Gender-specificity of resilience in major depressive disorder

Relationship between social inequality perception patterns and depressive symptoms among Chinese adults: A national representative longitudinal study

BACKGROUND

The rising prevalence of depressive symptoms presents a pressing global public health concern, exacerbated by prevailing social inequality.

AIM

This study seeks to identify latent profiles of social inequality perception and explore their associations with depressive symptoms.

METHODS

Data were obtained from the China Family Panel Studies (CFPS) involving 10,529 residents aged 18 years and above. Latent profile analysis (LPA) was used to identify different patterns of social inequality perception. Multiple linear regression analysis examined the links between these patterns and depressive symptoms.

RESULTS

Three distinct patterns of social inequality perception were identified: the disappointed pattern (TDP), the neutral pattern (TNP), and the positive pattern (TPP). Perceived social inequality was significantly associated with short-term and long-term depressive symptoms (β = .51, 95% CI [0.29, 0.72] vs. β = .51, 95% CI [0.27, 0.74]). Increases in social inequality perception patterns were also related to more severe depressive symptoms (β = .55, 95% CI [0.36, 0.74]).

CONCLUSIONS

Increasing perceived social inequality is closely linked to elevated depressive symptoms in Chinese adults. This underscores the need for tailored strategies aimed at addressing heightened perceptions of social inequality to reduce the risk of depressive symptoms.

Community Mobility and Depressive Symptoms During the COVID-19 Pandemic in the United States

Importance

Marked elevation in levels of depressive symptoms compared with historical norms have been described during the COVID-19 pandemic, and understanding the extent to which these are associated with diminished in-person social interaction could inform public health planning for future pandemics or other disasters.

Objective

To describe the association between living in a US county with diminished mobility during the COVID-19 pandemic and self-reported depressive symptoms, while accounting for potential local and state-level confounding factors.

Design, Setting, and Participants

This survey study used 18 waves of a nonprobability internet survey conducted in the United States between May 2020 and April 2022. Participants included respondents who were 18 years and older and lived in 1 of the 50 US states or Washington DC.

Main Outcome and Measure

Depressive symptoms measured by the Patient Health Questionnaire-9 (PHQ-9); county-level community mobility estimates from mobile apps; COVID-19 policies at the US state level from the Oxford stringency index.

Results

The 192 271 survey respondents had a mean (SD) of age 43.1 (16.5) years, and 768 (0.4%) were American Indian or Alaska Native individuals, 11 448 (6.0%) were Asian individuals, 20 277 (10.5%) were Black individuals, 15 036 (7.8%) were Hispanic individuals, 1975 (1.0%) were Pacific Islander individuals, 138 702 (72.1%) were White individuals, and 4065 (2.1%) were individuals of another race. Additionally, 126 381 respondents (65.7%) identified as female and 65 890 (34.3%) as male. Mean (SD) depression severity by PHQ-9 was 7.2 (6.8). In a mixed-effects linear regression model, the mean county-level proportion of individuals not leaving home was associated with a greater level of depression symptoms (β, 2.58; 95% CI, 1.57-3.58) after adjustment for individual sociodemographic features. Results were similar after the inclusion in regression models of local COVID-19 activity, weather, and county-level economic features, and persisted after widespread availability of COVID-19 vaccination. They were attenuated by the inclusion of state-level pandemic restrictions. Two restrictions, mandatory mask-wearing in public (β, 0.23; 95% CI, 0.15-0.30) and policies cancelling public events (β, 0.37; 95% CI, 0.22-0.51), demonstrated modest independent associations with depressive symptom severity.

Conclusions and Relevance

In this study, depressive symptoms were greater in locales and times with diminished community mobility. Strategies to understand the potential public health consequences of pandemic responses are needed.

Correlations to and potential implications of resilience among certified pharmacy technicians

OBJECTIVES

To assess resilience among a sample of certified pharmacy technicians in the United States and evaluate associations between resilience and various personal and work-related characteristics and conditions, including coworker support and pharmacist leadership behaviors, and to assess the relationship between technicians' resilience and support from coworkers and commitment to their organization.

METHODS

This study employed the use of a self-administered questionnaire survey electronically in a cross-sectional design. The questionnaire was delivered with a response portal open for approximately 6 weeks during the spring of 2022 to a sample of 3000 technicians certified through the National Healthcareer Association. The questionnaire consisted of items comprising the Brief Resilience Scale, an adapted version of the Multifactorial Leadership Questionnaire (A-MLQ), and items measuring aspects of coworker support, future uncertainty, commitment, and turnover, in addition to demographic and practice site-related questions.

RESULTS

Usable responses were acquired from 822 respondents, who reported relatively high levels of resilience. Resilience was observed to be positively correlated with pharmacy transformative leadership behaviors measured on the A-MLQ and with coworker support and negatively correlated with future uncertainty. Respondents indicating the highest level of profession commitment reported a statistically higher level of resilience than did others. There were very few relationships observed between resilience and technicians' personal characteristics.

CONCLUSIONS

Immutable characteristics (e.g., race/ethnicity, sex, and age) played a very small role in describing resilience among pharmacy technicians. Instead, organizational characteristics of the workplace were shown to be highly associative with resilience of technicians, adding further evidence that organizations and the profession can help facilitate resilience among these important pharmacy support personnel.

