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Toyoshima K, Masuya J, Ono M, Honyashiki M, Hashimoto S, Kusumi I, Inoue T. Effects of the Interaction between Affective Temperaments and BIS/BAS on Depressive Symptoms in Individuals with Major Depressive Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15841. [PMID: 36497915 PMCID: PMC9738088 DOI: 10.3390/ijerph192315841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 11/22/2022] [Indexed: 06/17/2023]
Abstract
Depressive symptoms (DepS) associated with major depressive disorder (MDD) are influenced by affective temperaments (ATs), behavioral inhibition system (BIS), and behavioral activation system (BAS). However, the effect of interactions between ATs and BIS/BAS on DepS in MDD remains poorly understood. Herein, we aimed to investigate the effects of these interactions. The Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Auto-questionnaire (TEMPS-A), BIS/BAS questionnaire, and Patient Health Questionnaire-9 (PHQ-9) were used to evaluate ATs, BIS/BAS, and DepS, respectively, in 90 participants with MDD. Data were analyzed using hierarchical multiple regression analysis to assess the interaction effect. The interaction (β = 0.199, p < 0.05) between depressive temperament (DepT) (β = 0.319, p < 0.01) and BIS scores (β = 0.300, p < 0.01) exhibited a significant positive effect on DepS (ΔR2 = 0.038, p < 0.05). However, the interaction between ATs and BAS scores did not exhibit a significant effect on DepS. Our findings suggest that interactions between BIS sensitivity and DepT worsen DepS in individuals with MDD. Hence, to manage DepS associated with BIS sensitivity and DepT, evaluating their interaction may be useful in daily clinical practice. This study presents important insights into MDD psychopathology.
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Affiliation(s)
- Kuniyoshi Toyoshima
- Department of Psychiatry, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan
| | - Jiro Masuya
- Department of Psychiatry, Tokyo Medical University, Tokyo 160-0023, Japan
| | - Miki Ono
- Department of Psychiatry, Tokyo Medical University, Tokyo 160-0023, Japan
| | - Mina Honyashiki
- Department of Psychiatry, Tokyo Medical University, Tokyo 160-0023, Japan
| | - Shogo Hashimoto
- Department of Psychiatry, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan
| | - Ichiro Kusumi
- Department of Psychiatry, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan
| | - Takeshi Inoue
- Department of Psychiatry, Tokyo Medical University, Tokyo 160-0023, Japan
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152
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Jin Y, Zhou X, Deng L, Xiong X, Li Y, Wei Q, Dong B, Qiu S. Association between the domestic use of solid cooking fuel and increased prevalence of depression and cognitive impairment in a big developing country: A large-scale population-based study. Front Public Health 2022; 10:1038573. [PMID: 36504928 PMCID: PMC9731231 DOI: 10.3389/fpubh.2022.1038573] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/04/2022] [Indexed: 11/25/2022] Open
Abstract
Background Previous studies have suggested that air pollution affects physiological and psychological health. Using solid fuel at home is a significant source of indoor air pollution. The associations between solid fuel use and depressive symptoms and cognitive health were unclear among older adults from low- and middle-income countries (LMICs). Methods To evaluate the association of solid fuel use with depressive symptoms and cognitive health among older adults, we obtained data from the Longitudinal Aging Study in India (LASI) and excluded subjects younger than 60 years and without critical data (solid fuel use, depressive symptoms, and cognitive health). The 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) was used to assess depressive symptoms, with more than ten indicative of depression. Cognitive health was assessed using measures from the Health and Retirement Study (HRS), and subjects with the lowest 10th percentile were considered to have cognitive impairment. The participants' responses defined solid fuel use. Multivariable logistic regression, linear regression, subgroup analysis, and interaction tests were performed to appraise the relationship between solid fuel use and depression and cognitive impairment. Results A total of 29,789 participants over 60 years old were involved in this study. Almost half of the participants (47.5%) reported using solid fuel for home cooking. Compared with clean fuel use, solid fuel use was related to an increased prevalence of depression [odds ratio (OR) 1.09, 95% CI 1.03-1.16] and higher CES-D-10 scores (β 0.23, 95% CI 0.12-0.35) after fully adjusted covariables. Using solid fuel was also related to a higher risk of cognitive impairment (OR 1.21, 95% CI 1.11-1.32) and a lower cognitive score (β -0.63, 95% CI -0.79 to -0.47) compared with those who used clean fuel. In the subgroup analysis, the prevalence of depression increased in females and non-smokers. The association of solid fuel use with depression and cognitive impairment exists in subgroups of BMI, economic status, caste, living area, education, and drinking. Conclusions The use of solid fuel at home was associated with an increased prevalence of depression and cognitive impairment among older adults in India.
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Affiliation(s)
- Yuming Jin
- Department of Urology, National Clinical Research Center for Geriatrics, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Xianghong Zhou
- Department of Urology, National Clinical Research Center for Geriatrics, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Linghui Deng
- National Clinical Research Center of Geriatrics, The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xingyu Xiong
- Department of Urology, National Clinical Research Center for Geriatrics, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Yifan Li
- Department of Urology, National Clinical Research Center for Geriatrics, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Qiang Wei
- Department of Urology, National Clinical Research Center for Geriatrics, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Birong Dong
- National Clinical Research Center of Geriatrics, The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China,Birong Dong
| | - Shi Qiu
- Department of Urology, National Clinical Research Center for Geriatrics, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China,Institute of Oncology Research (IOR) and Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland,*Correspondence: Shi Qiu
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153
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Tegeler C, Hoppmann F, Demmerle C, Gellert P, Ludwig V, Kessler EM. Implementierbarkeit, Praktikabilität und Akzeptanz ambulanter
Psychotherapie für zuhause lebende ältere Menschen mit
Depression und Pflegebedarf – Ergebnisse des Innovationsfondsprojekts
PSY-CARE. PSYCHIATRISCHE PRAXIS 2022; 50:196-203. [PMID: 36417929 PMCID: PMC10168998 DOI: 10.1055/a-1960-4723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Zusammenfassung
Ziel Zuhause lebende pflegebedürftige ältere Menschen mit
Depression sind psychotherapeutisch massiv unterversorgt. Untersucht wird die
Realisierbarkeit ambulanter Psychotherapie bei der Patientengruppe unter den
Bedingungen der Regelversorgung.
Methode Das Innovationsfonds-Projekt PSY-CARE ist eine in Berlin
angesiedelte pragmatische, randomisiert-kontrollierte Studie zur Untersuchung
von Kurzzeit-Verhaltenstherapie für zuhause lebende Menschen
über 60 Jahren mit Pflegegrad und Depression. Ausgewertet werden
Implementierbarkeit, Praktikabilität und Patientenzufriedenheit.
Ergebnisse Allen 102 in die Interventionsgruppe aufgenommenen Patienten
konnte Psychotherapie vermittelt werden, wovon fast alle Therapien
(92,3%) nur durch Hausbesuche realisierbar waren. Die Patienten waren
überwiegend (83,7%) weitgehend bis sehr zufrieden mit der
Psychotherapie. Die für das Projekt gewonnenen ambulanten
Psychotherapeuten bewerteten Angehörigeneinbezug und interprofessionelle
Zusammenarbeit als hilfreich. Anpassungen des Ausbildungs- und
Vergütungssystems wurden als notwendig erachtet.
Schlussfolgerung Hausbesuche, interprofessioneller Austausch und Arbeit
mit Angehörigen müssen reguläre Elemente ambulanter
Psychotherapie werden. Es bedarf einer speziellen gerontopsychologischen
Qualifikation für Psychotherapeuten.
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Affiliation(s)
- Christina Tegeler
- Department of Psychology, MSB Medical School Berlin GmbH, Berlin,
Germany
| | - Fee Hoppmann
- Department of Psychology, MSB Medical School Berlin GmbH, Berlin,
Germany
| | - Christina Demmerle
- Department of Psychology, MSB Medical School Berlin GmbH, Berlin,
Germany
| | - Paul Gellert
- Institut für Medizinische Soziologie und
Rehabilitationswissenschaft, Charité Universitätsmedizin Berlin,
Berlin, Germany
| | - Valentina Ludwig
- Department of Psychology, MSB Medical School Berlin GmbH, Berlin,
Germany
| | - Eva-Marie Kessler
- Department of Psychology, MSB Medical School Berlin GmbH, Berlin,
Germany
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154
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MacNeil A, Birk S, Villeneuve PJ, Jiang Y, de Groh M, Fuller-Thomson E. Incident and Recurrent Depression among Adults Aged 50 Years and Older during the COVID-19 Pandemic: A Longitudinal Analysis of the Canadian Longitudinal Study on Aging. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15032. [PMID: 36429749 PMCID: PMC9690838 DOI: 10.3390/ijerph192215032] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 10/24/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic and accompanying public health measures have exacerbated many risk factors for depression in older adulthood. The objectives of the current study are: (1) to determine the risk of incident and recurrent depression during the COVID-19 pandemic among those with, or without, a history of depression; and (2) to identify factors that were predictive of depression in these two groups. The study population included 22,622 participants of the Canadian Longitudinal Study on Aging who provided data at baseline (2011-2015), follow-up (2015-2018), and twice during the pandemic (April-May 2020, September-December 2020). The Center for Epidemiologic Studies Depression Scale (CES-D-10) was used to classify individuals with depression. Logistic regression was used to estimate the odds of depression during COVID across a series of risk factors. Individuals with a history of depression had four times the risk of depression during the pandemic when compared to those without a history of depression, even after controlling for relevant covariates. Other factors associated with depression during the pandemic include being female, having fewer savings, and experiencing COVID-19 related stressors, such as health stressors, difficulties accessing resources, and family conflict. Clinicians working with older adults should consider interventions to support high-risk groups, such as those with recurrent depression.
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Affiliation(s)
- Andie MacNeil
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON M5S 1V4, Canada
- Institute for Life Course and Aging, University of Toronto, Toronto, ON M5S 1V4, Canada
| | - Sapriya Birk
- Department of Neuroscience, Carleton University, Ottawa, ON K1S 5B6, Canada
| | - Paul J. Villeneuve
- Department of Neuroscience, Carleton University, Ottawa, ON K1S 5B6, Canada
- CHAIM Research Centre, Carleton University, Ottawa, ON K1S 5B6, Canada
| | - Ying Jiang
- Applied Research Division, Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON K1A 0K9, Canada
| | - Margaret de Groh
- Applied Research Division, Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON K1A 0K9, Canada
| | - Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON M5S 1V4, Canada
- Institute for Life Course and Aging, University of Toronto, Toronto, ON M5S 1V4, Canada
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155
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Felez-Nobrega M, Haro JM, Koyanagi A. Multimorbidity, depression with anxiety symptoms, and decrements in health in 47 low- and middle-income countries. J Affect Disord 2022; 317:176-184. [PMID: 36055525 DOI: 10.1016/j.jad.2022.08.110] [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: 01/07/2022] [Revised: 05/26/2022] [Accepted: 08/26/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Comorbid depression and anxiety is associated with worse health outcomes compared to depression or anxiety occurring in isolation, but there is little data on its association with multimorbidity. Thus, we investigated this association across 47 low- and middle-income countries, and further explored whether having anxiety symptoms in addition to depression is associated with significant declines in health outcomes among those with multimorbidity. METHODS Cross-sectional, predominantly nationally representative, community-based data were analyzed from the World Health Survey. DSM-IV depression was assessed with the Composite International Diagnostic Interview. Anxiety symptoms referred to severe/extreme problems with worry or anxiety. Ten chronic conditions and health status across five domains (cognition, interpersonal activities, sleep/energy, self-care, pain/discomfort) were assessed. Multivariable regression analyses conducted. RESULTS Data included 237,952 adults aged ≥18 years [mean age (SD) 38.4 (16.0); 50.8 % females]. Compared to no chronic conditions, 2 (OR = 6.86; 95%CI = 5.59-8.42), 3 (OR = 12.33; 95%CI = 9.72-15.63), and ≥4 (OR = 26.55; 95%CI = 20.21-35.17) chronic conditions were associated with significantly higher odds for comorbid depression/anxiety symptoms (vs. no depression or anxiety symptoms) in the multinomial logistic regression model. Among those with depression and multimorbidity, anxiety symptoms were associated with significantly worse health status across all domains. LIMITATIONS Cross-sectional design, depression and anxiety symptoms were not based on a clinical assessment. CONCLUSIONS Comorbid depression/anxiety is common in people with multimorbidity, and anxiety symptoms in people with depression and multimorbidity signify worse health status. Future studies should assess the utility of screening for and treating comorbid depression/anxiety in patients with multimorbidity in terms of clinical outcomes.
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Affiliation(s)
- M Felez-Nobrega
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Centre for Biomedical Research on Mental Health (CIBERSAM), Spain.
| | - J M Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Centre for Biomedical Research on Mental Health (CIBERSAM), Spain
| | - A Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Centre for Biomedical Research on Mental Health (CIBERSAM), Spain; ICREA, Pg. Lluis Companys 23, Barcelona, Spain
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156
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Zhang L, Shooshtari S, St. John P, Menec VH. Multimorbidity and depressive symptoms in older adults and the role of social support: Evidence using Canadian Longitudinal Study on Aging (CLSA) data. PLoS One 2022; 17:e0276279. [PMID: 36355773 PMCID: PMC9648733 DOI: 10.1371/journal.pone.0276279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 10/03/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The rising prevalence of multimorbidity poses challenges to health systems globally. The objectives of this study were to investigate: 1) the association between multimorbidity and depressive symptoms; and 2) whether social support plays a protective role in this association. METHODS A prospective population-based cohort study was conducted to analyze baseline and 3-year follow-up data of 16,729 community dwelling participants aged 65 and above in the Canadian Longitudinal Study of Aging (CLSA). Multimorbidity was defined as having three or more chronic conditions. The 10-item Center for Epidemiologic Studies Depression scale (CESD-10) was used to measure depressive symptoms. The 19-item Medical Outcomes Study (MOS) Social Support Survey was employed to assess perceived social support. Multivariate logistic regression models were used to examine the association between multimorbidity, social support and depressive symptoms. RESULTS Multimorbidity was very common among participants with a prevalence of 70.6%. Fifteen percent of participants had depressive symptoms at baseline. Multimorbidity was associated with increased odds of having depressive symptoms at 3-year follow-up (adjusted odds ratio, aOR = 1.51, 95% CI 1.33, 1.71), and developing depressive symptoms by follow-up among those with no depressive symptoms at baseline (aOR = 1.65, 95% CI 1.42, 1.92). Social support was consistently associated with decreased odds of depressive symptoms, regardless of level of multimorbidity. CONCLUSION Multimorbidity was positively associated with depressive symptoms over time, but social support served as a protective factor. As a modifiable, protective factor, emphasis should be placed in clinical practice to assess social support and refer patients to appropriate services, such as support groups. Similarly, health policy should focus on ensuring that older adults have access to social support opportunities as a way to promote mental health among older adults. Community organizations that offer social activities or support groups play a key role in this respect and should be adequately supported (e.g., with funding).
