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Guo M, Zhu C. Serum neurofilament light chain, markers of systemic inflammation and clinically relevant depressive symptoms in US adults. J Affect Disord 2024; 363:572-578. [PMID: 39074516 DOI: 10.1016/j.jad.2024.07.146] [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: 03/04/2024] [Revised: 07/03/2024] [Accepted: 07/26/2024] [Indexed: 07/31/2024]
Abstract
BACKGROUND Neurofilament light chain (NFL), a biomarker of neuroaxonal damage, has been linked to inflammation and depressive disorders, albeit with inconsistent results. We aimed to evaluate the association between serum NFL concentration and clinically relevant depressive symptoms in the general population and to examine the potential involvement of systemic inflammation in this association. METHODS The data of 1881 adults aged 20-75 years were extracted from the National Health and Nutrition Examination Survey (NHANES) 2013-2014 cycle. Serum NFL levels were quantified using a highly sensitive immunoassay. Further, markers of systemic inflammation, including systemic immune inflammation index (SII), system inflammation response index (SIRI), and white blood cell (WBC) counts were calculated based on whole blood cell counts. Clinically relevant depressive symptoms were evaluated using the 9-item Patient Health Questionnaire (PHQ-9) with a cut-off score of 10. RESULTS After adjusting for potential confounders, we found that each one-unit increase in ln-transformed serum NFL concentration was significantly associated with a 1.37-fold increase in the risk of clinically relevant depressive symptoms (95 % confidence interval [CI]: 1.06, 1.77; p = 0.017). Serum NFL level was significantly related to increased SII (regression coefficient [β] = 0.04, 95%CI: 0.01, 0.08; p = 0.027), SIRI (β = 0.09, 95%CI: 0.05, 0.14; p < 0.001), and WBC (β = 0.05, 95%CI: 0.03, 0.07; p < 0.001), respectively. These significant associations were observed only in elderly participants. LIMITATIONS The cross-sectional study design is limited in causal inference. CONCLUSIONS Our findings indicate that serum NFL levels are related to an increased risk of clinically relevant depressive symptoms and higher levels of markers of systemic inflammation.
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Affiliation(s)
- Menglu Guo
- Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Changlin Zhu
- Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Gurguis CI, Duckworth RA, Bucaro NM, Walss-Bass C. Fitness consequences of depressive symptoms vary between generations: Evidence from a large cohort of women across the 20th century. PLoS One 2024; 19:e0310598. [PMID: 39348394 PMCID: PMC11441685 DOI: 10.1371/journal.pone.0310598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 09/02/2024] [Indexed: 10/02/2024] Open
Abstract
Depression has strong negative impacts on how individuals function, leading to the assumption that there is strong negative selection on this trait that should deplete genetic variation and decrease its prevalence in human populations. Yet, depressive symptoms remain common. While there has been a large body of work trying to resolve this paradox by mapping genetic variation of this complex trait, there have been few direct empirical tests of the core assumption that there is consistent negative selection on depression in human populations. Here, we use a unique long-term dataset from the National Health and Nutrition Examination Survey that spans four generational cohorts (Silent Generation: 1928-1945, Baby Boomers: 1946-1964, Generation X: 1965-1980, and Millenials: 1981-1996) to measure both depression scores and fitness components (lifetime sexual partners, pregnancies, and live births) of women from the United States born between 1938-1994. We not only assess fitness consequences of depression across multiple generations to determine whether the strength and direction of selection on depression has changed over time, but we also pair these fitness measurements with mixed models to assess how several important covariates, including age, body mass, education, race/ethnicity, and income might influence this relationship. We found that, overall, selection on depression was positive and the strength of selection changed over time-women reporting higher depression had relatively more sexual partners, pregnancies, and births except during the Silent Generation when selection coefficients neared zero. We also found that depression scores and fitness components differed among generations-Baby Boomers showed the highest severity of depression and the most sexual partners. These results were not changed by the inclusion of covariates in our models. A limitation of this study is that for the Millenials, reproduction has not completed and data for this generation is interrupted by right censoring. Most importantly, our results undermine the common belief that there is consistent negative selection on depression and demonstrate that the relationship between depression and fitness changes between generations, which may explain its maintenance in human populations.
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Affiliation(s)
- Christopher I. Gurguis
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School at UTHealth, Houston, TX, United States of America
| | - Renée A. Duckworth
- Department of Ecology and Evolutionary Biology, University of Arizona, Tucson, AZ, United States of America
| | - Nicole M. Bucaro
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School at UTHealth, Houston, TX, United States of America
| | - Consuelo Walss-Bass
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School at UTHealth, Houston, TX, United States of America
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Xiong B, Li Z, Zhang S, Wang Z, Xie Y, Zhang M, Zhang G, Wen J, Tian Y, Li Q. Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and the risk of post-stroke depression: A cross-sectional study. J Stroke Cerebrovasc Dis 2024; 33:107991. [PMID: 39227001 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107991] [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: 06/30/2024] [Revised: 08/30/2024] [Accepted: 08/31/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND Limited observational research has explored the relationship between the non-high-density lipoprotein cholesterol (non-HDL-C) to high-density lipoprotein cholesterol (HDL-C) ratio (NHHR) and the risk of post-stroke depression (PSD). This study aims to investigate the potential associations between NHHR and PSD. METHODS A cross-sectional study was conducted using data from stroke participants aged 20 and older, sourced from the National Health and Nutrition Examination Survey (NHANES) spanning 2005 to 2018. Depression was assessed using the PHQ-9 questionnaire. The association between NHHR and PSD risk was evaluated through weighted multivariate logistic regression and restricted cubic spline (RCS) models. Subgroup and sensitivity analyses were performed to validate the findings. RESULTS In the continuous model, the NHHR value for the PSD group (3.23±1.84) was significantly higher than that of the non-PSD group (2.79±1.40, p=0.015). Logistic regression analysis in the fully adjusted model revealed a positive association between NHHR and PSD (OR 1.16, 95 % CI 1.03-1.30, p=0.016). Interaction tests showed no significant differences across strata (p > 0.05 for interaction). Restricted cubic spline results indicated a linear dose-response relationship between NHHR and PSD risk (P for non-linearity = 0.6). This association persisted in various subgroup analyses. CONCLUSION NHHR was significantly correlated with an increased risk of PSD among U.S. adults. Further re-search on NHHR could contribute to the prevention and treatment of PSD.
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Affiliation(s)
- Benbo Xiong
- Department of The Second Clinical Medical School, Anhui Medical University, Hefei 230601, Anhui, PR China
| | - Zhiming Li
- Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui, PR China
| | - Shanyu Zhang
- Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui, PR China
| | - Zijie Wang
- Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui, PR China
| | - Yanfang Xie
- Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui, PR China
| | - Mengqiu Zhang
- Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui, PR China
| | - Gaocai Zhang
- Department of Neurology, The Kaifeng Central Hospital, Kaifeng 475000, Henan, PR China
| | - Jianshang Wen
- Department of Neurology, Shucheng People's Hospital, Lu'an 231300, Anhui, PR China
| | - Yanghua Tian
- Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui, PR China
| | - Qi Li
- Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui, PR China; Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, PR China.
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Ke C, Zhang X, Wang X. Association between dietary inflammatory index and all-cause mortality in patients with osteopenia or osteoporosis: A retrospective cohort study from the NHANES 2007-2018. Prev Med Rep 2024; 45:102826. [PMID: 39156725 PMCID: PMC11328027 DOI: 10.1016/j.pmedr.2024.102826] [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: 02/06/2024] [Revised: 07/10/2024] [Accepted: 07/10/2024] [Indexed: 08/20/2024] Open
Abstract
Objective Osteoporosis is an inflammatory disease that causes a large disease burden worldwide. Dietary inflammation index (DII), a comprehensive assessment index that reflects the pro-inflammatory/anti-inflammatory level of diet was related to multiple inflammatory diseases. This study aimed to explore the association between DII and all-cause mortality in patients with osteoporosis or osteopenia. Methods In this retrospective cohort study, data of patients aged ≥ 45 years diagnosed as osteopenia or osteoporosis and had complete dietary intake information were extracted from the National Health and Nutrition Examination Survey (NHANES 2007-2010, 2013-2014, 2017-2018). Dietary intake information was obtained from 24-h dietary recall interviews and was used to calculate the DII score. Weighted univariate and multivariate Cox proportional hazard models were utilized to explore the association between DII and all-cause mortality in patients with osteoporosis or osteopenia, with hazard ratios (HRs) and 95 % confidence intervals (CIs). Subgroup analyses based on different age, gender and complications were further assessed this association. Results A total of 5,381 patients were included. Until December 31, 2019, 1,286 all-cause deaths occurred. After adjusting all covariates, high DII was associated with the high odds of all-cause mortality among patients with osteoporosis or osteopenia (HR=1.28, 95 %CI: 1.10-1.48), especially in the male (HR=1.38, 95 %CI: 1.06-1.78), aged < 65 years (HR=1.49, 95 %CI: 1.09-2.02), and without the history the cardiovascular disease (HR=1.30, 95 %CI: 1.03-1.65), diabetes mellitus (HR=1.27, 95 %CI: 1.06-1.52) and chronic kidney disease (HR=1.28, 95 %CI: 1.03-1.58). Conclusion A pro-inflammatory diet may have an adverse effect on the prognosis of osteoporosis patients.
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Affiliation(s)
- Chenrong Ke
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
- Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou 325000, Zhejiang Province, China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Xiaolei Zhang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
- Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou 325000, Zhejiang Province, China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Xiangyang Wang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
- Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou 325000, Zhejiang Province, China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
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Jiang H, Zhang X, Liang J. The Combined Effect Between Sleep Disorders and Depression Symptoms on Chronic Low Back Pain: A Cross-Sectional Study of NHANES. J Pain Res 2024; 17:2777-2787. [PMID: 39220223 PMCID: PMC11363950 DOI: 10.2147/jpr.s471401] [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: 03/29/2024] [Accepted: 08/08/2024] [Indexed: 09/04/2024] Open
Abstract
Purpose To explore the combined effects of sleep disorders and depression on chronic low back pain (CLBP) in American adults. Material and methods In this cross-sectional study, the data of all participants were obtained from the National Health and Nutrition Examination Survey (NAHNES) between 2009 and 2010. CLBP was defined as persistent LBP for a consecutive three-month period. Sleep disorders were self-reported and were diagnosed by a doctor before. The Patient Health Questionnaire-9 (PHQ-9) was used to assess depressive symptoms by trained personnel. Potential covariates were selected using weighted univariate logistic regression models. Weighted univariate and multivariate logistic regression models were used to evaluate the separate and combined effects of sleep disorders and depression on CLBP, respectively. Results were presented as odds ratios (ORs) and 95% confidence intervals (CIs). Associations were further explored in the subgroups of age, chronic kidney disease (CKD), diabetes, and having pain outside the low back. Results A total of 5275 participants were included. Among them, 542 (10.28%) had CLBP. The mean age of all participants was 47.19 (0.53), and 50.65% (n=2668) were female. Sleep disorder (OR=1.52, 95% CI: 1.17-1.98) or depressive symptoms (OR=3.06, 95% CI: 2.41-3.88) were associated with higher odds of CLBP. Compared to participants without sleep disorders and depression symptoms, participants in both conditions had an increased risk of CLBP (OR=3.95, 95% CI: 2.58-6.05, P for trend <0.001). The combined effects of sleep disorders and depressive symptoms were also found in the population aged <45 years, ≥45 years, with and without CKD, with and without diabetes, and no pain outside the low back. Conclusion Sleep disorders and depressive symptoms may increase the odds of reporting CLBP. Further research is necessary to explore the effectiveness of multidisciplinary interventions targeting sleep disorders, depressive symptoms, and CLBP.
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Affiliation(s)
- Hao Jiang
- Department of Anesthesiology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, 150081, People’s Republic of China
| | - Xiaomin Zhang
- Department of Anesthesiology, Beidahuang Industry Group General Hospital, Harbin, Heilongjiang, 150000, People’s Republic of China
| | - Jie Liang
- Department of Anesthesiology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, 150081, People’s Republic of China
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Liu L, Wang B, Wen H, Yang C, Wang B. Modulatory effect of sedentary behaviour on obesity and chronic low back pain: a cross-sectional study using data from the National Health and Nutrition Examination Survey. BMJ Open 2024; 14:e082851. [PMID: 39187278 PMCID: PMC11367289 DOI: 10.1136/bmjopen-2023-082851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 08/09/2024] [Indexed: 08/28/2024] Open
Abstract
OBJECTIVE To explore whether sedentary behaviour could modulate the association between overweight or obesity and chronic low back pain (CLBP). DESIGN A retrospective cross-sectional study. SETTING AND PARTICIPANTS A total of 4289 participants in the US cohort from the National Health and Nutrition Examination Survey were included. PRIMARY AND SECONDARY OUTCOME MEASURES CLBP was the outcome. RESULTS After adjusting for confounding factors, an increased risk of CLBP was identified in people who were overweight (OR 1.41, 95% CI 1.13 to 1.76) and obesity (OR 1.48, 95% CI 1.01 to 2.18). No significant association between sedentary behaviour time and CLBP was observed. In body mass index (BMI)<25 kg/m2 vs BMI≥30 kg/m2 group, sedentary behaviour time showed a modulatory effect on obesity and CLBP (p=0.047). In the sedentary behaviour time >4.5 hours group, the risk of CLBP was increased as BMI elevation, indicating sedentary behaviour time >4.5 hours played a modulatory role in the relationship between obesity and CLBP. CONCLUSION Obesity was significantly associated with an increased risk of CLBP, and sedentary behaviour time modulated the association between obesity and CLBP. The findings might provide a reference for the lifestyle modifications among individuals with obesity and reducing sedentary behaviour is recommended for this population.
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Affiliation(s)
- Lu Liu
- Department of Rehabilitation, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong, China
| | - Bihan Wang
- Department of Rehabilitation, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong, China
| | - Huaneng Wen
- Department of Rehabilitation, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong, China
- Southern Medical University, Guangzhou, Guangdong, China
| | - Cheng Yang
- Department of Rehabilitation, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong, China
| | - Bingshui Wang
- Department of Rehabilitation, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong, China
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Crawford CA, Polanka BM, Wu W, MacDonald KL, Gupta SK, Stewart JC. Depressive symptom clusters and biomarkers of monocyte activation, inflammation, and coagulation in people with HIV and depression. J Health Psychol 2024:13591053241270630. [PMID: 39148313 DOI: 10.1177/13591053241270630] [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: 08/17/2024] Open
Abstract
We assess associations of somatic and cognitive/affective depressive symptom clusters with monocyte activation (soluble (s)CD14, sCD163), systemic inflammation (interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP)), and coagulation (D-dimer, fibrinogen) in people with HIV (PWH) on suppressive antiretroviral therapy with depression. Utilizing baseline data from a randomized controlled trial, we found no significant associations in linear regression models examining individual depressive symptom clusters; however, models examining both clusters simultaneously showed that the somatic cluster was positively associated with inflammation biomarkers, while the cognitive/affective cluster was negatively associated with inflammation and coagulation biomarkers (suggesting a cooperative suppression effect). Our findings indicate a differential association with depressive symptom clusters and biological mechanisms underlying cardiovascular disease (CVD) in HIV, which may be driven by unique components of each depressive symptom cluster. This line of research could identify subgroups of PWH with depression at elevated CVD risk needing early CVD prevention approaches. Supported by R01 HL126557.
