1
|
Liu J, Tong R, Lu Z, Wang Z, Wang Y, Liu Y, Yuan H, Jia F, Zhang X, Li Z, Du X, Zhang X. Development and validation of a nomogram for suicide attempts in patients with first-episode drug-naïve major depressive disorder. Front Psychiatry 2024; 15:1398733. [PMID: 38903642 PMCID: PMC11187325 DOI: 10.3389/fpsyt.2024.1398733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 05/22/2024] [Indexed: 06/22/2024] Open
Abstract
Objective The risk of suicide can be decreased by accurately identifying high-risk suicide groups and implementing the right interventions. The aim of this study was to develop a nomogram for suicide attempts (SA) in patients with first-episode drug-naïve (FEDN) major depressive disorder (MDD). Methods This study undertook a cross-sectional analysis of 1,718 patients diagnosed with FEDN MDD, providing comprehensive clinical data from September 2016 to December 2018. Data on anthropometric and sociodemographic factors were gathered, and the severity of depression and anxiety was evaluated using the 17-item Hamilton Depression Scale (HAMD-17) and the Hamilton Anxiety Scale (HAMA), respectively. Additionally, thyroid hormone levels, lipid profile parameters, and fasting blood glucose (FBG) were measured. Suicide attempt (SA) history was verified based on an amalgamation of medical records, patient interviews, and family interviews. Participants were randomly divided into a training group (70%, n = 1,204) and a validation group (30%, n = 514). In the training group, LASSO analysis and multivariate regression were used to identify variables associated with SA. A nomogram was then constructed using the identified risk factors to estimate the likelihood of SA within the training group. To assess the accuracy, the area under the receiver operating characteristic curve (AUC) was utilized, and calibration plots were employed to evaluate calibration. Additionally, decision curve analysis (DCA) was performed to assess the precision of the model. Finally, internal validation was carried out using the validation group. Results A practical nomogram has been successfully constructed, incorporating HAMD, HAMA, thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), and systolic blood pressure (SBP) parameters, to estimate the probability of SA in Chinese patients diagnosed with FEDN MDD. The pooled area under the ROC for SA risk in both the training and validation groups was found to be 0.802 (95% CI: 0.771 to 0.832) and 0.821 (95% CI: 0.774 to 0.868), respectively. Calibration analysis revealed a satisfactory correlation between the nomogram probabilities and the actual observed probabilities. The clinical applicability of the nomogram was confirmed through decision curve analysis. To enhance accessibility for clinicians and researchers, an online version of the nomogram can be accessed at https://doctorjunjunliu.shinyapps.io/dynnomapp/. Conclusions We constructed and validated a nomogram for the early detection of FEDN MDD patients with a high risk of SA, thereby contributing to the implementation of effective suicide prevention programs.
Collapse
Affiliation(s)
- Junjun Liu
- Nanjing Meishan Hospital, Nanjing, China
- Soochow University, Suzhou, China
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | | | - Zhaomin Lu
- Nanjing Meishan Hospital, Nanjing, China
| | - Zhiye Wang
- Nanjing Meishan Hospital, Nanjing, China
| | | | - Yang Liu
- Nanjing Meishan Hospital, Nanjing, China
| | | | - Fengnan Jia
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xiaobin Zhang
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Zhe Li
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xiangdong Du
- Soochow University, Suzhou, China
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xiangyang Zhang
- Chinese Academy of Sciences (CAS) Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| |
Collapse
|
2
|
Sternberg A, Bethge M, Ober J, Weier L, Benninghoven D. [Sensitivity and specificity of the PHQ-9 for identifying suicidality in medical rehabilitation]. DIE REHABILITATION 2024; 63:180-188. [PMID: 38552642 DOI: 10.1055/a-2192-3688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
PURPOSE Suicidality is rarely assessed in patients treated in German rehabilitation centers, although individuals with physical and mental impairments have an increased risk for suicidality. The item 9 of the 9-item depression module of the Patient Health Questionnaire (PHQ-9) asks about the desire to be dead or to harm oneself and could be used as a possible screening for suicidality. The Columbia Suicide Severity Rating Scale (C-SSRS) is a standardized interview to assess suicidality. We assessed the prevalence of suicidality in orthopedic and cardiac rehabilitation using the C-SSRS and the PHQ-9, examined the diagnostic accuracy of the item 9 of the PHQ-9 and of the PHQ-9 total score for identifying suicidality and surveyed the acceptance of the suicidality assessment by the rehabilitants. METHODS Study participants were screened with the PHQ-9 and subsequently interviewed using C-SSRS. Sensitivity and specificity of the item 9 of the PHQ-9 and the PHQ-9 total score were tested for the presence of suicidality assessed with the C-SSRS and in a sensitivity analysis for the presence of nonspecific active suicidal ideation (item 2 of the C-SSRS). We calculated the area under the curve (AUC) to predict the ability of the PHQ-9 to discriminate between individuals with and without acute suicidality. Screening and interview were evaluated by the rehabilitants. RESULTS Among 405 study participants, the prevalence of acute suicidality measured by the C-SSRS was 0.5%. 4% reported nonspecific active suicidal ideation on the C-SSRS. 10.4% reported suicidal ideation on item 9 of the PHQ-9. The sensitivity of item 9 and the PHQ-9 total score for identifying acute suicidality was only 50.0% (95% CI: 1.3% to 98.7%). However, item 9 was sensitive (81.3%, 95% CI: 54.4% to 96.0%) and specific (92.5%, 95% CI: 89.5% to 95.0%) for identifying nonspecific active suicidal ideation. Estimators for sensitivity were highly uncertain because of the low prevalence of acute suicidality. Addressing suicidality was rated as useful and helpful by study participants. CONCLUSION If the response to item 9 is positive, the immediate risk of suicide is low. However, PHQ-9 is suitable for identifying patients with non-specific suicidal thoughts. A conspicuous score on the item 9 of the PHQ-9 should be further clarified by a psychotherapist.
