Ji
- Department of General Surgery, The Chenggong Hospital Affiliated to Xiamen University, Xiamen, Fujian, PR China
| | - Qiuxiang Jiang
- Department of Anesthesia, The Chenggong Hospital Affiliated to Xiamen University, Xiamen, Fujian, PR China
| | - Huijuan Cao
- Department of Anesthesia, The Chenggong Hospital Affiliated to Xiamen University, Xiamen, Fujian, PR China
| | - Zhibin Wang
- Medical Department, The Chenggong Hospital Affiliated to Xiamen University, Xiamen, Fujian, PR China.
| | - Shanshan Liu
- Department of Anesthesia, The Chenggong Hospital Affiliated to Xiamen University, Xiamen, Fujian, PR China.
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13
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Qi Y, Meng F, Yan X, Huang H, Chen X, He F. The effects of health risk behaviors to excess mortality in the population with depression: A cohort study based on NHANES data. J Affect Disord 2024; 356:233-238. [PMID: 38608768 DOI: 10.1016/j.jad.2024.04.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/28/2024] [Accepted: 04/09/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND The population with depression had a considerable excess mortality risk. This increased mortality may be attributed to the biological consequences of depression or the substantial prevalence of health risk behaviors (HRBs). This study aimed to quantify the combined effects of four major HRBs - smoking, excessive alcohol use, physical inactivity, and an unhealthy diet - on excess mortality among depressed individuals. METHODS This study included 35,738 adults from the National Health and Nutrition Examination Survey 2005-06 to 2017-18, with mortality follow-up data censored through 2019. The standardized prevalence of HRBs was calculated for populations with and without depression. Poisson regression models were used to calculate the mortality rate ratio (MRR). Based on model adjusting for socio-demographic factors, the attenuation of MRR was determined after further adjustment for HRBs. RESULTS A total of 3147 participants were identified as having depression. All HRBs showed a significantly higher prevalence among the population with depression. After adjusting for socio-demographic factors, depression was associated with 1.7 and 1.8 times higher all-cause and cardiovascular disease mortality rate, respectively. Further adjustment for all current HRBs resulted in a 21.9 % reduction in all-cause mortality rate and a 15.4 % decrease in cardiovascular disease mortality rate. LIMITATION HRBs were reported at a single time point, and we are unable to demonstrate a causal effect. CONCLUSION At least 1/5 of excess mortality for population with depression was attributable to HRBs. Efforts should be made to address HRBs among population with depression.
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Affiliation(s)
- Yanjie Qi
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Fanchao Meng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xiuping Yan
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Huanhuan Huang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xu Chen
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Fan He
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
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14
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Okoli CTC, Abufarsakh B, Wang T, Makowski A, Cooley A. Assessing the impact of long-acting injectable compared to oral antipsychotic medications on readmission to a state psychiatric hospital. J Psychiatr Ment Health Nurs 2024. [PMID: 38922793 DOI: 10.1111/jpm.13075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 03/01/2024] [Accepted: 06/15/2024] [Indexed: 06/28/2024]
Abstract
WHAT IS KNOWN ON THE SUBJECT People living with schizophrenia spectrum disorder (SSD) have a higher death rate which is caused, in part, by poorer adherence to treatment as compared to those with other mental illnesses. Using long-acting injectable antipsychotic (LAI) medications can improve medication adherence and reduce hospitalizations for people living with SSD but are often underutilized. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE As compared to oral antipsychotic medications provided to patients with SSD at discharge from a psychiatric hospitalization, being provided with an LAI antipsychotic medication may reduce subsequent rehospitalization. Specifically, patients discharged on an atypical or second-generation LAI medication are less likely to be readmitted to the hospital when compared to those discharged on a typical first-generation oral medication. WHAT ARE THE IMPLICATIONS FOR PRACTICE Because LAI antipsychotic medications are often underutilized as treatment options, the study findings suggest that this modality may be considered for patients with SSD when being discharged from a psychiatric hospitalization. Ideally, psychiatric-mental health nurses can educate patients about indications, benefits, and risks of using atypical or second-generation LAI antipsychotic medications during hospitalization and at discharge prevent the risk for future rehospitalizations. ABSTRACT INTRODUCTION: People living with schizophrenia spectrum disorder (SSD) have poorer medication adherence compared to those with other mental illnesses. Long-acting injectable antipsychotic (LAI) medication use is associated with greater adherence, reduced re-hospitalizations, and improved recovery outcomes when compared to oral formulations. AIM To compare LAI antipsychotic medication use versus oral formulations on readmission to an inpatient hospital. METHOD Medical records (N = 707) from a state psychiatric hospital in the southern region of the United States were reviewed. Controlling for demographic variables, logistic regression analyses were used to examine LAI compared to oral formulations on readmission. RESULTS Compared to patients discharged with oral antipsychotic medications, those with LAIs had a lower proportion of readmission rates in 6-month and 1-year periods, but not 30-day or 2-year periods. When controlling for demographic variables, those discharged with an atypical LAI had significantly lower odds of being readmitted within the 24-year period compared to those discharged on a typical oral antipsychotic. DISCUSSION Compared to orals, LAIs do not increase and may mitigate readmissions to psychiatric hospitalization. IMPLICATIONS FOR PRACTICE Psychiatric-mental health nurses and other professionals may recommend LAIs when indicated for those with SSD.
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Affiliation(s)
| | | | - Tianyi Wang
- Department of Statistics, University of Kentucky College of Arts and Sciences, Lexington, Kentucky, USA
| | - Andrew Makowski
- University of Kentucky College of Nursing, Lexington, Kentucky, USA
| | - Andrew Cooley
- Department of Psychiatry, University of Kentucky College of Medicine, Lexington, Kentucky, USA
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15
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Luna E, Pikhart H, Peasey A. Association between depressive symptoms and all-cause mortality in Chilean adult population: prospective results from two national health surveys. Soc Psychiatry Psychiatr Epidemiol 2024; 59:1003-1012. [PMID: 37474619 PMCID: PMC11116228 DOI: 10.1007/s00127-023-02534-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 07/12/2023] [Indexed: 07/22/2023]
Abstract
PURPOSE Depression is a prevalent disorder with effects beyond mental health. A positive association with mortality has been mostly reported, however, evidence comes from a few high-income countries. This study aims to assess the association between depressive symptoms and all-cause mortality in the Chilean population and assess a potential secular effect in this association. METHODS This prospective study used data from the Chilean National Health Survey (CNHS). Data from 3151 and 3749 participants from the 2003 and 2010 CNHS, respectively, were linked to mortality register data. Cox survival analysis was performed. The main exposure was depressive symptoms, measured with CIDI-SF (cut-off ≥ 5), and the outcome all-cause mortality. The study period was limited to 8.5 years to allow for the same length of follow-up. RESULTS 10% and 8.5% of participants from the 2003 and 2010 cohort died during the follow-up. Adjusting for age and sex, those with depressive symptoms had 1.58 (95% CI 1.18-2.13) and 1.65 (95% CI 1.14-2.12) times the risk to die than those without symptoms in the 2003 and 2010 cohort, respectively. In models adjusted for demographic, socioeconomic, behavioural variables and comorbidities, participants with depressive symptoms had 1.42 (95% CI 1.05-1.92) and 1.46 (95% CI 1.07-- 1.99) times the risk to die compared to those without symptoms in the 2003 and 2010 cohort, respectively. CONCLUSION Chilean adults with depressive symptoms are at higher risk of all-cause mortality compared to those without symptoms. The effect size was similar regardless of the economic development of the country.
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Affiliation(s)
- Eliazar Luna
- Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, UK.
| | - Hynek Pikhart
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington place, London, UK
| | - Anne Peasey
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington place, London, UK
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16
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Zhang Y, Peña MT, Lal LS, Lin YY, Summers RL, Chandra S, Swint JM. Telemental Health Services Usage and Association with Health Care Utilization and Expenditures Among Vulnerable Medicare Beneficiaries in 2019: A Comparative Study Using Propensity Score Matching. Telemed J E Health 2024; 30:1848-1856. [PMID: 38546441 DOI: 10.1089/tmj.2023.0632] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
Background: Telemental health (TMH) offers a promising approach to managing major depressive disorder (MDD). The objective of our work was to evaluate TMH usage among a vulnerable population of MDD Medicare beneficiaries and its association with health care utilization and expenditures. Methods: This cohort study analyzed 2019 Mississippi Medicare fee-for-service data for adult beneficiaries with MDD. Subjects were matched by the use of TMH following 1:1 propensity score matching. Comparisons between TMH and non-TMH cohorts were made on health care utilization and expenditure outcomes, adjusting for provider types postmatching. Results: Among 7,673 identified beneficiaries, 551 used TMH and 7,122 did not. Prematching, TMH cohort showed greater proportions of dual beneficiaries, rural residents, subjects with income below $40,000, those with disability entitlement, and higher Charlson comorbidity index scores, compared to the non-TMH cohort (all p < 0.001). Moreover, the TMH cohort had fewer outpatient visits, but more inpatient admissions, emergency department (ED) visits, and higher medical, pharmacy, and total expenditures (all p < 0.001). Postmatching, TMH was associated with a 25% reduction in outpatient visits (p < 0.001) and a 20% reduction in pharmacy expenditures (p = 0.01), with no significant effect on inpatient admissions, ED visits, medical expenditures, or total expenditures. Conclusions: These results underscore the potential of TMH in enhancing accessible health care services for vulnerable populations and affordable services for Medicare. Our results provide a robust baseline for future policy discussions concerning TMH. Future studies should consider identifying barriers to TMH use among vulnerable populations and ensuring equitable and high-quality patient care.
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Affiliation(s)
- Yunxi Zhang
- Department of Data Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, Mississippi, USA
- Center for Telehealth, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Maria T Peña
- Department of Management, Policy and Community Health, The University of Texas School of Public Health, Houston, Texas, USA
- KFF, Washington DC, USA
| | - Lincy S Lal
- Department of Management, Policy and Community Health, The University of Texas School of Public Health, Houston, Texas, USA
| | - Yueh-Yun Lin
- Center for Telehealth, University of Mississippi Medical Center, Jackson, Mississippi, USA
- Department of Management, Policy and Community Health, The University of Texas School of Public Health, Houston, Texas, USA
| | - Richard L Summers
- Department of Emergency Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Saurabh Chandra
- Center for Telehealth, University of Mississippi Medical Center, Jackson, Mississippi, USA
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - John Michael Swint
- Department of Management, Policy and Community Health, The University of Texas School of Public Health, Houston, Texas, USA
- Institute for Clinical Research and Learning Healthcare, John P. and Katherine G. McGovern Medical School, The University of Texas Health Science Center at Houston, Texas, USA
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17
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Galin S, Keren H. The Predictive Potential of Heart Rate Variability for Depression. Neuroscience 2024; 546:88-103. [PMID: 38513761 DOI: 10.1016/j.neuroscience.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 02/29/2024] [Accepted: 03/16/2024] [Indexed: 03/23/2024]
Abstract
Heart rate variability (HRV),a measure of the fluctuations in the intervals between consecutive heartbeats, is an indicator of changes in the autonomic nervous system. A chronic reduction in HRV has been repeatedly linked to clinical depression. However, the chronological and mechanistic aspects of this relationship, between the neural, physiological, and psychopathological levels, remain unclear. In this review we present evidence by which changes in HRV might precede the onset of depression. We describe several pathways that can facilitate this relationship. First, we examine a theoretical model of the impact of autonomic imbalance on HRV and its role in contributing to mood dysregulation and depression. We then highlight brain regions that are regulating both HRV and emotion, suggesting these neural regions, and the Insula in particular, as potential mediators of this relationship. We also present additional possible mediating mechanisms involving the immune system and inflammation processes. Lastly, we support this model by showing evidence that modification of HRV with biofeedback leads to an improvement in some symptoms of depression. The possibility that changes in HRV precede the onset of depression is critical to put to the test, not only because it could provide insights into the mechanisms of the illness but also because it may offer a predictive anddiagnosticphysiological marker for depression. Importantly, it could also help to develop new effective clinical interventions for treating depression.