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Affiliation(s)
| | | | - Wei Wu
- Indiana University-Purdue University Indianapolis, USA
| | - Krysha L MacDonald
- Indiana University-Purdue University Indianapolis, USA
- Sandra Eskenazi Mental Health Center, Eskenazi Health, USA
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Richardson BT, Jackson J, Marable G, Barker J, Gardiner H, Igarabuza L, Leasy M, Matthews E, Zisman-Ilani Y. The Role of Black Churches in Promoting Mental Health for Communities of Socioeconomically Disadvantaged Black Americans. Psychiatr Serv 2024; 75:740-747. [PMID: 38595118 DOI: 10.1176/appi.ps.20230263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
OBJECTIVE Churches in socioeconomically disadvantaged neighborhoods serve as safe havens in many Black communities. Churches provide faith and charitable services but often have limited resources to address the mental health needs of their communities. This article reports on a collaborative effort, driven by members of a Black church, to understand mental health needs, coping strategies, and resilience factors in a community of socioeconomically disadvantaged Black Americans. METHODS A community-based participatory research effort was established among a church, a community mental health organization, clinicians, and researchers to interview and survey individuals residing near the church. RESULTS The sample consisted of 59 adults, most of whom were ages 46-65 years, men (N=34, 58%), and unemployed (N=46, 78%). Mean scores on the Patient Health Questionnaire-9 (9.2±7.7) and Generalized Anxiety Disorder-7 scale (9.4±6.7) were almost three times higher than those reported by studies of other Black populations in the United States. Five themes emerged: prolonged poverty and daily exposure to violence trigger emotional distress, mental health stigma affects help seeking, spirituality promotes mental relief and personal recovery, spirituality helps in coping with poverty and unsafe neighborhoods, and church-based programs are needed. CONCLUSIONS Uptake of traditional mental health services was low, and reliance on faith and resource distribution by the church was high. Church-led interventions are needed to promote mental health at the individual and community levels. Mental health stigma, and negative attitudes toward mental health promotion in the community, may be addressed by integrating traditional mental health services in church-based recreational and leisure activities.
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Affiliation(s)
- Briana T Richardson
- Office of Community-Engaged Research and Practice (Richardson, Barker, Gardiner) and Department of Social and Behavioral Sciences (Gardiner, Zisman-Ilani), College of Public Health, and the Lewis Katz School of Medicine (Igarabuza, Leasy), Temple University, Philadelphia; Bethel Presbyterian Church, Philadelphia (Jackson, Marable); Graduate School of Social Service, Fordham University, New York City (Matthews); Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani)
| | - Jacqueline Jackson
- Office of Community-Engaged Research and Practice (Richardson, Barker, Gardiner) and Department of Social and Behavioral Sciences (Gardiner, Zisman-Ilani), College of Public Health, and the Lewis Katz School of Medicine (Igarabuza, Leasy), Temple University, Philadelphia; Bethel Presbyterian Church, Philadelphia (Jackson, Marable); Graduate School of Social Service, Fordham University, New York City (Matthews); Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani)
| | - Grace Marable
- Office of Community-Engaged Research and Practice (Richardson, Barker, Gardiner) and Department of Social and Behavioral Sciences (Gardiner, Zisman-Ilani), College of Public Health, and the Lewis Katz School of Medicine (Igarabuza, Leasy), Temple University, Philadelphia; Bethel Presbyterian Church, Philadelphia (Jackson, Marable); Graduate School of Social Service, Fordham University, New York City (Matthews); Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani)
| | - Jessica Barker
- Office of Community-Engaged Research and Practice (Richardson, Barker, Gardiner) and Department of Social and Behavioral Sciences (Gardiner, Zisman-Ilani), College of Public Health, and the Lewis Katz School of Medicine (Igarabuza, Leasy), Temple University, Philadelphia; Bethel Presbyterian Church, Philadelphia (Jackson, Marable); Graduate School of Social Service, Fordham University, New York City (Matthews); Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani)
| | - Heather Gardiner
- Office of Community-Engaged Research and Practice (Richardson, Barker, Gardiner) and Department of Social and Behavioral Sciences (Gardiner, Zisman-Ilani), College of Public Health, and the Lewis Katz School of Medicine (Igarabuza, Leasy), Temple University, Philadelphia; Bethel Presbyterian Church, Philadelphia (Jackson, Marable); Graduate School of Social Service, Fordham University, New York City (Matthews); Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani)
| | - Laura Igarabuza
- Office of Community-Engaged Research and Practice (Richardson, Barker, Gardiner) and Department of Social and Behavioral Sciences (Gardiner, Zisman-Ilani), College of Public Health, and the Lewis Katz School of Medicine (Igarabuza, Leasy), Temple University, Philadelphia; Bethel Presbyterian Church, Philadelphia (Jackson, Marable); Graduate School of Social Service, Fordham University, New York City (Matthews); Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani)
| | - Menachem Leasy
- Office of Community-Engaged Research and Practice (Richardson, Barker, Gardiner) and Department of Social and Behavioral Sciences (Gardiner, Zisman-Ilani), College of Public Health, and the Lewis Katz School of Medicine (Igarabuza, Leasy), Temple University, Philadelphia; Bethel Presbyterian Church, Philadelphia (Jackson, Marable); Graduate School of Social Service, Fordham University, New York City (Matthews); Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani)
| | - Elizabeth Matthews
- Office of Community-Engaged Research and Practice (Richardson, Barker, Gardiner) and Department of Social and Behavioral Sciences (Gardiner, Zisman-Ilani), College of Public Health, and the Lewis Katz School of Medicine (Igarabuza, Leasy), Temple University, Philadelphia; Bethel Presbyterian Church, Philadelphia (Jackson, Marable); Graduate School of Social Service, Fordham University, New York City (Matthews); Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani)
| | - Yaara Zisman-Ilani
- Office of Community-Engaged Research and Practice (Richardson, Barker, Gardiner) and Department of Social and Behavioral Sciences (Gardiner, Zisman-Ilani), College of Public Health, and the Lewis Katz School of Medicine (Igarabuza, Leasy), Temple University, Philadelphia; Bethel Presbyterian Church, Philadelphia (Jackson, Marable); Graduate School of Social Service, Fordham University, New York City (Matthews); Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani)
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Liu T, Wang L, Zhu Z, Wang B, Lu Z, Pan Y, Sun L. Association of both depressive symptoms scores and specific depressive symptoms with all-cause and cardiovascular disease mortality. Ann Gen Psychiatry 2024; 23:25. [PMID: 39010080 PMCID: PMC11250981 DOI: 10.1186/s12991-024-00509-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 06/14/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND The presence of depression related to an increased risk of all-cause and cardiovascular disease (CVD) mortality has been reported. However, studies conducted on certain specific depressive symptoms are scarce. Our purpose was to assess the effect of both depressive symptoms scores and certain specific depressive symptoms on all-cause and CVD mortality. METHODS In the present cohort study, all participants, aged 18 years or older, were enrolled in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2014. Depressive symptoms score was assessed using the validated 9-item Patient Health Questionnaire Depression Scale (PHQ-9), which ranges from 0 to 27, with a PHQ-9 score ≥ 10 diagnosed as depression. The outcome events were all-cause and CVD mortality, which were followed up from 2005 to 2014. The associations of both depressive symptoms score and certain specific depressive symptoms with all-cause and CVD mortality were examined by weighted multivariable proportional hazards models. RESULTS A total of 26,028 participants aged ≥ 18 years were included in the statistical analysis, including 12,813 (49.2%) males and 13,215 (50.8%) females, with a mean (SD) age of 47.34 (18.86) years. During the 9.32 (3.20) years of mean (SD) follow-up, 3261 deaths were recorded, of which 826 were cardiovascular deaths. All-cause mortality was 16.87/1000 person-years in subjects with depression. In terms of CVD mortality, these figures were 4.53/1000 person-years. In the full model (model 3), elevated depressive symptoms scores were independently associated with an increased risk of all-cause mortality (Highest depression symptom score group: adjusted hazard ratio, 1.63; 95% CI 1.44-1.85) and CVD mortality (Highest depression symptom score group: adjusted hazard ratio, 1.73; 95% CI 1.34-2.24). All 9 specific depressive symptoms that make up the PHQ-9 were related to an increased risk of all-cause mortality. However, only 3 symptoms, including trouble sleeping or sleeping too much, poor appetite or overeating, and suicidal ideation, were no significantly associated with an increased risk of CVD mortality. CONCLUSIONS The elevated depressive symptoms scores were strongly associated with an increased risk of all-cause and CVD mortality in US adults. Furthermore, all 9 specific depressive symptoms were associated with high all-cause mortality. However, trouble sleeping or sleeping too much, poor appetite or overeating, and suicidal ideation might not increase the risk of CVD mortality.
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Affiliation(s)
- Tao Liu
- Department of Cardiology, Jinshan District Central Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Lili Wang
- Department of Cardiology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Zhijian Zhu
- Department of Cardiology, Jinshan District Central Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Bing Wang
- Department of Cardiology, Jinshan District Central Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Zhigang Lu
- Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yesheng Pan
- Department of Cardiology, Jinshan District Central Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China.
| | - Lifang Sun
- Department of Cardiology, Jinshan District Central Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
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Law M, Pickering I, Humphrey G, Sebaratnam G, Schamberg G, Simpson K, Varghese C, Du P, Daker C, Huang IH, Khalsa SS, Gharibans A, O'Grady G, Andrews CN, Calder S. Development and validation of the Alimetry Gut-Brain Wellbeing Survey: a novel patient-reported mental health scale for patients with chronic gastroduodenal symptoms. Front Psychol 2024; 15:1389671. [PMID: 39040963 PMCID: PMC11262055 DOI: 10.3389/fpsyg.2024.1389671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 06/24/2024] [Indexed: 07/24/2024] Open
Abstract
Objective There is currently a lack of validated questionnaires designed specifically to assess mental health within patients with chronic gastroduodenal symptoms. This research describes the multi-phase process used to develop and validate a novel mental health scale for patients with chronic gastroduodenal symptoms, the Alimetry® Gut-Brain Wellbeing (AGBW) Survey. Methods A patient-centered multi-phase process was implemented. In Phase 1, the most relevant concepts for this patient population were selected from existing mental health scales, using data from 79 patients. In Phase 2, an interdisciplinary panel of experts generated scale items. In Phase 3, the scale underwent pre-testing with gastroenterologists (n = 9), health psychologists (n = 3), and patients (n = 12), with feedback incorporated over multiple rounds. Lastly, the psychometric properties of the scale were assessed in a sample of 311 patients via an online survey. Results The AGBW Survey comprises a patient preface, 10 close-ended questions, and an optional open-ended question. This multidimensional scale assesses general mental health, alongside specific subscales relating to depression, stress, and anxiety. The subscale and total scores demonstrated high internal consistency (α = 0.91 for the total scale; α = 0.72-0.86 for subscales) and good convergent, divergent, concurrent validity, and known groups validity, with large effect sizes. Conclusion The AGBW Survey is a brief, valid, and reliable scale for assessing mental health in patients with chronic gastroduodenal symptoms. It can be used as a tool to complement physiological tests and has the potential to guide psychological referrals, inform multidisciplinary management, and evaluate treatment outcomes.
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Affiliation(s)
- Mikaela Law
- Department of Surgery, The University of Auckland, Auckland, New Zealand
- Alimetry Ltd., Auckland, New Zealand
| | - Isabella Pickering
- Alimetry Ltd., Auckland, New Zealand
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Gayl Humphrey
- Department of Surgery, The University of Auckland, Auckland, New Zealand
| | | | - Gabriel Schamberg
- Department of Surgery, The University of Auckland, Auckland, New Zealand
- Alimetry Ltd., Auckland, New Zealand
| | - Katie Simpson
- Department of General Surgery, Auckland City Hospital, Auckland, New Zealand
| | - Chris Varghese
- Department of Surgery, The University of Auckland, Auckland, New Zealand
| | - Peng Du
- Alimetry Ltd., Auckland, New Zealand
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Charlotte Daker
- Alimetry Ltd., Auckland, New Zealand
- Department of Gastroenterology, Te Whatu Ora - Waitematā, Auckland, New Zealand
| | - I-Hsuan Huang
- Translational Research Center for Gastrointestinal Disorders (TARGID), University of Leuven, Leuven, Belgium
| | - Sahib S. Khalsa
- Laureate Institute for Brain Research, Tulsa, OK, United States
- Oxley College of Health Sciences, University of Tulsa, Tulsa, OK, United States
| | - Armen Gharibans
- Department of Surgery, The University of Auckland, Auckland, New Zealand
- Alimetry Ltd., Auckland, New Zealand
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Greg O'Grady
- Department of Surgery, The University of Auckland, Auckland, New Zealand
- Alimetry Ltd., Auckland, New Zealand
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
- The Insides Company, Auckland, New Zealand
| | - Christopher N. Andrews
- Alimetry Ltd., Auckland, New Zealand
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- The Division of Gastroenterology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Stefan Calder
- Department of Surgery, The University of Auckland, Auckland, New Zealand
- Alimetry Ltd., Auckland, New Zealand
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Kawilapat S, Traisathit P, Maneeton N, Prasitwattanaseree S, Kongsuk T, Arunpongpaisal S, Leejongpermpoon J, Sukhawaha S, Maneeton B. Factor Structures in the Depressive Symptoms Domains in the 9Q for Northern Thai Adults and Their Association with Chronic Diseases. Behav Sci (Basel) 2024; 14:577. [PMID: 39062400 PMCID: PMC11274117 DOI: 10.3390/bs14070577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 06/03/2024] [Accepted: 07/01/2024] [Indexed: 07/28/2024] Open
Abstract
Most of the common models to examine depression are one-factor models; however, previous studies provided several-factor structure models on each depressive symptom using the Patient Health Questionnaire-9 (PHQ-9). The Nine-Questions Depression-Rating Scale (9Q) is an alternative assessment tool that was developed for assessing the severity of depressive symptoms in Thai adults. This study aimed to examine the factor structure of this tool based on the factor structure models for the PHQ-9 provided in previous studies using confirmatory factor analysis (CFA). We also examined the association of chronic diseases and depressive symptoms using the Multiple Indicators Multiple Causes model among 1346 participants aged 19 years old or more without psychiatric disorders. The results show that the two-factor CFA model with six items in the cognitive-affective domain and three items in the somatic domain provided the best fit for depressive symptoms in the study population (RMSEA = 0.077, CFI = 0.953, TLI = 0.936). Dyslipidemia was positively associated with both cognitive-affective symptoms (β = 0.120) and somatic depressive symptoms (β = 0.080). Allergies were associated with a higher level of cognitive-affective depressive symptoms (β = 0.087), while migraine (β = 0.114) and peptic ulcer disease (β = 0.062) were associated with a higher level of somatic symptoms. Increased age was associated with a lower level of somatic symptoms (β = -0.088). Our findings suggested that considering depressive symptoms as two dimensions yields a better fit for depressive symptoms. The co-occurrence of chronic diseases associated with depressive symptoms should be monitored.
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Affiliation(s)
- Suttipong Kawilapat
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand; (S.K.); (P.T.); (S.P.)
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Patrinee Traisathit
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand; (S.K.); (P.T.); (S.P.)
| | - Narong Maneeton
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Sukon Prasitwattanaseree
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand; (S.K.); (P.T.); (S.P.)
| | - Thoranin Kongsuk
- Prasrimahabhodi Psychiatric Hospital, Ubon Ratchathani 34000, Thailand; (T.K.); (J.L.); (S.S.)