Collapse
Affiliation(s)
- Annika Sternberg
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck
| | - Matthias Bethge
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck
| | - Jona Ober
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck
| | - Lisa Weier
- Mühlenbergklinik Holsteinische Schweiz, Malente
| | | |
Collapse
|
3
|
Huang ZX, Wang Q, Lei S, Zhang W, Huang Y, Zhang C, Zhang X. Development and validation of the risk score for estimating suicide attempt in patients with major depressive disorder. Soc Psychiatry Psychiatr Epidemiol 2024; 59:1029-1037. [PMID: 37831079 DOI: 10.1007/s00127-023-02572-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 09/28/2023] [Indexed: 10/14/2023]
Abstract
Early identification of high-risk patients with Major depressive disorder (MDD) having suicide attempts (SAs) is essential for timely targeted and tailored psychological interventions and medications. This study aimed to develop and validate a web-based dynamic nomogram as a personalized predictor of SA in MDD patients. A dynamic nomogram was developed using data collected from 1718 patients in China. The dynamic model was established based on a machine learning-based regression technique in the training cohort. We validated the nomogram internally using 1000 bootstrap replications. The nomogram performance was assessed using estimates of discrimination (via the concordance index) and calibration (calibration plots). The nomogram incorporated five predictors, including Hamilton anxiety rating scale (odds ratio [OR]: 1.255), marital status (OR: 0.618), clinical global impressions (OR: 2.242), anti-thyroid peroxidase antibodies (OR: 1.002), and systolic pressure levels (OR: 1.037). The model demonstrated good overall discrimination (Harrell's C-index = 0.823). Using decision curve analysis, this model also demonstrated good clinical applicability. An online web server was constructed ( https://odywong.shinyapps.io/PRSM/ ) to facilitate the use of the nomogram. Based on these results, our study developed a nomogram to predict SA in MDD patients. The application of this nomogram may help for patients and clinicians to make decisions.
Collapse
Affiliation(s)
- Zhi-Xin Huang
- Department of Neurology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, China
- Jinan University Faculty of Medical Science, Guangzhou, Guangdong, China
- Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Qizhang Wang
- Department of Neurology, Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, Shenzhen, Guangdong, China
| | - Shasha Lei
- Jinan University Faculty of Medical Science, Guangzhou, Guangdong, China
| | - Wenli Zhang
- Department of Neurology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, China
| | - Ying Huang
- Department of Neurology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, China
| | - Caiping Zhang
- Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoying District, Beijing, 100101, China.
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
| |
Collapse
|
4
|
Tian X, Liu X, Bai F, Li M, Qiu Y, Jiao Q, Li J, Zhang X. Sex differences in correlates of suicide attempts in Chinese Han first-episode and drug-naïve major depressive disorder with comorbid subclinical hypothyroidism: A cross-sectional study. Brain Behav 2024; 14:e3578. [PMID: 38844426 PMCID: PMC11156525 DOI: 10.1002/brb3.3578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 05/11/2024] [Accepted: 05/18/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND This study aimed to investigate sex differences in risk factors for suicide attempts in first-episode and drug naive (FEDN) major depressive disorder (MDD) with comorbid subclinical hypothyroidism (SCH). METHODS A total of 1034 FEDN MDD patients with comorbid SCH were enrolled. The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Positive and Negative Syndrome Scale (PANSS) positive subscale were used to assess patients' symptoms. Thyroid hormone levels and metabolic parameters were measured. RESULTS MDD patients with SCH had a significantly higher risk of suicide attempts than those without SCH (25.4% vs. 12.2%). Logistic regression showed that HAMA score, thyroid stimulating hormone (TSH) levels, and thyroid peroxidase antibody (TPOAb) levels were significantly associated with an increased risk for suicide attempts in both male and female MDD patients comorbid SCH, while low-density lipoprotein cholesterol (LDL-C) was significantly associated with an increased risk for suicide attempts only in male patients, HAMD score and systolic blood pressure were significantly associated with an increased risk for suicide attempts only in female patients. CONCLUSION SCH comorbidities may increase suicide attempts in MDD patients. Our results showed significant sex differences in clinical and metabolic factors associated with suicide attempts among FEDN MDD patients with comorbid SCH, highlighting appropriate sex-based preventive interventions are needed.