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Affiliation(s)
- Shir Galin
- Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel; Gonda Interdisciplinary Brain Research Center, Bar Ilan University, Ramat Gan, Israel
| | - Hanna Keren
- Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel; Gonda Interdisciplinary Brain Research Center, Bar Ilan University, Ramat Gan, Israel.
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18
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Zhang YP, Gao QY, Gao JW, Liang XT, Guo DC, Chen ZT, Wang JF, Tang DM, Zhang HF. The association between tinnitus and risk of cardiovascular events and all-cause mortality: insight from the UK Biobank. Acta Cardiol 2024; 79:374-382. [PMID: 38469674 DOI: 10.1080/00015385.2024.2324222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 02/22/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND The potential influence of tinnitus on cardiovascular disease (CVD) and all-cause mortality has yet to be explored. We aim to examine the correlations between tinnitus and the risk of cardiovascular events and all-cause mortality. METHODS We conducted a prospective cohort study utilising data from the UK Biobank. The presence of tinnitus was evaluated through a questionnaire. The primary outcome was defined as a composition of cardiovascular events, including myocardial infarction (MI), stroke, and mortality from CVD, as well as all-cause mortality. Cox proportional hazard models were employed to examine the associations between tinnitus and both the primary outcome and its individual components. Sensitivity analyses were conducted to evaluate the robustness of the primary analysis. RESULTS A total of 140,146 participants were included in the study. The presence of tinnitus was found to be associated with a higher incident rate of the primary outcome (HR = 1.057, 95%CI: 1.017-1.099, p = 0.005), MI (HR = 1.139, 95%CI: 1.061-1.222, p < 0.001) and all-cause mortality (HR = 1.053, 95%CI: 1.003-1.105, p = 0.038) after adjusting for confounders. However, there was no significant association between tinnitus and stroke or mortality from CVD. Subgroup analysis revealed that the association between tinnitus and the primary outcome was significant in females, participants with abnormal BMI, and those without hearing difficulty, depression or anxiety. Sensitivity analyses yielded consistent results. CONCLUSION The findings from this study contribute to the existing body of evidence suggesting an association between tinnitus and an increased risk of cardiovascular events and all-cause mortality.
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Affiliation(s)
- Yi-Peng Zhang
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Qing-Yuan Gao
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Jing-Wei Gao
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xiao-Tian Liang
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Da-Chuan Guo
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Zhi-Teng Chen
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Jing-Feng Wang
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Dong-Mei Tang
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Hai-Feng Zhang
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
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Low CE, Yau CE, Tan RY, Ong VCS, Ho RCM, Ho CSH, Lee ARYB, Chen MZ. Association of depression with all-cause and cancer-specific mortality in older adults with cancer: Systematic review, meta-analysis, and meta-regression. J Geriatr Oncol 2024; 15:101700. [PMID: 38218674 DOI: 10.1016/j.jgo.2023.101700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/30/2023] [Accepted: 12/22/2023] [Indexed: 01/15/2024]
Abstract
INTRODUCTION The incidence and mortality of cancer is increasing worldwide with studies reporting that cumulative risk of cancer rises as age increases. Against the backdrop of the increasing prevalence of cancer amongst older patients, we conducted a systematic review and meta-analysis examining the depression-mortality relationship in older adults with cancer (OAC). MATERIALS AND METHODS This PRISMA-adherent systematic review involved a systematic search of PubMed, Medline, EMBASE, and PsycINFO for prospective and retrospective cohort studies comparing the risk of all-cause and cancer-related mortality among OAC with depression. Random effects meta-analyses and meta-regressions were used for the primary analysis. RESULTS From 5,280 citations, we included 14 cohort studies. Meta-analyses of hazard ratios (HRs) showed an increased incidence of all-cause mortality in OAC with depression (pooled HR: 1.40; 95% confidence interval [CI]: 1.25, 1.55). Subgroup analyses of other categorical study-level characteristics were insignificant. While risk of cancer-related mortality in OAC with depression was insignificantly increased with a pooled HR of 1.21 (95% CI: 0.98, 1.49), subgroup analysis indicated that risk of cancer-related mortality in OAC with depression significantly differed with cancer type. Our systematic review found that having fewer comorbidities, a higher education level, greater socioeconomic status, and positive social supportive factors lowered risk of all-cause mortality in OAC with depression. DISCUSSION Depression in OAC significantly increases risk of all-cause mortality and cancer-related mortality among different cancer types. It is imperative for healthcare providers and policy makers to recognize vulnerable subgroups among older adults with cancer to individualize interventions.
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Affiliation(s)
- Chen Ee Low
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chun En Yau
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ren Ying Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Roger Chun Man Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Psychological Medicine, National University Hospital, Singapore
| | - Cyrus Su Hui Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Psychological Medicine, National University Hospital, Singapore
| | | | - Matthew Zhixuan Chen
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore.
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20
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Wang W, Shi Y, Zhang J, Wang Y, Cheteu Wabo TM, Yang Y, He W, Zhu S. Association of dietary overall antioxidant intake with all-cause and cause-specific mortality among adults with depression: evidence from NHANES 2005-2018. Food Funct 2024; 15:4603-4613. [PMID: 38590241 DOI: 10.1039/d4fo00236a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Higher intakes of individual antioxidants such as vitamins A, C, and E have been linked to mortality in the general population, but the association of overall antioxidant intake with mortality especially in depressed adults remains unclear. We aimed to investigate whether the dietary overall antioxidant intake is associated with all-cause and cause-specific mortality among depressed adults. This study included 3051 US adults with depression, who participated in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. Patient Health Questionnaire-9 (PHQ-9) was used to define depression and evaluate depression severity. The dietary antioxidant quality score (DAQS) and dietary antioxidant index (DAI) were calculated based on the intakes of vitamins A, C, and E, zinc, selenium, and magnesium. A higher DAQS and DAI were significantly associated with lower depression scores (PHQ-9) (all P-trend < 0.05). For individual antioxidants, significant negative associations of vitamins A and E with all-cause mortality were observed. For overall antioxidant intake, the DAQS and DAI were inversely associated with all-cause and cancer mortality. Compared with participants in the lowest categories of DAQS and DAI, the corresponding HRs (95% CIs) in the highest categories were 0.63 (0.42-0.93) and 0.70 (0.49-0.98) for all-cause mortality and 0.39 (0.17-0.87) and 0.43 (0.21-0.88) for cancer mortality, respectively. The overall dietary antioxidant intake was beneficially associated with all-cause and cancer mortality in depressed adults. These findings suggest that comprehensive dietary antioxidant intake may improve depressive symptoms and lower mortality risk among adults with depression.
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Affiliation(s)
- Wenjie Wang
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, 866 Yu-hang-tang Road, Hangzhou, Zhejiang, 310058, China.
- Department of Nutrition and Food Hygiene, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yuwei Shi
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, 866 Yu-hang-tang Road, Hangzhou, Zhejiang, 310058, China.
- Department of Nutrition and Food Hygiene, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jiakai Zhang
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, 866 Yu-hang-tang Road, Hangzhou, Zhejiang, 310058, China.
- Department of Nutrition and Food Hygiene, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yifeng Wang
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, 866 Yu-hang-tang Road, Hangzhou, Zhejiang, 310058, China.
- Department of Nutrition and Food Hygiene, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Therese Martin Cheteu Wabo
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, 866 Yu-hang-tang Road, Hangzhou, Zhejiang, 310058, China.
- Department of Nutrition and Food Hygiene, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yang Yang
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, 866 Yu-hang-tang Road, Hangzhou, Zhejiang, 310058, China.
- Department of Nutrition and Food Hygiene, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Wei He
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, 866 Yu-hang-tang Road, Hangzhou, Zhejiang, 310058, China.
- Department of Nutrition and Food Hygiene, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Shankuan Zhu
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, 866 Yu-hang-tang Road, Hangzhou, Zhejiang, 310058, China.
- Department of Nutrition and Food Hygiene, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
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21
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Morito K, Yamagata M, Naka F, Kobayashi K, Ueda H, Morimoto H, Yasukawa T, Takayama K, Uozumi Y, Nagasawa K. Sub-chronic and mild social defeat stress exposure to C57BL/6J mice increases visceral fat mass and causes accumulation of cholesterol and bile acids in the liver. Biochem Biophys Res Commun 2024; 702:149631. [PMID: 38335703 DOI: 10.1016/j.bbrc.2024.149631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/10/2024] [Accepted: 02/04/2024] [Indexed: 02/12/2024]
Abstract
Major depressive disorder is accompanied by a high metabolic illness comorbidity and patients with atypical depression are a subgroup with particularly high risk of obesity, dyslipidemia, and metabolic syndrome; however, the underlying mechanisms have not been fully elucidated. In this study, we examined visceral fat deposition, lipid profiles in the liver, and gut microbiota in sub-chronic and mild social defeat stress (sCSDS)-exposed C57BL/6J mice, which exhibit atypical depression-like phenotypes, i.e., increased body weight and food and water intake. We found that visceral fat mass and levels of hepatic cholesterol and bile acids in sCSDS-exposed mice were significantly increased compared to those in controls. The expression of hepatic small heterodimer partner, a negative regulator of cholesterol metabolism, was significantly elevated in sCSDS-exposed mice. We also found that gut microbial diversity and composition including lower relative abundance of Bacteroides spp. and Bifidobacterium spp. in sCSDS-exposed mice were different from those in controls. In addition, relative abundance of Bacteroides spp. and Bifidobacterium spp. was significantly and negatively correlated with body weight, visceral fat mass, and hepatic cholesterol and bile acids levels. These results indicate that sCSDS-exposure induces dysbiosis, and thereby contributes to metabolic disorder development.
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Affiliation(s)
- Katsuya Morito
- Laboratory of Environmental Biochemistry, Division of Biological Sciences, Kyoto Pharmaceutical University, 5 Misasaginakauchi-cho, Yamashina-ku, Kyoto, 607-8414, Japan
| | - Mayu Yamagata
- Laboratory of Environmental Biochemistry, Division of Biological Sciences, Kyoto Pharmaceutical University, 5 Misasaginakauchi-cho, Yamashina-ku, Kyoto, 607-8414, Japan
| | - Futaba Naka
- Laboratory of Environmental Biochemistry, Division of Biological Sciences, Kyoto Pharmaceutical University, 5 Misasaginakauchi-cho, Yamashina-ku, Kyoto, 607-8414, Japan
| | - Kayo Kobayashi
- Laboratory of Environmental Biochemistry, Division of Biological Sciences, Kyoto Pharmaceutical University, 5 Misasaginakauchi-cho, Yamashina-ku, Kyoto, 607-8414, Japan
| | - Hikari Ueda
- Laboratory of Environmental Biochemistry, Division of Biological Sciences, Kyoto Pharmaceutical University, 5 Misasaginakauchi-cho, Yamashina-ku, Kyoto, 607-8414, Japan
| | - Hirotoshi Morimoto
- Technical Development Division, Ako Kasei, Co., Ltd., 329 Sakoshi, Ako, 678-0193, Japan
| | - Takeshi Yasukawa
- Technical Development Division, Ako Kasei, Co., Ltd., 329 Sakoshi, Ako, 678-0193, Japan
| | - Kentaro Takayama
- Laboratory of Environmental Biochemistry, Division of Biological Sciences, Kyoto Pharmaceutical University, 5 Misasaginakauchi-cho, Yamashina-ku, Kyoto, 607-8414, Japan
| | - Yoshinobu Uozumi
- Technical Development Division, Ako Kasei, Co., Ltd., 329 Sakoshi, Ako, 678-0193, Japan
| | - Kazuki Nagasawa
- Laboratory of Environmental Biochemistry, Division of Biological Sciences, Kyoto Pharmaceutical University, 5 Misasaginakauchi-cho, Yamashina-ku, Kyoto, 607-8414, Japan.