- Somdet Chaopraya Institute of Psychiatry, Bangkok 10600, Thailand
| | - Suwanna Arunpongpaisal
- Department of Psychiatry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand;
| | - Jintana Leejongpermpoon
- Prasrimahabhodi Psychiatric Hospital, Ubon Ratchathani 34000, Thailand; (T.K.); (J.L.); (S.S.)
| | - Supattra Sukhawaha
- Prasrimahabhodi Psychiatric Hospital, Ubon Ratchathani 34000, Thailand; (T.K.); (J.L.); (S.S.)
| | - Benchalak Maneeton
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
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Ma L, Yuan J, Yang X, Yan M, Li Y, Niu M. Association between the adherence to Mediterranean diet and depression in rheumatoid arthritis patients: a cross-sectional study from the NHANES database. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:103. [PMID: 38970091 PMCID: PMC11227153 DOI: 10.1186/s41043-024-00572-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 05/23/2024] [Indexed: 07/07/2024]
Abstract
BACKGROUND Rheumatoid arthritis (RA) is a systemic autoimmune disease, and depression is a most frequent comorbid condition associated with RA. Studies have shown that inflammation plays a vital role in the pathophysiology of depression and RA. Mediterranean diet (MED) has been proved to be a healthy anti-inflammatory dietary pattern. This study aims to explore the association between the adherence to Mediterranean diet (aMED) and depression in RA patients. METHODS In this study, RA patients aged ≥ 20 years old were extracted from the National Health and Nutrition Examination Survey (NAHNES) database. Dietary intake information was obtained from 24-h dietary recall interview. Covariates included sociodemographic information, lifestyles, laboratory parameters, and the history of diseases and medications were included. The weighted univariable and multivariable logistic regression models were used to assess the association between aMED and depression. Subgroup analysis was conducted to further explore the association between MED components and depression. RESULTS Totally 1,148 patients were included, of whom 290 (25.26%) had depression. After adjusted all covariates, high aMED was associated with the lower odds of depression in RA patients (OR = 0.53, 95%CI: 0.29-0.97). Among MED components, higher consumption of vegetables (OR = 0.54, 95%CI: 0.34-0.84) and cereals (OR = 0.63, 95%CI: 0.39-0.99) contributed more to decrease the odds of depression. CONCLUSION Greater aMED may have potential benefits for improving mental health in RA patients. Future large-scale cohort studies are needed to explore the association between aMED and depression in RA patients.
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Affiliation(s)
- Liya Ma
- Department of Rheumatology Immunology and Endocrinology, Honghui Hospital Affiliated of Xi'an Jiaotong University, No.76 Nanguo Road, Beilin District, Xi'an, Shaanxi Province, 710061, China
| | - Jingman Yuan
- Department of Rheumatology Immunology and Endocrinology, Honghui Hospital Affiliated of Xi'an Jiaotong University, No.76 Nanguo Road, Beilin District, Xi'an, Shaanxi Province, 710061, China
| | - Xichao Yang
- Department of Rheumatology Immunology and Endocrinology, Honghui Hospital Affiliated of Xi'an Jiaotong University, No.76 Nanguo Road, Beilin District, Xi'an, Shaanxi Province, 710061, China
| | - Meixi Yan
- Department of Rheumatology Immunology and Endocrinology, Honghui Hospital Affiliated of Xi'an Jiaotong University, No.76 Nanguo Road, Beilin District, Xi'an, Shaanxi Province, 710061, China
| | - Ying Li
- Department of Geriatric, Xi'an Qinhuang Hospital, Xi'an, Shaanxi Province, 710061, China
| | - Min Niu
- Department of Rheumatology Immunology and Endocrinology, Honghui Hospital Affiliated of Xi'an Jiaotong University, No.76 Nanguo Road, Beilin District, Xi'an, Shaanxi Province, 710061, China.
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13
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Wang B, Fan Y, Wang X, Zeng X, Zeng S, Jia H, Li Y, Dai C. Influence of lifestyle patterns on depression among adults with diabetes: a mediation effect of dietary inflammatory index. BMC Public Health 2024; 24:1779. [PMID: 38961392 PMCID: PMC11223315 DOI: 10.1186/s12889-024-19319-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Accepted: 07/01/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND Lifestyle has become a crucial modulator in the management of diabetes and is intimately linked with the development and exacerbation of comorbid depression. The study aimed to analyze lifestyle patterns and their impact on depression in individuals with diabetes and to explore the role of the Dietary Inflammatory Index (DII) in the relationship between lifestyle patterns and depression. METHODS Data was attained from the National Health and Nutrition Examination Survey (NHANES) between 2009 and 2020. A latent class analysis (LCA) was performed on 3,009 diabetic adults based on lifestyle behaviors. A generalised linear model (GLM) was employed to analyse the effects of different lifestyle patterns on depression. The mediation effect model was utilised to examine the relationship between lifestyle patterns, DII and Patient Health Questionnaire-9 (PHQ-9) scores. RESULTS The cohort was divided through LCA into unhealthy lifestyle (44.53%), unhealthy but non-alcohol use (48.06%) and healthy but smoking (7.41%) groups of lifestyle behaviors, the unhealthy but non-alcohol use group was identified as a risk factor for depression (OR = 1.379, 95%CI = 1.095 ~ 1.735, P = 0.006). The DII partially mediated the relationship between the unhealthy but non-alcohol use group and PHQ-9, and fully mediated the relationship between the healthy but smoking group and PHQ-9, with effect coefficients of - 0.018 (95%CI: -0.044 ~ - 0.001) and - 0.035 (95%CI: -0.083 ~ - 0.001). CONCLUSIONS Lifestyle patterns significantly influence the occurrence of depression among diabetes patients. The dietary inflammation plays a varying mediating role between different lifestyle patterns and depression. Restricting pro-inflammatory diets or encouraging anti-inflammatory diets, combined with the promotion of healthy lifestyle practices, may be an effective method for preventing and alleviating symptoms of depression among patients with diabetes.
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Affiliation(s)
- Baoping Wang
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Yuxin Fan
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Xin Wang
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Xiangru Zeng
- Department of Endocrinology, Tianjin Dongli Hospital, Tianjin, 300300, China
| | - Sha Zeng
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital Airport Hospital, Tianjin, 300000, China
| | - Hongwei Jia
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Yin Li
- Dept. Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Chenlin Dai
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China.
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14
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Guo Y, Yan J. Association between tobacco smoke exposure and depression: the NHANES 2005-2018 and Mendelian randomization study. Arch Public Health 2024; 82:100. [PMID: 38961510 PMCID: PMC11221044 DOI: 10.1186/s13690-024-01322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 06/09/2024] [Indexed: 07/05/2024] Open
Abstract
OBJECTIVE The relationship between tobacco smoke exposure (TSE) and depression is controversial. This study combined observational research and Mendelian randomization (MR) to explore the relationship of depression with both smoking status and cotinine levels. METHOD We collected relevant data from the National Health and Nutrition Examination Survey (NHANES) database from 2005 to 2018, and used weighted multifactorial logistic regression modelling to assess the correlation between TSE and depression, and assessed the causal relationship of depression with both smoking status and cotinine levels by MR. RESULT Current smokers had the highest risk of depression (OR 1.94; P < 0.01); there was a positive trend for correlation between daily smoking and depression (OR 1.66; P for trend < 0.01). Serum ketamine levels above 3.00 ng/ml had a higher risk of depression (OR 2.13; P < 0.001). MR results showed that current smoking (OR = 4.66; P < 0.001) and previous smoking (OR 2.09; P < 0.01) were risk factors for the onset of depression, and that there was no causal association between cotinine levels and depression. CONCLUSION Smoking is significantly associated with depression and plays a potential causal role in the development of depression. Cotinine was significantly associated with depression, however MR results showed no causal relationship between cotinine and depression.
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Affiliation(s)
- Yikun Guo
- Department of Respiratory, Dongzhimen Hospital, Beijing University of Chinese Medicine, Dongcheng District, Beijing, 100700, China
- Beijing University of Chinese medicine, Chaoyang District, Beijing, 100029, China
| | - Jun Yan
- Department of Respiratory, Dongzhimen Hospital, Beijing University of Chinese Medicine, Dongcheng District, Beijing, 100700, China.
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15
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Hong Y, Jin X, Shi L. Association between polyunsaturated fatty acids and depression in women with infertility: a cross-sectional study based on the National Health and Nutrition Examination Survey. Front Psychiatry 2024; 15:1345815. [PMID: 39015886 PMCID: PMC11249730 DOI: 10.3389/fpsyt.2024.1345815] [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: 11/28/2023] [Accepted: 06/11/2024] [Indexed: 07/18/2024] Open
Abstract
Background Identifying possible influencing factors is crucial for the depression symptoms of women experiencing infertility. This study aims to explore the association between polyunsaturated fatty acids (PUFAs) and the odds of depression symptoms in women experiencing infertility. Methods This is a cross-sectional study based on the National Health and Nutrition Examination Survey (NHANES). PUFA intake was obtained through a 24-h dietary recall interview. Depression symptoms were defined using the Patient Health Questionnaire-9 (PHQ-9) with a score of ≥10 points or as taking antidepressants. The association between PUFA and depression was assessed using a logistic regression model by calculating the odds ratio (OR) with 95% confidence interval (CI). Subgroup analysis was carried out based on menopausal status and female hormone use. Results There were 725 participants included for analysis. After adjusting the covariables, lower odds of depression symptoms were found in patients with the intake of omega-3 PUFA (OR = 0.48, 95% CI: 0.24-0.96) and omega-6 PUFA (OR = 0.24, 95% CI: 0.14-0.42) in the second tertile (T2) in comparison to the first tertile (T1). The intake of α-linolenic (ALA) (OR = 0.48, 95% CI: 0.23-0.97) and linoleic acid (OR = 0.24, 95% CI: 0.14-0.41) in T2 was also found to be related to the reduced odds of depression symptoms in comparison to T1. Conclusions Our findings suggest a potential association between moderate omega-3 and omega-6 PUFA intake and a reduced risk of depression symptoms in women experiencing infertility. This implies that clinicians might find it useful to consider dietary advice that includes PUFA-rich foods as part of a broader strategy to address mental health in this patient group. However, further research is needed to confirm these preliminary findings and to establish the optimal levels of PUFA intake for mental health benefits.
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Affiliation(s)
- Yan Hong
- Department of Traditional Chinese Medicine, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xia Jin
- Department of Gynaecology and Obstetrics, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Lihong Shi
- Department of Reproductive Medicine, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
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Euteneuer F, Salzmann S, Süssenbach P. Income rank and depressive symptoms among employees in Germany - A 5-year cross-lagged panel analysis. Int J Clin Health Psychol 2024; 24:100485. [PMID: 39101052 PMCID: PMC11296231 DOI: 10.1016/j.ijchp.2024.100485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 07/02/2024] [Indexed: 08/06/2024] Open
Abstract
Background/Objective Socioeconomic disparities in mental health are well-established. Previous research suggests that relative income rank is associated with depressive symptoms above and beyond absolute income. This study aimed to investigate the predictive value of income rank for future depressive symptoms while accounting for absolute income. Exploring potential reverse pathways from depressive symptoms to income rank was a secondary objective. Method A two-wave cross-lagged panel design with a 5-year follow-up was used to analyze data for income rank, absolute income, and two dimensions of depressive symptoms (i.e., cognitive-affective and somatic symptoms) from initially 4,201 employees. Income rank was calculated for reference groups, based on the same gender, the same 5-year age band, and the same occupational skill level. Results Lower income rank at baseline predicted a higher severity of cognitive-affective depressive symptoms at five-year follow-up, even after adjusting for absolute income. In contrast, income rank did not demonstrate a significant unique longitudinal association with somatic depressive symptoms when simultaneously taking absolute income into account. There was no evidence for the assumption that depressive symptoms are predictive for future income rank (i.e., reverse pathway). Conclusions Cognitive-affective symptoms of depression might be particularly responsive to social comparisons and a relatively low social rank.
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Affiliation(s)
- Frank Euteneuer
- Department of Psychology, Clinical Psychology and Psychotherapy, Medical School Berlin, Berlin, Germany
- Division of Translational Clinical Stress Research, Institute of Neuroscience and Biopsychology for Clinical Application, Medical School Berlin, Berlin, Germany
| | - Stefan Salzmann
- Medical Psychology, Department of Medicine, Health and Medical University, Erfurt, Germany
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Germany
| | - Philipp Süssenbach
- Fachhochschule des Mittelstands (FHM) Bielefeld–University of Applied Sciences, Bielefeld, Germany
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Edie AH, Carmody KA, Scott J. Building resilience in families experiencing homelessness through integration of health, parenting and child development programs. Child Care Health Dev 2024; 50:e13290. [PMID: 38874392 DOI: 10.1111/cch.13290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 04/11/2024] [Accepted: 05/25/2024] [Indexed: 06/15/2024]
Abstract
Children who experience homelessness are vulnerable to mental health problems, developmental delays and lower academic achievement. Research suggests that parental health literacy, sensitive parenting behaviour and child self-regulation are modifiable mechanisms that might enhance children's resilience to adversities associated with homelessness, yet empirical evidence on implementing such interventions in shelter settings is limited. Through a coordinated academic-community partnership, this study aimed to examine the (1) feasibility of conducting an integrated health approach in shelter settings and (2) the effectiveness of separate interventions on child and parent outcomes. Results are discussed in terms of best practices in shelter settings and building resilience in families experiencing homelessness with young children.
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Affiliation(s)
| | - Karen Appleyard Carmody
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Jewel Scott
- Duke University School of Nursing, Durham, North Carolina, USA
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Li G, Ji H, Jiang Q, Cao H, Wang Z, Liu S. Association between physical activity and depression in adult prescription opioid users: A cross-sectional analysis based on NHANES 2007-2018. Gen Hosp Psychiatry 2024; 89:1-7. [PMID: 38579547 DOI: 10.1016/j.genhosppsych.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 03/27/2024] [Accepted: 03/30/2024] [Indexed: 04/07/2024]
Abstract
OBJECTIVE This study was designed to examine the association between physical activity (PA) and depression among adult prescription opioid users. METHOD Data of adults who recently took prescription opioids were collected from NHANES 2007-2018. Participants were divided into two groups according to whether PA in each domain was ≥600 MET-min/week. According to weekly activity frequency, recreational physical activity (RPA) was divided into inactivity, insufficient activity, weekend warrior (WW), and regular activity. PHQ-9 scores ≥10 were identified as depression. RESULTS RPA of ≥600 MET-min/week was associated with a 40% (OR: 0.60, 95%CI: 0.38-0.96, P = 0.032) reduction in the risk of depression. Restricted Cubic Spline plots found a nonlinear dose-response relationship between RPA and depression (P = 0.045), and the turning point of depression risk was around 600 MET-min/week. There was no significant difference in the risk of depression between the WW and inactivity groups (OR: 0.65, 95%CI: 0.25-1.72, P = 0.382). The regular activity group had an 45% (OR: 0.55, 95%CI: 0.31-0.99, P = 0.046)lower risk for depression than the inactivity group. CONCLUSION Only regular RPA is associated with a reduced risk of depression, and RPA showed a nonlinear dose-response relationship. The antidepressant effect of the WW is not significant.
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Affiliation(s)
- Gang Li
- Department of Anesthesia, The Chenggong Hospital Affiliated to Xiamen University, Xiamen, Fujian, PR China
| | - Hongxiang Ji
- Department of General Surgery, The Chenggong Hospital Affiliated to Xiamen University, Xiamen, Fujian, PR China
| | - Qiuxiang Jiang
- Department of Anesthesia, The Chenggong Hospital Affiliated to Xiamen University, Xiamen, Fujian, PR China
| | - Huijuan Cao
- Department of Anesthesia, The Chenggong Hospital Affiliated to Xiamen University, Xiamen, Fujian, PR China
| | - Zhibin Wang
- Medical Department, The Chenggong Hospital Affiliated to Xiamen University, Xiamen, Fujian, PR China.
| | - Shanshan Liu
- Department of Anesthesia, The Chenggong Hospital Affiliated to Xiamen University, Xiamen, Fujian, PR China.