Collapse
Affiliation(s)
- Xue Tian
- Institute of Mental HealthTianjin Anding Hospital, Mental Health Center of Tianjin Medical UniversityTianjinChina
| | - Xiao‐En Liu
- Institute of Mental HealthTianjin Anding Hospital, Mental Health Center of Tianjin Medical UniversityTianjinChina
| | - Fengfeng Bai
- Institute of Mental HealthTianjin Anding Hospital, Mental Health Center of Tianjin Medical UniversityTianjinChina
| | - Meijuan Li
- Institute of Mental HealthTianjin Anding Hospital, Mental Health Center of Tianjin Medical UniversityTianjinChina
| | - Yuying Qiu
- Institute of Mental HealthTianjin Anding Hospital, Mental Health Center of Tianjin Medical UniversityTianjinChina
| | - Qingyan Jiao
- Institute of Mental HealthTianjin Anding Hospital, Mental Health Center of Tianjin Medical UniversityTianjinChina
| | - Jie Li
- Institute of Mental HealthTianjin Anding Hospital, Mental Health Center of Tianjin Medical UniversityTianjinChina
| | - Xiang‐Yang Zhang
- CAS Key Laboratory of Mental HealthInstitute of PsychologyChinese Academy of SciencesBeijingChina
- Department of PsychologyUniversity of Chinese Academy of SciencesBeijingChina
| |
Collapse
|
5
|
Wang H, Lyu N, Huang J, Fu B, Shang L, Yang F, Zhao Q, Wang G. Real-world evidence from a retrospective study on suicide during depression: clinical characteristics, treatment patterns and disease burden. BMC Psychiatry 2024; 24:300. [PMID: 38641767 PMCID: PMC11031916 DOI: 10.1186/s12888-024-05726-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/27/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Suicide stands as both a primary symptom and the direst outcome of major depressive disorder (MDD). The scarcity of effective treatment strategies makes managing MDD patients with suicide especially challenging. Hence, it is crucial to investigate disease characteristics and efficacious therapeutic strategies for these patients, drawing insights from disease databases and real-world data. METHODS In this retrospective study, MDD patients hospitalized between January 2013 and December 2020 were investigated using Electronic Health Records (EHR) data from Beijing Anding Hospital. The study enrolled 4138 MDD patients with suicidal ideation or behavior (MDS) and 3848 without (MDNS). Demographic data, clinical attributes, treatment approaches, disease burden, and re-hospitalization within one year of discharge were extracted and compared. RESULTS Patients in the MDS group were predominantly younger and female, exhibiting a higher prevalence of alcohol consumption, experiencing frequent life stress events, and having an earlier onset age. Re-hospitalizations within six months post-discharge in the MDS group were significantly higher than in the MDNS group (11.36% vs. 8.91%, p < 0.001). Moreover, a more considerable fraction of MDS patients underwent combined electroconvulsive therapy treatment (56.72% vs. 43.71%, p < 0.001). Approximately 38% of patients in both groups were prescribed two or more therapeutic regimes, and over 90% used antidepressants, either alone or combined. Selective serotonin reuptake inhibitors (SSRIs) were the predominant choice in both groups. Furthermore, antidepressants were often prescribed with antipsychotics or mood stabilizers. When medication alterations were necessary, the favoured options involved combination with antipsychotics or transitioning to alternative antidepressants. Yet, in the MDS group, following these initial modifications, the addition of mood stabilizers tended to be the more prioritized alternative. CONCLUSIONS MDD patients with suicidal ideation or behaviour displayed distinctive demographic and clinical features. They exhibited intricate treatment patterns, a pronounced burden of illness, and an increased likelihood of relapse.
Collapse
Affiliation(s)
- Han Wang
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical University, 5 Ankang Hutong Road, Xicheng District, 100088, Beijing, China
| | - Nan Lyu
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical University, 5 Ankang Hutong Road, Xicheng District, 100088, Beijing, China
| | - Juan Huang
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical University, 5 Ankang Hutong Road, Xicheng District, 100088, Beijing, China
| | - Bingbing Fu
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical University, 5 Ankang Hutong Road, Xicheng District, 100088, Beijing, China
| | - Lili Shang
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical University, 5 Ankang Hutong Road, Xicheng District, 100088, Beijing, China
| | - Fan Yang
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical University, 5 Ankang Hutong Road, Xicheng District, 100088, Beijing, China
| | - Qian Zhao
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical University, 5 Ankang Hutong Road, Xicheng District, 100088, Beijing, China.
- The Advanced Innovation Center for Human Brain Protection, Capital Medical University, 100069, Beijing, China.
| | - Gang Wang
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical University, 5 Ankang Hutong Road, Xicheng District, 100088, Beijing, China.