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22
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Arnone D, Karmegam SR, Östlundh L, Alkhyeli F, Alhammadi L, Alhammadi S, Alkhoori A, Selvaraj S. Risk of suicidal behavior in patients with major depression and bipolar disorder - A systematic review and meta-analysis of registry-based studies. Neurosci Biobehav Rev 2024; 159:105594. [PMID: 38368970 DOI: 10.1016/j.neubiorev.2024.105594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/29/2024] [Accepted: 02/14/2024] [Indexed: 02/20/2024]
Abstract
Suicide is a health priority and one of the most common causes of death in mood disorders. One of the limitations of this type of research is that studies often establish rates of suicide behaviors in mood disorders by using diverse comparison groups or simply monitoring cohort of patients over a time period. In this registry-based systematic review, national registers were identified through searches in six academic databases, and information about the occurrence of suicide behaviors in mood disorders was systematically extracted. Odds ratios were subsequently calculated comparing rates of death by suicide in mood disorders in comparison with age and period matched rates of death by suicide in the general population obtained from country-wide national registers. The aim was to provide the most recent summary of epidemiological and clinical factors associated to suicide in mood disorders whilst calculating the likelihood of death by suicide in mood disorders in comparison with non-affected individuals according to national databases. The study follows the Preferred Reporting Guidelines for Systematic Reviews and Meta-analyses and was prespecify registered on Prospero (CRD42020186857). Results suggest that patients with mood disorders are at substantially increased risk of attempting and dying by suicide. Several epidemiological, clinical and social factors are reported to be associated with clinical populations at risk of suicide. Meta-analyses of completed deaths by suicide suggest that the likelihood for dying by suicide in mood disorders is 8.62 times higher in major depression and 8.66 times higher in bipolar disorder with higher number of untoward events in women compared to men in both conditions. The likelihood of dying by suicide in major depressive disorders is higher in the first year following discharge. Clinical guidelines might consider longer periods of monitoring following discharge from hospital. Overall, due to the higher risk of suicide in mood disorders, efforts should be made to increase detection and prevention whilst focusing on reducing risk in the most severe forms of illness with appropriate treatment to promote response and remission at the earliest convenience.
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Affiliation(s)
- Danilo Arnone
- Centre for Affective Disorders, Psychological Medicine, King's College London, London, United Kingdom; Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada; Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada.
| | - Sendhil Raj Karmegam
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.
| | | | - Fatima Alkhyeli
- United Arab Emirates University, Al Ain, United Arab Emirates
| | - Lamia Alhammadi
- United Arab Emirates University, Al Ain, United Arab Emirates
| | - Shama Alhammadi
- United Arab Emirates University, Al Ain, United Arab Emirates
| | - Amal Alkhoori
- United Arab Emirates University, Al Ain, United Arab Emirates
| | - Sudhakar Selvaraj
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA; Intra-Cellular Therapies, Inc, USA
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23
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Johnson KA, Okun MS, Scangos KW, Mayberg HS, de Hemptinne C. Deep brain stimulation for refractory major depressive disorder: a comprehensive review. Mol Psychiatry 2024; 29:1075-1087. [PMID: 38287101 PMCID: PMC11348289 DOI: 10.1038/s41380-023-02394-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 12/18/2023] [Accepted: 12/21/2023] [Indexed: 01/31/2024]
Abstract
Deep brain stimulation (DBS) has emerged as a promising treatment for select patients with refractory major depressive disorder (MDD). The clinical effectiveness of DBS for MDD has been demonstrated in meta-analyses, open-label studies, and a few controlled studies. However, randomized controlled trials have yielded mixed outcomes, highlighting challenges that must be addressed prior to widespread adoption of DBS for MDD. These challenges include tracking MDD symptoms objectively to evaluate the clinical effectiveness of DBS with sensitivity and specificity, identifying the patient population that is most likely to benefit from DBS, selecting the optimal patient-specific surgical target and stimulation parameters, and understanding the mechanisms underpinning the therapeutic benefits of DBS in the context of MDD pathophysiology. In this review, we provide an overview of the latest clinical evidence of MDD DBS effectiveness and the recent technological advancements that could transform our understanding of MDD pathophysiology, improve the clinical outcomes for MDD DBS, and establish a path forward to develop more effective neuromodulation therapies to alleviate depressive symptoms.
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Affiliation(s)
- Kara A Johnson
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
- Department of Neurology, University of Florida, Gainesville, FL, USA
| | - Michael S Okun
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
- Department of Neurology, University of Florida, Gainesville, FL, USA
| | - Katherine W Scangos
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Helen S Mayberg
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Coralie de Hemptinne
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA.
- Department of Neurology, University of Florida, Gainesville, FL, USA.
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24
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Moss S, Zhang X, Taleb ZB, Gu X. The Associations of Physical Activity and Health-Risk Behaviors toward Depressive Symptoms among College Students: Gender and Obesity Disparities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:401. [PMID: 38673314 PMCID: PMC11050621 DOI: 10.3390/ijerph21040401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/21/2024] [Accepted: 03/22/2024] [Indexed: 04/28/2024]
Abstract
Engaging in health-risk behaviors (HRBs) may be correlated with depressive symptoms among college students, but these relationships require more research. The purpose of this study was to examine the associations of physical activity levels (i.e., light [LPA] and moderate-vigorous [MVPA]) and HRBs (i.e., sedentary behavior [screen-based and non-screen-based behavior] and cigarette and e-cigarette tobacco use) with depressive symptoms in a sample of college students. Physical activity levels and HRBs were assessed through validated questionnaires. In total, 366 students participated (Mage = 22.59 ± 3.54; 60.1% female; 52.9% normal weight). E-cigarette use in males (β = 0.23, p < 0.05) and screen-based sedentary behavior in females (β = 0.14, p < 0.05) showed significant predictive utility toward depressive symptoms. In the overweight/obese group, screen-based sedentary behaviors (β = 0.19, p < 0.05) and e-cigarette use (β = 0.23, p < 0.01) showed significant predictive utility toward depressive symptoms. Females reported higher levels of depressive symptoms (Mfemale = 18.23 vs. Mmale = 14.81; η2 = 0.03) and less MVPA (Mmale = 52.83 vs. Mfemale = 41.09; η2 = 0.06) than males. Enhancing mental health by improving physical activity and eliminating HRBs should be tailored toward at-risk demographics.
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Affiliation(s)
- Samantha Moss
- Kinesiology Department, State University of New York at Cortland, Cortland, NY 13045, USA;
| | - Xiaoxia Zhang
- School of Sport Sciences, West Virginia University, Morgantown, WV 26506, USA;
| | - Ziyad Ben Taleb
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX 76019, USA;
| | - Xiangli Gu
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX 76019, USA;
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25
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Pedersen JK, Wang L, Risbo N, Pedersen AB, Andersen K, Ellingsen T. Mortality in patients with incident rheumatoid arthritis and depression: a Danish cohort study of 11 071 patients and 55 355 comparators. Rheumatology (Oxford) 2024; 63:680-688. [PMID: 37252810 DOI: 10.1093/rheumatology/kead259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 04/26/2023] [Accepted: 05/23/2023] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVES In patients with RA, the association between mortality and depression has been investigated only in patients with prevalent RA. In this study, we estimated the mortality risk associated with depression, defined as the first filling of a prescription for antidepressants, in patients with incident RA and background population comparators. METHODS From 2008 to 2018, we identified patients with incident RA in the nationwide Danish rheumatologic database, DANBIO. For each patient, we randomly selected five comparators. Participants were not treated with antidepressants or diagnosed with depression 3 years prior to the index date. From other registers we collected data on socioeconomic status, mortality and cause of death using unique personal identifiers. Using Cox models, we calculated hazard rate ratios (HRR) with 95% CI. RESULTS In depressed patients with RA vs patients without depression, adjusted HRR for all-cause mortality was 5.34 (95% CI 3.02, 9.45) during 0-2 years and 3.15 (95% CI 2.62, 3.79) during the total follow-up period, and highest in patients <55 years with HRR 8.13 (95% CI 3.89, 17.02). In comparators with depression vs comparators without depression, the association with mortality was similar to that in patients with RA. There were no unnatural causes of death among depressed patients with RA. The most frequent natural causes of death were cancer, cardiovascular disease, stroke and pneumonia. CONCLUSION In patients with RA, depression was a predictor of death but with a strength similar to that in matched comparators.
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Affiliation(s)
- Jens K Pedersen
- Department of Rheumatology C, Research Unit, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Lei Wang
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Nickolaj Risbo
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Alma B Pedersen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Kjeld Andersen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Mental Health Odense, Mental Health Services Region of Southern Denmark, Odense, Denmark
| | - Torkell Ellingsen
- Department of Rheumatology C, Research Unit, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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26
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de Sousa BG, Silva ÍC, da Costa RF, Rebouças ERN, Ramos TR, Almondes JGDS, Pereira EDB, Campos NG. Persistence of symptoms and lung function in mild cases of COVID-19 six months after infection: a cross-sectional study. J Bras Pneumol 2024; 50:e20230305. [PMID: 38422339 PMCID: PMC11095931 DOI: 10.36416/1806-3756/e20230305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 11/16/2023] [Indexed: 03/02/2024] Open
Abstract
OBJECTIVES To describe persistent symptoms and lung function in mild cases of COVID-19 six months after infection. METHODS Data collection was performed through a semi-structured questionnaire containing information on the participants' demographic and anthropometric data, the disease in the acute phase, and persistent symptoms six months after COVID-19 using spirometry and manovacuometry. RESULTS A total of 136 participants were evaluated, of whom 64% were male, with a mean age of 38.17 ± 14.08 years and a body mass index (BMI) of 29.71 ± 17.48 kg/m2. The main persistent symptoms reported were dyspnea on exertion (39.7%), memory loss (38.2%), and anxiety (48.5%). Considering lung function, the participants reached 88.87 ± 17.20% of the predicted forced vital capacity (FVC), 86.03 ± 22.01% of the forced expiratory volume in one second (FEV1), and 62.71 ± 25.04% of peak expiratory flow (PEF). Upon manovacuometry, 97.41 ± 34.67% of the predicted inspiratory force (Pimax) and 66.86 ± 22.97% of the predicted expiratory force (Pemax) were observed. CONCLUSIONS Six months after COVID-19 infection, a reduction in PEF and MEP was observed. Among the most commonly reported persistent symptoms were fatigue, tiredness with the slightest exertion, anxiety and depression, memory loss, and deficits in concentration.
