Risk factors of geriatric depression among elderly Bangladeshi people: A pilot interview study

Psychobiotics for Mitigation of Neuro-Degenerative Diseases: Recent Advancements

Ageing is inevitable and poses a universal challenge for all living organisms, including humans. The human body experiences rapid cell division and metabolism until approximately 25 years of age, after which the accumulation of metabolic by-products and cellular damage leads to age-related diseases. Neurodegenerative diseases are of concern due to their irreversible nature, lack of effective treatment, and impact on society and the economy. Researchers are interested in finding drugs that can effectively alleviate ageing and age-related diseases without side-effects. Psychobiotics are a novel class of probiotic organisms and prebiotic interventions that confer mental health benefits to the host when taken appropriately. Psychobiotic strains affect functions related to the central nervous system (CNS) and behaviors mediated by the Gut-Brain-Axis (GBA) through various pathways. There is an increasing interest in researchers of these microbial-based psychopharmaceuticals. Psychobiotics have been reported to reduce neuronal ageing, inflammation, oxidative stress, and cortisol levels; increase synaptic plasticity and levels of neurotransmitters and antioxidants. The present review focuses on the manifestation of elderly neurodegenerative and mental disorders, particularly Alzheimer's disease (AD), Parkinson's disease (PD), and depression, and the current status of their potential alleviation through psychobiotic interventions, highlighting their possible mechanisms of action.

Dietary inflammatory index is associated with severe depression in older adults with stroke: a cross-sectional study

Inflammation is involved in the pathogenesis of stroke and depression. We aimed to investigate the association between the dietary inflammatory index (DII) and depression in American adults with stroke. Adults with stroke were enrolled in the National Health and Nutrition Examination Survey between 2005 and 2018 in the USA. The DII was obtained from a 24-h dietary recall interview for each individual. Multivariate regression and restricted cubic spline analyses were conducted to evaluate the association between DII and depression in adults with stroke. The mean age of the 1239 participants was 63·85 years (50·20 % women), and the prevalence of depression was 18·26 %. DII showed a linear and positive association with severe depression in adults with stroke (OR 1·359; 95 % CI 1·021, 1·810; P for non-linearity = 0·493). Compared with those in the lowest tertile of the DII, adults with stroke in the third tertile of the DII had a 3·222-fold higher risk of severe depression (OR 3·222; 95 % CI 1·150, 9·026). In the stratified analyses, the association between DII score and severe depression was more significant in older adults (P for interaction = 0·010) but NS with respect to sex (P for interaction = 0·184) or smoking status (P for interaction = 0·396). No significant association was found between DII and moderate-to-moderately severe depression in adults with stroke. In conclusion, an increase in DII score was associated with a higher likelihood of severe depression in older adults with stroke.

Understanding the impact of socioeconomic and health factors on geriatric depression: A comparative study in rural and urban Bangladesh

Background and Aims

The prevalence of depression among the elderly is a growing concern, and this study examines the differences between urban and rural areas in terms of geriatric depression.

Methods

Using a two-stage random sampling approach in urban areas and a multistage random sampling approach in rural areas, the study surveyed 944 elderly individuals of both sexes.

Results

The results indicate that the prevalence of depression was high, with 52.5% of the elderly population experiencing mild to severe depression. The study found that increasing age, female gender, nuclear family structure, and involvement of housewives or others were significant factors affecting depression in urban areas, while increasing age and elderly people without spouses were significant factors in rural areas. Additionally, the study identified hearing impairment, asthma, and arthritis as risk factors for depression in rural areas, and bronchitis, heart disease, and thyroid illness as significant factors in urban areas.

Conclusion

These findings highlight the need for policymakers to focus on addressing the mental health needs of older people, particularly women and those without spouses.

The influence of different sources of anticipated instrumental support on depressive symptoms in older adults

Objective

This study investigated how anticipated instrumental support sources and intergenerational support influence depressive symptoms in older Chinese adults.

Methods

We employed binary logistic regression on data from 7,117 adults aged ≥60 in the 2018 China Health and Retirement Longitudinal Study, controlling for gender, marital status, and self-rated health.