- The Advanced Innovation Center for Human Brain Protection, Capital Medical University, 100069, Beijing, China.
| |
Collapse
|
6
|
Song X, Liu X, Zhou Y, Zhang X. Prevalence and correlates of suicide attempts in young patients with first-episode and drug-naïve major depressive disorder: A large cross-sectional study. J Affect Disord 2023; 340:340-346. [PMID: 37541596 DOI: 10.1016/j.jad.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/07/2023] [Accepted: 08/01/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND Few studies in China have reported factors influencing suicide attempt in young first-episode drug-free (FEDN) MDD patients. This study aimed to investigate the incidence and potential relevant factors of suicide attempt among young Chinese patients with FEDN MDD to prevent suicidal behavior in this population. METHODS We recruited 1076 FEDN MDD outpatients aged 18-45 years. Patients' mental states were measured by the Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Positive and Negative Syndrome Scale (PANSS) positive subscale, and Clinical Global Impression Severity Scale (CGIS). Fasting blood glucose, lipid levels, and thyroid function parameters were also measured. RESULTS The prevalence of suicide attempt for FEDN MDD patients was 18.31 %. Compared to patients without suicide attempt, patients with suicide attempt had an older age of onset, higher HAMA, HAMD, PANSS-positive subscale and CGI-S scores, higher blood pressure, fasting blood glucose, thyroid peroxidases antibody (A-TPO), anti-thyroglobulin (A-TG), thyroid stimulating hormone (TSH), low-density lipoprotein cholesterol (LDL-C), and total cholesterol (TC), but lower high-density lipoprotein cholesterol (HDLC) (all p < 0.05). Logistic regression analysis showed that duration of illness, hypertension, PANSS-positive subscale, HAMA and CGI-S scores, and A-TPO, LDL-C, TC, and HDL-C were associated with suicide attempt in patients with MDD. LIMITATIONS The main limitations are cross-sectional design and inability to control selection bias. CONCLUSIONS This study suggests that young patients with FEDN MDD have a high rate of suicide attempts. Several clinical and metabolic indicators related to lipids and thyroid function may be involved in suicide attempts in FEDN MDD patients.
Collapse
Affiliation(s)
- Xiuli Song
- Clinical psychology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China
| | - Xiaoran Liu
- School of Nursing, Binzhou Medical University, Yantai, China
| | | | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
| |
Collapse
|
7
|
Oh TK, Park HY, Song IA. Suicidal Thinking Among Patients With Spinal Conditions in South Korea: A Population-Based Cross-Sectional Study. Psychiatry Investig 2023; 20:834-842. [PMID: 37794665 PMCID: PMC10555517 DOI: 10.30773/pi.2023.0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/15/2023] [Accepted: 06/28/2023] [Indexed: 10/06/2023] Open
Abstract
OBJECTIVE Chronic pain increases the risk of suicide because it is often accompanied by depressive symptoms. However, the existing information regarding suicidal thinking in patients with chronic pain such as spinal conditions is insufficient. We aimed to examine the prevalence of suicidal thinking and the factors associated with it among patients with spinal conditions. METHODS Data from the National Health Insurance Service database in South Korea were used in this population-based, cross-sectional study, and 2.5% of adult patients diagnosed with spinal conditions (low back pain and/or neck pain) between 2018 and 2019 were selected using a stratified random sampling technique. Patient Health Questionnaire-9 was used to determine the presence of suicidal thoughts and depressive symptoms. RESULTS 33,171 patients with spinal conditions were included in this study. Among them, 5.9% had suicidal thinking and 20.7% had depressive symptoms. In the multivariable logistic regression model, old age, male sex, and employment were associated with a decreased prevalence of suicidal thinking. Current smokers, previous smokers, medical aid program recipients, and patients with mild-to-moderate or severe disability showed increased suicidal thinking. Underlying depression, bipolar disorder, insomnia disorder, and substance abuse were also associated with increased suicidal thinking. CONCLUSION In South Korea, 5.9% and 20.7% of patients with spinal conditions had suicidal thoughts and depressive symptoms, respectively. Some factors were associated with an increased prevalence of suicidal thoughts among patients with spinal conditions. Our results suggest that screening for these factors can help prevent suicide in patients with spinal conditions.
Collapse
Affiliation(s)
- Tak Kyu Oh
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Hye Yoon Park
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - In-Ae Song
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| |
Collapse
|
8
|
Nawata K. Heart diseases, hypertension and effects of antihypertensive medications: Is hypertension a true risk factor of heart diseases? Front Public Health 2022; 10:929840. [PMID: 36388284 PMCID: PMC9659607 DOI: 10.3389/fpubh.2022.929840] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 10/10/2022] [Indexed: 01/24/2023] Open
Abstract
Background Heart diseases (HD) are the leading cause of deaths in the world. Many studies have been done on the relationships among hypertension, HD and antihypertensive medications. Most of the studies find that hypertension is a significant risk factor of HD, but there are some studies in which hypertension is not a risk factor. As antihypertensive medications are routinely prescribed to prevent HD, it is necessary to evaluate the effects of these and other risk factors of HD. Data and methods The relationship between hypertension and HD was analyzed using 6,773,464 medical checkups obtained from the JMDC Claims Database obtained from January 2005 to September 2019. Factors potentially affecting HD, including blood pressures (BP) and usage of antihypertensive medications, were evaluated using 2,861,769 observations. To avoid the causality problem, probit models were used to analyze the probability of an individual who had no history of HD at year t developing HD by year t + 1. Results A positive relation between systolic blood pressure (SBP) and HD was found in the equation without any other covariates. However, the significant relation between HD and BP disappeared when the models contained various other factors as covariates. When a 10-year age or longer interval was used in the model, a positive relation between the two variables was found, suggesting that SBP works as a proxy variable. Taking antihypertensive medications greatly increases the probability of developing HD in the next year. Higher levels of cholesterols decrease the probability of developing HD. Conclusion Unlike many previous studies, no significant relationship between HD and hypertension was found in the models containing multiple covariates. The accepted relation might actually be spurious, and it is important to select covariates carefully. Taking antihypertensive medications appears to increase the probability of developing HD in the next year, suggesting the need for further research and greater caution in the use of antihypertensive medications.