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Affiliation(s)
- Lixia Zhang
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Shahin Shooshtari
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Philip St. John
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Verena H. Menec
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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157
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The prevalence, incidence, and risk factors of mental health problems and mental health service use before and 9 months after the COVID-19 outbreak among the general Dutch population. A 3-wave prospective study. PLoS One 2022; 17:e0276834. [DOI: 10.1371/journal.pone.0276834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 10/14/2022] [Indexed: 11/12/2022] Open
Abstract
Objectives
Gain insight into the effects of the COVID-19 pandemic on the prevalence, incidence, and risk factors of mental health problems among the Dutch general population and different age groups in November-December 2020, compared with the prevalence, incidence, and risk factors in the same period in 2018 and 2019. More specifically, the prevalence, incidence, and risk factors of anxiety and depression symptoms, sleep problems, fatigue, impaired functioning due to health problems, and use of medicines for sleep problems, medicines for anxiety and depression, and mental health service.
Methods
We extracted data from the Longitudinal Internet studies for the Social Sciences (LISS) panel that is based on a probability sample of the Dutch population of 16 years and older by Statistics Netherlands. We focused on three waves of the longitudinal Health module in November-December 2018 (T1), November-December 2019 (T2), and November-December 2020 (T3), and selected respondents who were 18 years and older at T1. In total, 4,064 respondents participated in all three surveys. Data were weighted using 16 demographics profiles of the Dutch adult population. The course of mental health problems was examined using generalized estimating equations (GEE) for longitudinal ordinal data and differences in incidence with logistic regression analyses. In both types of analyses, we controlled for sex, age, marital status, employment status, education level, and physical disease.
Results
Among the total study sample, no significant increase in the prevalence of anxiety and depression symptoms, sleep problems, fatigue, impaired functioning due to health problems, use of medicines for sleep problems, of medicines for anxiety and depression, and of mental health service in November-December 2020 was observed, compared with the prevalence in November-December 2018 and 2019 (T3 did not differ from T1 and T2). Among the four different age categories (18–34, 35–49, 50–64, and 65 years old and older respondents), 50–64 years respondents had a significantly lower prevalence of anxiety and depression symptoms at T3 than at T1 and T2, while the prevalence at T1 and T2 did not differ. A similar pattern among 65+ respondents was found for mental health service use. We found no indications that the incidence of examined health problems at T2 (no problems at T1, problems at T2) and T3 (no problems at T2, problems at T3) differed. Risk factors for mental health problems at T2 were mostly similar to risk factors at T3; sex and age were less/not a risk factor for sleep problems at T3 compared with at T2.
Conclusions
The prevalence, incidence, and risk factors of the examined mental health problems examined nine months after the COVID-19 outbreak appear to be very stable across the end of 2018, 2019, and 2020 among the Dutch adult population and different age categories, suggesting that the Dutch adult population in general is rather resilient given all disruptions due to this pandemic.
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158
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Kim S, Choi M, Lee J, Kim H, Song K, Park HJ. Type D personality, cognitive illness perception, depression, approach coping, and self-management among older adults in long-term care hospitals: Structural equation modeling. Geriatr Nurs 2022; 48:150-157. [PMID: 36219934 DOI: 10.1016/j.gerinurse.2022.09.011] [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: 07/22/2022] [Revised: 09/19/2022] [Accepted: 09/21/2022] [Indexed: 12/14/2022]
Abstract
This study aimed to construct a structural equation model to explore the relationship between Type D personality, cognitive illness perception, depression, approach-coping, and self-management. The study was conducted at two long-term care hospitals with 300 or more beds in Korea. Participants were 287 older patients from whom data were collected from February 17 to March 10, 2021, using a structured questionnaire comprising items on the following variables: Type D personality, cognitive illness perception, depression, approach coping, and self-management. Type D personality (β=-.601, p=.001), cognitive illness perception (β =.692, p <.001), depression (β =-.204, p =.011), and approach-coping (β =.326, p <.001) explained 78.8% of the total variance of self-management, highlighting their impact on how patients accept and manage a disease and their relevance to the self-management of older adults in long-term care hospitals.
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Affiliation(s)
- Sunki Kim
- College of Nursing, CHA University, 120 Haeryong-ro, Pocheon-si, Gyeonggi-do 11160, Republic of Korea
| | - Mona Choi
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Yonsei-ro 50, Seodaemun-gu, Seoul 03722, Republic of Korea.
| | - JuHee Lee
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Yonsei-ro 50, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Heejung Kim
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Yonsei-ro 50, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Kijun Song
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Yonsei-ro 50, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Hye-Ja Park
- College of Nursing, CHA University, 120 Haeryong-ro, Pocheon-si, Gyeonggi-do 11160, Republic of Korea
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159
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Comorbid Major Depressive Disorder and Obstructive Sleep Apnea. Case Rep Psychiatry 2022; 2022:2943059. [PMID: 36386061 PMCID: PMC9643066 DOI: 10.1155/2022/2943059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 10/25/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction Major depressive disorder (MDD) and obstructive sleep apnoea (OSA) are prevalent in the general population. Moreover, early studies found that the two conditions are associated bidirectionally and lead to poor health outcomes. The prevalence of comorbid MDD in OSA patients could be as high as two-thirds. A sedentary lifestyle and psychological stress in the globalisation age may increase the risk of MDD and OSA. Method We reported a case of an MDD patient with OSA as well as discussed the assessment method and also reviewed the treatment of both conditions. We aimed to raise awareness for psychiatrists to differentiate other medical conditions when the symptomatology of MDD is atypical and unresponsive to standard psychiatric treatment. Conclusion Early detection and effective treatment for MDD and OSA are essential to achieve patient outcomes. Furthermore, it can reduce complications from both conditions. Therefore, a comprehensive evaluation should be made to determine the diagnoses when physicians suspect overlapping MDD and OSA.
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160
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Montayre J, Liu MF, Wang T, Zhao IY, Dimalapang E, Chang HCR, Ho MH. Diagnostic Evaluation of Depression Screening Tools in Asian New Zealanders. Clin Nurs Res 2022; 31:1472-1480. [PMID: 35950325 DOI: 10.1177/10547738221114013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This study aimed to compare the Kessler Psychological Distress Scale (K10) and Short-Form 12-Item Health Survey Mental Component Score (SF-12 MCS) for the effectiveness as screening tools for depression in Asian New Zealanders. A national, representative New Zealand Health Survey (NZHS) data set was used. In total, 1,277 participants were included in the analyses. The sensitivity and specificity values, as well as the areas under the receiver operating characteristics curves (AUROC), for the K10 and the SF-12 MCS scores were examined. The AUROCs for K10 and SF-12 MCS were 0.787 (95% CI [0.736, 0.837]) and 0.725 (95% CI [0.656, 0.793]), respectively. A less than optimal sensitivity and positive predictive value of K10 support the need to reexamine the optimal cut-off point according to the results of the Youden index. Strengthening the K10 predictive accuracy will increase the practical application among Asian populations.
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Affiliation(s)
| | | | | | - Ivy Yan Zhao
- The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | | | | | - Mu-Hsing Ho
- The University Hong Kong, Pokfulam, Hong Kong
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161
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Figeys M, Villarey S, Leung AWS, Raso J, Buchan S, Kammerer H, Rawani D, Kohls-Wiebe M, Kim ES. tDCS over the left prefrontal Cortex improves mental flexibility and inhibition in geriatric inpatients with symptoms of depression or anxiety: A pilot randomized controlled trial. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:997531. [PMID: 36386776 PMCID: PMC9641275 DOI: 10.3389/fresc.2022.997531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 10/04/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND Patients with depression and/or anxiety are commonly seen in inpatient geriatric settings. Both disorders are associated with an increased risk of cognitive impairments, notably in executive functioning. Transcranial direct current stimulation (tDCS), a type of non-invasive brain stimulation, involves the administration of a low-dose electrical current to induce neuromodulation, which ultimately may act on downstream cognitive processing. OBJECTIVE The purpose of this study was to determine the effects of tDCS on executive functioning in geriatric inpatients with symptoms of depression and/or anxiety. DESIGN Pilot Randomized Controlled Trial. SETTING Specialized geriatric wards in a tertiary rehabilitation hospital. METHODS Thirty older-aged adults were recruited, of which twenty completed ten-to-fifteen sessions of 1.5 mA anodal or sham tDCS over the left dorsolateral prefrontal cortex. Cognitive assessments were administered at baseline and following the tDCS protocol; analyses examined the effects of tDCS on cognitive performance between groups (anodal or sham tDCS). RESULTS tDCS was found to increase inhibitory processing and cognitive flexibility in the anodal tDCS group, with significant changes on the Stroop test and Trail Making Test-Part B. No significant changes were observed on measures of attention or working memory. DISCUSSION These results provide preliminary evidence that tDCS-induced neuromodulation may selectively improve cognitive processing in older adults with symptoms of depression and/or anxiety. CLINICAL TRIALS REGISTRATION www.clinicaltrials.gov, NCT04558177.
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Affiliation(s)
- Mathieu Figeys
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada,Alberta Health Services, Edmonton, AB, Canada,Correspondence: Mathieu Figeys
| | - Sheryn Villarey
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
| | - Ada W. S. Leung
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada,Department of Occupational Therapy, University of Alberta, Edmonton, AB, Canada
| | - Jim Raso
- Alberta Health Services, Edmonton, AB, Canada
| | - Steven Buchan
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | | | - David Rawani
- Alberta Health Services, Edmonton, AB, Canada,Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | | | - Esther S. Kim
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada,Department of Communication Sciences and Disorders, University of Alberta, Edmonton, AB, Canada
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162
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Yuan J, Wang Y, Liu Z. Chronic disease and depression among the elderly in China: the mediating role of instrumental activities of daily living and the moderating role of area of residence. CURRENT PSYCHOLOGY 2022; 42:1-8. [PMID: 36258891 PMCID: PMC9561327 DOI: 10.1007/s12144-022-03782-9] [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: 03/11/2022] [Revised: 09/08/2022] [Accepted: 09/15/2022] [Indexed: 12/02/2022]
Abstract
Chronic diseases are associated with depressive symptoms in older adults. However, the mechanism of this relation is not clear. In this study, we explored the mediating role of instrumental activities of daily living and the moderating role of area of residence in the relationship between chronic diseases and depression. The data was from the Chinese Longitudinal Healthy Longevity Study. Results showed that chronic diseases were positively correlated with depression, and negatively associated with instrumental activities of daily living (IADLs). Moreover, IADLs mediated the relationship between chronic diseases and depression. In addition, area of residence (rural/urban) moderated the relation between IADLs and depression, such that this negative relation was stronger for old adults lived in rural area than for urban area. These results have important significance for prevention and intervention of depression in the elderly.
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Affiliation(s)
- Jing Yuan
- School of Nursing, Hebei University, Baoding, Hebei China
| | - Yan Wang
- School of Nursing, Hebei University, Baoding, Hebei China
| | - Zejun Liu
- Department of Psychology, Educational College, Shanghai Normal University, Shanghai, China
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163
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Wu Y, Jin S, Guo J, Zhu Y, Chen L, Huang Y. The Economic Burden Associated with Depressive Symptoms among Middle-Aged and Elderly People with Chronic Diseases in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12958. [PMID: 36232268 PMCID: PMC9566659 DOI: 10.3390/ijerph191912958] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/03/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
Coexisting physical diseases and depressive symptoms exacerbate morbidity and disability, but their incremental economic burden remains unclear. We used cross-sectional data from the China Health and Retirement Longitudinal Study (CHARLS) survey in 2018 to estimate the economic burden associated with depressive symptoms among middle-aged and elderly people with chronic diseases. A multivariable regression model was used to assess the annual health care utilization, expenditures, and productivity loss of depressive symptoms among people with 12 common chronic diseases. We found that depressive symptoms were associated with higher incremental economic burdens, as the total health care costs increased by 3.1% to 85.0% and annual productivity loss increased by 1.6% to 90.1%. Those with cancer or malignant tumors had the largest economic burden associated with depressive symptoms, with CNY 17,273.7 additional annual health care costs and a loss of CNY 2196.2 due to additional annual productivity loss. The effect of depressive symptoms on the economic burden of patients with chronic conditions did not increase by the number of chronic conditions. Considering the high economic burden associated with depressive symptoms among patients with chronic conditions, it is important to consider the mental health of patients in chronic disease treatment and management.