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Affiliation(s)
- Barbara Galdino de Sousa
- . Programa de Pós-Graduação em Fisioterapia e Funcionalidade, Universidade Federal do Ceará, Fortaleza (CE), Brasil
- . Grupo de Pesquisa InspiraFisio, Universidade Federal do Ceará, Fortaleza (CE), Brasil
| | - Ítalo Caldas Silva
- . Programa de Pós-Graduação em Ciências Médicas, Departamento de Clínica Médica, Universidade Federal do Ceará, Fortaleza (CE), Brasil
- . Grupo de Pesquisa InspiraFisio, Universidade Federal do Ceará, Fortaleza (CE), Brasil
| | - Rayana Fialho da Costa
- . Programa de Pós-Graduação em Ciências Médicas, Departamento de Clínica Médica, Universidade Federal do Ceará, Fortaleza (CE), Brasil
- . Grupo de Pesquisa InspiraFisio, Universidade Federal do Ceará, Fortaleza (CE), Brasil
| | - Ellys Rhaiara Nunes Rebouças
- . Programa de Pós-Graduação em Fisioterapia e Funcionalidade, Universidade Federal do Ceará, Fortaleza (CE), Brasil
- . Grupo de Pesquisa InspiraFisio, Universidade Federal do Ceará, Fortaleza (CE), Brasil
| | - Taynara Rodrigues Ramos
- . Programa de Pós-Graduação em Fisioterapia e Funcionalidade, Universidade Federal do Ceará, Fortaleza (CE), Brasil
- . Grupo de Pesquisa InspiraFisio, Universidade Federal do Ceará, Fortaleza (CE), Brasil
| | | | - Eanes Delgado Barros Pereira
- . Programa de Pós-Graduação em Ciências Médicas, Departamento de Clínica Médica, Universidade Federal do Ceará, Fortaleza (CE), Brasil
| | - Nataly Gurgel Campos
- . Programa de Pós-Graduação em Fisioterapia e Funcionalidade, Universidade Federal do Ceará, Fortaleza (CE), Brasil
- . Programa de Pós-Graduação em Ciências Médicas, Departamento de Clínica Médica, Universidade Federal do Ceará, Fortaleza (CE), Brasil
- . Grupo de Pesquisa InspiraFisio, Universidade Federal do Ceará, Fortaleza (CE), Brasil
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27
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Bellón JÁ. Exercise for the treatment of depression. BMJ 2024; 384:q320. [PMID: 38355168 DOI: 10.1136/bmj.q320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Affiliation(s)
- Juan Ángel Bellón
- Department of Public Health and Psychiatry, Faculty of Medicine, University of Malaga, SAS, IBIMA and RICAPPS, Malaga, Spain
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28
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Griffin SC, Blakey SM, Brant TR, Eshera YM, Calhoun PS. Disentangling the Longitudinal Relationship between Loneliness and Depressive Symptoms in U.S. Adults Over 50. Clin Gerontol 2024; 47:257-269. [PMID: 36401538 DOI: 10.1080/07317115.2022.2147115] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVES A seminal study on loneliness and depression suggested that loneliness influences depression more than the reverse. However, the study's analytic method has since been criticized for failing to account for the trait-like nature of variables. This study aimed to examine the longitudinal relationship between loneliness and depressive symptoms while accounting for the trait-like nature of both variables. METHODS Data (n = 16,478) came from the Health and Retirement Study (2006-2016). Measures included the Hughes Loneliness Scale and a modified Center for Epidemiologic Studies Depression scale (loneliness item omitted). Analyses consisted of random intercepts cross-lagged panel models (three time-points evenly spaced across eight years). RESULTS There was evidence that loneliness and depressive symptoms are trait-like and these trait-like components are strongly associated. There was not evidence of cross-lagged effects between loneliness and depressive symptoms. CONCLUSIONS A tendency toward loneliness corresponded with a tendency toward depressive symptoms. However, deviations in one's typical level of loneliness did not predict deviations in one's typical level of depressive symptoms or vice-versa. These findings do not support past assertions that loneliness shapes subsequent depression more than the reverse. CLINICAL IMPLICATIONS By middle to late adulthood, loneliness and depressive symptoms are trait-like phenomena that are strongly associated.
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Affiliation(s)
- Sarah C Griffin
- Behavioral Health Department, Durham Veterans Affairs Health Care System, Durham, North Carolina, USA
- Behavioral Health Department, VA Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), Durham, North Carolina, USA
| | - Shannon M Blakey
- Behavioral Health Department, Durham Veterans Affairs Health Care System, Durham, North Carolina, USA
- Behavioral Health Department, VA Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), Durham, North Carolina, USA
| | - Taylor R Brant
- Behavioral Health Department, Durham Veterans Affairs Health Care System, Durham, North Carolina, USA
| | - Yasmine M Eshera
- Division of Behavioral Medicine and Neurosciences, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Patrick S Calhoun
- Behavioral Health Department, Durham Veterans Affairs Health Care System, Durham, North Carolina, USA
- Behavioral Health Department, VA Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), Durham, North Carolina, USA
- Division of Behavioral Medicine and Neurosciences, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
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29
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Chen H, Wang B, Lv R, Zhou T, Shen J, Song H, Xu X, Ma Y, Yuan C. Progression and trajectory network of age-related functional impairments and their combined associations with mortality. iScience 2023; 26:108368. [PMID: 38058300 PMCID: PMC10696261 DOI: 10.1016/j.isci.2023.108368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/06/2023] [Accepted: 10/26/2023] [Indexed: 12/08/2023] Open
Abstract
Age-related functional impairments (ARFIs) contribute to the loss of independence in older adults, but their progressions, interrelations, and combined relations with mortality are largely unknown. We conducted a prospective study among 17,914 participants in the Health and Retirement Study (2000-2020). The incidence rates of visual impairment, hearing impairment, physical frailty, and cognitive impairment increased exponentially with age, while those of restless sleep and depression increased relatively slowly. These ARFIs were associated with each other in temporal sequence and constituted a hazard network. We observed a dose-response relationship between the number of ARFIs and mortality risk, and the dyads involving physical frailty demonstrated the strongest associations with mortality. Our findings may assist in the identification of individuals at higher mortality risk and highlight the potential for future investigations to explore the impact of multiple ARFIs in aging.
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Affiliation(s)
- Hui Chen
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Binghan Wang
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Rongxia Lv
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Tianjing Zhou
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jie Shen
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Huan Song
- West China Biomedical Big Data Center and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Xiaolin Xu
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Yuan Ma
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Changzheng Yuan
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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30
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Lundberg J, Cars T, Lampa E, Ekholm Selling K, Leval A, Gannedahl A, Själin M, Björkholm C, Hellner C. Determinants and Outcomes of Suicidal Behavior Among Patients With Major Depressive Disorder. JAMA Psychiatry 2023; 80:1218-1225. [PMID: 37585196 PMCID: PMC10433143 DOI: 10.1001/jamapsychiatry.2023.2833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/09/2023] [Indexed: 08/17/2023]
Abstract
Importance Major depressive disorder (MDD) is an important risk factor of suicidal behavior, but the added burden of suicidal behavior and MDD on the patient and societal level, including all-cause mortality, is not well studied. Also, the contribution of various prognostic factors for suicidal behavior has not been quantified in larger samples. Objective To describe the clinical and societal outcomes, including all-cause mortality, of suicidal behavior in patients with MDD and to explore associated risk factors and clinical management to inform future research and guidelines. Design, Setting, and Participants This population-based cohort study used health care data from the Stockholm MDD Cohort. Patients aged 18 years or older with episodes of MDD diagnosed between January 1, 2012, and December 31, 2017, in any health care setting were included. The dates of the data analysis were February 1 to November 1, 2022. Exposures Patients with MDD with and without records of suicidal behavior. Main Outcomes and Measures The main outcome was all-cause mortality. Secondary outcomes were comorbid conditions, medications, health care resource utilization (HCRU), and work loss. Using Region Stockholm registry variables, a risk score for factors associated with suicidal behavior within 1 year after the start of an MDD episode was calculated. Results A total of 158 169 unipolar MDD episodes were identified in 145 577 patients; 2240 (1.4%) of these episodes, in 2219 patients, included records of suicidal behavior (mean [SD] patient age, 40.9 [18.6] years; 1415 episodes [63.2%] in women and 825 [36.8%] in men). A total of 11 109 MDD episodes in 9574 matched patients with MDD without records of suicidal behavior were included as controls (mean [SD] patient age, 40.8 [18.5] years; 7046 episodes [63.4%] in women and 4063 [36.6%] in men). The all-cause mortality rate was 2.5 per 100 person-years at risk for the MDD-SB group and 1.0 per 100 person-years at risk for the MDD-non-SB group, based on 466 deaths. Suicidal behavior was associated with higher all-cause mortality (hazard ratio, 2.62 [95% CI, 2.15-3.20]), as well as with HCRU and work loss, compared with the matched controls. Patients with MDD and suicidal behavior were younger and more prone to have psychiatric comorbid conditions, such as personality disorders, substance use, and anxiety, at the start of their episode. The most important factors associated with suicidal behavior within 1 year after the start of an MDD episode were history of suicidal behavior and age, history of substance use and sleep disorders, and care setting in which MDD was diagnosed. Conclusions and Relevance This cohort study's findings suggest that high mortality, morbidity, HCRU, and work loss associated with MDD may be substantially accentuated in patients with MDD and suicidal behavior. Use of medication aimed at decreasing the risk of all-cause mortality during MDD episodes should be systematically evaluated to improve long-term outcomes.
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Affiliation(s)
- Johan Lundberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Stockholm, Sweden
| | - Thomas Cars
- Sence Research AB, Uppsala, Sweden
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Erik Lampa
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Katarina Ekholm Selling
- Sence Research AB, Uppsala, Sweden
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Amy Leval
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Janssen-Cilag AB, Solna, Sweden
| | | | | | | | - Clara Hellner
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Stockholm, Sweden
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Oude Voshaar RC. The 'discontinuity hypothesis' of depression in later life-clinical and research implications. Age Ageing 2023; 52:afad239. [PMID: 38156879 PMCID: PMC10756079 DOI: 10.1093/ageing/afad239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 01/08/2023] [Indexed: 01/03/2024] Open
Abstract
The term depression is overused as an umbrella term for a variety of conditions, including depressed mood and various psychiatric disorders. According to psychiatric diagnostic criteria, depressive disorders impact nearly all aspects of human life and are a leading cause of disability worldwide. The widespread assumption that different types of depression lie on a continuum of severity has stimulated important research on subthreshold depression in later life. This view assumes that depressed mood is a precursor of a depressive disorder. The present narrative review argues why in later life depressed mood might either (i) lie on a continuum with depressive disorders among people vulnerable for a depressive disorder or (ii) be an ageing-related epiphenomenon of underlying physical illnesses in people who are resilient to depressive disorders ('discontinuity hypothesis'). Three arguments are discussed. First, the course of depressed mood and depressive disorders differs across the life span. Second, screening instruments for depression have low predictive value for depressive disorders in later life. Third, a dose-response relationship has not been consistently found across different types of depression and detrimental health outcomes. Using the umbrella term depression may partly explain why pharmacological treatment is less effective with increasing age, and negative health-related outcomes might be overestimated. The discontinuity hypothesis may prevent pharmacological overtreatment of milder subtypes of depression and may stimulate comprehensive multidisciplinary assessment as well as the development of separate treatment algorithms for depressed mood and depressive disorders.