Biopsychosocial Response to the COVID-19 Lockdown in People with Major Depressive Disorder and Multiple Sclerosis

BACKGROUND

Changes in lifestyle, finances and work status during COVID-19 lockdowns may have led to biopsychosocial changes in people with pre-existing vulnerabilities such as Major Depressive Disorders (MDDs) and Multiple Sclerosis (MS).

METHODS

Data were collected as a part of the RADAR-CNS (Remote Assessment of Disease and Relapse-Central Nervous System) program. We analyzed the following data from long-term participants in a decentralized multinational study: symptoms of depression, heart rate (HR) during the day and night; social activity; sedentary state, steps and physical activity of varying intensity. Linear mixed-effects regression analyses with repeated measures were fitted to assess the changes among three time periods (pre, during and post-lockdown) across the groups, adjusting for depression severity before the pandemic and gender.

RESULTS

Participants with MDDs (N = 255) and MS (N = 214) were included in the analyses. Overall, depressive symptoms remained stable across the three periods in both groups. A lower mean HR and HR variation were observed between pre and during lockdown during the day for MDDs and during the night for MS. HR variation during rest periods also decreased between pre- and post-lockdown in both clinical conditions. We observed a reduction in physical activity for MDDs and MS upon the introduction of lockdowns. The group with MDDs exhibited a net increase in social interaction via social network apps over the three periods.

CONCLUSIONS

Behavioral responses to the lockdown measured by social activity, physical activity and HR may reflect changes in stress in people with MDDs and MS. Remote technology monitoring might promptly activate an early warning of physical and social alterations in these stressful situations. Future studies must explore how stress does or does not impact depression severity.

Effects of social support on depression risk during the COVID-19 pandemic: What support types and for whom?

Background

Rates of depression have increased worldwide during the COVID-19 pandemic. One known protective factor for depression is social support, but more work is needed to quantify the extent to which social support could reduce depression risk during a global crisis, and specifically to identify which types of support are most helpful, and who might benefit most.

Methods

Data were obtained from participants in the All of Us Research Program who responded to the COVID-19 Participant Experience (COPE) survey administered monthly from May 2020 to July 2020 (N=69,066, 66% female). Social support was assessed using 10 items measuring emotional/informational support (e.g., someone to confide in or talk to about yourself or your problems), positive social interaction support (e.g., someone to do things with to help you get your mind off things), and tangible support (e.g., someone to help with daily chores if sick). Elevated depression symptoms were defined based on having a moderate-to-severe (≥10) score on the Patient Health Questionnaire (PHQ-9). Mixed-effects logistic regression models were used to test associations across time between overall social support and its subtypes with depression, adjusting for age, sex, race, ethnicity, and socioeconomic factors. We then assessed interactions between social support and potential effect modifiers: age, sex, pre-pandemic mood disorder, and pandemic-related stressors (e.g., financial insecurity).

Results

Approximately 16% of the sample experienced elevated depressive symptoms. Overall social support was associated with significantly reduced odds of depression (adjusted odds ratio, aOR [95% CI]=0.44 [0.42-0.45]). Among subtypes, emotional/informational support (aOR=0.42 [0.41-0.43]) and positive social interactions (aOR=0.43 [0.41-0.44]) showed the largest protective associations with depression, followed by tangible support (aOR=0.63 [0.61-0.65]). Sex, age, and pandemic-related financial stressors were statistically significant modifiers of the association between social support and depression.

Conclusions

Individuals reporting higher levels of social support were at reduced risk of depression during the early COVID-19 pandemic. The perceived availability of emotional support and positive social interactions, more so than tangible support, was key. Individuals more vulnerable to depression (e.g., women, younger individuals, and those experiencing financial stressors) may particularly benefit from enhanced social support, supporting a precision prevention approach.

Low and mismatched socioeconomic status between newlyweds increased their risk of depressive symptoms: A multi-center study

BACKGROUND

While there is evidence that low socioeconomic status (SES) increases susceptibility to depression, few studies have focused on the effect of marital SES matching on depression. This study aimed to explore the impact of SES indicator matching on depressive symptoms in newlyweds and clarify the interaction of depressive symptoms between couples.

METHODS

We assessed the depressive symptoms of newlyweds (N = 28, 179 couples) using a 9-item Patient Health Questionnaire. Logistic regression models and restricted cubic splines were used to explore the association between SES indicator matching and depressive symptoms and the interaction of depressive symptoms in newlyweds, respectively.

RESULTS

Compared with newlyweds with both high-level SES, the newlyweds with both low-level SES, male higher SES, or female higher SES had an increased risk of depressive symptoms in husbands (OR = 1.31; 1.22; 1.30), wives (OR = 1.30; 1.36; 1.32), and couples (OR = 1.48; 1.56; 1.57) (all P < 0.05). In addition, as the level of depression in one partner increases, the risk of depression in the other partner also increases.

CONCLUSION

Mismatched SES and low-level SES between couples have adverse effects on depressive symptoms in newlyweds, with depressive symptoms having a positive association between newlyweds.