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Affiliation(s)
- Yun Wu
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74, Zhongshan 2nd Road, Guangzhou 510030, China
| | - Sihui Jin
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74, Zhongshan 2nd Road, Guangzhou 510030, China
| | - Jianwei Guo
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74, Zhongshan 2nd Road, Guangzhou 510030, China
| | - Yi Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, Huazhong University of Science and Technology, 1037 Luoyu Road, Hongshan District, Wuhan 430074, China
| | - Lijin Chen
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74, Zhongshan 2nd Road, Guangzhou 510030, China
| | - Yixiang Huang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74, Zhongshan 2nd Road, Guangzhou 510030, China
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164
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Cushnie D, Soroceanu A, Stratton A, Dea N, Finkelstein J, Bailey CS, Weber MH, Paquet J, Glennie A, Hall H, Rampersaud R, Ahn H, Kelly A, Christie S, Nataraj A, Johnson M, Abraham E, Attabib N, Fisher C, Manson N, Thomas K. Outcome of spine surgery in patients with depressed mental states: a Canadian spine outcome research network study. Spine J 2022; 22:1700-1707. [PMID: 35671946 DOI: 10.1016/j.spinee.2022.05.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Depression is higher among spine patients than among the general population. Some small studies, but not others, have suggested that depression may be a predictor of worse outcome after surgery. PURPOSE Determination whether there is an association between depression and worse response to surgery among spine patients. STUDY DESIGN/SETTING The national, prospective, Canadian Spine Outcome Research Network (CSORN) surgical outcome registry. PATIENT SAMPLE All patients in the CSORN registry who received surgery for thoracic or lumbar degenerative deformity, stenosis, spondylolisthesis, disc disease, or disc herniation with a minimum of 12 months follow-up postoperation (n = 2310). OUTCOME MEASURES Oswestry Disability Index (ODI), SF12 Physical Component Score (PCS), European Quality of Life (EuroQoL), and pain scales. METHODS Change in preoperative to 12-month postoperative ODI, and secondary measures, were compared to assess if there was an association between preoperative depression, as measured by PHQ9, and smaller response to surgery. Multivariate regression analysis was used to search for preoperative factors which might interact with PHQ9 to predict ODI outcome. RESULTS Patients with PHQ9<5, associated with minimal to no depression, had the smallest ODI improvement (-16.8 [95%CI -18.1 to -15.3]) and patients with severe preoperative depression (PHQ9 ≥ 10) had the largest ODI improvement (-22.8 [95%CI -24.1 to -21.5]; p<.00001). Similar findings were found in the EQ5D and PCS. Pain improvement was not different between depression levels. Multivariate modeling found worse baseline PHQ9 and ODI, greater age, nicotine use, more operative levels, and worse American Society of Anesthesiology score was predictive of worse ODI outcomes. CONCLUSIONS Depressed patients have similar or better relative improvements in disability, quality of life, and pain, when compared to nondepressed patients, although their preoperative and postoperative levels of disability are higher. Surgeons should not be concerned that depression will reduce the patient-reported beneficial response to surgical intervention.
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Affiliation(s)
| | | | | | - Nicolas Dea
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | | | | | | | | | | | - Henry Ahn
- University of Toronto, Toronto, Ontario, Canada
| | - Adrienne Kelly
- Northern Ontario School of Medicine, Sault Ste. Marie, Ontario, Canada
| | | | | | | | - Ed Abraham
- Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Charles Fisher
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Neil Manson
- Dalhousie University, Halifax, Nova Scotia, Canada
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165
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Wang Y, Jiang G, Wang L, Chen M, Yang K, Wen K, Lan Y, Hou N, Li W. Association of the depressive scores, depressive symptoms, and conversion patterns of depressive symptoms with the risk of new-onset chronic diseases and multimorbidity in the middle-aged and elderly Chinese population. EClinicalMedicine 2022; 52:101603. [PMID: 35958523 PMCID: PMC9358433 DOI: 10.1016/j.eclinm.2022.101603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 07/16/2022] [Accepted: 07/19/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The relationship between depressive symptoms (DS) and their conversion patterns over time and the new-onset risk of diseases in the middle-aged and elderly population has not been extensively studied. METHODS Based on The China Health and Retirement Longitudinal Study participants in 2013, we established 13 cohorts involving 12 types of chronic diseases and multimorbidity, who were identified by face-to-face questionnaires. We retrospectively assessed their DS during 2011 and 2013 through the 10-item Center for Epidemiological Studies Depression Scale (CES-D), which were classified into never, newly developed, relieved, and persistent DS, and these participants were followed from 2013 to 2018. FINDINGS CES-D scores were new-onset risk factors for 9 diseases. The new-onset risk of diseases increased with higher CES-D scores. When CES-D scores were higher than approximately 6, the hazard ratios (HRs) of emergent diseases were greater than 1. DS was independent new-onset risk factors for 8 diseases, with HRs (95% CI) ranging from 1.2635 (1.0061-1.5867) to 1.5231 (1.0717-2.165). Persistent DS was an independent risk factor for most diseases but might be an independent protective factor for new-onset cancer (HR, 95% CI: 0.276, 0.106-0.723). INTERPRETATION DS is closely associated with new-onset risk of chronic diseases and multimorbidity, and awareness of the risk associated with pre-DS status (6<CES-D<12) should be raised. chronic disease risks were almost lower with newly developed and relieved DS than with persistent DS, suggesting the potential benefits of active management of DS to reduce the risk of emergent diseases in middle-aged and elderly population. FUNDING National Natural Science Foundation of China.
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Affiliation(s)
- Yaoling Wang
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science &Technology, Wuhan, China
| | - Gege Jiang
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science &Technology, Wuhan, China
| | - Liping Wang
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science &Technology, Wuhan, China
| | - Minfang Chen
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science &Technology, Wuhan, China
| | - Kang Yang
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science &Technology, Wuhan, China
| | - Kai Wen
- School of Software & Microelectronics, Peking University, Beijing, China
| | - Yujie Lan
- School of Accountancy, Shanghai University of Finance and Economic, China
| | - Niuniu Hou
- Department of Thyroid, Breast and Vascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
- Department of General Surgery, Eastern Theater Air Force Hospital of PLA, Nanjing, China
- Corresponding author at: Department of Thyroid, Breast and Vascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China. Department of General Surgery, Eastern Theater Air Force Hospital of PLA, Nanjing, China.
| | - Wei Li
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science &Technology, Wuhan, China
- Corresponding author at: Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No 1277, Jiefang Avenue, Wuhan 430022, Hubei Province, China.
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166
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Castro-de-Araujo LFS, Rodrigues EDS, Machado DB, Henriques CMP, Verotti MP, Gonçalves AQ, Duarte-Salles T, Kanaan RA, Barreto ML, Lewis G, Barbosa JR. Multimorbidity worsened anxiety and depression symptoms during the COVID-19 pandemic in Brazil. J Affect Disord 2022; 314:86-93. [PMID: 35810830 PMCID: PMC9259509 DOI: 10.1016/j.jad.2022.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 05/16/2022] [Accepted: 07/03/2022] [Indexed: 11/24/2022]
Abstract
Multimorbidity is a global health issue impacting the quality of life of all ages. Multimorbidity with a mental disorder is little studied and is likely to have been affected by the COVID-19 pandemic. We used a survey of 14,007 respondents living in Brazil to investigate whether people who already had at least one chronic medical condition had more depression and anxiety symptoms during social distancing in 2020. Generalized linear models and structural equation modelling were used to estimate the effects. A 19 % and 15 % increase in depressive symptoms were found in females and males, respectively, for each unit of increase in the observed value of reported chronic disease. Older subjects presented fewer symptoms of depression and anxiety. There was a 16 % increase in anxiety symptoms in females for each unit increase in the reported chronic disease variable and a 14 % increase in males. Younger subjects were more affected by anxiety symptoms in a dose-response fashion. High income was significantly related to fewer depressive and anxiety symptoms in both males and females. Physical activity was significantly associated with fewer anxiety and depression symptoms. Structural equation modelling confirmed these results and provided further insight into the hypothesised paths.
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Affiliation(s)
- Luis Fernando Silva Castro-de-Araujo
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Salvador, Brazil; Dept of Psychiatry, The University of Melbourne, Austin Health, Victoria, Australia.
| | - Elisângela da Silva Rodrigues
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Salvador, Brazil; Federal University of Ceará, Campus Jardins de Anita, Itapajé, Ceará, Brazil.
| | - Daiane Borges Machado
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Salvador, Brazil; Harvard Medical School, Department Global Health and Social Medicine, United States of America.
| | | | | | - Alessandra Queiroga Gonçalves
- Unitat de Suport a la Recerca Terres de l'Ebre, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Tortosa, Catalunya, Spain; Unitat Docent de Medicina de Família i Comunitària Tortosa-Terres de L'Ebre, Institut Català de la Salut, Tortosa, Catalunya, Spain.
| | - Talita Duarte-Salles
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.
| | - Richard A Kanaan
- Dept of Psychiatry, The University of Melbourne, Austin Health, Victoria, Australia
| | - Mauricio Lima Barreto
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Salvador, Brazil
| | - Glyn Lewis
- Division of Psychiatry, UCL, London, United Kingdom of Great Britain and Northern Ireland
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167
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Pedrosa B, Neto M, Namorado S, Leite A. Depression and multimorbidity - Results from a nationwide study. THE EUROPEAN JOURNAL OF PSYCHIATRY 2022. [DOI: 10.1016/j.ejpsy.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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168
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Targeting NMDA Receptors in Emotional Disorders: Their Role in Neuroprotection. Brain Sci 2022; 12:brainsci12101329. [PMID: 36291261 PMCID: PMC9599159 DOI: 10.3390/brainsci12101329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/28/2022] [Accepted: 09/28/2022] [Indexed: 12/03/2022] Open
Abstract
Excitatory glutamatergic neurotransmission mediated through N-methyl-D-Aspartate (NMDA) receptors (NMDARs) is essential for synaptic plasticity and neuronal survival. While under pathological states, abnormal NMDAR activation is involved in the occurrence and development of psychiatric disorders, which suggests a directional modulation of NMDAR activity that contributes to the remission and treatment of psychiatric disorders. This review thus focuses on the involvement of NMDARs in the pathophysiological processes of psychiatric mood disorders and analyzes the neuroprotective mechanisms of NMDARs. Firstly, we introduce NMDAR-mediated neural signaling pathways in brain function and mood regulation as well as the pathophysiological mechanisms of NMDARs in emotion-related mental disorders such as anxiety and depression. Then, we provide an in-depth summary of current NMDAR modulators that have the potential to be developed into clinical drugs and their pharmacological research achievements in the treatment of anxiety and depression. Based on these findings, drug-targeting for NMDARs might open up novel territory for the development of therapeutic agents for refractory anxiety and depression.
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169
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Castro-de-Araujo LFS, Cortes F, de Siqueira Filha NT, Rodrigues EDS, Machado DB, de Araujo JAP, Lewis G, Denaxas S, Barreto ML. Patterns of multimorbidity and some psychiatric disorders: A systematic review of the literature. Front Psychol 2022; 13:940978. [PMID: 36186392 PMCID: PMC9524392 DOI: 10.3389/fpsyg.2022.940978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/26/2022] [Indexed: 11/25/2022] Open
Abstract
Objective The presence of two or more chronic diseases results in worse clinical outcomes than expected by a simple combination of diseases. This synergistic effect is expected to be higher when combined with some conditions, depending on the number and severity of diseases. Multimorbidity is a relatively new term, with the first fundamental definitions appearing in 2015. Studies usually define it as the presence of at least two chronic medical illnesses. However, little is known regarding the relationship between mental disorders and other non-psychiatric chronic diseases. This review aims at investigating the association between some mental disorders and non-psychiatric diseases, and their pattern of association. Methods We performed a systematic approach to selecting papers that studied relationships between chronic conditions that included one mental disorder from 2015 to 2021. These were processed using Covidence, including quality assessment. Results This resulted in the inclusion of 26 papers in this study. It was found that there are strong associations between depression, psychosis, and multimorbidity, but recent studies that evaluated patterns of association of diseases (usually using clustering methods) had heterogeneous results. Quality assessment of the papers generally revealed low quality among the included studies. Conclusions There is evidence of an association between depressive disorders, anxiety disorders, and psychosis with multimorbidity. Studies that tried to examine the patterns of association between diseases did not find stable results. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021216101, identifier: CRD42021216101.
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Affiliation(s)
- Luis Fernando Silva Castro-de-Araujo
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Bahia, Brazil
- Department of Psychiatry, Austin Health, The University of Melbourne, Parkville, VIC, Australia
| | - Fanny Cortes
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Bahia, Brazil
| | - Noêmia Teixeira de Siqueira Filha
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Bahia, Brazil
- Department of Health Sciences, University of York, York, United Kingdom
| | - Elisângela da Silva Rodrigues
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Bahia, Brazil
- Federal University of Ceará, Ceará, Brazil
| | - Daiane Borges Machado
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Bahia, Brazil
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States
| | - Jacyra Azevedo Paiva de Araujo
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Bahia, Brazil
- *Correspondence: Jacyra Azevedo Paiva de Araujo
| | - Glyn Lewis
- Division of Psychiatry, University College London, London, United Kingdom
| | - Spiros Denaxas
- Institute of Health Informatics, University College London, London, United Kingdom
| | - Mauricio L. Barreto
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, Bahia, Brazil
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170
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Severe psychiatric disorders and general medical comorbidities: inflammation-related mechanisms and therapeutic opportunities. Clin Sci (Lond) 2022; 136:1257-1280. [PMID: 36062418 DOI: 10.1042/cs20211106] [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: 04/11/2022] [Revised: 08/16/2022] [Accepted: 08/22/2022] [Indexed: 11/17/2022]
Abstract
Individuals with severe psychiatric disorders, such as mood disorders and schizophrenia, are at increased risk of developing other medical conditions, especially cardiovascular and metabolic diseases. These medical conditions are underdiagnosed and undertreated in these patients contributing to their increased morbidity and mortality. The basis for this increased comorbidity is not well understood, possibly reflecting shared risks factors (e.g. lifestyle risk factors), shared biological mechanisms and/or reciprocal interactions. Among overlapping pathophysiological mechanisms, inflammation and related factors, such as dysbiosis and insulin resistance, stand out. Besides underlying the association between psychiatric disorders and cardiometabolic diseases, these mechanisms provide several potential therapeutic targets.