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Affiliation(s)
- Richard C Oude Voshaar
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherland
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Crawford CA, Williams MK, Shell AL, MacDonald KL, Considine RV, Wu W, Rand KL, Stewart JC. Effect of modernized collaborative care for depression on brain-derived neurotrophic factor (BDNF) and depressive symptom clusters: Data from the eIMPACT trial. Psychiatry Res 2023; 330:115581. [PMID: 37931480 PMCID: PMC10842310 DOI: 10.1016/j.psychres.2023.115581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/20/2023] [Accepted: 10/27/2023] [Indexed: 11/08/2023]
Abstract
Brain-derived neurotrophic factor (BDNF) levels are lower in people with depression and are normalized following pharmacological treatment. However, it is unknown if psychological treatments for depression improve BDNF and if change in BDNF is a mediator of intervention effects on depressive symptoms. Therefore, using data from the eIMPACT trial, we sought to determine the effect of modernized collaborative care for depression on 12-month changes in BDNF and cognitive/affective and somatic depressive symptom clusters and to examine whether BDNF changes mediate intervention effects on depressive symptoms. 216 primary care patients with depression from a safety net healthcare system were randomized to 12 months of the eIMPACT intervention (internet cognitive-behavioral therapy [CBT], telephonic CBT, and select antidepressant medications) or usual primary care. Plasma BDNF was measured with commercially available kits, and depressive symptom clusters were assessed by the Patient Health Questionnaire-9. The intervention did not influence BDNF but did improve both the cognitive/affective and somatic clusters over 12 months. Changes in BDNF did not mediate the intervention effect on either cluster. Our findings suggest that modernized collaborative care is an effective treatment for both the cognitive/affective and somatic symptoms of depression and that the mechanism of action is not improvements in BDNF. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02458690.
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Affiliation(s)
- Christopher A Crawford
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), 402 North Blackford Street, LD 100E, Indianapolis, IN 46202, USA
| | - Michelle K Williams
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), 402 North Blackford Street, LD 100E, Indianapolis, IN 46202, USA
| | - Aubrey L Shell
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), 402 North Blackford Street, LD 100E, Indianapolis, IN 46202, USA
| | - Krysha L MacDonald
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), 402 North Blackford Street, LD 100E, Indianapolis, IN 46202, USA; Sandra Eskenazi Mental Health Center, Eskenazi Health, Indianapolis, IN, USA
| | - Robert V Considine
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Wei Wu
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), 402 North Blackford Street, LD 100E, Indianapolis, IN 46202, USA
| | - Kevin L Rand
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), 402 North Blackford Street, LD 100E, Indianapolis, IN 46202, USA
| | - Jesse C Stewart
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), 402 North Blackford Street, LD 100E, Indianapolis, IN 46202, USA.
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Horner A, Olschewski H, Hartl S, Valipour A, Funk GC, Studnicka M, Merkle M, Kaiser B, Wallner EM, Brecht S, Lamprecht B. Physical Activity, Depression and Quality of Life in COPD - Results from the CLARA II Study. Int J Chron Obstruct Pulmon Dis 2023; 18:2755-2767. [PMID: 38050481 PMCID: PMC10693753 DOI: 10.2147/copd.s435278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 11/01/2023] [Indexed: 12/06/2023] Open
Abstract
Background Symptoms of depression, pain and limitations in physical activity may affect quality of life in COPD patients independent from their respiratory burden. We aimed to analyze the associations of these factors in outpatients with COPD in Austria in a stable phase of disease. Methods We conducted a national, cross-sectional study among patients with COPD. For depression, the Patient Health Questionnaire-9 (PHQ-9) and for respiratory symptoms the St. George's Respiratory Questionnaire for COPD patients (SGRQ-C) were used along with 10-point scales for physical activity and pain. Results After exclusion of 211 patients due to non-obstructive spirometry or missing data, 630 patients (62.5% men; mean age 66.8 ± 8.6 (SD) years; mean FEV1%pred. 54.3 ± 16.5 (SD)) were analyzed. Of these, 47% reported one or more exacerbations in the previous year, 10.4% with hospitalization. A negative depression score was found in 54% and a score suggesting severe depression (PHQ-9 score ≥ 15) in 4.7%. In a multivariate linear regression model, self-reported pain, dyspnea, and number of exacerbations were predictors for higher PHQ-9-scores. A negative pain score was found in 43.8%, and a score suggesting severe pain in 2.9% (8-10 points of 10-point scale). Patients reporting severe pain were more often female, had more exacerbations, and reported more respiratory and depressive symptoms, a lower quality of life, and less physical activity. About 46% of patients rated their physical activity as severely impaired. These patients were significantly older, had more exacerbations, concomitant heart disease, a higher pain and depression score, and a lower quality of life (SGRQ-C - total score and all subscores). Conclusions In Austria, nearly half of stable COPD outpatients reported symptoms of depression, which were associated with lower levels of self-reported physical activity, more pain, and respiratory symptoms. The associations were particularly strong for depression with SGRQ-C.
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Affiliation(s)
- Andreas Horner
- Johannes Kepler University Linz, Kepler University Hospital, Department of Pulmonology, Linz, Austria
| | - Horst Olschewski
- Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, and Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
| | - Sylvia Hartl
- Department of Respiratory and Critical Care Medicine, Klinik Penzing and Sigmund Freud University, Medical School, Vienna, Austria
| | - Arschang Valipour
- Karl-Landsteiner-Institute for Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna, Austria
| | - Georg-Christian Funk
- Department of Internal and Respiratory Medicine, Klinik Ottakring, Vienna, Austria
| | - Michael Studnicka
- Department of Pulmonary Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Monika Merkle
- Specialist Office for Pulmonology Dr. Merkle, Vienna, Austria
| | - Bernhard Kaiser
- Johannes Kepler University Linz, Kepler University Hospital, Department of Pulmonology, Linz, Austria
| | | | | | - Bernd Lamprecht
- Johannes Kepler University Linz, Kepler University Hospital, Department of Pulmonology, Linz, Austria
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Müller F, Munagala A, Arnetz JE, Achtyes ED, Alshaarawy O, Holman HT. Racial disparities in emergency department utilization among patients with newly diagnosed depression. Gen Hosp Psychiatry 2023; 85:163-170. [PMID: 37926052 DOI: 10.1016/j.genhosppsych.2023.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/25/2023] [Accepted: 10/28/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE To test the hypothesis that racial and ethnic minorities have increased emergency department visit rates, despite being established with a primary care provider. METHODS In this retrospective cohort study, ED visits without hospital admission in a 12-month period among patients with a new primary care provider-issued diagnosis of depression were assessed. Electronic medical record (EMR) data was obtained from 47 family medicine clinics in a large Michigan-based healthcare system. General linear regression models with Poisson distribution were used to predict frequency of ED visits. RESULTS A total of 4159 patients were included in the analyses. In multivariable analyses, Black / African American race was associated with an additional 0.90 (95% CI 0.64, 1.16) ED visits and American Indian or Alaska Native race was associated with an additional 1.39 (95% CI 0.92, 1.87) ED visits compared to White or Caucasians (null value 0). These risks were only exceeded by patients who received a prescription for a typical antipsychotic drug agent. CONCLUSION Despite being established patients at primary care providers and having follow-up encounters, Black / African American and American Indian or Alaska Native patients with depression were considerably more likely to seek ED treatment compared to White/Caucasian patients with depression.
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Affiliation(s)
- Frank Müller
- Department of Family Medicine, Michigan State University, Grand Rapids, MI, USA; Corewell Health Family Medicine Residency Clinic, Grand Rapids, MI, USA; Department of General Practice, University Medical Center Göttingen, Göttingen, Germany.
| | - Akhilesh Munagala
- Department of Family Medicine, Michigan State University, Grand Rapids, MI, USA.
| | - Judith E Arnetz
- Department of Family Medicine, Michigan State University, Grand Rapids, MI, USA.
| | - Eric D Achtyes
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA.
| | - Omayma Alshaarawy
- Department of Family Medicine, College of Human Medicine, Michigan State University, East Lansing, MI, USA.
| | - Harland T Holman
- Department of Family Medicine, Michigan State University, Grand Rapids, MI, USA; Corewell Health Family Medicine Residency Clinic, Grand Rapids, MI, USA.
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Cha EJ, Suh S, Jeon HJ, Chung S. Identifying the Bridge Between Anxiety Response to COVID-19 and Depression Symptoms in General Population: A Network Analysis. J Acad Consult Liaison Psychiatry 2023; 64:492-500. [PMID: 37295775 PMCID: PMC10247300 DOI: 10.1016/j.jaclp.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/10/2023] [Accepted: 06/01/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Previous studies have suggested links between anxiety response to the novel coronavirus (COVID-19) and depression symptoms in general population. However, a symptom-level investigation has not been reported. OBJECTIVE This study aimed to use network analysis to identify central symptoms and bridge symptoms that link COVID-19 anxiety and depression. METHODS Data from 1788 participants were analyzed. Coronavirus anxiety and depression symptoms were measured using the Stress and Anxiety to Viral Epidemics-6 Items Scale and the Patient Health Questionnaire-9, respectively. Network analysis was performed using R. RESULTS The results revealed 'thoughts of suicide or self-harm' from Patient Health Questionnaire-9 and 'worry about others avoiding me' from Stress and Anxiety to Viral Epidemics-6 Items Scale as bridge symptoms. Findings suggest direct relationship between fear of social isolation and thoughts of suicide or self-harm. 'Feeling tired with little energy' and 'trouble concentrating' are strongly linked to 'thoughts of suicide or self-harm', suggesting these symptoms as risk factors for suicidal or self-injurious thoughts during the pandemic. CONCLUSIONS The findings suggest fear of social isolation as a risk factor for developing thoughts of suicide or self-harm. These results should be taken into account during evaluation of risk of suicide or mental health interventions for the pandemic.
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Affiliation(s)
- Eun Jung Cha
- Department of Psychiatry, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Sooyeon Suh
- Department of Psychology, Sungshin Women's University, Seoul, Republic of Korea
| | - Hong Jun Jeon
- Department of Psychiatry, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.
| | - Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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Coleman KJ, Rossom RC, Braciszewski JM, Padilla A, Li X, Waters HC, Penfold RB, Simon GE, Nau CL. Beyond clinical outcomes: Case control study of the role of race in disruptive life events for people with serious mental illness. Gen Hosp Psychiatry 2023; 85:80-86. [PMID: 37844540 DOI: 10.1016/j.genhosppsych.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/28/2023] [Accepted: 10/03/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVE To understand how race and serious mental illness (SMI) interact for disruptive life events defined as financial (bankruptcy and judgement filings), and non-financial (arrests). METHODS Patients were adults with schizophrenia (SCZ; N = 16,159) or bipolar I disorder (BPI; N = 30,008) matched 1:1 to patients without SMI (non-SMI) from health systems in Michigan and Southern California during 1/1/2007 through 12/31/2018. The main exposure was self-reported race, and the outcome was disruptive life events aggregated by Transunion. We hypothesized that Black patients with SCZ or BPI would be the most likely to experience a disruptive life event when compared to Black patients without SMI, and all White or Asian patients regardless of mental illness. RESULTS Black patients with SCZ had the least likelihood (37% lower) and Asian patients with BPI had the greatest likelihood (2.25 times higher) of experiencing a financial disruptive life event among all patients in the study. There was no interaction of race with either SCZ or BPI for experiencing an arrest. The findings did not support our hypotheses for patients with SCZ and partially supported them for patients with BPI. CONCLUSIONS Clinical initiatives to assess social determinants of health should consider a focus on Asian patients with BPI.