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Schuler M, Gerlich C, Leven L, Renz S, Pamperin I, Vorsatz N, Vogel H. [The Blaufeuer measure for employees with mental stress and simultaneous workplace problems-Is the target group being reached?]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:806-814. [PMID: 38896151 DOI: 10.1007/s00103-024-03907-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Employees with mental burden and simultaneous workplace problems have an increased risk of chronification and disability pension. To support this group of people, the German Pension Insurance (Deutsche Rentenversicherung Bund) developed the Systemic Integration Management for People with Mental Impairments (SEMpsych) project as part of the rehapro federal program. The Blaufeuer counselling service was implemented in three model regions (Berlin, Cologne, and Nuremberg). The measure usually comprises up to 12 counselling sessions in 12 months. This article describes the characteristics of the participants and examines whether they belong to the intended target group. METHOD During September 2020 and June 2022, the participants completed a questionnaire between the first and second counselling sessions. Socio-demographic-, clinical- and work-related variables were assessed. The data were analysed using descriptive statistics and 95% confidence intervals. RESULTS Data from n = 482 participants (66.4% female; MAge = 45.2 years (±10.2 years); 64.1% working full-time; 49.8% currently on sick leave) were included. The participants have high psychological impairments (e.g. PHQ-9: M = 14.6 (±5.4)) and low subjective work ability (e.g. WAS: M = 3.2 (±2.6)). Most participants report overload at work and problems with superiors. DISCUSSION Participants exhibit mental burden values that correspond to those of patients at the beginning of outpatient psychotherapy or the first contact in an inpatient psychiatric clinic. Blaufeuer addresses a highly stressed group of people who have not yet received adequate treatment. Further studies on process and outcome evaluation will follow.
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Affiliation(s)
- Michael Schuler
- Institut für Klinische Epidemiologie und Biometrie, Universität Würzburg, Würzburg (Bayern), Deutschland.
- Department für Angewandte Gesundheitswissenschaften, Hochschule für Gesundheit, Bochum (Nordrhein-Westfalen), Deutschland.
| | - Christian Gerlich
- Arbeitsgruppe Rehabilitationswissenschaften im Zentrum Psychische Gesundheit, Universitätsklinikum Würzburg, Würzburg (Bayern), Deutschland
| | - Lorenz Leven
- Institut für Klinische Epidemiologie und Biometrie, Universität Würzburg, Würzburg (Bayern), Deutschland
| | - Silvan Renz
- Institut für Klinische Epidemiologie und Biometrie, Universität Würzburg, Würzburg (Bayern), Deutschland
| | - Ina Pamperin
- Deutsche Rentenversicherung Bund, Berlin, Deutschland
| | | | - Heiner Vogel
- Arbeitsgruppe Rehabilitationswissenschaften im Zentrum Psychische Gesundheit, Universitätsklinikum Würzburg, Würzburg (Bayern), Deutschland
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20
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Yan B, Jin Y, Mao S, Yin Y. Association of Life's essential 8 score with the risk of all-cause mortality and cardio-cerebrovascular mortality in patients with stroke. BMC Cardiovasc Disord 2024; 24:320. [PMID: 38918724 PMCID: PMC11197366 DOI: 10.1186/s12872-024-03947-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 05/16/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND A higher Life's Essential 8 (LE8)-based cardiovascular health (CVH) has been reported to be associated with a lower risk of both all-cause mortality and cardio-cerebrovascular diseases (CCVDs) related mortality in adults in the United States. At the same time, multiple studies have shown a significant negative association of CVH with the risk of stroke and CCVDs. Since no research has investigated the applicability of the LE8 in stroke patients, this study aimed to explore the association of LE8 with all-cause mortality and cardio-cerebrovascular mortality in stroke patients. METHODS Data of patients were extracted from the National Health and Nutrition Examination Surveys (NHANES) database in 2007-2018 in this retrospective cohort study. Weighted univariate and multivariate COX regression analyses were utilized to investigate the associations of LE8 with all-cause mortality and cardio-cerebrovascular mortality. We further explored these relationships in subgroups of age, gender, body mass index (BMI), cancer, congestive heart failure (CHF), and coronary heart disease (CHD). The evaluation indexes were hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS Among the eligible patients, 278 died from all-cause and 89 (8.38%) of them died due to CCVDs. After adjusting for covariates, patients with LE8 score ≥ 58.75 seemed to have both lower risk of all-cause mortality (HR = 0.46, 95%CI: 0.31-0.69) and cardio-cerebrovascular mortality (HR = 0.51, 95%CI: 0.26-0.98), comparing to those with LE8 score < 48.123. Higher LE8 scores were associated with lower risk of all-cause mortality in patients aged < 65 years old, without cancer, and whatever the gender, BMI, CHF or CHD conditions (all P < 0.05). The relationships between high LE8 scores and low cardio-cerebrovascular mortality risk were only found in age < 65 years old and non-cancer subgroups (all P < 0.05). CONCLUSION A higher LE8 score was associated with lower risk of both all-cause mortality and cardio-cerebrovascular mortality in patients with stroke, which may provide some reference for risk management and prognosis improvement in stoke. However, more evidences are needed to verify this beneficial role of high LE8 score in stroke prognosis.
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Affiliation(s)
- Bin Yan
- Department of Geriatric Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, Jiangsu Province, People's Republic of China
| | - Yan Jin
- Department of Pharmacy, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, Jiangsu Province, People's Republic of China
| | - Song Mao
- Department of Pediatrics, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, Jiangsu Province, People's Republic of China
| | - Yugang Yin
- Department of Geriatric Cardiology, Jinling Hospital, Medical School of Nanjing University, No.305 Zhongshan East Road, Xuanwu District, Nanjing, 210002, Jiangsu Province, People's Republic of China.
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21
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Fei S, Liu M, Shanshan H, Xie R, Danni W, Ningying Z. Association between weight-adjusted-waist index and depression: a cross-sectional study. Endocr Connect 2024; 13:e230450. [PMID: 38657652 PMCID: PMC11227061 DOI: 10.1530/ec-23-0450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 04/23/2024] [Indexed: 04/26/2024]
Abstract
Background Depression has become a multifaceted global health issue, with complex connections to obesity. Weight-adjusted-waist index (WWI) can effectively evaluate central obesity, but the relationship between WWI and depression has not been well studied. The study aims to investigate the potential correlation between these two health parameters. Methods According to the data from National Health and Nutrition Examination Survey, this cross-sectional study used multiple regression analysis, subgroup analysis, and smooth curve fitting to explore the relationship between WWI and depression. The assessment ability of WWI was evaluated and compared to other obesity indicators using the receiver operating characteristic (ROC) curve. Results This study analyzed 38,154 participants. Higher WWI is associated with higher depression scores (β = 0.41; 95% CI, 0.36-0.47). After adjusting for various confounding factors, the positive correlation between WWI and depression remained significant (P for trend < 0.0001). Nonlinear positive correlation was detected with a breakpoint of 11.14. ROC analysis shows that compared to other obesity indicators (ROCWWI = 0.593; ROCBMI = 0.584; and ROCWC = 0.581), the correlation between WWI and depression has better discrimination and accuracy. DII mediated 4.93%, SII mediated 5.08%, and sedentary mediated 0.35% of the total association between WWI and depression. Conclusion WWI levels were related to an increased likelihood of depression and showed a stronger relationship than BMI and waist circumference. Our findings indicated that WWI may serve as a simple anthropometric index to evaluate depression.
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Affiliation(s)
- Sun Fei
- Wuxi Medical College of Jiangnan University, Wuxi, China
| | - Min Liu
- Wuxi Maternity and Child Health Care Hospital, Wuxi, China
| | - Hu Shanshan
- Wuxi Maternity and Child Health Care Hospital, Wuxi, China
| | - Ruijie Xie
- Department of Microsurgery, University of South China, Hengyang, China
| | - Wu Danni
- Wuxi Medical College of Jiangnan University, Wuxi, China
| | - Zhou Ningying
- Wuxi Medical College of Jiangnan University, Wuxi, China
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22
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Zeng Y, Hu CH, Li YZ, Zhou JS, Wang SX, Liu MD, Qiu ZH, Deng C, Ma F, Xia CF, Liang F, Peng YR, Liang AX, Shi SH, Yao SJ, Liu JQ, Xiao WJ, Lin XQ, Tian XY, Zhang YZ, Tian ZY, Zou JA, Li YS, Xiao CY, Xu T, Zhang XJ, Wang XP, Liu XL, Wu F. Association between pretreatment emotional distress and immune checkpoint inhibitor response in non-small-cell lung cancer. Nat Med 2024; 30:1680-1688. [PMID: 38740994 PMCID: PMC11186781 DOI: 10.1038/s41591-024-02929-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 03/18/2024] [Indexed: 05/16/2024]
Abstract
Emotional distress (ED), commonly characterized by symptoms of depression and/or anxiety, is prevalent in patients with cancer. Preclinical studies suggest that ED can impair antitumor immune responses, but few clinical studies have explored its relationship with response to immune checkpoint inhibitors (ICIs). Here we report results from cohort 1 of the prospective observational STRESS-LUNG study, which investigated the association between ED and clinical efficacy of first-line treatment of ICIs in patients with advanced non-small-cell lung cancer. ED was assessed by Patient Health Questionnaire-9 and Generalized Anxiety Disorder 7-item scale. The study included 227 patients with 111 (48.9%) exhibiting ED who presented depression (Patient Health Questionnaire-9 score ≥5) and/or anxiety (Generalized Anxiety Disorder 7-item score ≥5) symptoms at baseline. On the primary endpoint analysis, patients with baseline ED exhibited a significantly shorter median progression-free survival compared with those without ED (7.9 months versus 15.5 months, hazard ratio 1.73, 95% confidence interval 1.23 to 2.43, P = 0.002). On the secondary endpoint analysis, ED was associated with lower objective response rate (46.8% versus 62.1%, odds ratio 0.54, P = 0.022), reduced 2-year overall survival rate of 46.5% versus 64.9% (hazard ratio for death 1.82, 95% confidence interval 1.12 to 2.97, P = 0.016) and detriments in quality of life. The exploratory analysis indicated that the ED group showed elevated blood cortisol levels, which was associated with adverse survival outcomes. This study suggests that there is an association between ED and worse clinical outcomes in patients with advanced non-small-cell lung cancer treated with ICIs, highlighting the potential significance of addressing ED in cancer management. ClinicalTrials.gov registration: NCT05477979 .
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Affiliation(s)
- Yue Zeng
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Chun-Hong Hu
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
- Hunan Cancer Mega-Data Intelligent Application and Engineering Research Centre, Changsha, China
| | - Yi-Zheng Li
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Molecular Radiation Oncology Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| | - Jian-Song Zhou
- National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Shu-Xing Wang
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Meng-Dong Liu
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Zhen-Hua Qiu
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Chao Deng
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Fang Ma
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Chun-Fang Xia
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Fei Liang
- Department of Biostatistics, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yu-Rong Peng
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Ao-Xi Liang
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Sheng-Hao Shi
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Shi-Jiao Yao
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Jun-Qi Liu
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Wen-Jie Xiao
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Xiao-Qiao Lin
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Xin-Yu Tian
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Ying-Zhe Zhang
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhuo-Ying Tian
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Ji-An Zou
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Yun-Shu Li
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Chao-Yue Xiao
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Tian Xu
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiao-Jie Zhang
- National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiao-Ping Wang
- National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xian-Ling Liu
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Fang Wu
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China.
- National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China.
- Hunan Cancer Mega-Data Intelligent Application and Engineering Research Centre, Changsha, China.
- Hunan Key Laboratory of Tumor Models and Individualized Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.
- Hunan Key Laboratory of Early Diagnosis and Precision Therapy in Lung Cancer, The Second Xiangya Hospital, Central South University, Changsha, China.
- FuRong Laboratory, Changsha, China.
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23
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Guo D, Wang C, Liu X. Association of chronic diseases with depression in the United States, NHANES 2007-2018. PSYCHOL HEALTH MED 2024; 29:1077-1090. [PMID: 37990352 DOI: 10.1080/13548506.2023.2277153] [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: 04/10/2023] [Accepted: 10/24/2023] [Indexed: 11/23/2023]
Abstract
Depression often coexists with many chronic diseases. However, previous studies mainly focused on the association between a single chronic disease or chronic diseases of the elderly and depression. This study included 26,177 adults aged more than 20 years old from the 2007-2018 National Health and Nutrition Examination Survey. Depression was determined by nine questions which were from the Patient Health Questionnaire. We used propensity score matching to reduce the influence of confounders between the depression and non-depression groups. A multivariate logistic regression model was used to analyze the relationship between various chronic diseases and the number of diseases and depression. The prevalence of depression in participants with chronic diseases was higher than that in participants without chronic diseases, 20.8% of participants with chronic bronchitis had depression. After matching and controlling sleep, insurance and smoking, the highest risk of depression (OR = 1.524; 95% CI: 1.162-2.001) was found in people with stroke, followed by arthritis (OR = 1.464; 95% CI: 1.275-1.681). The percentage of participants with two or more chronic diseases with depression and without depression was 68.9% and 51.9%, respectively. Participants with five or more chronic diseases had the highest risk of depression (OR = 3.653; 95% CI: 3.001-4.446). In conclusion, patients with chronic diseases are at higher risk for depression, especially those with multiple chronic diseases. This study suggested that we should pay more attention to the mental health of people with chronic diseases.
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Affiliation(s)
- Dingjie Guo
- Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Chunpeng Wang
- School of Mathematics and Statistics, Northeast Normal University, Changchun, Jilin, China
| | - Xin Liu
- Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
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24
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Li J, Shi H, Wang L, He N. Effect of Dietary Flavonoids on Circadian Syndrome: A Population-Based Cross-Sectional Study. Metab Syndr Relat Disord 2024; 22:385-393. [PMID: 38452163 DOI: 10.1089/met.2023.0245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024] Open
Abstract
Background: Altering the dietary patterns can potentially decrease the likelihood of metabolic syndrome and circadian syndrome (CircS), but it remains unclear which types of flavonoid compounds are responsible for these effects, particularly among nationally representative populations. Thus, we conducted a cross-sectional study to investigate the impact of flavonoid intake on CircS. Methods: The study included 9212 noninstitutionalized adults from two survey cycles (2007-2008 and 2009-2010) of the National Health and Nutrition Examination Survey (NHANES). Data on six dietary flavonoids were collected through a 24-hr dietary recall, including isoflavones, anthocyanidins, flavan-3-ols, flavanones, flavones, and flavonols. All statistical analyses were weighted to account for the complex survey sampling design to generate nationally representative estimates. Multivariable logistic regression and propensity score matching (PSM) were performed to control for potential confounders and assess the association between the six flavonoids and risk of short sleep. Results: After adjusting for all covariates, only individuals with high intake of total flavanones exhibited a 28% [odds ratio (OR) = 0.72, 95% confidence interval (CI) = 0.64-0.83, P < 0.001] decrease in the risk of CircS. The results obtained through PSM were consistent with this finding (OR = 0.70, 95% CI = 0.61-0.80, P < 0.001). Total flavanone intake displayed a linear dose-response relationship with the likelihood of CircS (P for interaction = 0.448). Conclusions: Our findings suggest that high dietary intakes of flavanones have beneficial effects on reducing the risk of CircS.