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171
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An association between multi-morbidity and depressive symptoms among Indian adults based on propensity score matching. Sci Rep 2022; 12:15518. [PMID: 36109532 PMCID: PMC9478135 DOI: 10.1038/s41598-022-18525-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 08/16/2022] [Indexed: 11/09/2022] Open
Abstract
AbstractKeeping in view the cascade of disturbances caused by the co-existence of multi-morbidity and depression among aged population, this study aims to ascertain the independent impact of multi-morbidity as a risk factor for the development of depressive symptoms among adults living in India. The present study utilizes data from the nationally representative survey “Longitudinal Ageing Study in India” (LASI, Wave-1, 2017–2018). The eligible sample size was 62,244 adults aged 45 years and above. Descriptive statistics along with bivariate analysis was used to understand the prevalence of depressive symptoms. Further, binary logistic regression and Propensity Score Matching (PSM) methods were applied to examine the independent effect of multi-morbidity on depressive symptoms while controlling the selected background characteristics. Overall, around one-third respondents had at least one chronic disease and one-fifth had multi-morbidity. The most prevalent chronic disease reported in the sampled population was hypertension followed by diabetes and joint disease. It is observed that older adults with multiple chronic diseases had 77% higher odds of having depressive symptoms as compared to those without a history of chronic disease in the multivariable logistic regression model. Results obtained from PSM indicate that the risk of having depressive symptoms was 3.7% higher for adults with multi- morbidity. Depressive symptom was identified to be associated with a wider range of multiple physical health problems and people with multi-morbidity are at a higher risk of having depressive symptoms. It is imperative that multi-morbidity can be used as a screener for identifying people with depressive symptoms.
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172
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Smith L, Shin JI, Haro JM, Jacob L, López Sánchez GF, Tully MA, Oh H, Carvalho AF, Barnett Y, Butler L, Koyanagi A. Physical multimorbidity and wish to die among adults aged ≥65 years: A cross-sectional analysis of the Irish Longitudinal Study on Ageing. J Affect Disord 2022; 313:263-269. [PMID: 35764230 DOI: 10.1016/j.jad.2022.06.063] [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: 02/09/2022] [Revised: 05/21/2022] [Accepted: 06/22/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Physical multimorbidity (i.e., ≥2 chronic conditions) may induce feelings of wish to die (WTD), but there is limited literature on this topic, while the mediators in this association are largely unknown. Thus, the aim of the present study was to investigate this association and its mediators among older Irish adults. METHODS Cross-sectional, nationally representative data from Wave 1 of the Irish Longitudinal Study on Ageing 2009-2011 were analyzed. Information on self-reported lifetime diagnosis of 14 chronic physical conditions were obtained. WTD was defined as answering affirmatively to the question "In the last month, have you felt that you would rather be dead?" Multivariable logistic regression and mediation analyses were conducted. RESULTS Data on 2941 adults aged ≥65 years [mean (SD) age 73.2 (5.2) years; 45.0 % males] were analyzed. Physical multimorbidity was associated with 3.39 (95%CI 1.58, 7.28) times higher odds for WTD. This association was largely explained by pain (% mediated 28.1 %), followed by depression (19.4 %), sleep problems (18.4 %), perceived stress (13.0 %), loneliness (10.4 %), anxiety (8.1 %), and disability (7.2 %). CONCLUSIONS Multimorbidity was associated with increased odds for WTD among Irish older adults. Addressing the identified mediators may contribute to reducing feelings of WTD among older adults with multimorbidity.
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Affiliation(s)
- Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Yonsei-ro 50, Seodaemun-gu, 8044, 120-752 Seoul, Seoul, Republic of Korea
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, 08830 Barcelona, Spain
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, 08830 Barcelona, Spain; Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain.
| | - Mark A Tully
- School of Health Sciences, Institute of Mental Health Sciences, Ulster University, Newtownabbey BT15 1ED, Newtownabbey, UK
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA 90007, USA
| | - Andre F Carvalho
- IMPACT (Innovation in Mental and Physical Health and Clinical Treatment) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, 3220, Australia
| | - Yvonne Barnett
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Laurie Butler
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, 08830 Barcelona, Spain; ICREA, Pg. Lluis Companys 23, 08010 Barcelona, Spain
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173
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Sun Y, Ji M, Zhang X, Chen J, Wang Y, Wang Z. Comparative effectiveness and acceptability of different ACT delivery formats to treat depression: A systematic review and network meta-analysis of randomized controlled trials. J Affect Disord 2022; 313:196-203. [PMID: 35764229 DOI: 10.1016/j.jad.2022.06.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 05/24/2022] [Accepted: 06/16/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Acceptance and Commitment Therapy (ACT) has been shown to be effective in the treatment of acute depression. However, whether ACT can be effectively delivered in individual, group, internet, and combined delivery format remain unclear. We aimed to examine the most effective delivery format for ACT via a network meta-analysis (NMA). METHODS An electronic literature search was conducted by two reviewers in the Pubmed, Cochrane library, Embase, PsycINFO, CINAHL, CNKI, Wangfang databases to identify relevant studies that were published up to March 21th, 2021. We conducted pairwise and NMA to evaluate the relative effectiveness and rank the probability of different ACT delivery formats. A series of analyses and assessments, such as the risk of bias, and GRADE were performed concurrently. RESULTS A total of 23 studies were included in our analysis based on a series of rigorous screenings, which comprised 690 depressed patients. The effectiveness of individual, group, internet, and combine ACT did not differ statistically significantly from each other. Compared with control group, individual delivery format (standardized mean difference [SMD] = -1.44, confidence interval (CI) = -2.11 to -0.76 GRADE low), group delivery format (SMD = -1.34, 95 % CI = -1.91 to -0.78 GRADE moderate), and internet delivery format (SMD = -0.66, 95 % CI = -1.25 to -0.06 GRADE low) showed the largest improvement on depressive symptoms, whereas the combined group and individual ACT was less effective. In terms of acceptability (dropout for any reason), all delivery formats did not differ statistically significantly from each other. CONCLUSIONS For depression symptoms, individual, group, and internet treatment formats appeared to be effective interventions. Applying effective and acceptable ACT in a range of different formats will make ACT easier to implement, disseminate, and deliver across different settings and diverse patient populations. More research is needed to verify the ACT in telephone and combined formats for the management of depression.
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Affiliation(s)
- Yue Sun
- School of Nursing, Peking University, Beijing, China
| | - Mengmeng Ji
- School of Nursing, Peking University, Beijing, China
| | - Xuer Zhang
- Department of Epidemiology, School of Public Health, Johns Hopkins University, United States
| | - Ji Chen
- Mianyang Hospital of Traditional Chinese Medicine, Mianyang Attachen Hospital of Chengdu University of Traditional Chinese Medicine, China
| | | | - Zhiwen Wang
- School of Nursing, Peking University, Beijing, China.
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Hvidberg MF, Frølich A, Lundstrøm SL, Kamstrup-Larsen N. Catalogue of multimorbidity mean based severity and associational prevalence rates between 199+ chronic conditions-A nationwide register-based population study. PLoS One 2022; 17:e0273850. [PMID: 36103504 PMCID: PMC9473636 DOI: 10.1371/journal.pone.0273850] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 08/16/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Real-world data on multimorbidity represents an important but underutilised source of evidence for the planning of healthcare services, including prevention, treatments, and health economic modelling. AIMS This study aimed to estimate means of multimorbidity and provide associated prevalence rates and frequencies between 199 x 199 chronic conditions and disease groups based on the total adult Danish population and sex, age, and educational attainment. Thus, this study provides an off-the-shelf catalogue for use in treatments and planning by clinicians, decision-makers and researchers. METHODS The study population contained all Danish residents above 16 years on 1 January 2013 (n = 4,555,439). The data was based on the linkage of six national registers covering hospital contacts, services in general practice, filled-in out-of-hospital prescriptions, and educational attainments. The health registers were used to identify the 199 chronic conditions based on the ICD-10 classification system. RESULTS The mean number of chronic conditions (NCC) was 2.2. The mean increased with age, women had a higher mean than men, and there was a social gradient with the mean increasing with lower educational attainment. The mean NCC varied from 3.3-9.8 among all conditions. Across disease groups, the highest mean NCC were found within disease group N (chronic renal failure, mean = 8.8), D (in situ and benign neoplasms; mean = 6.5), K (diseases of the digestive system; mean = 5.7), and H (diseases of the eye and the ear; mean = 5.6). The highest mean NCC among the 29 common diseases was heart failure, ischemic heart diseases, angina pectoris, stroke, and dementia, with a mean above 6.5. Several prevalent conditions like hypertension, arthritis, chronic lower respiratory diseases, depression, type 2 diabetes, and overweight transcended other conditions regarding the associated prevalence rates. As one of the most frequent, hypertensive diseases were highly associated with arthritis (50.4%), depression (37.4%), type 2 diabetes (75.4%), cancers (49.7%), and being overweight (39.7%)-meaning that 50.4% of people with arthritis, 37.4% of people with depression and so on also had hypertensive diseases. The largest differences in means between individuals with no educational attainment and individuals with high educational attainment were found within disease groups J (diseases of the respiratory system, ratio = 1.8), Q (congenital malformations, deformations, and chromosomal abnormalities, ratio = 1.7), and B (viral hepatitis and human immunodeficiency virus disease, ratio = 1.7). CONCLUSIONS The current study provides a nationwide off-the-shelf catalogue of multimorbidity means and real-world associations estimates of 199+ chronic conditions for future clinical treatments and health care systems planning. The findings described are just one example of numerous results and underline that multimorbidity is highly prevalent in the adult Danish population and that it is a vital condition transcending all future medical treatment. The data offer essential information on the multimorbidity burden of disease in future differentiated treatments, healthcare planning, and economic, aetiological, and other research.
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Affiliation(s)
- Michael Falk Hvidberg
- Innovation and Research Center for Multimorbidity, Slagelse Hospital, Slagelse, Denmark
- University of York, York, United Kingdom
| | - Anne Frølich
- Innovation and Research Center for Multimorbidity, Slagelse Hospital, Slagelse, Denmark
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, København, Denmark
| | - Sanne Lykke Lundstrøm
- Innovation and Research Center for Multimorbidity, Slagelse Hospital, Slagelse, Denmark
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region of Denmark, København, Denmark
| | - Nina Kamstrup-Larsen
- Innovation and Research Center for Multimorbidity, Slagelse Hospital, Slagelse, Denmark
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, København, Denmark
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Xiao S, Shi L, Dong F, Zheng X, Xue Y, Zhang J, Xue B, Lin H, Ouyang P, Zhang C. The impact of chronic diseases on psychological distress among the older adults: the mediating and moderating role of activities of daily living and perceived social support. Aging Ment Health 2022; 26:1798-1804. [PMID: 34238092 DOI: 10.1080/13607863.2021.1947965] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Previous literature has shown that chronic diseases and psychological distress are correlated. However, the mediating and moderating mechanisms underlying this relationship have not been sufficiently studied. The purpose of this study was to explore the role played by activities of daily living (ADL) and perceived social support. METHOD Face-to-face questionnaire-based surveys were conducted with 3250 valid participants (age ≥60 years). Participants were assessed using the Barthel Index, Perceived Social Support Scale, and Depression Anxiety Stress Scale-21. RESULTS 1) Chronic diseases had a significant direct effect on psychological distress in older adults; 2) the relationship between chronic diseases and psychological distress was partially mediated by ADL; and 3) the impact of chronic diseases on psychological distress was significantly moderated by perceived social support. More importantly, perceived social support was a protective factor that could effectively alleviate the adverse effects of chronic diseases on psychological distress. CONCLUSION The results add to the existing literature by uncovering the underlying mechanisms between chronic diseases and mental health. These findings have implications for early intervention and prevention of mental health problems in older adults.
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Affiliation(s)
- Shujuan Xiao
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Lei Shi
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Fang Dong
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiao Zheng
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Yaqing Xue
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Jiachi Zhang
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Benli Xue
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Huang Lin
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Ping Ouyang
- Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Chichen Zhang
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China.,Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,Institute of Health Management, Southern Medical University, Guangzhou, Guangdong, China
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Honda Y, Nakamura M, Aoki T, Ojima T. Multimorbidity patterns and the relation to self-rated health among older Japanese people: a nationwide cross-sectional study. BMJ Open 2022; 12:e063729. [PMID: 36538382 PMCID: PMC9438194 DOI: 10.1136/bmjopen-2022-063729] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Classifying individuals into multimorbidity patterns can be useful to identify the target population with poorer clinical outcomes. Self-rated health (SRH) is one of the core outcomes in multimorbidity patients. Although studies have reported that multimorbidity is associated with poor SRH, whether certain patterns have stronger associations remains unknown. Therefore, this study aimed to identify the prevalence and patterns of multimorbidity and investigate the association between multimorbidity patterns and SRH in an older Japanese population. DESIGN Cross-sectional study. SETTING Data were obtained from the 2013 Comprehensive Survey of Living Conditions, a nationally representative survey of the general Japanese population. PARTICIPANTS This study mainly examined 23 730 participants aged ≥65 years who were not hospitalised or institutionalised. PRIMARY OUTCOME MEASURE Poor SRH was defined as choosing 'not very good' or 'bad' from five options: 'excellent', 'fairly good', 'average', 'not very good' and 'bad'. RESULTS The prevalence of multimorbidity was 40.9% and that of poor SRH was 23.8%. Three multimorbidity patterns were identified by exploratory factor analysis: (1) degenerative/mental health, (3) malignant/digestive/urological/haematological and (3) cardiovascular/metabolic. Multivariable modified Poisson regression analysis revealed that high malignant/digestive/urological/haematological, degenerative/mental health and cardiovascular/metabolic pattern scores, corresponding to the number of affected body systems in each pattern, were significantly associated with poor SRH (adjusted risk ratio (aRR)=1.68, 95% CI: 1.60 to 1.76; aRR=1.63, 95% CI: 1.58 to 1.69; and aRR=1.31, 95% CI: 1.26 to 1.36, respectively). When including the Kessler 6 score, a screening scale for psychological distress, in the analysis, the association between each multimorbidity pattern score and poor SRH decreased. CONCLUSIONS Malignant/digestive/urological/haematological and degenerative/mental health patterns may be associated with a high risk for poor SRH. Further research should focus on interventions to improve SRH in multimorbidity patients.