Results

38.89% of respondents exhibited depressive symptoms. Anticipated support from spouse and children, spouse only, children only, or other sources showed 52, 25, 46, and 40% lower odds of depression, respectively, compared with no anticipated support. Those providing financial support had 36% higher odds of depression than those without exchanges. However, those receiving financial support, receiving instrumental support, and receiving and providing financial and emotional support had 19, 14, 23, and 24% lower odds of depression.

Conclusion

Different anticipated instrumental support sources and intergenerational support influenced depression odds in older adults, suggesting potential benefits in promoting such support systems.

Urban-rural and gender differential in depressive symptoms among elderly in India

Background

To date, evidence remained inconclusive explaining rural-urban and male-female differential in depression. Unlike other previous research on the association of several risk factors with depressive symptoms among the elderly, this study focussed on the socio-economic status-related inequality in the prevalence of depression among the elderly along with focussing urban-rural and male-female gradients of depression among the elderly.

Methods

This study used data from Longitudinal Ageing Study in India (LASI) Wave-I, 2017-18, survey. The outcome variable for this study was self-reported depression. Bivariate analysis was used to understand the prevalence by sociodemographic clusters. Fairlie decomposition analysis has been done to measures rural-urban inequalities for depression among older men and women.

Results

Results found that around 22 percent of urban elderly and 17 percent of rural elderly reported depression. A higher proportion of female elderly (22.6% vs. 18.4%) reported depression than male elderly. Almost one in every five elderly (20.6%) reported depression in India. The results found that a higher percentage of women in rural and urban areas reported depression than their male counterparts. While examining SES-related inequality in the prevalence of depression, education was a significant factor explaining the SES-related inequality in the prevalence of depression among female elderly and not in male elderly.

Conclusion

Given the large proportion of elderly reporting depression, this study highlights the need for improving health care services among the elderly. The increasing burden of depression in specific sub-populations also highlights the importance of understanding the broader consequences of depression among rural and female elderly.

Factors affecting depression among married adults: a gender-based household cross-sectional study

BACKGROUND

Depression is a common mental health problem all over the world including Bangladesh. World Health Organization included it in the Mental Health Gap Action Programme as one of its priority conditions. Research on this issue is scanty in Bangladesh. Therefore, we designed to a gender-based household study on associated factors of depression among married adults in Rajshahi City of Bangladesh.

METHODS

We conducted this household cross-sectional study from August 01 to October 31, 2019. A total of 708 married adults currently living together in Rajshahi City were recruited for this study. We applied a multi-stage random sampling technique for selecting samples and used a semi-structured questionnaire to collect necessary information from them. The Patient Health Questionnaire-9 was used for measuring depression and frequency distribution and binary logistic regression model were used for data analysis.

RESULTS

The prevalence of depression (moderate to severe) was 14.4% (95% CI: 11.9-16.9) among married adults, and females (21.2%, 95% CI: 17.2-25.4) suffered more than males (7.6%, 95% CI: 4.8-10.5). A multiple binary logistic regression model established four main factors of depression among married females: (i) multiple marriage [AOR = 19.982; 95% CI: 10.081-39.610; p < 0.01]; (ii) poor relationship with spouse [AOR = 2.175; 95%CI: 1.068-4.428; p < 0.05]; (iii) chronic medical comorbidity [AOR = 1.876; 95%CI: 1.009-2.626; p < 0.05]; and (iv) 7-12 years duration of conjugal life [AOR = 2.091, 1.009-4.334; p < 0.05]. Two main factors of depression among married males were (i) multiple marriage [AOR = 24.605; 95% CI: 20.228-40.402; p < 0.01] and hard work [AOR = 4.358; 95%CI: 1.109-7.132; p < 0.05].

CONCLUSION

The prevalence of depression was significantly high among the study population, and females were the most vulnerable group. The concerned authorities and stakeholders should take appropriate measures to manage the problem with special focus on the risk factors and the vulnerable groups.

Development and validation of the short form domestic elder abuse assessment questionnaire (SF-DEAQ)

BACKGROUND

The present study aimed to design and determine the psychometric properties of a short-form questionnaire to investigate the domestic elder abuse.

METHODS

This study consisted of two phases: in phase 1 we employed a modified Delphi approach with 18 participants. Consequently, content and face validity, and item analysis were applied. In Phase 2 we evaluated structural validity and convergent validity. Reliability was assessed by looking at internal consistency, stability, and absolute reliability.