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Affiliation(s)
- Jingkai Li
- College of Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Huishan Shi
- College of Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Lingyun Wang
- College of Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Naifeng He
- School of Health, Shandong University of Traditional Chinese Medicine, Jinan, China
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25
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Kern Sliwa J, Naranjo RR, Turkoz I, Petrillo MP, Cabrera P, Trivedi M. Effects of esketamine nasal spray on depressive symptom severity in adults with treatment-resistant depression and associations between the Montgomery-Åsberg Depression Rating Scale and the 9-item Patient Health Questionnaire. CNS Spectr 2024; 29:176-186. [PMID: 38557430 DOI: 10.1017/s1092852924000105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
OBJECTIVE To examine the effect of esketamine nasal spray (ESK) plus newly initiated oral antidepressant (OAD) versus OAD plus placebo nasal spray (PBO) on the association between Montgomery-Åsberg Depression Rating Scale (MADRS) and 9-item Patient Health Questionnaire (PHQ-9) scores in adults with treatment-resistant depression (TRD). METHODS Data from TRANSFORM-1 and TRANSFORM-2 (two similarly designed, randomized, active-controlled TRD studies) and SUSTAIN-1 (relapse prevention study) were analyzed. Group differences for mean changes in PHQ-9 total score from baseline were compared using analysis of covariance. Associations between MADRS and PHQ-9 total scores from TRANSFORM-1/TRANSFORM-2 were assessed using simple parametric, nonparametric, and multiple regression models. RESULTS In TRANSFORM-1/TRANSFORM-2 (ESK + OAD, n = 343; OAD + PBO, n = 222), baseline PHQ-9 mean scores were 20.4 for ESK + OAD and 20.6 for OAD + PBO (severe depression). At day 28, significant group differences were observed in least squares mean change (SE) in PHQ-9 scores from baseline (-12.8 [0.46] vs -10.3 [0.53], P < .001) and in clinically substantial change in PHQ-9 scores (≥6 points; 77.1% vs 64%, P < .001) in ESK + OAD and OAD + PBO groups, respectively. A nonlinear relationship between MADRS and PHQ-9 was observed; total scores demonstrated increased correlation over time. In SUSTAIN-1, 57.3% of patients receiving ESK + OAD (n = 89) versus 44.2% receiving OAD + PBO (n = 86) retained remission status (PHQ-9 score ≤4) at maintenance treatment end point (P = .044). CONCLUSIONS In adults with TRD, ESK + OAD significantly improved severity of depressive symptoms, and more patients achieved clinically meaningful changes in depressive symptoms based on PHQ-9, versus OAD + PBO. PHQ-9 outcomes were consistent with those of clinician-rated MADRS. TRIAL REGISTRATION ClinicalTrials.gov: NCT02417064, NCT02418585, NCT02493868.
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Affiliation(s)
- Jennifer Kern Sliwa
- CNS Medical Information, Janssen Scientific Affairs, LLC, Titusville, NJ, USA
| | - Ronaldo R Naranjo
- US Neuroscience Medical Affairs, Janssen Scientific Affairs, LLC, Titusville, NJ, USA
| | - Ibrahim Turkoz
- Statistics & Decision Sciences, Janssen Research & Development, LLC, a Johnson & Johnson company, Titusville, NJ, USA
| | - Mary Pat Petrillo
- Value & Evidence Scientific Engagement, Janssen Scientific Affairs, LLC, Titusville, NJ, USA
| | - Patricia Cabrera
- Neuroscience, Janssen Scientific Affairs, LLC, Titusville, NJ, USA
| | - Madhukar Trivedi
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
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26
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Zhao Y, Liu F, Lin P, Tu Z, Wu B. Sleep quality and mental health among Chinese nurses after the COVID-19 pandemic: A moderated model. PLoS One 2024; 19:e0295105. [PMID: 38820459 PMCID: PMC11142611 DOI: 10.1371/journal.pone.0295105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 05/15/2024] [Indexed: 06/02/2024] Open
Abstract
INTRODUCTION AND AIMS In the specialized nursing setting, nurses are susceptible to developing negative mental health issues. Such conditions among nurses can potentially result in unfavorable medical outcomes. Consequently, this study aims to explore the role of social support in regulating between sleep and mental health in nurses. METHODS A cross-sectional study was carried out in September 2022 on 1219 nurses in Quanzhou. The study comprised general demographic information and utilized various questionnaires, namely the Social Support Rate Scale (SSRS), Pittsburgh Sleep Quality Index Questionnaire (PSQI), Generalized Anxiety Disorder Questionnaire (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). The data analysis was performed using t-tests, ANOVAs, Pearsons correlations and hierarchical regression analyses in SPSS software. RESULTS Results show that significant associations of sleep quality and social support with anxiety and depression. Simple slope analysis shows that under low levels of social support, sleep quality has a positive impact on anxiety(β = 0.598) and depression(β = 0.851), and the impact is significant. Under high levels of social support, sleep quality also has a positive impact on anxiety(β = 0.462) and depression(β = 0.578), but the impact is smaller. This indicates that as the level of social support increases, the positive predictive effect of sleep quality on anxiety and depression gradually diminishes. CONCLUSIONS Social support has the potential to alter the impact of sleep quality on anxiety and depression. Therefore, healthcare policymakers need to focus on enhancing the level of social support and mitigating the impact of poor sleep on anxiety and depression.
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Affiliation(s)
- Yanyan Zhao
- Department of Nursing, Quanzhou First Hospital, Quanzhou, China
| | - Fuzhi Liu
- Department of Preventive Medicine, School of Health, Quanzhou Medical College, Quanzhou, China
| | - Pingzhen Lin
- Department of Nursing, Quanzhou First Hospital, Quanzhou, China
| | - Zhuote Tu
- Department of Preventive Medicine, School of Health, Quanzhou Medical College, Quanzhou, China
| | - Biyu Wu
- Department of Nursing, Quanzhou First Hospital, Quanzhou, China
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27
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Xu Y, Yan Z, Liu L. Sex differences in the combined influence of inflammation and nutrition status on depressive symptoms: insights from NHANES. Front Nutr 2024; 11:1406656. [PMID: 38868555 PMCID: PMC11168495 DOI: 10.3389/fnut.2024.1406656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 05/13/2024] [Indexed: 06/14/2024] Open
Abstract
Background Both nutrition and inflammation are associated with depression, but previous studies have focused on individual factors. Here, we assessed the association between composite indices of nutrition and inflammation and depression. Methods Adult participants selected from the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2018 were chosen. The exposure variable was the Advanced Lung Cancer Inflammation Index (ALI) integrating nutrition and inflammation, categorized into low, medium, and high groups. The outcome variable was depression assessed using the Patient Health Questionnaire-9 (PHQ-9). A multivariable logistic regression model was employed to evaluate the relationship between ALI and the risk of depression. Results After extensive adjustment for covariates, in the overall population, participants with moderate and high levels of ALI had a decreased prevalence of depression compared to those with low ALI levels, with reductions of 17% (OR, 0.83; 95% CI: 0.72-0.97) and 23% (OR, 0.77; 95% CI: 0.66-0.91), respectively. Among females, participants with moderate and high ALI levels had a decreased prevalence of depression by 27% (OR, 0.73; 95% CI: 0.60-0.88) and 21% (OR, 0.79; 95% CI: 0.64-0.98), respectively, compared to those with low ALI levels, whereas no significant association was observed among males. Subgroup analyses based on females and males yielded consistent results. Conclusion In this study, we observed a negative correlation between moderate to high levels of ALI and the prevalence of depression, along with gender differences. Specifically, in females, greater attention should be given to the nutritional and inflammatory status.
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Affiliation(s)
- Yifeng Xu
- School of Clinical Medicine, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
| | - Zhaoqi Yan
- School of Clinical Medicine, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
| | - Liangji Liu
- Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
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28
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Shell AL, Crawford CA, Cyders MA, Hirsh AT, Stewart JC. Depressive disorder subtypes, depressive symptom clusters, and risk of obesity and diabetes: A systematic review. J Affect Disord 2024; 353:70-89. [PMID: 38432462 DOI: 10.1016/j.jad.2024.02.051] [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: 09/13/2023] [Revised: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Overlapping but divided literatures suggest certain depression facets may pose greater obesity and diabetes risk than others. Our objectives were to integrate the major depressive disorder (MDD) subtype and depressive symptom cluster literatures and to clarify which facets are associated with the greatest cardiometabolic disease risk. METHODS We conducted a systematic review of published studies examining associations of ≥2 MDD subtypes or symptom clusters with obesity or diabetes risk outcomes. We report which facets the literature is "in favor" of (i.e., having the strongest or most consistent results). RESULTS Forty-five articles were included. Of the MDD subtype-obesity risk studies, 14 were in favor of atypical MDD, and 8 showed similar or null associations across subtypes. Of the symptom cluster-obesity risk studies, 5 were in favor of the somatic cluster, 1 was in favor of other clusters, and 5 were similar or null. Of the MDD subtype-diabetes risk studies, 7 were in favor of atypical MDD, 3 were in favor of other subtypes, and 5 were similar or null. Of the symptom cluster-diabetes risk studies, 7 were in favor of the somatic cluster, and 5 were similar or null. LIMITATIONS Limitations in study design, sample selection, variable measurement, and analytic approach in these literatures apply to this review. CONCLUSIONS Atypical MDD and the somatic cluster are most consistently associated with obesity and diabetes risk. Future research is needed to establish directionality and causality. Identifying the depression facets conferring the greatest risk could improve cardiometabolic disease risk stratification and prevention programs.
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Affiliation(s)
- Aubrey L Shell
- Department of Psychiatry, Indiana University Health, United States of America
| | | | - Melissa A Cyders
- Department of Psychology, Indiana University-Indianapolis, United States of America
| | - Adam T Hirsh
- Department of Psychology, Indiana University-Indianapolis, United States of America
| | - Jesse C Stewart
- Department of Psychology, Indiana University-Indianapolis, United States of America.
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29
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Chen X, Blumberger DM, Downar J, Middleton VJ, Monira N, Bowman J, Kriske J, Kriske J, Donachie N, Kaster TS. Depressive symptom trajectories with prolonged rTMS treatment. Brain Stimul 2024; 17:525-532. [PMID: 38641170 DOI: 10.1016/j.brs.2024.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 02/05/2024] [Accepted: 04/15/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND A prolonged repetitive transcranial magnetic stimulation (rTMS) treatment course could be beneficial for some patients experiencing major depressive episodes (MDE). We identified trajectories of rTMS response in depressive patients who received an extended rTMS treatment course and sought to determine which trajectories achieved the greatest benefit with a prolonged treatment course. METHOD We applied group-based trajectory modeling to a naturalistic dataset of depressive patients receiving a prolonged course of sequential bilateral rTMS (up to 51 treatment sessions) to the dorsolateral prefrontal cortex. Trajectories of the PHQ-9 with extended treatment courses were characterized, and we explored the association between baseline clinical characteristics and group membership using multinomial logistic regression. RESULTS Among the 324 study participants, four trajectories were identified: "linear response, extended course" (N = 73; 22.5 %); "nonresponse" (N = 23; 7.1 %); "slowed response" (N = 159; 49.1 %); "rapid response, standard treatment length" (N = 69; 21.3 %). Only the "linear response, extended course" group showed considerable clinical improvement after receiving additional rTMS treatments. Greater baseline depressive symptoms were associated with linear response and non-response. CONCLUSION Our results confirmed the distinctive response trajectories in depressive patients receiving rTMS and further highlighted that prolonged rTMS treatment courses may be beneficial for a subset of patients with higher initial symptom levels and linear early treatment response.
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Affiliation(s)
- Xiao Chen
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, 100101, China; Temerty Centre for Therapeutic Brain Intervention, Campbell Family Research Institute, Centre for Addiction and Mental Health, Toronto, M6J1H4, Ontario, Canada; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China; Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; International Big-Data Center for Depression Research, Chinese Academy of Sciences, Beijing, 100101, China
| | - Daniel M Blumberger
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Research Institute, Centre for Addiction and Mental Health, Toronto, M6J1H4, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, M5T1R8, Ontario, Canada
| | - Jonathan Downar
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Research Institute, Centre for Addiction and Mental Health, Toronto, M6J1H4, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, M5T1R8, Ontario, Canada
| | | | - Naima Monira
- Salience Health Solutions, Plano, 75024, Texas, USA
| | | | | | - John Kriske
- Salience Health Solutions, Plano, 75024, Texas, USA
| | | | - Tyler S Kaster
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Research Institute, Centre for Addiction and Mental Health, Toronto, M6J1H4, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, M5T1R8, Ontario, Canada.
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Kebeh M, Dlott CC, Tung WS, Wiznia DH. Orthopaedic Nurse Navigators and Total Joint Arthroplasty Preoperative Optimization: Mental Health and Housing Status-Part Five of the Movement Is Life Special ONJ Series. Orthop Nurs 2024; 43:132-140. [PMID: 38861742 PMCID: PMC11178248 DOI: 10.1097/nor.0000000000001026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/13/2024] Open
Abstract
Mental health and housing status have the potential to impact total joint arthroplasty (TJA) outcomes and are common TJA eligibility criteria that prevent patients from receiving surgery. Our aim was to formulate recommendations for how nurse navigators can assist patients with managing mental health and housing concerns. Through discussions with nurse navigators and a literature search across two databases, we gathered information regarding the optimization of mental health and housing status among TJA patients. We observed a lack of standardized protocols for addressing these concerns and literature supporting an increased focus on mental health and housing status, indicating the potential for greater nurse navigator involvement in developing and implementing protocols. We recommend nurse navigators use screening tools to identify mental health and housing concerns and offer the suggested resources to support patients in an effort to improve postoperative outcomes and decrease surgical risks.
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Affiliation(s)
- Martha Kebeh
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, USA
| | - Chloe C. Dlott
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, USA
| | - Wei Shao Tung
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, USA
| | - Daniel H. Wiznia
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, USA
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Park H, Kim K, Moon E, Lim H, Suh H, Kang T. Psychometric Properties of the Patient Health Questionnaire-9 in Patients With Breast Cancer. Psychiatry Investig 2024; 21:521-527. [PMID: 38811001 PMCID: PMC11136583 DOI: 10.30773/pi.2023.0285] [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: 08/22/2023] [Revised: 01/23/2024] [Accepted: 02/28/2024] [Indexed: 05/31/2024] Open
Abstract
OBJECTIVE Due to the high frequency of depressive symptoms associated with breast cancer, it is crucial to screen for depression in breast cancer patients. While numerous screening tools are available for depression in this population, there is a need for a brief and convenient tool to enhance clinical use. This study aims to investigate the psychometric properties of the Patient Health Questionnaire-9 (PHQ-9) in patients with breast cancer. METHODS Patients with breast cancer (n=327) who visited the Breast Cancer Clinic were included in this study. The reliability of the PHQ-9 was analyzed by Cronbach's α, and the construct validity of the PHQ-9 was explored by factor analysis. The concurrent validity of the PHQ-9 was evaluated by Pearson correlation analysis with the Hospital Anxiety and Depression Scale (HADS) and Perceived Stress Scale (PSS). RESULTS The values of Cronbach's α ranged from 0.800 to 0.879 was acceptable. The exploratory factor analysis revealed that the one-factor model and two-factor model of the PHQ-9 explained 46% and 57% of the variance, respectively. The PHQ-9 were significantly correlated with those of HADS (r=0.702, p<0.001) and PSS (r=0.466, p<0.001). Consequently, the PHQ-9 demonstrated acceptable reliability and validity in breast cancer patients. CONCLUSION The findings of this study indicate that the PHQ-9 exhibits acceptable reliability and validity in patients with breast cancer. The convenience of this brief self-report questionnaire suggests its potential as a reliable and valid tool for assessing depression in breast cancer clinics.