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Affiliation(s)
- Yuki Honda
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
- Department of General Internal Medicine, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | - Mieko Nakamura
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Takuya Aoki
- Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, Minato-ku, Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
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177
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King O, Ingwersen K, Bufton B, Hitch D, Dupre B, Harding M, Mayhew C, van de Ven S. 'Are we opening a can of worms?': Community-based occupational therapists' experiences working with clients with unexpected mental health issues. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e2638-e2647. [PMID: 35953897 DOI: 10.1111/hsc.13707] [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: 06/24/2021] [Revised: 11/05/2021] [Accepted: 12/23/2021] [Indexed: 06/15/2023]
Abstract
General community occupational therapists (OTs) work with clients experiencing chronic and complex conditions, some living with one or more comorbid common mental health issues (such as anxiety, depression or distress). This study aimed to describe the perspectives of general community OTs of their engagement with clients experiencing mental health issues; their perceptions of the implementation of routine screening in their practice, and the knowledge, skills and support they need to identify and support their clients' mental health needs. Six focus groups were undertaken with general community OTs (n = 21) from three Australian health services in rural, regional and metropolitan settings, between December 2020 and January 2021. Data were analysed using a team-based framework approach. Three key themes were identified: (1) OTs' experiences working with people with mental health issues; (2) impacts of engaging with clients experiencing mental health issues on OTs; and (3) implementing routine mental health screening in general community OT practice. The latter had two sub-themes: (i) identified considerations and (ii) education and system-level support needs. General community OTs frequently work with clients with mental health issues. These experiences impact their practice in multiple ways. This study highlights opportunities for integrating routine mental health screening into general community OT practice and identifies the system and educational development required to support this enhancement to practice. Supporting general community OTs to routinely screen for mental health issues will enhance collaborative client-centred care. Our findings may also have implications for other community-based health professionals and services, particularly those delivered in clients' homes.
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Affiliation(s)
- Olivia King
- University Hospital Geelong, Geelong, Australia
- South West Healthcare, Warrnambool, Australia
- Monash University, Melbourne, Australia
| | - Kate Ingwersen
- University Hospital Geelong, Geelong, Australia
- Deakin University, Geelong, Australia
| | - Brooke Bufton
- University Hospital Geelong, Geelong, Australia
- Deakin University, Geelong, Australia
| | - Danielle Hitch
- Deakin University, Geelong, Australia
- Western Heath, Melbourne, Australia
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Kubon J, Romagnano V, Sokolov AN, Fallgatter AJ, Braun C, Pavlova MA. Neural circuits underpinning face tuning in male depression. Cereb Cortex 2022; 33:3827-3839. [PMID: 35989312 DOI: 10.1093/cercor/bhac310] [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: 06/08/2022] [Revised: 07/15/2022] [Accepted: 07/15/2022] [Indexed: 11/13/2022] Open
Abstract
Reading bodies and faces is essential for efficient social interactions, though it may be thought-provoking for individuals with depression. Yet aberrations in the face sensitivity and underwriting neural circuits are not well understood, in particular, in male depression. Here, we use cutting-edge analyses of time course and dynamic topography of gamma oscillatory neuromagnetic cortical activity during administration of a task with Arcimboldo-like images. No difference in face tuning was found between individuals with depression and their neurotypical peers. Furthermore, this behavioral outcome nicely dovetails with magnetoencephalographic data: at early processing stages, the gamma oscillatory response to images resembling a face was rather similar in patients and controls. These bursts originated primarily from the right medioventral occipital cortex and lateral occipital cortex. At later processing stages, however, its topography altered remarkably in depression with profound engagement of the frontal circuits. Yet the primary difference in depressive individuals as compared with their neurotypical peers occurred over the left middle temporal cortices, a part of the social brain, engaged in feature integration and meaning retrieval. The outcome suggests compensatory recruitment of neural resources in male depression.
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Affiliation(s)
- Julian Kubon
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), Medical School and University Hospital, Eberhard Karls University of Tübingen, Calwerstr. 14, 72076 Tübingen, Germany
| | - Valentina Romagnano
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), Medical School and University Hospital, Eberhard Karls University of Tübingen, Calwerstr. 14, 72076 Tübingen, Germany
| | - Alexander N Sokolov
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), Medical School and University Hospital, Eberhard Karls University of Tübingen, Calwerstr. 14, 72076 Tübingen, Germany
| | - Andreas J Fallgatter
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), Medical School and University Hospital, Eberhard Karls University of Tübingen, Calwerstr. 14, 72076 Tübingen, Germany
| | - Christoph Braun
- MEG Center, Medical School and University Hospital, Eberhard Karls University of Tübingen, Otfried Müller Str. 47, 72076 Tübingen, Germany
| | - Marina A Pavlova
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), Medical School and University Hospital, Eberhard Karls University of Tübingen, Calwerstr. 14, 72076 Tübingen, Germany
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179
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Yang CM, Sung FC, Mou CH, Liao CH, Wang PH, Shieh SH. Anxiety and depression risk in Taiwan women with breast cancer and cervical cancer. Front Oncol 2022; 12:946029. [PMID: 36059620 PMCID: PMC9437326 DOI: 10.3389/fonc.2022.946029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 07/13/2022] [Indexed: 12/24/2022] Open
Abstract
Background Studies comparing mental disorder risks between women with breast cancer and cervical cancer are lacking. This study compared risks of developing anxiety and depression between women with breast cancer (BC cohort) and women with cervical cancer (CC cohort) using insurance claims data of Taiwan. Methods From the 2000 to 2016 data, we identified a BC cohort and BC controls (N = 96,862) and a CC cohort and CC controls (N = 26,703), matched by propensity scores. Incident mental disorders and the Cox method estimated the related cancer cohort to control cohort hazard ratios (HRs), and 95% confidence intervals (CIs) were estimated by the end of 2016. Results Compared to the CC cohort, the BC cohort had slightly higher incident anxiety (15.9 versus 15.5 per 1,000 person-years) and depression (6.92 vs. 6.28 per 1,000 person-years). These mental disorders were higher in respective cancer cohorts than controls. The BC cohort to BC control adjusted HRs of anxiety and depression were 1.29 (95% CI = 1.25-1.33) and 1.78 (95% CI = 1.69-1.87), respectively. The corresponding adjusted HRs for the CC cohort were 1.12 (95% CI = 1.06-1.18) and 1.29 (95% CI = 1.18-1.41). The combined incidence rates of both disorders were 1.4-fold greater in the BC cohort than in BC controls (22.8 vs. 15.8 per 1,000 person-years), and 1.2-fold greater in the CC cohort than in the CC controls (21.7 vs. 18.3 per 1,000 person-years). Conclusion Women with breast cancer or cervical cancer are at an elevated likelihood of developing anxiety and depression disorders. These incident disorders are slightly higher in those with breast cancer.
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Affiliation(s)
- Chiu-Ming Yang
- Department of Health Services Administration, China Medical University College of Public Health, Taichung, Taiwan
- Department of Public Health, China Medical University College of Public Health, Taichung, Taiwan
| | - Fung-Chang Sung
- Department of Health Services Administration, China Medical University College of Public Health, Taichung, Taiwan
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- Department of Food Nutrition and Health Biotechnology, Asia University, Taichung, Taiwan
| | - Chih-Hsin Mou
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Chun-Hui Liao
- Department of Psychiatry, China Medical University College of Medicine, Taichung, Taiwan
| | - Po-Hui Wang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Shwn-Huey Shieh
- Department of Health Services Administration, China Medical University College of Public Health, Taichung, Taiwan
- Department of Nursing, China Medical University Hospital, Taichung, Taiwan
- Department of Nursing, Asia University, Taichung, Taiwan
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Modifiable and Non-modifiable Factors Associated with Low Awareness of Hypertension Treatment in Indonesia: A Cross-Sectional Population-Based National Survey. Glob Heart 2022; 17:56. [PMID: 36051316 PMCID: PMC9389957 DOI: 10.5334/gh.1143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/26/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction: Low awareness about hypertension treatment is recognized as a significant cause of treatment failure. Therefore, identifying its underlying factors is essential for developing effective intervention strategies. This study aims to identify the modifiable and non-modifiable factors associated with low awareness about hypertension treatment. Method: This national, cross-sectional, population-based survey used publicly available data from the Indonesian Family Life Survey (IFLS-5) for 2014 among respondents with hypertension aged ≥15 years. Depression and insomnia, as modifiable factors, were assessed using the Centre for Epidemiologic Studies—Depression (CES-D) and the Patient-Recorded Outcomes Measurement Information System (PROMIS) questionnaire, respectively. Non-modifiable factors, such as sociodemographic information, were obtained from self-reported data. Logistic regression analysis was used to assess the association between these factors and low awareness about hypertension treatment. Odds ratios (ORs) with 95% confidence intervals (CIs) were reported. Result: The study recruited 7,920 respondents, the majority of whom were female (53.8%) and aged <60 years (71.1%). The prevalence of low awareness of hypertension treatment was 87.1% (51.8% in women and 48.2% in men). Being an elderly (OR: 1.60, 95%CI 1.36–1.88), being irregularly blood pressure control (OR: 4.40, 95% CI 3.78–5.13), having depressive symptoms (OR: 1.35, 95% CI 1.12–1.62), having insomnia (OR: 1.31, 95% CI 1.11–1.53), and having low satisfaction with health care (OR: 1.28, 95% CI 1.08–1.51) were associated with low awareness of hypertension treatment. Surprisingly, respondents with strong religiosity (OR: 1.62; 95% CI 1.25–2.09) were more likely to display low awareness of hypertension treatment. Conclusion: The main factors associated with low awareness of hypertension treatment are modifiable. Thus, health care professionals should integrate more patient-specific factors when designing tailored interventions.
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McAiney C, Markle-Reid M, Ganann R, Whitmore C, Valaitis R, Urajnik DJ, Fisher K, Ploeg J, Petrie P, McMillan F, McElhaney JE. Implementation of the Community Assets Supporting Transitions (CAST) transitional care intervention for older adults with multimorbidity and depressive symptoms: A qualitative descriptive study. PLoS One 2022; 17:e0271500. [PMID: 35930542 PMCID: PMC9355229 DOI: 10.1371/journal.pone.0271500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 07/01/2022] [Indexed: 11/24/2022] Open
Abstract
Background Older adults with multimorbidity experience frequent care transitions, particularly from hospital to home, which are often poorly coordinated and fragmented. We conducted a pragmatic randomized controlled trial to test the implementation and effectiveness of Community Assets Supporting Transitions (CAST), an evidence-informed nurse-led intervention to support older adults with multimorbidity and depressive symptoms with the aim of improving health outcomes and enhancing transitions from hospital to home. This trial was conducted in three sites, representing suburban/rural and urban communities, within two health regions in Ontario, Canada. Purpose This paper reports on facilitators and barriers to implementing CAST. Methods Data collection and analysis were guided by the Consolidated Framework for Implementation Research framework. Data were collected through study documents and individual and group interviews conducted with Care Transition Coordinators and members from local Community Advisory Boards. Study documents included minutes of meetings with research team members, study partners, Community Advisory Boards, and Care Transition Coordinators. Data were analyzed using content analysis. Findings Intervention implementation was facilitated by: (a) engaging the community to gain buy-in and adapt CAST to the local community contest; (b) planning, training, and research meetings; (c) facilitating engagement, building relationships, and collaborating with local partners; (d) ensuring availability of support and resources for Care Transition Coordinators; and (e) tailoring of the intervention to individual client (i.e., older adult) needs and preferences. Implementation barriers included: (a) difficulties recruiting and retaining intervention staff; (b) difficulties engaging older adults in the intervention; (c) balancing tailoring the intervention with delivering the core intervention components; and (c) Care Transition Coordinators’ challenges in engaging providers within clients’ circles of care. Conclusion This research enhances our understanding of the importance of considering intervention characteristics, the context within which the intervention is being implemented, and the processes required for implementing transitional care intervention for complex older adults.
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Affiliation(s)
- Carrie McAiney
- School of Public Health Sciences, University of Waterloo and Schlegel-UW Research Institute for Aging, Waterloo, Ontario, Canada
- * E-mail:
| | - Maureen Markle-Reid
- Aging, Community and Health Research Unit, School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Rebecca Ganann
- Aging, Community and Health Research Unit, School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Carly Whitmore
- Aging, Community and Health Research Unit, School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Ruta Valaitis
- Aging, Community and Health Research Unit, School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Diana J. Urajnik
- Centre for Rural and Northern Health Research, Laurentian University, Sudbury, Ontario, Canada
| | - Kathryn Fisher
- Aging, Community and Health Research Unit, School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Jenny Ploeg
- Aging, Community and Health Research Unit, School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Penelope Petrie
- Aging, Community and Health Research Unit, School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Fran McMillan
- Centre for Rural and Northern Health Research, Laurentian University, Sudbury, Ontario, Canada
| | - Janet E. McElhaney
- Northern Ontario School of Medicine and Health Sciences North Research Institute, Sudbury, Ontario, Canada
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AlKhathami AD. An innovative 5-Step Patient Interview approach for integrating mental healthcare into primary care centre services: a validation study. Gen Psychiatr 2022; 35:e100693. [PMID: 36189183 PMCID: PMC9464802 DOI: 10.1136/gpsych-2021-100693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 07/17/2022] [Indexed: 11/17/2022] Open
Abstract
Background Mental health problems are prevalent among patients seeking primary healthcare. However, traditional patient interviews often fail to identify and manage these problems. Therefore, an improved patient interview process is needed to assess and treat mental health problems in primary care settings. Aims To assess the validity, reliability, sensitivity and specificity of a 5-Step Patient Interview approach for the screening, diagnosis and treatment of mental health problems. Design and setting This study compared a 5-Step Patient Interview approach (AlKhathami approach) with expert psychiatric interviews based on the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fifth edition, the Patient Health Questionnaire-9 (PHQ-9) and the Generalised Anxiety Disorder-7 (GAD-7) questionnaire from 1 January 2020 to 30 April 2020 in family practice or primary healthcare centres. Methods A total of 760 participants from five Saudi Arabian regions were selected using a multiclustered random sample of every third patient aged ≥18 years, drawn from the clinics’ patient list. Results A total of 732 patients agreed to participate, with a response rate of 96.3%; 396 (54.1%) were women; the mean (Standard Deviation) age was 41.28 (14.30) years (ranging from 18 to 84 years). Mental health problems were suspected in 40% of the participants. The 5-Step Patient Interview approach was shown to be comparable to an expert interview by a psychiatrist. Moreover, it was more accurate than the PHQ-9 and GAD-7 self-administered questionnaires in screening for stress and classifying it as mild, moderate to severe or severe. Additionally, the 5-Step Patient Interview approach improved physician-patient communication by encouraging the exploration of patients’ perspectives. Conclusions The 5-Step Patient Interview approach is a valid, reliable tool that can aid the integration of mental healthcare into primary healthcare and family practice. Future studies should evaluate the implementation outcomes of the 5-Step Patient Interview approach.