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Affiliation(s)
- Karen J Coleman
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA; Department of Health Systems Science, Kaiser Permanente Bernard J Tyson School of Medicine, Pasadena, CA, USA.
| | | | | | - Ariadna Padilla
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Xia Li
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Heidi C Waters
- Otsuka Pharmaceutical Development & Commercialization, Inc., Princeton, NJ, USA
| | - Robert B Penfold
- Health Research Institute, Kaiser Permanente Washington, Seattle, WA, USA
| | - Gregory E Simon
- Health Research Institute, Kaiser Permanente Washington, Seattle, WA, USA
| | - Claudia L Nau
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
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Ma X, Zhang H, Tian Y, Wang Y, Liu L, Wang L. Mediating effect of depression on the association between cardiovascular disease and the risk of all-cause mortality: NHANES in 2005-2018. Clin Cardiol 2023; 46:1380-1389. [PMID: 37593998 PMCID: PMC10642320 DOI: 10.1002/clc.24103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) patients are more likely to have depression than general populations, and meanwhile, depression increased all-cause mortality. However, the interaction effect of depression on CVD and all-cause mortality has not been reported yet. HYPOTHESIS Herein, we speculate that depression may play an intermediate role in the association of CVD and all-cause mortality. METHODS Demographic and clinical data of 33,156 adults (≥20 years old) were extracted from the National Health and Nutrition Examination Survey (NHANES) database in 2005-2018 in this retrospective cohort study. Weighted univariate and multivariate COX regression analyses were used to screen the covariates and to explore the relationship of CVD and depression. Distribution-of-product method was used to assess the mediating effect of depression on the association between CVD and all-cause mortality. The mediating effect of depression was also explored in age, gender, diabetes mellitus (DM), and dyslipidemia subgroups. The evaluation indexes were odds ratios (ORs), hazard ratios (HRs), and 95% confidence intervals (CIs). RESULTS Among the participants, 11 514 had CVD, 5844 had depression, and 4759 were died. After adjusting for covariates, CVD was related to high odds of depression (OR = 1.94). Depression played an intermediate role in CVD and all-cause mortality (HR = 1.23) with a mediational percentage of 9.13%. Subgroup analyses also showed this mediating effect existed in adults of different age, gender, DM and dyslipidemia status (all p < .05). CONCLUSION The intermediate effect of depression may help clinicians to early identify high-risk populations and provide some reference for disease management and mortality reduction.
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Affiliation(s)
- Xinxin Ma
- Department of Psychology and PsychiatryThe Second Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiP.R. China
| | - Huan Zhang
- Department of Psychology and PsychiatryThe Second Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiP.R. China
| | - Yuan Tian
- Department of Psychology and PsychiatryThe Second Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiP.R. China
| | - Yaping Wang
- Department of Psychology and PsychiatryThe Second Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiP.R. China
| | - Ling Liu
- Department of Psychology and PsychiatryThe Second Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiP.R. China
| | - Lei Wang
- Department of Psychology and PsychiatryThe Second Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiP.R. China
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Stacchini L, Catalini A, De Nicolò V, Cosma C, Gallinoro V, Ancona A, Berselli N, Caminiti M, Mazza C, Minutolo G, Cedrone F, Gianfredi V. Social Network Characteristics and Depressive Symptoms of Italian Public Health Medical Residents: The Public Health Residents' Anonymous Survey in Italy (PHRASI). Behav Sci (Basel) 2023; 13:881. [PMID: 37998628 PMCID: PMC10798373 DOI: 10.3390/bs13110881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/26/2023] [Accepted: 10/16/2023] [Indexed: 11/25/2023] Open
Abstract
Despite the high impact of the COVID-19 pandemic on social interactions and healthcare workers' (HWs') mental health, few studies have investigated the association between social network characteristics and HWs' mental health, particularly during the pandemic. Therefore, we aimed to assess the associations between public health residents' (PHRs') social network characteristics and depression. We used data from the Public Health Residents' Anonymous Survey in Italy (PHRASI), a nationwide cross-sectional study. Social network characteristics were self-reported. Depressive symptoms were assessed using the nine-item Patient Health Questionnaire. Linear and logistic models adjusted for age, sex, physical activity, and alcohol were used. A moderation analysis by sex was also performed. A total of 379 PHRs participated in the survey (58% females, median age of 30 years). More peer-to-peer (odds ratio OR = 0.62 (0.47-0.83)) and supervisor support (OR = 0.49 (0.36-0.68)), more social participation ((OR) = 0.36 95% CI (0.25-0.50)), and having a partner (OR = 0.49 (0.25-0.96)) were significantly associated with a lower risk of clinically relevant depressive symptoms. Work-to-private-life interference was significantly associated with a higher risk of clinically relevant depressive symptoms (OR = 1.77 (1.28-2.45)). Promoting a supportive work environment and social participation as well as reducing work-to-private life interference can contribute to reducing the high burden among PHRs.
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Affiliation(s)
- Lorenzo Stacchini
- Department of Health Sciences, University of Florence, 50121 Florence, Italy (V.G.)
| | - Alessandro Catalini
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60100 Ancona, Italy
| | - Valentina De Nicolò
- Department of Public Health and Infectious Disease, Sapienza University of Rome, 00185 Rome, Italy
| | - Claudia Cosma
- Department of Health Sciences, University of Florence, 50121 Florence, Italy (V.G.)
| | - Veronica Gallinoro
- Department of Health Sciences, University of Florence, 50121 Florence, Italy (V.G.)
| | - Angela Ancona
- School of Hygiene and Preventive Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy;
| | - Nausicaa Berselli
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy;
| | - Marta Caminiti
- Department of Medicine and Surgery—Sector of Public Health, University of Perugia, 06100 Perugia, Italy
| | - Clara Mazza
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Giuseppa Minutolo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy
| | - Fabrizio Cedrone
- Hospital Management, Local Health Authority of Pescara, 65100 Pescara, Italy;
| | - Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy;
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Zhu X, Zhao Y, Li L, Liu J, Huang Q, Wang S, Shu Y. Association of non-HDL-C and depression: a cross-sectional analysis of the NHANES data. Front Psychiatry 2023; 14:1274648. [PMID: 37928909 PMCID: PMC10623352 DOI: 10.3389/fpsyt.2023.1274648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 09/26/2023] [Indexed: 11/07/2023] Open
Abstract
Objectives Non-high-density lipoprotein cholesterol (non-HDL-C) has attracted attention because it is associated with a variety of diseases and is easy to measure. However, the relationship between non-HDL-C and depression is still unclear. Our aim was to assess the relationship between non-HDL-C and depression using the cross-sectional NHANES survey from 2005 to 2018. Methods We examined the association between non-HDL-C and depression using weighted multivariable logistic regression models and subgroup analysis. Sensitivity analysis demonstrated the robustness of the results. Results There were 42,143 participants in this study and 8.6% had depression (weighted 7.53%). Non-HDL-C was higher in participants with depression compared to those without depression (weighted mean 3.64 vs. 3.73, p < 0.01). There was a positive association between non-HDL-C and depression with a 95% OR of 1.22 adjusted for multifactorial (95% CI,1.03-1.45). In subgroup analyses, non-HDL-C was positively associated with depression in men (OR, 1.31; 95% CI, 1.01-1.70), normal BMI (OR: 0.93; 95% CI: 0.66-1.32) and in participants without hypertension (OR, 1.29; 95% CI, 1.01-1.66). Conclusion Non-HDL-C positively correlated with depression, and further research may be better for clinical service.
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Affiliation(s)
- Xianlin Zhu
- Department of Clinical Psychology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Yiwen Zhao
- Department of Psychiatry, Linhai Kangning Hospital, Linhai, China
| | - Lu Li
- Department of Psychiatry, Linhai Kangning Hospital, Linhai, China
| | - Jiaoying Liu
- Graduate School of Zunyi Medical University, Zunyi Medical University, Zunyi, China
- Department of Psychiatry of Women and Children, The Second People's Hospital of Guizhou Province, Guivang, China
| | - Qiankun Huang
- Department of Psychology, Yichang Mental Health Center, Yichang, China
| | - Suhong Wang
- Department of Clinical Psychology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Yanping Shu
- Department of Psychiatry of Women and Children, The Second People's Hospital of Guizhou Province, Guivang, China
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Warren N, Leske S, Arnautovska U, Northwood K, Kisely S, Siskind D. Prevalence of frailty in severe mental illness: findings from the UK Biobank. BJPsych Open 2023; 9:e185. [PMID: 37821357 PMCID: PMC10594184 DOI: 10.1192/bjo.2023.580] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 08/28/2023] [Accepted: 09/10/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Severe mental illness (SMI) is associated with significant morbidity. Frailty combines biological ageing, comorbidity and psychosocial factors and can predict adverse health outcomes. Emerging evidence indicates that frailty is higher in individuals with SMI than in the general population, although studies have been limited by sample size. AIMS To describe the prevalence of frailty in people with SMI in a large cohort using three different frailty measures and examine the impact of demographic and sociodemographic variables. METHOD The UK Biobank survey data, which included individuals aged 37-73 years from England, Scotland and Wales from 2006 to 2010, with linked in-patient hospital episodes, were utilised. The prevalence of frailty in individuals with and without SMI was assessed through three frailty measures: frailty index, physical frailty phenotype (PFP) and Hospital Frailty Risk Score (HFRS). Stratified analysis and dichotomous logistic regression were conducted. RESULTS A frailty index could be calculated for 99.5% of the 502 412 UK Biobank participants and demonstrated greater prevalence of frailty in women and an increase with age. The prevalence of frailty for those with SMI was 3.19% (95% CI 3.0-3.4), 4.2% (95% CI 3.8-4.7) and 18% (95% CI 15-23) using the frailty index, PFP and HFRS respectively. The prevalence ratio was between 3 and 18 times higher than in those without SMI. CONCLUSIONS As a measure, frailty captures the known increase in morbidity associated with SMI and may potentially allow for earlier identification of those who will benefit from targeted interventions.
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Affiliation(s)
- Nicola Warren
- Faculty of Medicine, The University of Queensland, Brisbane, Australia; and Metro South Addiction and Mental Health Service, Metro South Health, Brisbane, Australia
| | - Stuart Leske
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Urska Arnautovska
- Faculty of Medicine, The University of Queensland, Brisbane, Australia; and Metro South Addiction and Mental Health Service, Metro South Health, Brisbane, Australia
| | - Korinne Northwood
- Faculty of Medicine, The University of Queensland, Brisbane, Australia; and Metro South Addiction and Mental Health Service, Metro South Health, Brisbane, Australia
| | - Steve Kisely
- Faculty of Medicine, The University of Queensland, Brisbane, Australia; and Metro South Addiction and Mental Health Service, Metro South Health, Brisbane, Australia
| | - Dan Siskind
- Faculty of Medicine, The University of Queensland, Brisbane, Australia; and Metro South Addiction and Mental Health Service, Metro South Health, Brisbane, Australia
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Gong IY, Cheung MC, Chan KKW, Arya S, Faught N, Calzavara A, Liu N, Odejide OO, Abel G, Kurdyak P, Raphael MJ, Kuczmarski T, Prica A, Mozessohn L. Mortality among patients with diffuse large B-cell lymphoma and mental disorders: a population-based study. J Natl Cancer Inst 2023; 115:1194-1203. [PMID: 37531271 DOI: 10.1093/jnci/djad149] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/04/2023] [Accepted: 07/28/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Mental disorders have been reported in patients with diffuse large B-cell lymphoma (DLBCL), but studies examining their association with mortality are lacking. METHODS We conducted a population-based study using linked administrative health-care databases from Ontario, Canada. All patients with DLBCL 18 years of age or older treated with rituximab-based therapy between January 1, 2005, and December 31, 2017, were identified and followed until March 1, 2020. Mental disorders were defined as either preexisting or postdiagnosis (after lymphoma treatment initiation). Cox proportional hazards models were used to estimate the adjusted hazard ratio (HR) between mental disorders and 1-year and all-cause mortality while controlling for covariates. RESULTS We identified 10 299 patients with DLBCL. The median age of the cohort was 67 years; 46% of patients were female, and 28% had a preexisting mental disorder. At 1-year follow-up, 892 (9%) had a postdiagnosis mental disorder, and a total of 2008 (20%) patients died. Preexisting mental disorders were not associated with 1-year mortality (adjusted HR = 1.06, 95% confidence interval [CI] = 0.96 to 1.17, P = .25), but postdiagnosis disorders were (adjusted HR = 1.51, 95% CI = 1.26 to 1.82, P = .0001). During a median follow-up of 5.2 years, 2111 (22%) patients had a postdiagnosis mental disorder, and 4084 (40%) patients died. Both preexisting and postdiagnosis mental disorders were associated with worse all-cause mortality (preexisting adjusted HR = 1.12, 95% CI = 1.04 to 1.20, P = .0024; postdiagnosis adjusted HR = 1.63, 95% CI = 1.49 to 1.79, P < .0001). CONCLUSIONS Patients with DLBCL and mental disorders had worse short-term and long-term mortality, particularly those with postdiagnosis mental disorders. Further studies are needed to examine mental health service utilization and factors mediating the relationship between mental disorders and inferior mortality.