RESULTS

The findings led to the development of a 27-items short form of domestic elder abuse in four domains that jointly accounted for 74.14% of the variance observed. The short form showed high internal consistency (Cronbach's alpha = 0.93) and significantly correlated (r = 0.91; p < 0.001 for both scales) with the comprehensive (49-item) domestic elder abuse.

CONCLUSION

The short form of domestic elder abuse was found to be reliable and valid as the longer version. The short form of domestic elder abuse could lessen the burden on respondents.

The assessment of geriatric malnutrition, geriatric depression and associated co-morbidities among forcibly displaced Myanmar nationals in Bangladesh

OBJECTIVE

To assess the nutritional status and depression of the elderly forcibly displaced Myanmar nationals (FDMN) in Bangladesh and determine the associated factors of geriatric depression (GD).

DESIGN

This was a community-based, cross-sectional study among elderly FDMN. The Mini Nutritional Assessment Short-Form (MNA@-SF) and Geriatric Depression Scale Short-Form (GDS-15 SF) were used to determine malnutrition and GD, respectively.

SETTING

The study was conducted between November 2021 and March 2022 in Kutupalong Refugee Camp, Cox's Bazar, Bangladesh.

PARTICIPANTS

The study participants were elderly FDMN aged ≥ 60 years (n 430).

RESULTS

The mean age and BMI were 71·7(±7·8) years and 21·94(±2·6) kg/m2, respectively. There was a high prevalence of self-reported diabetes mellitus (32·1 %), hypertension (26·7 %), hypotension (20 %), skin diseases (28·4 %) and chronic obstructive pulmonary disease (16·5 %). The prevalence of malnutrition was 25·3 %, and another 29·1 % were at risk. The prevalence of GD was 57·9 %, and co-occurrences of GD and malnutrition were seen in 17·5 % of participants. GD was significantly higher among elderly people with malnutrition (adjusted OR, AOR = 1·71, 95 % CI: 1·01, 2·89). FDMN aged ≥ 80 years were at higher risk of GD (AOR = 1·84, 95 % CI: 1·01, 3·37), and having fewer than five members in the household was an independent predictor of GD. Diabetes mellitus (AOR = 1·95, 95 % CI: 1·24, 3·08) and hypotension (AOR = 2·17, 95 % CI: 1·25, 2·78) were also significantly associated with an increased risk of GD.

CONCLUSION

A high prevalence of GD and malnutrition was observed among elderly FDMN in Bangladesh. The agencies working in Cox's Bazar should focus on geriatric malnutrition and GD for the improvement of the health situation of FDMN in Bangladesh.

Astute exploration of collective mental health events among the residents of elderly care homes

Background & objective

Developing countries are presently witnessing a great burden of rapid aging followed by losing the social values of older adults due to age-related cognitive impairment as well as rising depression levels. This study was designed to assess the cognitive impairment and depression status combinedly among older adults in elderly care homes.

Methods

It was a cross-sectional survey among randomly selected 200 older adults aged between 60 and 80 years residing in some old homes in Dhaka district, Bangladesh. Data were collected through face-to-face interviews while Cognitive function and level of depression were assessed by applying the Standardized Mini-Mental State Examination (MMSE) and Geriatric Depression Scale (GDS).

Results

Among all the respondents, the majority (81.5%) were staying in old homes for 1-5 years. The majority (91.0%) had difficulties with vision, 40.7% had difficulties with hearing and 19.6% had difficulties moving around. The MMSE test revealed that 43% had moderate cognitive impairment, 36% had mild and 19.5% were found normal while more than half (56%) had severe depression. Significant cognitive impairment was found among the illiterate respondents who did not have any family care support. In addition, higher-educated respondents were found to have more severe depression (OR/p = 6.33/<0.01; 95% CI: 2.36-16.96). Furthermore, severely depressed respondents had more severe cognitive impairment (COR/p = 3.83/0.01; 95% CI: 1.66-8.83). Functional disabilities were also a greater concern for cognitive impairment and depression.

Conclusion

An increasing number of old home residents are suffering from significant mental disorders while there is no mental health support in the elderly care homes in Bangladesh. Finally, there is a great need to develop packages and programs of mental health care for senior citizens and their caregivers residing in old homes, which can be scaled up across the country's mixed healthcare delivery system.