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Jaisoorya TS, Bhaskarapillai B, Manoj L, Sunil Kumar G, Gokul GR, Thennarasu K. Risk estimates of anxiety and depressive disorders among primary care patients with chronic medical illness - A Indian study. Asian J Psychiatr 2022; 74:103190. [PMID: 35772291 DOI: 10.1016/j.ajp.2022.103190] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/13/2022] [Accepted: 06/13/2022] [Indexed: 11/02/2022]
Abstract
Risk estimates of depression and anxiety disorders in primary care patients was studied in 7017 patients from 71 primary health centres in Kerala, India. When compared to those without, patients with a single chronic medical illness had approximately 3-4-fold higher rates of depression and anxiety disorders; this increases to 6-fold when the number of medical illnesses is two or more. Patients with hypertension, diabetes, epilepsy, tuberculosis, asthma, and arthritis had higher odds of depression after controlling for socio-demographic variables and co-occurring medical illnesses. The findings were replicated for anxiety disorders except for tuberculosis. Findings highlight the need for integrated interventions.
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Affiliation(s)
| | | | - L Manoj
- National Health Mission (Kerala), India.
| | | | - G R Gokul
- National Health Mission (Kerala), India.
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184
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Kabir A, Tran A, Ansari S, Conway DP, Barr M. Impact of multimorbidity and complex multimorbidity on mortality among older Australians aged 45 years and over: a large population-based record linkage study. BMJ Open 2022; 12:e060001. [PMID: 35882467 PMCID: PMC9330333 DOI: 10.1136/bmjopen-2021-060001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES Multimorbidity (MM, co-occurrence of two or more chronic conditions) and complex multimorbidity (CMM, three or more chronic conditions affecting three or more different body systems) are used in the assessment of complex healthcare needs and their impact on health outcomes. However, little is known about the impacts of MM and CMM on mortality in Australia. DESIGN Community-based prospective cohort study. SETTING New South Wales, Australia. PARTICIPANTS People aged 45 years and over who completed the baseline survey of the 45 and Up Study. MEASURES Baseline survey data from the 45 and Up Study were linked with deaths registry data. Deaths that occurred within 8 years from the baseline survey date were the study outcome. Eleven self-reported chronic conditions (cancer, heart disease, diabetes, stroke, Parkinson's disease, depression/anxiety, asthma, allergic rhinitis, hypertension, thrombosis and musculoskeletal conditions) from the baseline survey were included in the MM and CMM classifications. Cox proportional hazard models were used to estimate adjusted and unadjusted 8-year mortality hazard ratios (HRs). RESULTS Of 251 689 people (53% female and 54% aged ≥60 years) in the cohort, 111 084 (44.1%) were classified as having MM and 39 478 (15.7%) as having CMM. During the 8-year follow-up, there were 25 891 deaths. Cancer (34.7%) was the most prevalent chronic condition and the cardiovascular system (50.9%) was the body system most affected by a chronic condition. MM and CMM were associated with a 37% (adjusted HR 1.36, 95% CI 1.32 to 1.40) and a 22% (adjusted HR 1.22, 95% CI 1.18 to 1.25) increased risk of death, respectively. The relative impact of MM and CMM on mortality decreased as age increased. CONCLUSION MM and CMM were common in older Australian adults; and MM was a better predictor of all-cause mortality risk than CMM. Higher mortality risk in those aged 45-59 years indicates tailored, person-centred integrated care interventions and better access to holistic healthcare are needed for this age group.
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Affiliation(s)
- Alamgir Kabir
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia
| | - An Tran
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia
| | - Sameera Ansari
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia
| | - Damian P Conway
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
- Population and Community Health Directorate, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Margo Barr
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia
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185
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Eimontas J, Gegieckaitė G, Zamalijeva O, Pakalniškienė V. Unmet Healthcare Needs Predict Depression Symptoms among Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158892. [PMID: 35897261 PMCID: PMC9330083 DOI: 10.3390/ijerph19158892] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 07/09/2022] [Accepted: 07/19/2022] [Indexed: 02/04/2023]
Abstract
Risk factors for depression in older adults include significant interpersonal losses, increasing social isolation, and deteriorating physical abilities and health that require healthcare. The effects of unmet healthcare needs on depression in older adults are understudied. This study aimed to analyze the association between unmet healthcare needs and symptoms of depression, sleep, and antidepressant medication while controlling for other significant factors among older adults. For this study, we used a multinational database from The Survey of Health, Ageing and Retirement in Europe (SHARE), containing data of individuals aged 50 and older. The final sample used in this research consisted of 39,484 individuals from 50 to 100 years (mean − 71.15, SD ± 9.19), 42.0 percent of whom were male. Three path models exploring relationships between symptoms of depression at an older age and unmet healthcare needs were produced and had a good model fit. We found that unmet healthcare needs were directly related to depression, activity limitations were related to depression directly and through unmet healthcare needs, whereas financial situation mostly indirectly through unmet healthcare needs. We discuss how depression itself could increase unmet healthcare needs.
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186
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Kappelin C, Carlsson AC, Wachtler C. Specific content for collaborative care: a systematic review of collaborative care interventions for patients with multimorbidity involving depression and/or anxiety in primary care. Fam Pract 2022; 39:725-734. [PMID: 34546354 PMCID: PMC9295603 DOI: 10.1093/fampra/cmab079] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In primary care (PC) many patients suffer from multimorbidity involving depression and/or anxiety. Collaborative care (CC) has shown promising results for patients with depression, anxiety, and multimorbidity involving depression. However, specific content in CC for patients with multimorbidity involving depression and/or anxiety is unknown. OBJECTIVE (i) To examine the effect of CC interventions in patients with multimorbidity involving depression and/or anxiety compared with usual care; (ii) to identify specific content of CC. METHODS We conducted a systematic literature review of randomized controlled trial studies evaluating CC models for adults with multimorbidity involving depression and/or anxiety in PC settings. PubMed, CINAHL, Web of Science, and PsycInfo were searched in December 2019. We conducted a qualitative synthesis using an existing framework and developed a new framework to map the content for each studied intervention. RESULTS We identified 1,447 studies. Twelve publications were included. Eleven had medium-to-high quality of CC for patients with multimorbidity involving depression. Specific content of CC in these studies is: A stepped care model, involving medication and psychotherapy delivered by a nurse or psychologist Care Manager (CM) focusing on problem-solving techniques; follow-up including monitoring of symptoms and function, and relapse prevention strategies; scheduled CM supervision. CONCLUSIONS Specific content for CC for patients with multimorbidity involving depression is identified from current research. Research gaps were found regarding CC for patients with multimorbidity and anxiety, depression and anxiety, and depression and/or anxiety and more than 2 diseases.
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Affiliation(s)
- Caroline Kappelin
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institute, Huddinge, Sweden
| | - Axel C Carlsson
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institute, Huddinge, Sweden.,Academic Primary Healthcare Centre, Stockholm, Sweden
| | - Caroline Wachtler
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institute, Huddinge, Sweden
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187
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Dear BF, Scott AJ, Fogliati R, Gandy M, Karin E, Dudeney J, Nielssen O, McDonald S, Heriseanu AI, Bisby MA, Sharpe L, Jones MP, Ali S, Titov N. The Chronic Conditions Course: A Randomised Controlled Trial of an Internet-Delivered Transdiagnostic Psychological Intervention for People with Chronic Health Conditions. PSYCHOTHERAPY AND PSYCHOSOMATICS 2022; 91:265-276. [PMID: 35367986 DOI: 10.1159/000522530] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 02/06/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Psychological adjustment to chronic health conditions is important, as poor adjustment predicts a range of adverse medical and psychosocial outcomes. Psychological treatments demonstrate efficacy for people with chronic health conditions, but existing research takes a disorder-specific approach and they are predominately delivered in face-to-face contexts. The internet and remotely delivered treatments have the potential to overcome barriers to accessing traditional face-to-face treatment. OBJECTIVE The current study examined the efficacy and acceptability of an internet-delivered transdiagnostic psychological intervention to promote adjustment to illness, based on cognitive behaviour therapy principles. METHODS In a two-arm randomised controlled trial, participants (n = 676) were randomly allocated to the 8-week intervention or a waitlist control. Treatment included five core lessons, homework tasks, additional resources, and weekly contact with a psychologist. Primary outcomes included depression, anxiety, and disability, assessed at pre-treatment, post-treatment, 3-month follow-up, and 12-month follow-up. RESULTS The treatment group reported significantly greater improvements in depression (between-groups d = 0.47), anxiety (d = 0.32), and disability (d = 0.17) at post-treatment (all ps <0.001). Improvements were sustained over the 3-month and 12-month follow-ups. High treatment completion rates (69%) and levels of satisfaction (86%) were reported by participants in treatment. The intervention required a mean clinician time of 56.70 min per participant. CONCLUSIONS The findings provide preliminary and tentative support for the potential of internet-delivered transdiagnostic interventions to promote adjustment to chronic health conditions. Further research using robust control groups, and exploring the generalisability of findings, is needed before firm conclusions can be drawn.
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Affiliation(s)
- Blake F Dear
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Amelia J Scott
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Rhiannon Fogliati
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Milena Gandy
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Eyal Karin
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Joanne Dudeney
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Olav Nielssen
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Sarah McDonald
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Andreea I Heriseanu
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Madelyne A Bisby
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Louise Sharpe
- School of Psychology, Faculty of Science, University of Sydney, Sydney, New South Wales, Australia
| | - Michael P Jones
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Shehzad Ali
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia.,Department of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, Ontario, Canada
| | - Nickolai Titov
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
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188
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Skou ST, Mair FS, Fortin M, Guthrie B, Nunes BP, Miranda JJ, Boyd CM, Pati S, Mtenga S, Smith SM. Multimorbidity. Nat Rev Dis Primers 2022; 8:48. [PMID: 35835758 PMCID: PMC7613517 DOI: 10.1038/s41572-022-00376-4] [Citation(s) in RCA: 277] [Impact Index Per Article: 138.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2022] [Indexed: 02/06/2023]
Abstract
Multimorbidity (two or more coexisting conditions in an individual) is a growing global challenge with substantial effects on individuals, carers and society. Multimorbidity occurs a decade earlier in socioeconomically deprived communities and is associated with premature death, poorer function and quality of life and increased health-care utilization. Mechanisms underlying the development of multimorbidity are complex, interrelated and multilevel, but are related to ageing and underlying biological mechanisms and broader determinants of health such as socioeconomic deprivation. Little is known about prevention of multimorbidity, but focusing on psychosocial and behavioural factors, particularly population level interventions and structural changes, is likely to be beneficial. Most clinical practice guidelines and health-care training and delivery focus on single diseases, leading to care that is sometimes inadequate and potentially harmful. Multimorbidity requires person-centred care, prioritizing what matters most to the individual and the individual's carers, ensuring care that is effectively coordinated and minimally disruptive, and aligns with the patient's values. Interventions are likely to be complex and multifaceted. Although an increasing number of studies have examined multimorbidity interventions, there is still limited evidence to support any approach. Greater investment in multimorbidity research and training along with reconfiguration of health care supporting the management of multimorbidity is urgently needed.
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Affiliation(s)
- Søren T Skou
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Slagelse, Denmark.
| | - Frances S Mair
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Martin Fortin
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Quebec, Canada
| | - Bruce Guthrie
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Bruno P Nunes
- Postgraduate Program in Nursing, Faculty of Nursing, Universidade Federal de Pelotas, Pelotas, Brazil
| | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
- The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Cynthia M Boyd
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Epidemiology and Health Policy & Management, Johns Hopkins University, Baltimore, MD, USA
| | - Sanghamitra Pati
- ICMR Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Sally Mtenga
- Department of Health System Impact Evaluation and Policy, Ifakara Health Institute (IHI), Dar Es Salaam, Tanzania
| | - Susan M Smith
- Discipline of Public Health and Primary Care, Institute of Population Health, Trinity College Dublin, Russell Building, Tallaght Cross, Dublin, Ireland
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189
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Xu P, Huang Y, Hou Q, Cheng J, Ren Z, Ye R, Yao Z, Chen J, Lin Z, Gao Y, Chen Y. Relationship between physical activity and mental health in a national representative cross-section study: Its variations according to obesity and comorbidity. J Affect Disord 2022; 308:484-493. [PMID: 35439463 DOI: 10.1016/j.jad.2022.04.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 03/11/2022] [Accepted: 04/09/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Physical activity is positively associated with mental health in obese people with chronic comorbidities. However, how physical activity types (PATs), physical activity frequency (PAF), and physical activity duration (PAD) are associated with mental health need to be further clarified. The current study investigated and compared the effectiveness of PATs, physical activity frequency PAF and PAD for mental health in obese people with various chronic comorbid conditions. METHODS This cross-sectional study included 871,919 adults who participated in the Behavioral Risk Factor Surveillance System (BRFSS). They were divided into four groups: healthy people, obese people with 0, 1, and 2+ chronic comorbid conditions. The zero-inflated negative binomial (ZINB) regression model and the generalized additive model were used to explore the association between physical activity and mental health burden in the four groups, respectively. RESULTS Jogging (30.00%), hiking (28.36%) and bicycling (28.32%) have greater improvement in mental health of healthy people; jogging (19.25%), golf (19.95%) and bicycling machine exercise (19.13%) showed a greater improvement in mental health of obese people with no chronic comorbid condition; and aerobic exercise videos or class showed a greater improvement in mental health of obese people with one chronic comorbid condition (22.14%) and obese people with two or more chronic comorbid conditions (19.60%). Non-linear relationships were observed between PAF, PAD, and energy expenditure and mental health. The healthy participants who exercised about 10-15 times a month and 40-50 min per session or about 400-600 METs-min per week had greater benefits for mental health. However, the lowest point of the smooth curve moved to the left with an increasing number of chronic comorbid conditions in obese people. CONCLUSIONS Almost all PATs were associated with better mental health, but their benefits decreased with increasing number of chronic comorbid conditions in obese people. There were U-shaped relationships between mental health and weekly physical activity frequency, duration, and METs-min.