Collapse
Affiliation(s)
- Kazumitsu Nawata
- Hitotsubashi Institute for Advanced Study (HISA), Hitotsubashi University, Tokyo, Japan
| |
Collapse
|
9
|
Zhu XM, Xu YM, Wang ZQ, Zhong BL. Prevalence and correlates of suicidal ideation among older adults attending primary care clinics in Wuhan, China: A multicenter cross-sectional study. Front Psychiatry 2022; 13:1003810. [PMID: 36159910 PMCID: PMC9500179 DOI: 10.3389/fpsyt.2022.1003810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 08/23/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Primary care represents an ideal setting for screening for and managing suicidal older adults but the clinical epidemiology of suicidal ideation in Chinese older primary care patients remains unclear. This study investigated the prevalence and correlates of suicidal ideation in older Chinese adults receiving primary care. METHODS This multicenter cross-sectional survey included a total of 769 older adults (≥65 years) from seven urban and six rural primary care clinics in Wuhan, China. The presence of depressive symptoms and suicidal ideation was assessed with the Geriatric Depression Scale and a single-item question "In the past 12 months, did you think about ending your life?," respectively. RESULTS The 12-month prevalence of suicidal ideation in older primary care patients was 16.6%. Significant correlates of suicidal ideation were poor economic status (vs. good, OR = 2.80, P = 0.008), heart disease (OR = 2.48, P = 0.005), chronic gastric ulcer (OR = 3.55, P = 0.012), arthritis (OR = 2.10, P = 0.042), and depressive symptoms (OR = 11.29, P < 0.001). CONCLUSIONS Suicidal ideation is common among older adults attending Chinese primary care clinics. It is necessary to integrate psychological crisis intervention into primary care to prevent late-life suicide.
Collapse
Affiliation(s)
- Xiao-Min Zhu
- Department of Psychiatry, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Yan-Min Xu
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China.,Department of Clinical Psychology, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Zong-Qin Wang
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China.,Department of Clinical Psychology, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Bao-Liang Zhong
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China.,Department of Clinical Psychology, Wuhan Hospital for Psychotherapy, Wuhan, China
| |
Collapse
|
10
|
Motsa MPS, Chiou HY, Chen YH. Association of chronic diseases and lifestyle factors with suicidal ideation among adults aged 18-69 years in Eswatini: evidence from a population-based survey. BMC Public Health 2021; 21:2245. [PMID: 34893094 PMCID: PMC8665558 DOI: 10.1186/s12889-021-12302-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 11/11/2021] [Indexed: 12/26/2022] Open
Abstract
Background How chronic diseases and lifestyle affect suicidal ideation in the sub-Saharan region remains unclear. We investigated the association of chronic diseases and lifestyle with suicidal ideation in the past year and the potential modifying role of sociodemographic status on this association. The findings can guide suicide prevention interventions. Methods We analyzed 3026 respondents from the World Health Organization STEPwise approach to noncommunicable disease risk factor surveillance conducted in Eswatini in 2014. The outcome was past-year suicidal ideation, and the main predictors were chronic diseases and lifestyle. Multiple logistic regression was used to estimate predictors, and subgroup analysis was performed to assess effect modification. Results The prevalence of past-year suicidal ideation was 9.9%. After adjustment for covariates, including sex, marital status, employment status, and education level, individuals aged 18–30 years (adjusted odds ratio [aOR]: 2.27, 95% confidence interval [CI]: 1.22–4.22) were more likely to have had past-year suicidal ideation than those aged 45–69 years. After adjustment for covariates among employed individuals, having high blood pressure (aOR: 3.38, 95% CI: 1.54–7.40), not exercising (aOR: 2.65, 95% CI: 1.09–6.39), drinking alcohol (aOR: 2.40, 95% CI: 1.14–5.05), being aged 18–30 years (aOR: 3.50, 95% CI: 1.01–12.1), and being exposed to threats (aOR: 2.37, 95% CI: 1.01–5.53) were significantly associated with past-year suicidal ideation. Conclusions Among currently employed individuals, having high blood pressure, not exercising, and drinking alcohol were associated with past-year suicidal ideation. The findings highlight the importance of developing and strengthening systems for early identification of suicidal ideation risk.