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Affiliation(s)
- Heeseung Park
- Breast Cancer Clinic of Busan Cancer Center, Pusan National University Hospital, Busan, Republic of Korea
- Department of Surgery, Pusan National University School of Medicine, Busan, Republic of Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Kyungwon Kim
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Department of Psychiatry, Pusan National University Hospital, Busan, Republic of Korea
- Department of Psychiatry, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Eunsoo Moon
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Department of Psychiatry, Pusan National University Hospital, Busan, Republic of Korea
- Department of Psychiatry, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Hyunju Lim
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Department of Psychiatry, Pusan National University Hospital, Busan, Republic of Korea
- Department of Psychology, Gyeoungsang National University, Jinju, Republic of Korea
| | - Hwagyu Suh
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Department of Psychiatry, Pusan National University Hospital, Busan, Republic of Korea
- Department of Psychiatry, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Taewoo Kang
- Breast Cancer Clinic of Busan Cancer Center, Pusan National University Hospital, Busan, Republic of Korea
- Department of Surgery, Pusan National University School of Medicine, Busan, Republic of Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
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You Y, Chen Y, Wei M. Leveraging NHANES database for sleep and health-related research: methods and insights. Front Psychiatry 2024; 15:1340843. [PMID: 38745782 PMCID: PMC11091369 DOI: 10.3389/fpsyt.2024.1340843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/10/2024] [Indexed: 05/16/2024] Open
Affiliation(s)
- Yanwei You
- Division of Sports Science & Physical Education, Tsinghua University, Beijing, China
- School of Social Sciences, Tsinghua University, Beijing, China
| | - Yuquan Chen
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Mengxian Wei
- Division of Sports Science & Physical Education, Tsinghua University, Beijing, China
- School of Social Sciences, Tsinghua University, Beijing, China
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Weisenburger RL, Mullarkey MC, Labrada J, Labrousse D, Yang MY, MacPherson AH, Hsu KJ, Ugail H, Shumake J, Beevers CG. Conversational assessment using artificial intelligence is as clinically useful as depression scales and preferred by users. J Affect Disord 2024; 351:489-498. [PMID: 38290584 DOI: 10.1016/j.jad.2024.01.212] [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: 09/05/2023] [Revised: 01/15/2024] [Accepted: 01/22/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Depression is prevalent, chronic, and burdensome. Due to limited screening access, depression often remains undiagnosed. Artificial intelligence (AI) models based on spoken responses to interview questions may offer an effective, efficient alternative to other screening methods. OBJECTIVE The primary aim was to use a demographically diverse sample to validate an AI model, previously trained on human-administered interviews, on novel bot-administered interviews, and to check for algorithmic biases related to age, sex, race, and ethnicity. METHODS Using the Aiberry app, adults recruited via social media (N = 393) completed a brief bot-administered interview and a depression self-report form. An AI model was used to predict form scores based on interview responses alone. For all meaningful discrepancies between model inference and form score, clinicians performed a masked review to determine which one they preferred. RESULTS There was strong concurrent validity between the model predictions and raw self-report scores (r = 0.73, MAE = 3.3). 90 % of AI predictions either agreed with self-report or with clinical expert opinion when AI contradicted self-report. There was no differential model performance across age, sex, race, or ethnicity. LIMITATIONS Limitations include access restrictions (English-speaking ability and access to smartphone or computer with broadband internet) and potential self-selection of participants more favorably predisposed toward AI technology. CONCLUSION The Aiberry model made accurate predictions of depression severity based on remotely collected spoken responses to a bot-administered interview. This study shows promising results for the use of AI as a mental health screening tool on par with self-report measures.
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Affiliation(s)
- Rachel L Weisenburger
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, United States of America.
| | | | | | - Daniel Labrousse
- Department of Psychiatry, Georgetown University Medical Center, United States of America
| | - Michelle Y Yang
- Department of Psychiatry, Georgetown University Medical Center, United States of America
| | - Allison Huff MacPherson
- Department of Family and Community Medicine, College of Medicine, University of Arizona, United States of America
| | - Kean J Hsu
- Department of Psychiatry, Georgetown University Medical Center, United States of America; Department of Psychology, National University of Singapore, Singapore
| | - Hassan Ugail
- Centre for Visual Computing, University of Bradford, United Kingdom of Great Britain and Northern Ireland
| | | | - Christopher G Beevers
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, United States of America
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Rebić N, Law MR, Brotto LA, Cragg JJ, De Vera MA. The Intersectional Impact of Cost-Related Non-Adherence and Depression: A Cross-Sectional Analysis of the Canadian Community Health Survey by Sex, Race, and Indigeneity. Community Ment Health J 2024; 60:515-524. [PMID: 37930467 DOI: 10.1007/s10597-023-01202-1] [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: 04/05/2023] [Accepted: 10/22/2023] [Indexed: 11/07/2023]
Abstract
We evaluated the relationship between cost-related non-adherence (CRNA) and depressive symptoms. Pooling data from the 2015, 2016, 2018, and 2019 annual Canadian Community Health Survey, we analyzed the relationship between CRNA and moderate to severe depressive symptoms, assessed by the Patient Health Questionnaire (PHQ-9). Among the sample, 4.9% experienced CRNA and 6.8% experienced moderate to severe depressive symptoms. Respondents who reported CRNA had 1.51 (95% confidence interval [CI], 1.51-1.52) greater odds of experiencing moderate to severe depressive symptoms. Stratified analysis by sex and race showed the association between CRNA and depressive symptoms was greatest among racialized males (aOR: 1.83, 95% CI: 1.81- 1.85). Stratified analysis by sex and Indigeneity showed this association was greatest for Indigenous males (aOR: 2.16, 95% CI: 2.10-2.22). Forgoing prescribed medications due to cost is associated with more severe depressive symptoms among Canadians, particularly racialized and Indigenous males.
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Affiliation(s)
- Nevena Rebić
- Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
- Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, 570-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Michael R Law
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
- Centre for Health Services and Policy Research, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Lori A Brotto
- Department of Obstetrics and Gynaecology, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada
| | - Jacquelyn J Cragg
- Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Mary A De Vera
- Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
- Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, 570-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
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Shi L, He F, Wu F, Ren Y, Xiong M, Wu Y, Zhang C. Serial mediation effect of physical activity and sleep quality between dietary behaviour and depression symptoms: A nationwide cross-sectional survey. J Glob Health 2024; 14:04081. [PMID: 38549517 PMCID: PMC10979249 DOI: 10.7189/jogh.14.04081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2024] Open
Abstract
Background Substantial studies have revealed the potential mechanisms underlying the link between dietary behaviour and depression symptoms. This study investigated the relationship between depression symptoms and dietary behaviour, physical activity, and sleep quality in a nationwide sample of Chinese residents. Methods A total of 18 819 Chinese Residents completed the dietary behaviour, patient health questionnaire, international physical activity questionnaire, and Pittsburgh sleep quality index. We used the Hayes' serial mediation model to investigate the correlation between the variables. Results Among the participants, 85.5% were aged between 18 and 59, 41.2% were male, and 73.8% were urban residents. There is a negative correlation between dietary behaviour and physical activity (r = -0.038, P < 0.001), while there is a positive correlation with depression symptoms (r = 0.238, P < 0.001) and sleep quality (r = 0.115, P < 0.001). Additionally, depression shows a positive correlation with physical activity (r = 0.024, P < 0.001) and sleep quality (r = 0.298, P < 0.001), while there is a negative correlation between physical activity and sleep quality (r = -0.035, P < 0.001). Dietary behaviour was found to be connected with depression symptoms via three mediation pathways: (1) physical activity (B = -0.003, 95% confidence interval (CI) = -0.016, -0.007), (2) sleep quality (B = 0.034, 95% CI = 0.126, 0.164), and (3) physical activity and sleep quality (B = 0.001, 95% CI = 0.001, 0.003). Conclusions These findings highlight the significance of psychological and physical factors in exploring the mechanisms through which dietary behaviour is related to depression symptoms. Overall, this study showed the important role of lifestyle factors in depression symptoms, suggesting that appropriate dietary behaviours, appropriate physical activity, and good sleep quality are necessary for the avoidance or improvement of depression symptoms.
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Affiliation(s)
- Lei Shi
- School of Health Management, Guangzhou Medical University, Guangzhou, China
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Feiying He
- School of Health Management, Southern Medical University, Guangzhou, China
- Entrepreneurship Academy of Southern Medical University, Guangzhou,China
| | - Fangjing Wu
- Department of Statistics, School of Arts and Sciences, Rutgers University, New Brunswick, New Jersey, USA
| | - Yitao Ren
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Man Xiong
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Yibo Wu
- School of Public Health, Peking University, Beijing, China
| | - Chichen Zhang
- School of Health Management, Southern Medical University, Guangzhou, China
- Institute of Health Management, Southern Medical University, Guangzhou, China
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Robeson M, Brasil KM, Adams HC, Zlomke KR. Measuring depression and anxiety in autistic college students: A psychometric evaluation of the PHQ-9 and GAD-7. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241240183. [PMID: 38514920 DOI: 10.1177/13623613241240183] [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: 03/23/2024]
Abstract
LAY ABSTRACT Anxiety, depression, and suicidality are major concerns among college students, though less is known about these constructs in autistic college students. Given the rising number of autistic individuals entering college, adequate screening and diagnosis of mental health difficulties is necessary to provide care to this population. For example, despite widespread usage of the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), it is unknown if the two instruments accurately measure depression and anxiety the same way between non-autistic and autistic individuals. Thus, the current study was the first to examine how these instruments measure depression and anxiety symptoms in autistic versus non-autistic college students. Utilizing tests of construct measurement in a sample of autistic (n = 477) and non-autistic (n = 429) university students aged 18-29, results showed that while the GAD-7 and PHQ-9 appear to be accurately capturing anxiety and depression in autistic college students, the PHQ-9 item assessing suicidality was found to be measuring different things. This indicates that autistic college students are not interpreting this question the way non-autistic students are, and thus, the measure is failing to capture suicidality in autistic people. Future investigators should continue to assess the appropriateness of using common screening measures, originally created by non-autistic people, in autistic populations.
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Yu X, Tian S, Wu L, Zheng H, Liu M, Wu W. Construction of a depression risk prediction model for type 2 diabetes mellitus patients based on NHANES 2007-2014. J Affect Disord 2024; 349:217-225. [PMID: 38199400 DOI: 10.1016/j.jad.2024.01.083] [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: 06/20/2023] [Revised: 12/31/2023] [Accepted: 01/04/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a prevalent global health issue that has been linked to an increased risk of depression. The objective of this study was to construct a nomogram model for predicting depression in T2DM patients. METHODS A total of 4280 patients with T2DM were included in this study from the 2007-2014 NHANES. The entire dataset was split randomly into training set comprising 70 % of the data and a validation set comprising 30 % of the data. LASSO and multivariate logistic regression analyses identified predictors significantly associated with depression, and the nomogram was constructed with these predictors. The model was assessed by C-index, calibration curve, the hosmer-lemeshow test and decision curve analysis (DCA). RESULTS The nomogram model comprised of 9 predictors, namely age, gender, PIR, BMI, education attainment, smoking status, LDL-C, sleep duration and sleep disorder. The C-index of the training set was 0.780, while that of the validation set was 0.752, indicating favorable discrimination for the model. The model exhibited excellent clinical applicability and calibration in both the training and validation datasets. Moreover, the cut-off value of the nomogram is 223. LIMITATIONS This study has shortcomings in data collection, lack of external validation, and results non-extrapolation. CONCLUSIONS Our nomogram exhibits high clinical predictability, enabling clinicians to utilize this tool in identifying high-risk depressed patients with T2DM. It has the potential to decrease the incidence of depression and significantly improve the prognosis of patients with T2DM.
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Affiliation(s)
- Xinping Yu
- Department of Neurology, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, PR China; Institute of Neuroscience, Nanchang University, Nanchang 330006, PR China
| | - Sheng Tian
- Department of Neurology, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, PR China; Institute of Neuroscience, Nanchang University, Nanchang 330006, PR China
| | - Lanxiang Wu
- Department of Neurology, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, PR China; Institute of Neuroscience, Nanchang University, Nanchang 330006, PR China
| | - Heqing Zheng
- Department of Neurology, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, PR China; Institute of Neuroscience, Nanchang University, Nanchang 330006, PR China
| | - Mingxu Liu
- Department of Neurology, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, PR China; Institute of Neuroscience, Nanchang University, Nanchang 330006, PR China
| | - Wei Wu
- Department of Neurology, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, PR China; Institute of Neuroscience, Nanchang University, Nanchang 330006, PR China.
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Rufino JV, Rodrigues R, Birolim MM, Girotto E, Mesas AE, Martínez-Vizcaíno V, Guidoni CM. Analysis of the dimensional structure of the Patient Health Questionnaire-9 (PHQ-9) in undergraduate students at a public university in Brazil. J Affect Disord 2024; 349:158-164. [PMID: 38199387 DOI: 10.1016/j.jad.2024.01.051] [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: 04/19/2023] [Revised: 12/12/2023] [Accepted: 01/04/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND The prevalence of mental health-related problems has increased in recent years, especially among young adults, such as university students. Several measurement instruments have been developed to identify individuals at risk for depression, such as the Patient Health Questionnaire-9 (PHQ-9). However, different dimensional structures of the PHQ-9 can make it difficult to interpret and compare research results. To analyze the dimensional structure and convergent validity of the PHQ-9 in university students. METHODS This is a cross-sectional study developed with 3163 students enrolled in different courses at a university in southern Brazil. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to identify the most parsimonious and best-fitting model. Convergent validity was verified through the significant relationship (p < 0.05) between theoretically related constructs (sleep quality, alcohol consumption, and physical activity practice). RESULTS The EFA resulted in two models (unidimensional and two-dimensional), with better indices for the two-dimensional model. In the CFA, both the unidimensional and the two-dimensional models presented satisfactory fit indices that were higher for the unidimensional model. LIMITATIONS The analysis of convergent validity is limited by the absence of a gold standard for comparison. CONCLUSIONS This study provided support for the unidimensional structure of the PHQ-9, with adequate convergent validity, among university students.
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Affiliation(s)
- Jessica Vertuan Rufino
- Universidade Estadual de Londrina, Centro de Ciências da Saúde, Departamento de Saúde Coletiva, Londrina, PR, Brazil
| | - Renne Rodrigues
- Universidade Estadual de Londrina, Centro de Ciências da Saúde, Departamento de Saúde Coletiva, Londrina, PR, Brazil
| | - Marcela Maria Birolim
- Faculdade Guairacá, Departamento de Enfermagem e Odontologia, Guarapuava, PR, Brazil
| | - Edmarlon Girotto
- Universidade Estadual de Londrina, Centro de Ciências da Saúde, Departamento de Ciências Farmacêuticas, Londrina, PR, Brazil
| | - Arthur Eumann Mesas
- Universidad de Castilla-La Mancha, Facultad de Enfermería de Cuenca, Centro Estudios Sociosanitarios, Cuenca, Spain.
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Facultad de Enfermería de Cuenca, Centro Estudios Sociosanitarios, Cuenca, Spain; Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile
| | - Camilo Molino Guidoni
- Universidade Estadual de Londrina, Centro de Ciências da Saúde, Departamento de Ciências Farmacêuticas, Londrina, PR, Brazil
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Zhang L, Zhao S, Yang Z, Zheng H, Lei M. An Artificial Intelligence Platform to Stratify the Risk of Experiencing Sleep Disturbance in University Students After Analyzing Psychological Health, Lifestyle, and Sports: A Multicenter Externally Validated Study. Psychol Res Behav Manag 2024; 17:1057-1071. [PMID: 38505352 PMCID: PMC10949300 DOI: 10.2147/prbm.s448698] [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: 11/07/2023] [Accepted: 02/10/2024] [Indexed: 03/21/2024] Open
Abstract
Background Sleep problems are prevalent among university students, yet there is a lack of effective models to assess the risk of sleep disturbance. Artificial intelligence (AI) provides an opportunity to develop a platform for evaluating the risk. This study aims to develop and validate an AI platform to stratify the risk of experiencing sleep disturbance for university students. Methods A total of 2243 university students were included, with 1882 students from five universities comprising the model derivation group and 361 students from two additional universities forming the external validation group. Six machine learning techniques, including extreme gradient boosting machine (eXGBM), decision tree (DT), k-nearest neighbor (KNN), random forest (RF), neural network (NN), and support vector machine (SVM), were employed to train models using the same set of features. The models' prediction performance was assessed based on discrimination and calibration, and feature importance was determined using Shapley Additive exPlanations (SHAP) analysis. Results The prevalence of sleep disturbance was 44.69% in the model derivation group and 49.58% in the external validation group. Among the developed models, eXGBM exhibited superior performance, surpassing other models in metrics such as area under the curve (0.779, 95% CI: 0.728-0.830), accuracy (0.710), precision (0.737), F1 score (0.692), Brier score (0.193), and log loss (0.569). Calibration and decision curve analyses demonstrated favorable calibration ability and clinical net benefits, respectively. SHAP analysis identified five key features: stress score, severity of depression, vegetable consumption, age, and sedentary time. The AI platform was made available online at https://sleepdisturbancestudents-xakgzwectsw85cagdgkax9.streamlit.app/, enabling users to calculate individualized risk of sleep disturbance. Conclusion Sleep disturbance is prevalent among university students. This study presents an AI model capable of identifying students at high risk for sleep disturbance. The AI platform offers a valuable resource to guide interventions and improve sleep outcomes for university students.