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Affiliation(s)
- Peng Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510220, China
| | - Yanhong Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510220, China
| | - Qingqin Hou
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510220, China
| | - Jinqun Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510220, China
| | - Zhiqiang Ren
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510220, China
| | - Rongrong Ye
- Department of Medical Statistics, School of Basic Medicine and Public Health, Jinan University, Guangzhou 510632, China
| | - Zifeng Yao
- Department of Medical Statistics, School of Basic Medicine and Public Health, Jinan University, Guangzhou 510632, China
| | - Jiade Chen
- Department of Medical Statistics, School of Basic Medicine and Public Health, Jinan University, Guangzhou 510632, China
| | - Ziqiang Lin
- Department of Medical Statistics, School of Basic Medicine and Public Health, Jinan University, Guangzhou 510632, China; Department of Psychiatry, New York University School of Medicine, One Park Ave, New York, NY 10016, United States.
| | - Yanhui Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510220, China; Department of Medical Statistics, School of Basic Medicine and Public Health, Jinan University, Guangzhou 510632, China.
| | - Yue Chen
- School of Epidemiology and Public Health, University of Ottawa, K1G5Z3, Canada
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190
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Ronaldson A, Arias de la Torre J, Gaughran F, Bakolis I, Hatch SL, Hotopf M, Dregan A. Prospective associations between vitamin D and depression in middle-aged adults: findings from the UK Biobank cohort. Psychol Med 2022; 52:1866-1874. [PMID: 33081855 PMCID: PMC9340850 DOI: 10.1017/s0033291720003657] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/04/2020] [Accepted: 09/15/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND A possible role of vitamin D in the pathophysiology of depression is currently speculative, with more rigorous research needed to assess this association in large adult populations. The current study assesses prospective associations between vitamin D status and depression in middle-aged adults enrolled in the UK Biobank. METHODS We assessed prospective associations between vitamin D status at the baseline assessment (2006-2010) and depression measured at the follow-up assessment (2016) in 139 128 adults registered with the UK Biobank. RESULTS Amongst participants with no depression at baseline (n = 127 244), logistic regression revealed that those with vitamin D insufficiency [adjusted odds ratio (aOR) = 1.14, 95% confidence interval (CI) = 1.07-1.22] and those with vitamin D deficiency (aOR = 1.24, 95% CI 1.13-1.36) were more likely to develop new-onset depression at follow-up compared with those with optimal vitamin D levels after adjustment for a wide range of relevant covariates. Similar prospective associations were reported for those with depression at baseline (n = 11 884) (insufficiency: aOR = 1.11, 95% CI 1.00-1.23; deficiency: aOR = 1.30, 95% CI 1.13-1.50). CONCLUSIONS The prospective associations found between vitamin D status and depression suggest that both vitamin D deficiency and insufficiency might be risk factors for the development of new-onset depression in middle-aged adults. Moreover, vitamin D deficiency (and to a lesser extent insufficiency) might be a predictor of sustained depressive symptoms in those who are already depressed. Vitamin D deficiency and insufficiency is very common, meaning that these findings have significant implications for public health.
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Affiliation(s)
- Amy Ronaldson
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Jorge Arias de la Torre
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
| | - Fiona Gaughran
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Ioannis Bakolis
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Stephani L. Hatch
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Matthew Hotopf
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Alexandru Dregan
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
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191
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Lindsay M, Decker VB. Improving Depression Screening in Primary Care. J Dr Nurs Pract 2022; 15:84-90. [DOI: 10.1891/jdnp-2021-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BackgroundDepression is a serious problem in the United States. It not only impacts chronic illness and healthcare utilization, but it can also result in death, intentional or unintentional. Despite the seriousness associated with depression, it continues to be underdiagnosed and undertreated. The primary care setting provides an ideal location to screen and initiate treatment for depression in individuals who would otherwise not be screened.ObjectiveThe objective of this evidence-based practice project was to improve the diagnosis and treatment of depression in an adult primary care office.MethodAn intervention consisting of a HealthWatcher reminder for depression screening, the administration of the PHQ-9 instrument, and a treatment algorithm was incorporated into the office workflow. The charts of a pre-intervention random sample were compared to a post-intervention random sample to test for significant differences in depression screening and treatment rates.ResultsUsing the chi-squared test, the post-intervention sample screening rate was significantly higher than pre-intervention sample rate (90% vs 23.3%; χ2 = 54.3, df = 1, P < .000).Conclusion/ImplicationsIt is feasible to improve the diagnosis and treatment of depression for adult primary care patients by modifying office protocols and using the PHQ-9 screening instrument and a treatment algorithm.
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192
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Rengasamy M, Arruda Da Costa E Silva S, Marsland A, Price RB. The association of physical illness and low-grade inflammatory markers with depressive symptoms in a large NHANES community sample: Dissecting mediating and moderating effects. Brain Behav Immun 2022; 103:215-222. [PMID: 35447303 DOI: 10.1016/j.bbi.2022.04.006] [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: 01/09/2022] [Revised: 03/12/2022] [Accepted: 04/10/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Both low-grade elevation in peripheral inflammatory markers (e.g., white blood count (WBC) and C-reactive protein (CRP)) and physical illness (both chronic and acute) have been associated with depressive symptomology. However, it is unclear if low-grade elevation in inflammatory markers mediates relationships between physical illness and depression or if physical illness positively moderates relationships between inflammatory markers and depression. METHODS In a well-powered, racially diverse cohort (n = 21,525) from NHANES datasets, we examined if inflammatory markers (CRP and WBC) and physical illnesses (acute and chronic) were independently associated with depression severity. We also examined if associations between physical illness and depression severity were mediated by inflammatory markers and if physical illness moderated associations between inflammatory markers and depression. RESULTS We found that both inflammatory markers and physical illness were associated with depression severity, even after considering a wide range of potential confounders (e.g., age, gender, body mass index). Inflammatory markers mediated a marginal portion (<5%; p < 0.001) of potential effects of physical illness on depression severity. In moderation analyses, associations between inflammatory markers and depression severity were significantly stronger in participants with chronic physical illness than those without. This moderating effect was not present for acute physical illness. CONCLUSIONS Inflammatory markers and physical illness appear independently linked to depression severity and, in individuals with chronic physical illness, inflammatory markers are more tightly connected to depressive symptomology. Such findings could help guide future individualized treatment research for depression based on both inflammatory marker level and physical illness burden.
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Affiliation(s)
- Manivel Rengasamy
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
| | | | - Anna Marsland
- Department of Psychology, University of Pittsburgh, Pittsburgh, USA
| | - Rebecca B Price
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA; Department of Psychology, University of Pittsburgh, Pittsburgh, USA
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193
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Walrave R, Beerten SG, Mamouris P, Coteur K, Van Nuland M, Van Pottelbergh G, Casas L, Vaes B. Trends in the epidemiology of depression and comorbidities from 2000 to 2019 in Belgium. BMC PRIMARY CARE 2022; 23:163. [PMID: 35764925 PMCID: PMC9241171 DOI: 10.1186/s12875-022-01769-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/10/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Depression is a common mental disorder in family practice with an impact on global health. The aim of this study is to provide insight in the trends of epidemiological measures as well as pharmacological treatments and comorbidities of depression. METHODS A study using data from INTEGO, a family practice registration network in Flanders, Belgium. Trends in age-standardized prevalence and incidence of depression from 2000 to 2019 as well as antidepressant prescriptions in prevalent depression cases were analyzed with join point regression. Comorbidity profiles were explored using the Cochran-Armitage test and the Jonckheere-Terpstra test. RESULTS We identified 538 299 patients older than 15 years during the study period. We found an increasing trend in the age-standardized prevalence of depression from 6.73 % in 2000 to 9.20 % in 2019. For the incidence of depression, a decreasing trend was observed from 2000 to 2015 with an incidence of 9.42/1000 in 2000 and 6.89/1000 in 2015, followed by an increasing trend from 2015 to 2019 (incidence of 13.64/1000 in 2019). The average number of chronic diseases per patient with depression increased significantly during the study period (from 1.2 to 1.8), and the proportion of patients relative to the whole study population that received at least one antidepressant prescription per year increased between 2000 and 2019 from 26.44% to 40.16%. CONCLUSIONS The prevalence of depression increases while the incidence sharply rises, but only in recent years. Patients with depression tend to have more comorbidities, making a multi-faceted approach to these patients more important.
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Affiliation(s)
- Roosje Walrave
- Department of Public Health and Primary Care, Kapucijnenvoer 7 blok h, bus 7001, KU Leuven, Leuven, Belgium
| | - Simon Gabriël Beerten
- Department of Public Health and Primary Care, Kapucijnenvoer 7 blok h, bus 7001, KU Leuven, Leuven, Belgium.
| | - Pavlos Mamouris
- Department of Public Health and Primary Care, Kapucijnenvoer 7 blok h, bus 7001, KU Leuven, Leuven, Belgium
| | - Kristien Coteur
- Department of Public Health and Primary Care, Kapucijnenvoer 7 blok h, bus 7001, KU Leuven, Leuven, Belgium
| | - Marc Van Nuland
- Department of Public Health and Primary Care, Kapucijnenvoer 7 blok h, bus 7001, KU Leuven, Leuven, Belgium
| | - Gijs Van Pottelbergh
- Department of Public Health and Primary Care, Kapucijnenvoer 7 blok h, bus 7001, KU Leuven, Leuven, Belgium
| | - Lidia Casas
- Social Epidemiology and Health Policy (SEHPO), Department of Family Medicine and Population Health (FAMPOP), University of Antwerp, Antwerp, Belgium
- Institute for Environment and Sustainable Development (IMDO), University of Antwerp, Antwerp, Belgium
| | - Bert Vaes
- Department of Public Health and Primary Care, Kapucijnenvoer 7 blok h, bus 7001, KU Leuven, Leuven, Belgium
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Gramaglia C, Gattoni E, Gambaro E, Bellan M, Balbo PE, Baricich A, Sainaghi PP, Pirisi M, Binda V, Feggi A, Jona A, Marangon D, Prosperini P, Zeppegno P. Anxiety, Stress and Depression in COVID-19 Survivors From an Italian Cohort of Hospitalized Patients: Results From a 1-Year Follow-Up. Front Psychiatry 2022; 13:862651. [PMID: 35782424 PMCID: PMC9247238 DOI: 10.3389/fpsyt.2022.862651] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 05/10/2022] [Indexed: 11/23/2022] Open
Abstract
Background Mental health-related symptoms can persist over time beyond the most common respiratory clinical features of COVID-19. A recent meta-analysis underlined that mental health sequalae may be relevant for COVID-19 survivors and reported the following prevalence rates: 20% for post-traumatic stress disorder, 22% for anxiety, 36% for psychological distress, and 21% for depression. In the context of a multi-disciplinary follow-up project, we already investigated the mid-term (4 months) psychiatric outcomes in a sample of COVID-19 survivors. Patients were re-assessed after 1-year since hospital discharge. Methods Follow-up conducted after 1 year involved 196 individuals recovered from COVID-19. Patients were assessed with a multi-disciplinary approach; including both a clinical interview performed by an experienced psychiatrist, trained in the use of the Mini-International Neuropsychiatric Interview (MINI) to assess the presence of anxiety, stress, and depressive symptoms and the following self-administered questionnaires: Beck Anxiety Inventory, Beck Depression Inventory-II, Resilience Scale for Adults, Impact of Event Scale, and COVID-19 Peritraumatic Distress Index (CPDI). Results Anxiety (p < 0.0001) and depressive (p < 0.0003) symptoms registered at the clinical interview showed a significant improvement from the 4 to 12-months follow-up. Logistic regression model showed that female gender (p = 0.006), arterial hypertension (p = 0.01), obesity (0.04), anxiety (p < 0.0001), and depressive (p = 0.02) symptoms at 4-months follow-up were associated with persistence of anxiety symptoms at 12 months. At logistic regression analysis female gender (p = 0.02) and depressive symptoms at 4-months follow-up (p = 0.01) were associated with depressive symptoms after 12 months. Conclusion Severity of the disease in the acute phase, in this study, was not a determining factor in identifying subjects at risk of developing clinically relevant anxiety and depression as a consequence of COVID-19 disease. Findings from the logistic regressions suggest that the factors most affecting depression and anxiety in COVID survivors after 12 months were female gender, the presence of anxiety and depression after 4 months and some physical symptoms, not necessarily COVID-related. Impact of infection and consequent hospitalization for COVID-19 did no longer represent a relevant issue for depressive symptoms, compared to other general factors.