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Affiliation(s)
- Inna Y Gong
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Matthew C Cheung
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - Kelvin K W Chan
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
- Canadian Centre for Applied Research in Cancer Control, Vancouver, BC, Canada
| | - Sumedha Arya
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Neil Faught
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | | | - Ning Liu
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | | | | | - Paul Kurdyak
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
- Centre for Addition and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Michael J Raphael
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
| | - Thomas Kuczmarski
- University of Washington Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Anca Prica
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Lee Mozessohn
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
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Zhang Z, Jackson SL, Gillespie C, Merritt R, Yang Q. Depressive Symptoms and Mortality Among US Adults. JAMA Netw Open 2023; 6:e2337011. [PMID: 37812418 PMCID: PMC10562940 DOI: 10.1001/jamanetworkopen.2023.37011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/19/2023] [Indexed: 10/10/2023] Open
Abstract
Importance Depression is a common mental health disorder in the US. Depressive symptoms have been associated with increased cardiovascular disease incidence and mortality, but studies have largely focused on narrow population subgroups. Objective To examine the association between depressive symptoms and mortality in a large, diverse, nationally representative sample of US adults, and to examine how lifestyle factors mediate this association. Design, Setting, and Participants This was a prospective cohort study of a nationally representative sample of US adults using National Health and Nutrition Examination Survey 2005 to 2018 data linked with the National Death Index through 2019 for adults aged 20 years and older. Data were analyzed between March 1 and May 26, 2023. Main Outcomes and Measures All-cause, cardiovascular disease, and ischemic heart disease mortality. Depressive symptoms were defined by Patient Health Questionnaire-9 scores and were categorized as none or minimal, mild, and moderate to severe. Secondarily, we assessed degree of mediation by lifestyle factors. Results A total of 23 694 participants were included (unweighted n = 11 862 male [weighted 49.8%]; mean [SE] age, 44.7 [0.24] years). Prevalences of mild and moderate to severe depression were 14.9% and 7.2%, respectively. For all-cause mortality, hazard ratios were 1.35 (95% CI, 1.07-1.72) for mild depressive symptoms vs none and 1.62 (95% CI, 1.24-2.12) for moderate to severe depressive symptoms vs none. The corresponding hazard ratios were 1.49 (95% CI, 1.11-2.00) and 1.79 (95% CI, 1.22-2.62) for cardiovascular disease mortality and 0.96 (95% CI, 0.58-1.60) and 2.21 (95% CI, 1.24-3.91) for ischemic heart disease mortality. The associations were largely consistent across subgroups. Approximately 11.0% to 16.1% of the associations between depression and mortality could be explained by lifestyle factors. Feeling tired or having little energy, poor appetite or overeating, and having little interest in doing things were independently associated with all-cause and cardiovascular disease mortality but not with ischemic heart disease mortality. Conclusions and Relevance In this prospective cohort study of a nationally representative sample of US adults, there was a graded positive association between depressive symptoms and mortality. Public health efforts to improve awareness and treatment of depression and associated risk factors could support a comprehensive, nationwide strategy to reduce the burden of depression.
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Affiliation(s)
- Zefeng Zhang
- Division for Heart Disease and Stroke Prevention, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sandra L. Jackson
- Division for Heart Disease and Stroke Prevention, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cathleen Gillespie
- Division for Heart Disease and Stroke Prevention, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Robert Merritt
- Division for Heart Disease and Stroke Prevention, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Quanhe Yang
- Division for Heart Disease and Stroke Prevention, US Centers for Disease Control and Prevention, Atlanta, Georgia
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Kuroda N, Tamiya N. Excess mortality among adults with mental disorders treated in psychiatric and general medical settings: A population-based cohort study using municipal medical claims data in Japan. Asian J Psychiatr 2023; 88:103719. [PMID: 37567083 DOI: 10.1016/j.ajp.2023.103719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 07/26/2023] [Accepted: 07/29/2023] [Indexed: 08/13/2023]
Abstract
OBJECTIVES To estimate the excess mortality associated with serious mental illnesses (schizophrenia and bipolar disorder) and common mental disorders (depression and anxiety) at the population level. METHODS We conducted a population-based, retrospective cohort study in Tsukuba, Japan. Individuals aged 20-74 years and insured for at least 12 months by the National Health Insurance or Late Elders' Health Insurance as of April 2015 were included (n = 41,618, 29% of the city's population aged 20-74 years). Individuals with mental disorders (International Classification of Diseases-10 code: F00-F99) were identified in psychiatric and general medical services using medical claims during the 12-month baseline period and classified into mutually exclusive diagnostic subgroups. Their age/sex-adjusted all-cause mortality rate ratios (aMRRs) were estimated and compared to those of individuals without mental disorders. RESULTS Altogether, 12.0% of participants had mental disorders (general medical service: 7.2% vs. psychiatric service: 4.8%). Common mental disorders were the most prevalent (8.1%). During the median 48 months of observation, 225 deaths were observed in people with mental disorders. The aMRR was 1.98 (95%CI: 1.70-2.29) for all mental disorders, with a higher rate ratio in psychiatric service than in general medical service users (aMRR: 2.64 [2.12-3.29] vs. 1.70 [1.42-2.04]), 3.57 (2.71-4.70) for serious mental illness, with a higher rate ratio in psychiatric inpatient service than in outpatient service users (aMRR: 5.74 [3.76-8.78] vs. 2.84 [2.00-4.04]), and 1.53 (1.27-1.84) for common mental disorders. CONCLUSION Serious and common mental disorders in psychiatric and general health services are associated with increased mortality in Japan.
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Affiliation(s)
- Naoaki Kuroda
- Health Services Research and Development Center, University of Tsukuba, 1-1-1 Tenno-dai, Tsukuba, Ibaraki 305-8575, Japan; Health Department, Tsukuba City, 1-1-1 Kenkyu-Gakuen, Tsukuba, Ibaraki 305-0817, Japan; Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8553, Japan.
| | - Nanako Tamiya
- Health Services Research and Development Center, University of Tsukuba, 1-1-1 Tenno-dai, Tsukuba, Ibaraki 305-8575, Japan; Department of Health Services Research, Institute of Medicine, University of Tsukuba, 1-1-1 Tenno-dai, Tsukuba, Ibaraki 305-8575, Japan
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Lin Z, Cheng L, Han X, Wang H, Liao Y, Guo L, Shi J, Fan B, Teopiz KM, Jawad MY, Zhang H, Chen Y, Lu C, McIntyre RS. The Effect of Internet-Based Cognitive Behavioral Therapy on Major Depressive Disorder: Randomized Controlled Trial. J Med Internet Res 2023; 25:e42786. [PMID: 37738092 PMCID: PMC10559190 DOI: 10.2196/42786] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 01/10/2023] [Accepted: 07/31/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Many people living with major depressive disorder (MDD) in China do not receive treatment owing to a lack of mental health services, along with significant stigma toward mental illness. Internet-based cognitive behavioral therapy (ICBT) has been proposed to increase access to mental health care for people with MDD. OBJECTIVE The aims of this study were to (1) evaluate the efficacy of ICBT for depressive symptoms in patients with MDD; (2) evaluate the effect of ICBT on anxiety symptoms, nonspecific psychological distress, general self-efficacy, depression stigma, social function, and health-related quality of life (HRQoL); and (3) explore the acceptability of and satisfaction with the ICBT program among participants. METHODS Patients with MDD were enrolled and randomized to the ICBT group or the waiting-list control (WLC) group. The ICBT group received ICBT delivered through a WeChat mini-program with general support by nonspecialists. Participants in the 2 groups were self-evaluated online at baseline and posttreatment for changes in the primary outcome (ie, depressive symptoms) and secondary outcomes (ie, anxiety symptoms, nonspecific psychological distress, general self-efficacy, depression stigma, social functional impairment, and HRQoL). Changes in outcomes were measured by changes in overall scores on respective scales, and response and remission rates were calculated based on depressive symptoms. The acceptability of and satisfaction with the ICBT program were measured by treatment adherence and participants' feelings (ie, modules seriously completed, perceived benefit, and satisfaction). RESULTS We included 40 patients who were randomly assigned to the ICBT group and 44 who were assigned to the WLC group. Compared with the WLC group, the ICBT group had fewer depressive symptoms, fewer anxiety symptoms, less nonspecific psychological distress, and greater general self-efficacy. Moreover, the ICBT group had higher response (18/31, 58%) and remission rates (17/31, 55%). The adherence rate in the ICBT group was 78% (31/40), and the majority of participants who completed all ICBT modules were satisfied with the ICBT program. CONCLUSIONS ICBT demonstrated greater improvements in depressive symptoms, anxiety symptoms, nonspecific psychological distress, and general self-efficacy among selected patients with MDD in comparison with the findings in waiting-list controls. The ICBT program in this study had good acceptability and satisfaction among participants. TRIAL REGISTRATION Chinese Clinical Trial Registry (ChiCTR2100046425); https://tinyurl.com/bdcrj4zv.
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Affiliation(s)
- Ziyi Lin
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Lu Cheng
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Xue Han
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Hongqiong Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Yuhua Liao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Jingman Shi
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Beifang Fan
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Kayla M Teopiz
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Muhammad Youshay Jawad
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Huimin Zhang
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Yan Chen
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Roger S McIntyre
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Pan YJ, Yeh LL. Associations between mortality and exposure to psychotropic medication: A population-based cohort study for depressive disorders. Aust N Z J Psychiatry 2023; 57:1253-1262. [PMID: 36629047 DOI: 10.1177/00048674221145337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Use of antidepressants and antipsychotics to treat depressive disorders is becoming increasingly prevalent. METHODS This study investigated how the use and cumulative dosage of these medications affect the mortality risk in a Taiwan's national cohort of individuals ages 15 years and older who were diagnosed with depressive disorders in 2010 and followed up for 5 years. An age- and gender-matched control group was identified. The mean defined daily doses of antidepressants and antipsychotics were calculated, and survival analyses were conducted to examine the effects of exposure dosage on overall mortality and mortality due to cardiovascular diseases, in comparison with the control sample. RESULTS A total of 400,042 individuals (255,288 women; 63.8%) with depressive disorders were identified. A low-to-moderate dosage of antidepressants was associated with a decrease in cardiovascular disease-related mortality risks compared to no exposure for those with depressive disorders. By contrast, a dose-related increase was found when using antipsychotics, with a 1.6-, 2.4- and 2.9-fold risk in the low, moderate and high exposure groups, respectively, for overall mortality, and a 1.2-, 2.4- and 3.5-fold risk in the low, moderate and high exposure groups, respectively, for cardiovascular disease-related mortality, relative to the control sample. CONCLUSION For individuals with depression, use of low-to-moderate dosage antidepressants was associated with decreased mortality. However, use of antipsychotics was found to be associated with a dose-related increase in overall and cardiovascular disease-related mortality risks. Adverse health outcomes should be also considered when prescribing psychotropic medications to patients with depressive disorders.