Collapse
Affiliation(s)
- Mfundi President Sebenele Motsa
- PhD Program in Global Health and Health Security, College of Public Health, Taipei Medical University, 250 Wuxing St., Taipei City, 110, Taiwan
| | - Hung-Yi Chiou
- School of Public Health, College of Public Health, Taipei Medical University, 250 Wuxing St., Taipei City, 110, Taiwan.,Institute of Population Health Sciences, National Health Research Institutes, Zhunan Town, Miaoli County, 35053, Taiwan
| | - Yi-Hua Chen
- School of Public Health, College of Public Health, Taipei Medical University, 250 Wuxing St., Taipei City, 110, Taiwan.
| |
Collapse
|
11
|
Alias A, Bertrand L, Bisson-Gervais V, Henry M. Suicide in obstructive lung, cardiovascular and oncological disease. Prev Med 2021; 152:106543. [PMID: 34538370 DOI: 10.1016/j.ypmed.2021.106543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/28/2021] [Accepted: 03/30/2021] [Indexed: 01/04/2023]
Abstract
Healthcare institutions face increasing demands stemming from the burden of noncommunicable diseases. The personal, social, financial and societal impact of these diseases are well-documented. However, the mental health concerns and trajectories of patients afflicted by chronic medical diseases have been under-recognized and are under-resourced. Despite that chronic diseases are associated with substantially increased risk of suicide, the medical world has largely failed to properly address suicide in the medically ill. Considering their high prevalence and mortality rate, this review article will highlight the mental health burden and suicide risk in obstructive lung, cardiovascular (including stroke) and oncological disease, in light of relevant data and conceptual models of suicide. Finally, general evidence-based suicide intervention strategies and potential selective adaptation of these strategies to the chronic medically ill patient populations and medical settings will be reviewed.
Collapse
Affiliation(s)
- Ali Alias
- Faculty of Medicine and Health Sciences, McGill University, 3605 de la Montagne, Montreal, QC H3G 2M1, Canada
| | - Lia Bertrand
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, St Joseph's Healthcare Hamilton, West 5(th) Campus, 100 West 5(th) Street, Hamilton, ON L8N 3K7, Canada.
| | - Vanessa Bisson-Gervais
- Faculty of Medicine and Health Sciences, McGill University, 3605 de la Montagne, Montreal, QC H3G 2M1, Canada
| | - Melissa Henry
- Gerald Bronfman Department of Oncology, Faculty of Medicine and Health Sciences, McGill University, 5100 de Maisonneuve Blvd. West, Suite 720, Montreal, QC H4A 3T2, Canada; Segal Cancer Centre, Jewish General Hospital, 3755 Chemin de la Cote-Sainte-Catherine, Montreal, QC H3T 1E2, Canada; Lady-Davis Institute for Medical Research, Jewish General Hospital, 3755 Chemin de la Cote-Sainte-Catherine, Montreal, QC H3T 1E2, Canada
| |
Collapse
|
12
|
Tailor BV, Thompson RE, Nunney I, Agius M, Phillips JS. Suicidal ideation in people with tinnitus: a systematic review and meta-analysis. J Laryngol Otol 2021; 135:1-9. [PMID: 34689843 DOI: 10.1017/s0022215121003066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Tinnitus is associated with a variety of cognitive, psychosocial and psychiatric disorders, and may contribute to suicidality. However, the prevalence of suicidal ideation (SI) in tinnitus populations has not previously been systematically reviewed. METHOD Medline, Embase and PsychInfo were searched in August 2020 to identify studies that assessed suicidal ideation in people aged 16 years and above with subjective tinnitus. RESULTS Six cross-sectional studies were included, representing 7192 tinnitus sufferers across 4 countries. The pooled prevalence of suicidal ideation in tinnitus populations was 20.6 per cent (95 per cent confidence interval, 10.8-30.3 per cent; I2 = 88 per cent). Two studies included a control population, in which the prevalence of suicidal ideation was significantly lower. The quality of included studies was variable. CONCLUSION It is not possible to arrive at any reasonable conclusion given the lack of quality studies, meaning the pooled prevalence should be interpreted very cautiously. Suicidal ideation may be more prevalent in tinnitus populations. Further large-scale epidemiological research investigating this relationship is needed, which may help psychiatric risk stratification.
Collapse
Affiliation(s)
- B V Tailor
- Department of Otolaryngology, Norfolk and Norwich University Hospital National Health Service Foundation Trust, Norwich
| | - R E Thompson
- School of Clinical Medicine, University of Cambridge
| | - I Nunney
- Norwich Clinical Trials Unit, Norwich Medical School, University of East Anglia
| | - M Agius
- Center for Mental Health Research in Association with the University of Cambridge, Cambridge, UK
| | - J S Phillips
- Department of Otolaryngology, Norfolk and Norwich University Hospital National Health Service Foundation Trust, Norwich
| |
Collapse
|
13
|
The association of clinical correlates, metabolic parameters, and thyroid hormones with suicide attempts in first-episode and drug-naïve patients with major depressive disorder comorbid with anxiety: a large-scale cross-sectional study. Transl Psychiatry 2021; 11:97. [PMID: 33542178 PMCID: PMC7862235 DOI: 10.1038/s41398-021-01234-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 12/09/2020] [Accepted: 12/16/2020] [Indexed: 01/30/2023] Open
Abstract
The associated factors of suicide attempts in patients with major depressive disorder (MDD) comorbid with anxiety remains unclear. To the best of our knowledge, this is the first study with a large sample size that examines the risk factors of suicide attempts in first-episode drug-naïve (FEND) MDD patients comorbid with anxiety and includes clinical correlates, metabolic parameters, and thyroid hormone levels. A total of 1718 FEDN MDD patients were enrolled. The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Positive and Negative Syndrome Scale (PANSS) were used to assess the symptoms of patients. Metabolic parameters and thyroid hormone levels were measured. The prevalence of suicide attempts in MDD patients comorbid anxiety symptoms was 24.28%, which was 9.51 times higher than that in MDD patients without anxiety symptoms (3.25%). Compared to non-attempters, MDD patients with anxiety symptoms who attempted suicide scored higher on HAMD and HAMA, and had higher systolic blood pressure, higher levels of thyroid stimulating hormone (TSH), and thyroid peroxidases antibody (TPOAb), which were also correlated with suicide attempts in MDD patients comorbid anxiety symptoms. The combination of HAMA score, HAMD score, and TSH could differentiate suicide attempters from non-suicide attempters. Further, the age of onset, illness duration, BMI, TSH, and TPOAb were associated with the times of suicide attempts in MDD patients comorbid anxiety symptoms. Our results demonstrate high prevalence of suicide attempts in MDD patients comorbid anxiety symptoms. Several clinical correlates, metabolic parameters, and thyroid hormones function contribute to the suicide attempts in MDD patients comorbid anxiety symptoms.