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Affiliation(s)
- Lirong Zhang
- Department of Physical Education, Xiamen University of Technology, Xiamen, Fujian, 361024, People’s Republic of China
| | - Shaocong Zhao
- Department of Physical Education, Xiamen University of Technology, Xiamen, Fujian, 361024, People’s Republic of China
| | - Zhongbing Yang
- School of Physical Education, Guizhou Normal University, Guizhou, 550025, People’s Republic of China
| | - Hua Zheng
- College of Physical Education and Health Sciences, Chongqing Normal University, Chongqing, 401331, People’s Republic of China
| | - Mingxing Lei
- National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing, 100039, People’s Republic of China
- Department of Orthopedic Surgery, Chinese PLA General Hospital, Beijing, 100039, People’s Republic of China
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Sun F, Liu M, Hu S, Xie R, Chen H, Sun Z, Bi H. Associations of weight-adjusted-waist index and depression with secondary infertility. Front Endocrinol (Lausanne) 2024; 15:1330206. [PMID: 38516413 PMCID: PMC10956697 DOI: 10.3389/fendo.2024.1330206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 02/19/2024] [Indexed: 03/23/2024] Open
Abstract
Background Obesity and psychological factors were identified as risk factors for female infertility. The study investigated the correlation between WWI, depression, and secondary infertility, focusing on the potential mediating role of depression. Methods According to the data from NHANES, this cross-sectional study used multiple regression analysis, subgroup analysis, and smooth curve fitting to explore the relationship between WWI, depression, and secondary infertility. The diagnostic ability of WWI was evaluated and compared to other obesity indicators using the ROC curve. The mediating effect test adopted the distribution of the product. Results This study involved 2778 participants, including 381 (13.7%) women with secondary infertility. Results showed that higher WWI (OR = 1.31; 95% CI, 1.11-1.56) and depression scores (OR = 1.03; 95% CI, 1.01-1.06) were associated with secondary infertility. There was a positive correlation between WWI and secondary infertility (nonlinear p = 0.8272) and this association was still consistent in subgroups (all P for interaction> 0.05). Compared with other obesity indicators, WWI (AUC = 0.588) also shows good predictive performance for secondary infertility. Mediation analysis showed that depression mediated the relationship between 3.94% of WWI and secondary infertility, with a confidence interval of Za * Zb excluding 0. Conclusion WWI exhibited a relatively good correlation in predicting secondary infertility than other obesity indicators, and depression may be a mediator between WWI and secondary infertility. Focusing on the potential mediating role of depression, the risk of secondary infertility due to obesity may be beneficially reduced in women.
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Affiliation(s)
- Fei Sun
- Wuxi Medical College of Jiangnan University, Wuxi, China
| | - Min Liu
- Department of Nursing, Wuxi Maternity and Child Health Care Hospital, Wuxi, China
| | - Shanshan Hu
- Department of Nursing, Wuxi Maternity and Child Health Care Hospital, Wuxi, China
| | - Ruijie Xie
- Department of Microsurgery, University of South China, Hengyang, China
| | - Huijuan Chen
- Department of Nursing, Wuxi Maternity and Child Health Care Hospital, Wuxi, China
| | - Zhaona Sun
- Department of Nursing, Wuxi Maternity and Child Health Care Hospital, Wuxi, China
| | - Huiya Bi
- Department of Nursing, Wuxi Maternity and Child Health Care Hospital, Wuxi, China
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Zhang J, Xu Z, Wei X, Fu Y, Zhu Z, Wang Q, Wang Q, Liu Q, Guo J, Hao Y, Yang L. Analysis of health service utilization and influencing factors due to COVID-19 in Beijing: a large cross-sectional survey. Health Res Policy Syst 2024; 22:31. [PMID: 38439096 PMCID: PMC10910832 DOI: 10.1186/s12961-024-01118-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/05/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND In the wake of China's relaxed zero-COVID policy, there was a surge in coronavirus disease 2019 (COVID-19) infections. This study aimed to examine the infection status and health service utilization among Beijing residents during a widespread outbreak, and to explore the factors that affected utilization of health services due to COVID-19. METHODS A cross-sectional survey was conducted among Beijing residents from 13 January to 13 February 2023, collecting information on socio-demographic characteristics, health behaviours, COVID-19 infection status, utilization of health services and depressive symptoms. Multivariate Tobit regression was used for data analysis. RESULTS Among the 53 924 participants, 14.7% were older than 60 years, 63.7% were female and 84.8% were married. In total, 44 992 of the 53 924 individuals surveyed (83.4%) contracted COVID-19 during 2020-2023, and 25.2% (13 587) sought corresponding health services. The majority of individuals (85.6%) chose in-person healthcare, while 14.4% chose internet-based healthcare. Among those who chose in-person healthcare, 58.6% preferred primary healthcare institutions and 41.5% were very satisfied with the treatment. Factors affecting health service utilization include being female (β = -0.15, P < 0.001), older than 60 years (β = 0.23, P < 0.01), non-healthcare workers (β = -0.60, P < 0.001), rich self-rated income level (β = 0.59, P < 0.001), having underlying disease (β = 0.51, P < 0.001), living alone (β = -0.19, P < 0.05), depressive symptoms (β = 0.06, P < 0.001) and healthy lifestyle habits, as well as longer infection duration, higher infection numbers and severe symptoms. CONCLUSION As COVID-19 is becoming more frequent and less severe, providing safe and accessible healthcare remains critical. Vulnerable groups such as the elderly and those with underlying conditions need reliable health service. Prioritizing primary healthcare resources and online medical services have played a vital role in enhancing resource utilization efficiency.
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Affiliation(s)
- Jiawei Zhang
- Department of Health Policy and Management, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Zhihu Xu
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Xia Wei
- Department of Health Policy and Management, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, United Kingdom
| | - Yaqun Fu
- Department of Health Policy and Management, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Zheng Zhu
- Department of Health Policy and Management, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Quan Wang
- Department of Health Policy and Management, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
- Brown School, Washington University in St. Louis, St. Louis, Missouri, 63130, United States of America
| | - Qingbo Wang
- Department of Health Policy and Management, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Qing Liu
- General Practice Department, Second Outpatient Section, Peking University Third Hospital, Xisanqi Street, Haidian District, Beijing, 100096, China
| | - Jing Guo
- Department of Health Policy and Management, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
| | - Yuantao Hao
- Center for Public Health and Epidemic Preparedness and Response, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
| | - Li Yang
- Department of Health Policy and Management, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
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Zhao J, Ji Y, Zuo Y, Zhang L, Ku C, Wang W, Wang P, Yang Y, Kang Y, Wang F. Association of Oxidative Stress and Proinflammation with Insomnia in Perimenopause. J Womens Health (Larchmt) 2024; 33:379-387. [PMID: 38394165 DOI: 10.1089/jwh.2023.0316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Abstract
Background: The levels of oxidative stress and proinflammatory factors in perimenopausal females increased, and they were also deeply troubled by insomnia. The occurrence of insomnia is related to the changes of oxidative stress and inflammation levels in the body. Perimenopausal insomnia may be related to mild systemic inflammation, and oxidative stress can promote chronic inflammation. However, the underlying mechanism behind the phenomenon is still unclear. Objective: The aim was to investigate whether the occurrence of perimenopausal insomnia disorder is related to higher levels of oxidative stress and inflammation in the body, and to explore the role of inducible nitric oxide synthase (iNOS) in perimenopausal insomnia. Methods: A total of 127 perimenopausal participants were recruited in this study. Participants with global scores of the Pittsburgh sleep quality index (PSQI) >7 were diagnosed with insomnia (n = 54). The patient health questionnaire-9 (PHQ-9) and generalized anxiety disorder-7 (GAD-7) were evaluated, and sociodemographic data were obtained. The serum concentrations of iNOS, interleukin 6 (IL6), and tumor necrosis factor α (TNFα) were measured using commercial assays. Results: In the insomnia group, IL6 levels were positively correlated with scores of component 5 and component 7 of PSQI, respectively. PHQ-9 and GAD-7 were positively correlated with the global score of PSQI component 7 and PSQI, respectively; PHQ-9 was positively correlated with the global score of PSQI component 1. Finally, PHQ-9, iNOS, and IL6 were found to be independent predictors of perimenopausal insomnia using logistic regression. Conclusions: Moderate oxidative stress caused by a certain concentration of iNOS plays a protective role in perimenopausal insomnia, while proinflammation and depression are potential risk factors.
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Affiliation(s)
- Jing Zhao
- Medical Neurobiology Lab, Inner Mongolia Medical University, Huhhot, China
- Department of Basic Medical Teaching and Research, Ordos Institute of Technology, Ordos, China
| | - Yubo Ji
- Department of Medical Psychology, Inner Mongolia Medical University, Huhhot, China
| | - Yanni Zuo
- Physical Examination Center, Beijing Changping Hospital of Chinese Medicine, Beijing, China
| | - Long Zhang
- Department of Gynaecology and Obstetrics, the First Affiliated Hospital of Inner Mongolia Medical University, Huhhot, China
| | - Congwen Ku
- Dongzhimen Hospital, the First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Wenyan Wang
- School of Pharmacy, Yantai University, Yantai, China
| | - Pengxiang Wang
- Medical Neurobiology Lab, Inner Mongolia Medical University, Huhhot, China
| | - Yan Yang
- Urumqi Fourth People's Hospital, Urumqi, China
| | - Yimin Kang
- Medical Neurobiology Lab, Inner Mongolia Medical University, Huhhot, China
| | - Fan Wang
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
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Li R, Wang J, Wang Y, Lin X, Sun C, Xu L. Telomere length as a modifier in the relationship between phthalate metabolites exposure and glucose homeostasis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 344:123309. [PMID: 38190874 DOI: 10.1016/j.envpol.2024.123309] [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: 09/13/2023] [Revised: 12/20/2023] [Accepted: 01/04/2024] [Indexed: 01/10/2024]
Abstract
Given the rising concern over the potential impact of environmental factors on metabolic heath, we conducted a cross-sectional analysis among 645 adults aged 20 and older in the National Health and Nutrition Examination Survey (NHANES), examining the association between nine phthalate metabolites (Mono-n-butyl phthalate (MBP), Mono-ethyl phthalate (MEP), Mono-(2-ethyl)-hexyl phthalate (MEHP), Mono-benzyl phthalate (MBzP), Mono-n-methyl phthalate (MnMP), Mono-(3-carboxy propyl) phthalate (MCPP), Mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), Mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), Mono-isobutyl phthalate (MiBP)) and six glucose homeostasis indices (fasting glucose, fasting insulin, hemoglobin A1C (HbA1C), homeostatic model assessment of insulin resistance (HOMA-IR), single Point Insulin Sensitivity Estimator (SPISE), and HOMA-β). Latent Class Analysis identified three phthalate metabolites exposure patterns: high MEP-low MEOHP (n = 282), high MBzP-low MEHHP (n = 214), and high MEHHP, MEOHP (n = 149). The high MBzP-low MEHHP and high MEHHP, MEOHP, versus the high MEP-low MEOHP, exposure groups showed significantly higher levels of fasting insulin (β = 0.126, 95% CI: 0.023-0.228), SPISE (β = 0.091, 95% CI: 0.018-0.164), and HOMA-IR (β = 0.091, 95% CI: 0.018-0.164). In the shorter telomere length group, high MEHHP, MEOHP exposure showed an increase in SPISE levels (β = 0.153, 95% CI: 0.037-0.269), while in the overweight/obese subgroup, high MEHHP, MEOHP exposure was significantly positively associated with HOMA-IR (β = 0.392, 95% CI: 0.150-0.735). Bayesian kernel machine regression analyses showed positive associations between higher combined phthalate exposure and increased glucose homeostasis indices (fasting glucose, HbA1C, fasting insulin, SPISE, and HOMA-IR). The quantile of g-calculation analysis also supported the positive associations with HbA1C, HOMA-IR, and fasting insulin. Our findings indicate that phthalate exposure was positively associated with glucose homeostasis indices, which strengthen the call for proactive measures to reduce phthalate exposure and mitigate potential risks to glucose metabolism.
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Affiliation(s)
- Ruiqiang Li
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jiao Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ying Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiaoyi Lin
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ce Sun
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lin Xu
- School of Public Health, Sun Yat-sen University, Guangzhou, China; School of Public Health, The University of Hong Kong, Hong Kong, China; Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
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Tseng VWS, Tharp JA, Reiter JE, Ferrer W, Hong DS, Doraiswamy PM, Nickels S. Identifying a stable and generalizable factor structure of major depressive disorder across three large longitudinal cohorts. Psychiatry Res 2024; 333:115702. [PMID: 38219346 DOI: 10.1016/j.psychres.2023.115702] [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: 08/23/2023] [Revised: 12/21/2023] [Accepted: 12/26/2023] [Indexed: 01/16/2024]
Abstract
The Patient Health Questionnaire 9 (PHQ-9) is the current standard outpatient screening tool for measuring and tracking the nine symptoms of major depressive disorder (MDD). While the PHQ-9 was originally conceptualized as a unidimensional measure, it has become clear that MDD is not a monolithic construct, as evidenced by high comorbidities with other theoretically distinct diagnoses and common symptom overlap between depression and other diagnoses. Therefore, identifying reliable and temporally stable subfactors of depressive symptoms could allow research and care to be tailored to different depression phenotypes. This study improved on previous factor analysis studies of the PHQ-9 by leveraging samples that were clinical (participants with depression only), large (N = 1483 depressed individuals in total), longitudinal (up to 5 years), and from three diverse (matching racial distribution of the United States) datasets. By refraining from assuming the number of factors or item loadings a priori, and thus utilizing a solely data-driven approach, we identified a ranked list of best-fitting models, with the parsimonious one achieving good model fit across studies at most timepoints (average TLI >= 0.90). This model categorizes the PHQ-9 items into four factors: (1) Affective (Anhedonia + Depressed Mood), (2) Somatic (Sleep + Fatigue + Appetite), (3) Internalizing (Worth/Guilt + Suicidality), (4) Sensorimotor (Concentration + Psychomotor), which may be used to further precision psychiatry by testing factor-specific interventions in research and clinical settings.