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Affiliation(s)
- Yi-Ju Pan
- Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City
- Department of Medical Humanities and Education, Institute of Public Health, College of Medicine, National Yang Ming Chiao Tung University, Taipei
| | - Ling-Ling Yeh
- Graduate School of Humanities and Social Sciences, Dharma Drum Institute of Liberal Arts, New Taipei City
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Valletta M, Vetrano DL, Xia X, Rizzuto D, Roso-Llorach A, Calderón-Larrañaga A, Marengoni A, Laukka EJ, Canevelli M, Bruno G, Fratiglioni L, Grande G. Multimorbidity patterns and 18-year transitions from normal cognition to dementia and death: A population-based study. J Intern Med 2023; 294:326-335. [PMID: 37306092 DOI: 10.1111/joim.13683] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Several chronic diseases accelerate cognitive decline; however, it is still unknown how different patterns of multimorbidity influence individuals' trajectories across the cognitive continuum. OBJECTIVES We aimed to investigate the impact of multimorbidity and of specific multimorbidity patterns on the transitions across cognitive stages (normal cognition, cognitive impairment, no dementia [CIND], dementia) and death. METHODS We included 3122 dementia-free individuals from the Swedish National study on Aging and Care in Kungsholmen. Using fuzzy c-means cluster analysis, multimorbid participants were classified into mutually exclusive groups characterized by commonly coexisting chronic diseases. Participants were followed up to 18 years to detect incident CIND, dementia, or death. Transition hazard ratios (HRs), life expectancies, and time spent in different cognitive stages were estimated using multistate Markov models. RESULTS At baseline, five multimorbidity patterns were identified: neuropsychiatric, cardiovascular, sensory impairment/cancer, respiratory/metabolic/musculoskeletal, and unspecific. Compared to the unspecific pattern, the neuropsychiatric and sensory impairment/cancer ones showed reduced hazards of reverting from CIND to normal cognition (HR 0.53, 95% CI 0.33-0.85 and HR 0.60, 95% CI 0.39-0.91). Participants in the cardiovascular pattern exhibited an increased hazard of progression from CIND to dementia (HR 1.70, 95% CI 1.15-2.52) and for all transitions to death. Subjects with the neuropsychiatric and cardiovascular patterns showed reduced life expectancy at age 75, with an anticipation of CIND (up to 1.6 and 2.2 years, respectively) and dementia onset (up to 1.8 and 3.3 years, respectively). CONCLUSIONS Multimorbidity patterns differentially steer individual trajectories across the cognitive continuum of older adults and may be used as a risk stratification tool.
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Affiliation(s)
- Martina Valletta
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - Davide Liborio Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Xin Xia
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Debora Rizzuto
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Albert Roso-Llorach
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | - Amaia Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Alessandra Marengoni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Erika J Laukka
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Marco Canevelli
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - Giuseppe Bruno
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Giulia Grande
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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Boyle CC, Bower JE, Eisenberger NI, Irwin MR. Stress to inflammation and anhedonia: Mechanistic insights from preclinical and clinical models. Neurosci Biobehav Rev 2023; 152:105307. [PMID: 37419230 DOI: 10.1016/j.neubiorev.2023.105307] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 06/30/2023] [Accepted: 07/04/2023] [Indexed: 07/09/2023]
Abstract
Anhedonia, as evidenced by impaired pleasurable response to reward, reduced reward motivation, and/or deficits in reward-related learning, is a common feature of depression. Such deficits in reward processing are also an important clinical target as a risk factor for depression onset. Unfortunately, reward-related deficits remain difficult to treat. To address this gap and inform the development of effective prevention and treatment strategies, it is critical to understand the mechanisms that drive impairments in reward function. Stress-induced inflammation is a plausible mechanism of reward deficits. The purpose of this paper is to review evidence for two components of this psychobiological pathway: 1) the effects of stress on reward function; and 2) the effects of inflammation on reward function. Within these two areas, we draw upon preclinical and clinical models, distinguish between acute and chronic effects of stress and inflammation, and address specific domains of reward dysregulation. By addressing these contextual factors, the review reveals a nuanced literature which might be targeted for additional scientific inquiry to inform the development of precise interventions.
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Affiliation(s)
- Chloe C Boyle
- Norman Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, UCLA, USA.
| | - Julienne E Bower
- Norman Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, UCLA, USA; Department of Psychology, UCLA, Los Angeles, CA, USA
| | | | - Michael R Irwin
- Norman Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, UCLA, USA
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Wang P, Shen X, Wang Y, Jia X. Association between constipation and major depression in adult Americans: evidence from NHANES 2005-2010. Front Psychiatry 2023; 14:1152435. [PMID: 37654986 PMCID: PMC10465693 DOI: 10.3389/fpsyt.2023.1152435] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 08/02/2023] [Indexed: 09/02/2023] Open
Abstract
Objective Current studies on the association between constipation and depression is still insufficient. In this study, we investigated the detailed association between constipation and major depression among American adults. Methods In this cross-sectional study, 12,352 adults aged 20 and older were selected from the National Health and Nutrition Examination Survey 2005-2010 for the sample. Constipation was defined as fewer than three defecation frequencies per week. For the assessment of major depression, the validated Patient Health Questionnaire-9 was used. Adjusted odds ratios (ORs) were calculated using multivariate logistic regression models. A subgroup analysis was carried out to ensure that the results were stable. Results Of the 12,352 participants, 430 reported constipation, with a prevalence of 3.5%. Depression was reported in 1030 cases, indicating a prevalence rate of 8.3%. Patients with constipation were significantly more likely to have major depression (20.9%) than those without it (7.9%, p < 0.001). After adjusting for age, sex, race/ethnicity, marital status, education level, body mass index, vigorous physical activity, alcohol consumption, smoking status, poverty income ratio, diabetes, selective serotonin reuptake inhibitor use, liver disease, heart disease, pulmonary disease, hypertension, arthritis, cancer, dietary fiber intake, moisture intake, total fat intake, carbohydrates intake, and protein intake, constipation is significantly associated with major depression (OR: 2.20, 95%CI: 1.68-2.87, p < 0.001). Subgroup analyses by age, sex, dietary intake, risk behaviors, and common complications showed no statistically significant interactions (p > 0.05). Conclusion In conclusion, this study showed that constipation were significantly associated with depression. When treating patients with constipation, it is necessary for clinicians to screen and evaluate depression, and provide timely and effective intervention for patients with depression to avoid further deterioration of the condition.
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Affiliation(s)
- Pengfei Wang
- Department of Anorectal Surgery, China Academy of Chinese Medical Sciences Xiyuan Hospital, Beijing, China
| | - Xia Shen
- Department of Nursing, Wuxi Medical College, Jiangnan University, Wuxi, China
| | - Yan Wang
- Department of Oncology, China Academy of Chinese Medical Sciences Guang’anmen Hospital, Beijing, China
| | - Xiaoqiang Jia
- Department of Anorectal Surgery, China Academy of Chinese Medical Sciences Xiyuan Hospital, Beijing, China
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Cuijpers P, Miguel C, Harrer M, Plessen CY, Ciharova M, Papola D, Ebert D, Karyotaki E. Psychological treatment of depression: A systematic overview of a 'Meta-Analytic Research Domain'. J Affect Disord 2023; 335:141-151. [PMID: 37178828 DOI: 10.1016/j.jad.2023.05.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 05/02/2023] [Accepted: 05/05/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Over the past 16 years, we have developed a 'Meta-analytic Research Domain' (MARD) of all randomized trials of psychological treatments of depression. A MARD is a living systematic review of a research field, that cannot be otherwise covered by one (network) meta-analysis and includes multiple PICOs. In this paper we give an overview of the findings of this MARD. METHODS A narrative review of the results of the 118 meta-analyses on psychotherapies for depression that were published within our MARD. RESULTS Most research has been conducted on cognitive-behavioral therapy (CBT), but several other psychotherapies are also effective, with few differences between therapies. They can be effectively delivered in individual, group, telephone and guided self-help format and are effective in many different target groups and across different age groups, although the effects are significantly smaller in children and adolescents. Psychotherapies have comparable effects as pharmacotherapy at the short term but are probably more effective at the longer term. Combined treatment is more effective than either psychotherapy or pharmacotherapy alone at the short, but also at the longer term. LIMITATIONS We did not summarize all published meta-analyses (protocols, methodological studies) and have not compared our results to those found in other meta-analyses on comparable subjects. CONCLUSION Psychotherapies can contribute considerably to a reduction of the disease burden of depression. MARDs are an important next step in the aggregation of knowledge from randomized controlled trials in psychological treatments of depression as well as in other healthcare sectors.
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Affiliation(s)
- Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, the Netherlands; Babeș-Bolyai University, International Institute for Psychotherapy, Cluj-Napoca, Romania.
| | - Clara Miguel
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Mathias Harrer
- Psychology & Digital Mental Health Care, Department of Health Sciences, Technical University Munich, Munich, Germany; Department of Clinical Psychology & Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Constantin Yves Plessen
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, the Netherlands; Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Marketa Ciharova
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Davide Papola
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Science, Section of Psychiatry, University of Verona, Italy; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - David Ebert
- Psychology & Digital Mental Health Care, Department of Health Sciences, Technical University Munich, Munich, Germany
| | - Eirini Karyotaki
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, the Netherlands
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Bryant E, Koemel N, Martenstyn J, Marks P, Hickie I, Maguire S. Mortality and mental health funding-do the dollars add up? Eating disorder research funding in Australia from 2009 to 2021: a portfolio analysis. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 37:100786. [PMID: 37693868 PMCID: PMC10485676 DOI: 10.1016/j.lanwpc.2023.100786] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 04/01/2023] [Accepted: 04/25/2023] [Indexed: 09/12/2023]
Abstract
Background Eating Disorders (EDs) are among the deadliest of the mental disorders and carry a sizeable public health burden, however their research and treatment is consistently underfunded, contributing to protracted illness and ongoing paucity of treatment innovation. Methods We compare absolute levels and growth rates of Australian mental health research funding by illness group for the years 2009-2021, with a specific focus on eating disorders analysed at the portfolio level. Findings Actual and adjusted data obtained from Australia's three national medical research funding bodies (NHMRC, ARC and MRFF) shows eating disorders receive a disproportionately low allocation of mental health research funding despite having amongst the highest mortality rates. Forty-one category one research grants totalling $AUD28.1 million were funded for eating disorders over the period. When adjusted for inflation, this equates to $2.05 per affected individual, compared with $19.56 for depression, $32.11 for autism, and $176.19 for schizophrenia. Half of all research funded for eating disorders was 'basic' research (e.g., illness underpinning), with little investment in the development of innovative treatment models, novel therapeutics or translation, well reflected by recovery rates of less than 50% in individuals with Anorexia Nervosa. Interpretation Significant discrepancy remains between research funding dollars and disease burden associated with the mental health disorders. The extent to which eating disorders are underfunded may in part be attributable to inaccuracies in epidemiological and burden of disease data. Funding This work was in-part funded by the Australian Government Department of Health and the National Eating Disorder Research & Translation Strategy. The funder was not directly involved in informing the development of the current study.
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Affiliation(s)
- E. Bryant
- InsideOut Institute, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Australia
| | - N. Koemel
- The Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Australia
| | - J.A. Martenstyn
- InsideOut Institute, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Australia
- School of Psychology, Faculty of Science, University of Sydney, Australia
| | - P. Marks
- InsideOut Institute, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Australia
| | - I. Hickie
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Australia
| | - S. Maguire
- InsideOut Institute, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Australia
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