Collapse
|
14
|
Schneider L, Hadjistavropoulos H, Dear B, Titov N. Efficacy of internet-delivered cognitive behavioural therapy following an acute coronary event: A randomized controlled trial. Internet Interv 2020; 21:100324. [PMID: 32455120 PMCID: PMC7235608 DOI: 10.1016/j.invent.2020.100324] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 04/29/2020] [Accepted: 05/04/2020] [Indexed: 12/29/2022] Open
Abstract
Depression and anxiety are common among people who have experienced an acute coronary event (e.g., heart attack). Multidisciplinary cardiac rehabilitation programs often focus on reducing risk factors associated with future cardiac events, however, mental health interventions are not routinely available. Given known difficulties with access to mental health treatment, the present study sought to explore the efficacy and acceptability of an Internet-delivered cognitive behavioural therapy program (Cardiac Wellbeing Course) among participants who experienced an acute coronary event. The five-lesson course was delivered over eight weeks and was provided with brief weekly contact, via telephone and secure email with a guide. Participants were randomized to the Cardiac Wellbeing Course (n = 25) or waiting-list control group (n = 28). Symptoms were assessed at pre-treatment, post-treatment, and four-week follow-up. Completion rates (84%) and satisfaction ratings (95%) were high. Statistically significant between-group improvements were observed for the treatment group on primary measures of general anxiety (Cohen's d = 1.62; 67% reduction), depression (Cohen's d = 1.09; 61% reduction), and physical activity levels (Cohen's d = 0.27; 70% increase). Statistically significant improvements were also observed on secondary measures of distress (Cohen's d = 0.98; 51% reduction), cardiac anxiety (Cohen's d = 0.92; 34% reduction), and mental-health quality of life (Cohen's d = 0.23; 24% improvement). The changes were maintained at four-week follow-up. The current findings add to the existing literature and highlight the potential of Internet-delivered cognitive behavioural therapy programs among participants who have experienced an acute coronary event.
Collapse
Affiliation(s)
- L.H. Schneider
- 3737 Wascana Parkway, Department of Psychology, University of Regina, Regina, SK S4S 0A2, Canada
| | - H.D. Hadjistavropoulos
- 3737 Wascana Parkway, Department of Psychology, University of Regina, Regina, SK S4S 0A2, Canada
- Corresponding author.
| | - B.F. Dear
- eCentreClinic, Department of Psychology, Macquarie University, Balaclava Road, North Ryde, NSW 2109, Australia
| | - N. Titov
- eCentreClinic, Department of Psychology, Macquarie University, Balaclava Road, North Ryde, NSW 2109, Australia
- MindSpot Clinic, Department of Psychology, Macquarie University, Balaclava Road, North Ryde, NSW 2109, Australia
| |
Collapse
|
15
|
Oh B, Yun JY, Yeo EC, Kim DH, Kim J, Cho BJ. Prediction of Suicidal Ideation among Korean Adults Using Machine Learning: A Cross-Sectional Study. Psychiatry Investig 2020; 17:331-340. [PMID: 32213803 PMCID: PMC7176567 DOI: 10.30773/pi.2019.0270] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 02/07/2020] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Suicidal ideation (SI) precedes actual suicidal event. Thus, it is important for the prevention of suicide to screen the individuals with SI. This study aimed to identify the factors associated with SI and to build prediction models in Korean adults using machine learning methods. METHODS The 2010-2013 dataset of the Korea National Health and Nutritional Examination Survey was used as the training dataset (n=16,437), and the subset collected in 2015 was used as the testing dataset (n=3,788). Various machine learning algorithms were applied and compared to the conventional logistic regression (LR)-based model. RESULTS Common risk factors for SI included stress awareness, experience of continuous depressive mood, EQ-5D score, depressive disorder, household income, educational status, alcohol abuse, and unmet medical service needs. The prediction performances of the machine learning models, as measured by the area under receiver-operating curve, ranged from 0.794 to 0.877, some of which were better than that of the conventional LR model (0.867). The Bayesian network, LogitBoost with LR, and ANN models outperformed the conventional LR model. CONCLUSION A machine learning-based approach could provide better SI prediction performance compared to a conventional LR-based model. These may help primary care physicians to identify patients at risk of SI and will facilitate the early prevention of suicide.