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Affiliation(s)
- Carla Gramaglia
- Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Eleonora Gattoni
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Eleonora Gambaro
- Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Mattia Bellan
- Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | | | - Alessio Baricich
- Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Pier Paolo Sainaghi
- Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Mario Pirisi
- Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Valeria Binda
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Alessandro Feggi
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Amalia Jona
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Debora Marangon
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | | | - Patrizia Zeppegno
- Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
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195
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Zhang Y, Hou F, Cheng J, Chen G, Wang L, Jiang X, Chen R, Shen G. The association between leftover food consumption and depression among older adults: Findings from a cross-sectional study. J Affect Disord 2022; 307:157-162. [PMID: 35390351 DOI: 10.1016/j.jad.2022.03.074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 03/27/2022] [Accepted: 03/31/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Leftover food consumption is very prevalent among the Chinese older adults, however, the potential effects of leftover eating consumption on depression have not yet been investigated. OBJECTIVES The study aims to determine the association between leftover consumption on depression among older adults. METHODS Data of leftover consumption frequency was collected in a cross-sectional study with a provincial representative sample of 5992 older adults (aged 60 or older) in 2019. Depression symptoms were assessed by the 9-item screener Patient Health Questionnaire (PHQ-9). Multiple logistic regression models were applied to analyze the association of the frequency of leftover eating consumption and the presence and the severity of depression. RESULTS After controlling for all the covariates, the participants who consume leftover food everyday had higher risk of having depression symptom comparing to those who had the lowest frequency of leftover eating (OR: 1.675, 95% CI: 1.435-1.956, p < 0.001). The participants who consume leftover food every day was also associated with more severe depression symptoms (OR: 1.621, 95% CI: 1.397-1.881, p < 0.001), when comparing to the reference group. The associations seemed stronger in men than women. LIMITATIONS The causal relationship between leftover consumption behavior and depression could not be determined due to the cross-sectional design. Moreover, the variety or handling method of the leftover food was not specified. CONCLUSION Leftovers eating frequency was associated with the presence and severity of depression symptoms among older adults.
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Affiliation(s)
- Yan Zhang
- School of Health Service Management, Anhui Medical University, Hefei 230032, Anhui, PR China
| | - Fangfang Hou
- School of Health Service Management, Anhui Medical University, Hefei 230032, Anhui, PR China
| | - Jing Cheng
- School of Health Service Management, Anhui Medical University, Hefei 230032, Anhui, PR China
| | - Guimei Chen
- School of Health Service Management, Anhui Medical University, Hefei 230032, Anhui, PR China
| | - Li Wang
- School of Health Service Management, Anhui Medical University, Hefei 230032, Anhui, PR China
| | - Xiaodong Jiang
- Department of Medical Oncology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, PR China.
| | - Ren Chen
- School of Health Service Management, Anhui Medical University, Hefei 230032, Anhui, PR China; The Affiliated Suzhou Hospital of Anhui Medical University, Suzhou 234000, Anhui, PR China.
| | - Guodong Shen
- Department of Geriatrics, The First Affiliated Hospital of University of Science and Technology of China, Gerontology Institute of Anhui Province, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, Anhui, PR China; Anhui Provincial Key Laboratory of Tumor Immunotherapy and Nutrition Therapy, Hefei 230001, Anhui, PR China.
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196
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Srinivasan K, Heylen E, Johnson Pradeep R, Mony PK, Ekstrand ML. Collaborative care compared to enhanced standard treatment of depression with co-morbid medical conditions among patients from rural South India: a cluster randomized controlled trial (HOPE Study). BMC Psychiatry 2022; 22:394. [PMID: 35698087 PMCID: PMC9195442 DOI: 10.1186/s12888-022-04000-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 05/11/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Depression is common among primary care patients in LMIC but treatments are largely ineffective. In this cluster-randomized controlled trial, we tested whether depression outcomes are different among recipients of a collaborative care model compared to enhanced standard treatment in patients with co-morbid chronic medical conditions. METHODS We conducted a cluster randomized controlled trial among participants 30 years or older seeking care at 49 primary health centers (PHCs) in rural Karnataka, diagnosed with major depressive disorder, dysthymia, generalized anxiety disorder, or panic disorder on the MINI-International Neuropsychiatric Interview plus either hypertension, diabetes, or ischemic heart disease. From a list of all PHCs in the district, 24 PHCs were randomized a priori to deliver collaborative care and 25 PHCs enhanced standard treatment. The collaborative care model consisted of a clinic-based and a community-based component. Study assessment staff was blinded to treatment arm allocation. The primary outcome was the individual-level PHQ-9 score over time. RESULTS Between May 2015 and Nov 2018, 2486 participants were enrolled, 1264 in the control arm, and 1222 in the intervention arm. They were assessed at baseline, 3, 6 and 12 months. The mean PHQ-9 depression score was around 8.5 at baseline. At each follow-up PHQ-9 scores were significantly lower in the intervention (5.24, 4.81 and 4.22 at respective follow-ups) than in the control group (6.69, 6.13, 5.23, respectively). A significant time-by-treatment interaction (p < 0.001) in a multi-level model over all waves, nested within individuals who were nested within PHCs, confirmed that the decrease in depression score from baseline was larger for collaborative care than enhanced standard care throughout follow-up. CONCLUSIONS The collaborative care intervention resulted in significantly lower depression scores compared to enhanced standard care among participants with co-morbid physical conditions. The findings have potential implications for integrating mental health and chronic disease treatment in resource constrained settings. TRIAL REGISTRATION ClinicalTrials.gov NCT02310932 , registered on December 8, 2014, and Clinical Trials Registry India CTRI/2018/04/013001 , registered on April 4, 2018. Retrospectively registered.
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Affiliation(s)
- Krishnamachari Srinivasan
- grid.418280.70000 0004 1794 3160Division of Mental Health & Neurosciences, St John’s Research Institute, Bangalore, India ,grid.416432.60000 0004 1770 8558Department of Psychiatry, St John’s Medical College, Bangalore, India
| | - Elsa Heylen
- grid.266102.10000 0001 2297 6811Division of Prevention Sciences, University of California, San Francisco, USA
| | - R. Johnson Pradeep
- grid.416432.60000 0004 1770 8558Department of Psychiatry, St John’s Medical College, Bangalore, India
| | - Prem K. Mony
- grid.416432.60000 0004 1770 8558Division of Epidemiology and Community Health, St John’s Medical College & Research Institute, Bangalore, India
| | - Maria L. Ekstrand
- grid.418280.70000 0004 1794 3160Division of Mental Health & Neurosciences, St John’s Research Institute, Bangalore, India ,grid.266102.10000 0001 2297 6811Division of Prevention Sciences, University of California, San Francisco, USA
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Ansari S, Anand A, Hossain B. Multimorbidity and depression among older adults in India: Mediating role of functional and behavioural health. PLoS One 2022; 17:e0269646. [PMID: 35671307 PMCID: PMC9173646 DOI: 10.1371/journal.pone.0269646] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 05/24/2022] [Indexed: 11/24/2022] Open
Abstract
Researchers have long been concerned about the association between depression and the prevalence of multiple chronic diseases or multimorbidity in older persons. However, the underlying pathway or mechanism in the multimorbidity-depression relationship is still unknown. Data were extracted from a baseline survey of the Longitudinal Ageing Survey of India (LASI) conducted during 2017–18 (N = 31,464; aged ≥ 60 years). Depression was assessed using the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10). Multivariable logistic regression was used to examine the association. The Karlson–Holm–Breen (KHB) method was adopted for mediation analysis. The prevalence of depression among older adults was nearly 29% (men: 26% and women 31%). Unadjusted and adjusted estimates in binary logistic regression models suggested an association between multimorbidity and depression (UOR = 1.28; 95% CIs 1.27–1.44 and AOR = 1.12; 95% CIs 1.12–1.45). The association was particularly slightly strong in the older men. In addition, the association was mediated by functional health such as Self Rated Health (SRH) (proportion mediated: 40%), poor sleep (35.15%), IADL disability (22.65%), ADL disability (21.49%), pain (7.92%) and by behavioral health such as physical inactivity (2.28%). However, the mediating proportion was higher among older women as compared to older men. Physical inactivity was not found to be significant mediator for older women. The findings of this population-based study revealed that older people with multimorbidity are more likely to suffer depressive symptoms in older ages, suggesting the need for more chronic disease management and research. Multimorbidity and depression may be mediated by certain functional health factors, especially in older women. Further longitudinal research is needed to better understand the underlying mechanisms of this association so that future preventive initiatives may be properly guided.
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Affiliation(s)
- Salmaan Ansari
- Department of Population Policies & Programs, International Institute for Population, Sciences, Mumbai, India
| | - Abhishek Anand
- Department of Public Health and Mortality Studies, International Institute for Population, Sciences, Mumbai, India
- * E-mail:
| | - Babul Hossain
- Department of Development Studies, International Institute for Population Sciences, Mumbai, India
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198
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Lu Y, Li G, Ferrari P, Freisling H, Qiao Y, Wu L, Shao L, Ke C. Associations of handgrip strength with morbidity and all-cause mortality of cardiometabolic multimorbidity. BMC Med 2022; 20:191. [PMID: 35655218 PMCID: PMC9164350 DOI: 10.1186/s12916-022-02389-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiometabolic multimorbidity (CM) is an increasing public health and clinical concern. However, predictors for the development and prognosis of CM are poorly understood. The aims of this study were to investigate the relation between handgrip strength (HGS) and the risk of CM and to examine the association of HGS with all-cause mortality risk among patients with CM. METHODS This prospective cohort study involved 493,774 participants from the UK Biobank. CM was defined as the simultaneous occurrence of two or more of the following conditions: type 2 diabetes, stroke, and coronary heart disease (CHD). Cox proportional hazards models were performed to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs). RESULTS During a median follow-up of 12.1 years, 4701 incident CM cases were documented among participants with none cardiometabolic disease at baseline. Compared with the fourth quartile (Q4), the multivariable adjusted HR (95% CI) value of Q1 of HGS for developing CM was 1.46 (1.34-1.60). In participants with one cardiometabolic disease at baseline, participants in Q1 of HGS also possessed higher risk of CM than those in Q4, with HRs (95% CIs) being 1.35 (1.23-1.49) in patients with type 2 diabetes, 1.23 (1.04-1.46) in patients with stroke, and 1.23 (1.11-1.36) in patients with CHD. For participants with CM at recruitment, HGS was also associated with the risk of all-cause mortality (Q1 vs. Q4 HR: 1.57, 95% CI: 1.36-1.80). CONCLUSIONS Our study provided novel evidence that HGS could be an independent predictor of morbidity and all-cause mortality of CM.
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Affiliation(s)
- Yanqiang Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, People's Republic of China
| | - Guochen Li
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, People's Republic of China
| | - Pietro Ferrari
- Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC/WHO), Lyon, France
| | - Heinz Freisling
- Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC/WHO), Lyon, France
| | - Yanan Qiao
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, People's Republic of China
| | - Luying Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, People's Republic of China
| | - Liping Shao
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, People's Republic of China
| | - Chaofu Ke
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, People's Republic of China.
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199
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Fishbook BN, Brinton CD, Siever J, Klassen TD, Sakakibara BM. Cardiometabolic multimorbidity and activity limitation: a cross-sectional study of adults using the Canadian Longitudinal Study on Aging data. Fam Pract 2022; 39:455-463. [PMID: 34644392 DOI: 10.1093/fampra/cmab129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cardiometabolic multimorbidity (CM) is the diagnosis of 2 or more cardiometabolic conditions. Multimorbidity and individual cardiometabolic conditions have been associated with activity limitation, a common form of disability, but few studies have investigated the association between CM and activity limitation. OBJECTIVES To estimate the prevalence of activity limitation among Canadians with CM and to quantify the association between CM and activity limitation. METHODS Using data from the Canadian Longitudinal Study on Aging, we conducted a cross-sectional analysis of activity limitation among Canadians aged 45-85 (n = 50,777; weighted n = 13,118,474). CM was defined as the diagnosis of 2 or more of diabetes/prediabetes, myocardial infarction, and stroke, and activity limitation was evaluated using the Older Americans Resources and Services scale. Descriptive statistics and logistic and multinomial logistic regression analyses were conducted to determine the association between CM and activity limitation. RESULTS The estimated prevalence of activity limitation among participants living with CM was 27.4% compared with 7.5% with no cardiometabolic conditions. Activity limitation increased in prevalence and severity with the number of cardiometabolic conditions. People with CM had increased odds of activity limitation compared with those without any cardiometabolic conditions (adjusted relative risk ratio = 3.99, 95% confidence interval [3.35-4.75]), and the odds increased with each additional condition. Stroke survivors had greater odds of activity limitation than those without a history of stroke and the same number of cardiometabolic conditions. CONCLUSION Activity limitation is common among Canadians living with CM. Odds of activity limitation increase with each additional cardiometabolic condition, especially for stroke survivors.
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Affiliation(s)
- Brayden N Fishbook
- Southern Medical Program, Faculty of Medicine, University of British Columbia, Kelowna, BC, Canada
| | - Christopher D Brinton
- Southern Medical Program, Faculty of Medicine, University of British Columbia, Kelowna, BC, Canada.,Centre for Chronic Disease Prevention and Management, Faculty of Medicine, University of British Columbia, Kelowna, BC, Canada
| | - Jodi Siever
- Southern Medical Program, Faculty of Medicine, University of British Columbia, Kelowna, BC, Canada
| | - Tara D Klassen
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Brodie M Sakakibara
- Southern Medical Program, Faculty of Medicine, University of British Columbia, Kelowna, BC, Canada.,Centre for Chronic Disease Prevention and Management, Faculty of Medicine, University of British Columbia, Kelowna, BC, Canada.,Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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200
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Rivera‐Matos L, Andrews S, Eswaran S. Sociodemographic Risk Factors for Depression in Patients With Chronic Liver Disease. Clin Liver Dis (Hoboken) 2022; 20:38-42. [PMID: 36033427 PMCID: PMC9405494 DOI: 10.1002/cld.1208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 11/18/2022] [Indexed: 02/04/2023] Open
Abstract
Content available: Audio Recording.
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Affiliation(s)
| | - Sarah Andrews
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMD
| | - Sheila Eswaran
- Department of GI, Hepatology and NutritionRush University Medical CenterChicagoIL
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