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Affiliation(s)
- Vincent W S Tseng
- Verily Life Sciences LLC, 269 E Grand Ave, South San Francisco, CA, USA.
| | - Jordan A Tharp
- Verily Life Sciences LLC, 269 E Grand Ave, South San Francisco, CA, USA
| | - Jacob E Reiter
- Verily Life Sciences LLC, 269 E Grand Ave, South San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, USA
| | - Weston Ferrer
- Verily Life Sciences LLC, 269 E Grand Ave, South San Francisco, CA, USA
| | - David S Hong
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, USA
| | - P Murali Doraiswamy
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; Duke Institute for Brain Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Stefanie Nickels
- Verily Life Sciences LLC, 269 E Grand Ave, South San Francisco, CA, USA
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Chen J, Li H, Zhou B, Li X, Zhu Y, Yao Y. Interaction between visual impairment and subjective cognitive complaints on physical activity impairment in U.S. older adults: NHANES 2005-2008. BMC Geriatr 2024; 24:167. [PMID: 38368377 PMCID: PMC10874547 DOI: 10.1186/s12877-024-04739-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 01/23/2024] [Indexed: 02/19/2024] Open
Abstract
BACKGROUND/AIM To investigate the independent relationships of visual impairment (VI) and Subjective cognitive complaints (SCC) with physical function impairment (PFI) and the interaction effect between VI and SCC on PFI in American older adults. METHODS The data of this cross-sectional study was obtained from the 2005-2008 National Health and Examination Survey (NHANES) conducted in the United States. The VI criterion included both subjective self-reported eyesight conditions and objective visual acuity test results. The self-reported questionnaires were utilized to determine PFI and SCC. According to the survey design of NHANS, original data were weighted to produce nationally representative estimates. Both the unweighted original data and weighted estimates underwent analysis. Crude and adjusted logistic models were employed to assess the pairwise associations among VI, SCC, and PFI. To assess the interactive effect, measures such as the relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (S) were calculated. RESULTS A total of 2,710 subjects (weighted n = 38,966,687) aged 60 years or older were included. Compared with subjects without subjective visual impairment (SVI), those with SVI had a significant positive association with PFI [weighted OR (95%CI): 3.11 (2.25, 4.31)]. After multi-variable adjusting, the relationship remained significant [weighted OR (95%CI): 1.90 (1.32, 2.72)]. Similarly, those with objective visual impairment (OVI) were positively associated with the risk of PFI in the crude model [weighted OR (95%CI): 2.35 (1.53, 3.61)] and adjusted model [weighted OR (95%CI): 1.84 (1.07, 3.17)]. Moreover, we found the association of SCC with an increased risk of FPI [crude weighted OR (95%CI): 5.02 (3.40, 7.40); adjusted weighted OR (95%CI): 3.29 (2.01, 5.38)]. Ultimately, the additive interaction showed there was a significant positive interaction term between SVI and SCC on PFI, while OVI and SCC did not. CONCLUSION Both VI and SCC were significantly associated with PFI in elder adults. Besides, there was a significant synergistic interaction between SVI and SCC on PFI, which indicated the improvement of SVI and SCC may be beneficial for the prevention of PFI. For the elderly, especially those with multiple disabilities, comprehensive and targeted approaches are imperative to foster their overall well-being and health.
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Affiliation(s)
- Jinyuan Chen
- Department of Ophthalmology, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Ophthalmology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Clinical Research Center for Eye Diseases and Optometry of Fujian Medical University, Fuzhou, China
| | - Haoyu Li
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, P. R. China
- Hunan Clinical Research Centre of Ophthalmic Disease, Changsha, P. R. China
| | - Biting Zhou
- Department of Ophthalmology, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Ophthalmology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Clinical Research Center for Eye Diseases and Optometry of Fujian Medical University, Fuzhou, China
| | - Xian Li
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Yihua Zhu
- Department of Ophthalmology, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
- Department of Ophthalmology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
- Clinical Research Center for Eye Diseases and Optometry of Fujian Medical University, Fuzhou, China.
| | - Yihua Yao
- Department of Ophthalmology, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
- Department of Ophthalmology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
- Clinical Research Center for Eye Diseases and Optometry of Fujian Medical University, Fuzhou, China.
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Cai D, Xia M, Chen X, Yagi K, Xu L, Wang B, Wang Y, Zhou Y, Liu J. Heartache and Heartbreak: An Observational and Mendelian Randomization Study. Glob Heart 2024; 19:19. [PMID: 38371655 PMCID: PMC10870952 DOI: 10.5334/gh.1302] [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] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/23/2024] [Indexed: 02/20/2024] Open
Abstract
Background Depression has a significant effect on cardiovascular disease (CVD), but uncertainties persist regarding which modifiable risk factors mediate the causal effects. We aim to determine whether depression is causally linked to CVD and which modifiable risk factors play potential mediating roles. Methods We used a two-sample Mendelian randomization (MR) approach and NHANES 2007-2018 data to estimate the effects of depression on various CVD cases and investigated 28 potential mediators of the association between depression and CVD. Results The results of our MR analysis indicated that genetically determined depression was associated with increased risk of several CVD, including coronary heart disease (odds ratio (OR) = 1.14; 95% confidence interval (CI): 1.05,1.22), myocardial infarction (OR = 1.19; 95% CI, 1.09,1.31), atrial fibrillation (OR = 1.14; 95% CI, 1.06,1.22), and stroke (OR = 1.13; 95% CI, 1.05,1.22). However, there was no causal association between depression and heart failure. Four out of 28 cardiometabolic risk factors, including hyperlipidemia, hypertension, diabetes, and prescription opioid use, were identified as mediators of the association between depression and various CVDs. Observational association analyses from NHANES data yielded consistent results. Conclusion Our findings demonstrated that depression has a causal detrimental effect on various CVDs. Four causal mediators (hyperlipidemia, hypertension, diabetes, and prescription opioid use) were screened to explain the causal effect. Implementing targeted management strategies for these risk factors may be warranted to mitigate the public health burden of CVD among individuals with depression.
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Affiliation(s)
- Dihui Cai
- Department of Cardiology, Ningbo Medical Center of Lihuili Hospital, Ningbo, Zhejiang, China
| | - Mengming Xia
- Department of Pharmacy, Ningbo Medical Center of Lihuili Hospital, Ningbo, Zhejiang, China
| | - Xuhui Chen
- Department of Pharmacy, Ningbo Medical Center of Lihuili Hospital, Ningbo, Zhejiang, China
| | - Kunimasa Yagi
- School of Medicine, Kanazawa Medical University, Kanazawa, Ishikawa, Japan
| | - Liang Xu
- School of Laboratory Medicine and Life Sciences, Wenzhou Medial University, Wenzhou, Zhejiang, China
| | - Bingyu Wang
- Department of Cardiology, Ningbo Medical Center of Lihuili Hospital, Ningbo, Zhejiang, China
| | - Yanyi Wang
- Health Science Center, Ningbo University, Ningbo, Zhejiang, China
| | - Yujie Zhou
- Health Science Center, Ningbo University, Ningbo, Zhejiang, China
| | - Jianhui Liu
- Department of Cardiology, Ningbo Medical Center of Lihuili Hospital, Ningbo, Zhejiang, China
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Pflanz CP, Gallacher J, Bauermeister S. A psychometric evaluation of the 16-item PHQ-ADS concomitant anxiety and depression scale in the UK biobank using item response theory. J Affect Disord 2024; 347:335-344. [PMID: 38000468 DOI: 10.1016/j.jad.2023.11.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 11/07/2023] [Accepted: 11/18/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) provides a reliable and valid measure of concomitant depression and anxiety. However, research on its psychometric efficiency and optimal scale length using item-response theory (IRT) has not been reported. This study aimed to optimize the length of the PHQ-ADS scale without losing information by discarding items that were a poor fit to the IRT model. METHODS The UK Biobank is a large cohort study designed to investigate risk factors for a broad range of disease. PHQ-ADS data were available from n = 152,826 participants (age = 55.87 years; SD = 7.73; 56.4 % female), 30.4 % of the entire UK Biobank sample. Psychometric properties of the PHQ-ADS were investigated using a 2-parameter IRT and Mokken analysis. Item statistics included discrimination, difficulty and Loevinger H coefficients of monotonicity. RESULTS In the entire 16-item scale, item discrimination ranged from 1.40 to 4.22, with the item 'worrying' showing the highest level of discrimination and the item 'sleep disturbance' showing the lowest. Mokken analysis showed that the 16-item PHQ-ADS scale could be reduced to a 7-item scale without loss of test information. The reduced scale comprised mainly items measuring cognitive-affective symptoms of anxiety/depression, whereas items measuring somatic symptoms were discarded. The revised scale showed high discrimination and scalability. LIMITATIONS Findings are limited by the use of cross-sectional data that only included the baseline online questionnaire, but not other waves. CONCLUSIONS IRT is a useful technique for scale reductions which serve the clinical and epidemiological need to optimize screening questionnaires to reduce redundancy and maximize information. A reduced-item 7-item PHQ-ADS scale reduces the response burden on participants in epidemiological research settings, without loss of information.
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Affiliation(s)
- Chris Patrick Pflanz
- Dementias Platform UK, Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford OX3 7JX, United Kingdom.
| | - John Gallacher
- Dementias Platform UK, Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford OX3 7JX, United Kingdom
| | - Sarah Bauermeister
- Dementias Platform UK, Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford OX3 7JX, United Kingdom
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Delamain H, Buckman JEJ, Stott J, John A, Singh S, Pilling S, Saunders R. Measurement invariance and differential item functioning of the PHQ-9 and GAD-7 between working age and older adults seeking treatment for common mental disorders. J Affect Disord 2024; 347:15-22. [PMID: 37989437 DOI: 10.1016/j.jad.2023.11.048] [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: 06/16/2023] [Revised: 11/09/2023] [Accepted: 11/15/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND The nine-item Patient Health Questionnaire (PHQ-9) and seven-item Generalised Anxiety Disorder (GAD-7) scale are widely used clinically and within research, and so it is important to determine how the measures, and individual items within the measures, are answered by adults of differing ages. This study sought to evaluate measurement invariance and differential item functioning (DIF) of the PHQ-9 and GAD-7 between working age and older adults seeking routine psychological treatment. METHODS Data of working age (18-64 years old) and older (≥65) adults in eight Improving Access to Psychological Therapies (IAPT) services were used. Confirmatory factor analysis (CFA) was used to establish unidimensionality of the PHQ-9 and GAD-7, with multiple-group CFA to test measurement invariance and The Multiple Indicators, Multiple Causes Models approach to assess DIF. The employed methods were applied to a propensity score matched (PSM) sample in sensitivity analyses to control for potential confounding. RESULTS Data from 166,816 patients (159,325 working age, 7491 older) were used to show measurement invariance for the PHQ-9 and GAD-7, with limited evidence of DIF and similar results found with a PSM sample (n = 5868). LIMITATIONS The localised sample creates an inability to detect geographical variance, and the potential effect of unmeasured confounders cannot be ruled out. CONCLUSIONS The findings support the use of the PHQ-9 and GAD-7 measures for working age and older adults, both clinically and in research settings. This study validates using the measures for these age groups to assess clinically significant symptom thresholds, and monitor treatment outcomes between them.
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Affiliation(s)
- H Delamain
- CORE Data Lab, Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational, and Health Psychology, UCL, London, United Kingdom.
| | - J E J Buckman
- CORE Data Lab, Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational, and Health Psychology, UCL, London, United Kingdom; iCope - Camden and Islington Psychological Therapies Services, Camden & Islington NHS Foundation Trust, London, United Kingdom
| | - J Stott
- ADAPT Lab, Research Department of Clinical, Educational and Health Psychology, UCL, London, United Kingdom
| | - A John
- ADAPT Lab, Research Department of Clinical, Educational and Health Psychology, UCL, London, United Kingdom
| | - S Singh
- Waltham Forest Talking Therapies, North East London NHS Foundation Trust, London, United Kingdom
| | - S Pilling
- CORE Data Lab, Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational, and Health Psychology, UCL, London, United Kingdom; Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - R Saunders
- CORE Data Lab, Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational, and Health Psychology, UCL, London, United Kingdom
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Li Z, Zhang L, Yang Q, Zhou X, Yang M, Zhang Y, Li Y. Association between geriatric nutritional risk index and depression prevalence in the elderly population in NHANES. BMC Public Health 2024; 24:469. [PMID: 38355455 PMCID: PMC10868080 DOI: 10.1186/s12889-024-17925-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 01/30/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND The prevalence of depression is increasing in the elderly population, and growing evidence suggests that malnutrition impacts mental health. Despites, research on the factors that predict depression is limited. METHODS We included 2946 elderly individuals from National Health and Nutrition Examination Survey (NHANES) spanning the years 2011 through 2014. Depressive symptoms were assessed using the PHQ-9 scale. Multinomial logistic regression was performed to evaluate the independent association between Geriatric Nutritional Risk Index (GNRI) and depression prevalence and scores. Subgroup analysis was conducted to explore potential factors influencing the negative correlation between GNRI and depression. Restricted cubic spline graph was employed to examine the presence of a non-linear relationship between GNRI and depression. RESULTS The depression group had a significantly lower GNRI than the non-depression group, and multivariate logistic regression showed that GNRI was a significant predictor of depression (P < 0.001). Subgroup analysis revealed that certain demographic characteristics were associated with a lower incidence of depression in individuals affected by GNRIs. These characteristics included being female (P < 0.0001), non-Hispanic black (P = 0.0003), having a moderate BMI (P = 0.0005), having a college or associates (AA) degree (P = 0.0003), being married (P = 0.0001), having a PIR between 1.50 and 3.49 (P = 0.0002), being a former smoker (P = 0.0002), and having no history of cardiovascular disease (P < 0.0001), hypertension (P < 0.0001), and diabetes (P = 0.0027). Additionally, a non-linear negative correlation (non-linear P < 0.01) was found between GNRI and depression prevalence, with a threshold identified at GNRI = 104.17814. CONCLUSION The GNRI demonstrates efficacy as a reliable indicator for forecasting depression in the elderly population. It exhibits a negative nonlinear correlation with the prevalence of depression among geriatric individuals.
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Affiliation(s)
- Zijiao Li
- Nephrology department of the First Affiliated Hospital of Army Medical University, 400038, Chongqing, China
| | - Li Zhang
- Department of Neurosurgery, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, 400014, Chongqing, China
| | - Qiankun Yang
- National & Regional United Engineering Lab of Tissue Engineering, Department of Orthopedics, Southwest Hospital, Army Medical University, 400038, Chongqing, China
| | - Xiang Zhou
- Nephrology department of the First Affiliated Hospital of Army Medical University, 400038, Chongqing, China
| | - Meng Yang
- Nephrology department of the First Affiliated Hospital of Army Medical University, 400038, Chongqing, China
| | - Yu Zhang
- Department of Dermatology, The Second Affiliated Hospital of Chongqing Medical University, 400010, Chongqing, China.
| | - Youzan Li
- Nephrology department of the First Affiliated Hospital of Army Medical University, 400038, Chongqing, China.
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Shaff J, Kahn G, Wilcox HC. An examination of the psychometric properties of the Patient Health Questionnaire-9 (PHQ-9) in a Multiracial/ethnic population in the United States. Front Psychiatry 2024; 14:1290736. [PMID: 38293592 PMCID: PMC10824969 DOI: 10.3389/fpsyt.2023.1290736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 12/26/2023] [Indexed: 02/01/2024] Open
Abstract
Depression and suicide are significant public health issues. The Patient Health Questionnaire-9 (PHQ-9) is commonly used to assess for symptoms of depression, but its psychometric properties within Multiracial/ethnic populations remains uncertain. In a study involving 1,012 English-speaking Multiracial/ethnic participants from the United States (US), the PHQ-9 showed strong internal consistency (α = 0.93) and supported a one-factor structure. No measurement variance was observed between Non-White and White/Non-White Multiracial/ethic subgroups. PHQ-2, with a cutoff of ≥3, identified fewer depression cases than PHQ-9 (32% vs. 40%), with sensitivities of 75-99% and specificities of 74-96%; a cutoff of ≥2 missed fewer cases. Item performance of the ninth PHQ-9 question, addressing thoughts of death or self-harm, varied across generations with younger generations more likely to endorse thoughts of death or self-harm at any level of symptom severity. The findings suggest the PHQ-9 demonstrated adequate reliability within a population of Multiracial/ethnic adults in the US; however, the use of the 9th item of the PHQ-9 may not be adequate for identifying individuals at risk for suicidal thoughts and/or behaviors, particularly for older Multiracial/ethnic adults. The lower sensitivity of the PHQ-2 with a ≥ 3 cutoff suggests a cutoff of ≥2 may be preferable to miss fewer cases of depression.
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Affiliation(s)
- Jaimie Shaff
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | | | - Holly C. Wilcox
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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