Collapse
Affiliation(s)
- Bumjo Oh
- Department of Family Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - Je-Yeon Yun
- Seoul National University Hospital, Seoul, Republic of Korea.,Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eun Chong Yeo
- School of Software, Hallym University, Chuncheon, Republic of Korea
| | - Dong-Hoi Kim
- School of Software, Hallym University, Chuncheon, Republic of Korea
| | - Jin Kim
- School of Software, Hallym University, Chuncheon, Republic of Korea
| | - Bum-Joo Cho
- Department of Ophthalmology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea.,Medical Artificial Intelligence Center, Hallym University Medical Center, Anyang, Republic of Korea.,Institute of New Frontier Research, Hallym University College of Medicine, Chuncheon, Republic of Korea
| |
Collapse
|
16
|
Ge D, Zhang X, Guo X, Chu J, Sun L, Zhou C. Suicidal ideation among the hypertensive individuals in Shandong, China: a path analysis. BMC Psychiatry 2019; 19:266. [PMID: 31477070 PMCID: PMC6719379 DOI: 10.1186/s12888-019-2256-7] [Citation(s) in RCA: 5] [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: 10/02/2018] [Accepted: 08/22/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Although massive studies have explored the risk factors of suicidal ideation (SI), the prevalence of SI and its associated factors in the hypertensive individuals are largely unknown. This study aims to investigate the factors associated with SI in the hypertensive individuals. METHODS Three thousand nine hundred eleven hypertensive individuals in Shandong, China were included in the analysis. SI was assessed by using a question from the NCS (National Comorbidity Survey). We used binary logistic regression analysis to explore the factors associated with SI, and path analysis to test the direct and indirect relationships between associated factors and SI among hypertensive patients. RESULTS The prevalence of SI in the hypertensive individual was19.6%. Psychological distress had the greatest direct (β = 0.640, p-value <0.01) and total effect (β = 0.640, p-value <0.01) on SI. Other factors including comorbidity (β = 0.090, p-value <0.01), gender (β = 0.088, p-value <0.01), marital status (β = - 0.037, p-value <0.01), economic status (β = - 0.106, p-value <0.01), residence (β = - 0.050, p-value <0.01), alcohol use (β = 0.011, p-value <0.01), exercise (β = - 0.114, p-value <0.01), hospitalization (β = 0.041, p-value <0.01) only had indirect effects on SI. Psychological distress was a mediator between SI and those variables. CONCLUSION A significant mediation effect of psychological distress on the associations between SI and some associated factors (i.e., economic status, comorbidity) was demonstrated.
Collapse
Affiliation(s)
- Dandan Ge
- 0000 0004 1761 1174grid.27255.37School of Public Health, Shandong University, Jinan, 250012 China
| | - Xinyi Zhang
- 0000 0004 1761 1174grid.27255.37School of Public Health, Shandong University, Jinan, 250012 China
| | - Xiaolei Guo
- 0000 0000 8803 2373grid.198530.6Shandong Center for Disease Control and Prevention, Jinan, China
| | - Jie Chu
- Shandong Centre for Disease Control and Prevention, Jinan, 250014 China
| | - Long Sun
- 0000 0004 1761 1174grid.27255.37School of Public Health, Shandong University, Jinan, 250012 China
| | - Chengchao Zhou
- School of Public Health, Shandong University, Jinan, 250012, China. .,School of Public Health, NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China.
| |
Collapse
|
17
|
Jha MK, Qamar A, Vaduganathan M, Charney DS, Murrough JW. Screening and Management of Depression in Patients With Cardiovascular Disease: JACC State-of-the-Art Review. J Am Coll Cardiol 2019; 73:1827-1845. [PMID: 30975301 PMCID: PMC7871437 DOI: 10.1016/j.jacc.2019.01.041] [Citation(s) in RCA: 155] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 01/02/2019] [Accepted: 01/02/2019] [Indexed: 12/11/2022]
Abstract
Depression is a common problem in patients with cardiovascular disease (CVD) and is associated with increased mortality, excess disability, greater health care expenditures, and reduced quality of life. Depression is present in 1 of 5 patients with coronary artery disease, peripheral artery disease, and heart failure. Depression complicates the optimal management of CVD by worsening cardiovascular risk factors and decreasing adherence to healthy lifestyles and evidence-based medical therapies. As such, standardized screening pathways for depression in patients with CVD offer the potential for early identification and optimal management of depression to improve health outcomes. Unfortunately, the burden of depression in patients with CVD is under-recognized; as a result, screening and management strategies targeting depression have been poorly implemented in patients with CVD. In this review, the authors discuss a practical approach for the screening and management of depression in patients with CVD.
Collapse
Affiliation(s)
- Manish K Jha
- Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, and Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Arman Qamar
- TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Harvard T.H. Chan School of Public Health, Boston, Massachusetts. https://twitter.com/AqamarMD
| | - Muthiah Vaduganathan
- Heart & Vascular Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. https://twitter.com/mvaduganathan
| | - Dennis S Charney
- Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, and Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York; Office of the Dean, Icahn School of Medicine at Mount Sinai, New York, New York
| | - James W Murrough
- Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, and Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York.
| |
Collapse
|