Prevalence and the affecting factors on depression, anxiety and stress (DASS) among elders in Qazvin City, in the Northwest of Iran

BACKGROUND

Depression, anxiety, and stress are among the most common mental health disorders of the elderly that affect the health of individuals and society. Considering the growing trend of the elderly population in Iran, this study aimed to determine the prevalence of these disorders and to identify the factors affecting them in the elderly.

METHODS

We conducted this cross-sectional study using cluster random sampling on 301 elderly people referred to Qazvin health centers. Data was collected using the Depression, Anxiety, Stress Scale 21 (DASS-21) questionnaire and analyzed through univariate and multivariate linear regression tests with the interaction between variables in STATA Version 14 software. A P-value of less than 0.05 was significant.

RESULTS

The prevalence of depression was 45.5%, anxiety 35.5%, and stress 40.2%. Our findings showed that 22.9%, 7.9%, and 14.3% of people had severe and very severe levels of depression, anxiety, and stress. The variables of age, comorbidity, living status and job status had a significant relationship with the DASS score (p < 0.05). There was an interaction between the variables of comorbidity and income status influencing the DASS score (β = 0.68, 95% CI 0.15, 1.22).

CONCLUSION

The prevalence of depression, anxiety and stress in the elderly was high, indicating the inappropriate status of their mental health. Therefore, it is necessary to take operational steps to reduce some problems in the elderly, prioritize the elderly suffering from concurrent diseases, the unemployed elderly, those who do not have a certain income, and the elderly who live alone.

Prevalence of depression and anxiety in older people in low- and middle- income countries in Africa, Asia and South America: A systematic review and meta-analysis

BACKGROUND

There is rapid growth of older people in Low- and Middle- Income Countries (LMICs). The aim of this review was to assess the literature on prevalence of anxiety and depression in this demographic, which to our knowledge, has not yet been conducted.

METHODS

Databases including Medline, PsychInfo, Embase, Scielo and African Journals Online were searched for terms including "mental disorders", "neurotic disorders", "mood disorders" and "anxiety disorders". Studies published between 1990 and 2020 providing data on older people (≥50 years) in LMICs (defined by World Bank Criteria) were included and quality-assessed. Meta-analysis was conducted on a subset of higher-quality studies to derive pooled prevalence estimates of depression.

RESULTS

One hundred and forty relevant studies were identified, of which thirty-two were included in meta-analysis. One hundred and fifteen studies reported depression prevalence only, 19 reported both depression and anxiety, and six reported anxiety only. In all studies identified, depression prevalence ranged from 0.5 % to 62.7 %, and Generalised Anxiety Disorder prevalence ranged from 0.2 % to 32.2 %. The pooled prevalence of depression on meta-analysis was 10.5 % (95 % CI, 8.9 % - 11.2 %). Reported prevalence rates of depression were significantly different in studies using ICD-10 compared with DSM criteria, and between community and clinical settings.

LIMITATIONS

The search strategy contained bias towards English language papers and high income country (HIC) publications. There is significant heterogeneity within the meta-analysis.

DISCUSSION

A wide range of methodologies and clinical criteria are used in prevalence studies of depression and anxiety in older people. Studies using screening tools found higher prevalence rates; clinicians and researchers should ensure diagnosis is made with gold-standard clinical criteria. Meta-analysis data suggest that rates of depression are similar in older people in LMICs compared to HICs but mental healthcare resources are limited, suggesting a large potential treatment gap.

Change in prevalence over time and factors associated with depression among Bangladeshi older adults during the COVID-19 pandemic

BACKGROUND

Globally, the COVID-19 pandemic seriously affected both physical and mental health conditions. This study aims to assess changes in the prevalence of depression among older adults during the COVID-19 pandemic in Bangladesh and explore the correlates of depression in pooled data.

METHODS

This study followed a repeated cross-sectional design and was conducted through telephone interviews on two successive occasions during the COVID-19 pandemic (October 2020 and September 2021) among 2077 (1032 in 2020-survey and 1045 in 2021-survey) older Bangladeshi adults aged 60 years and above. Depression was measured using the 15-item Geriatric Depression Scale (GDS-15). The binary logistic regression model was used to identify the factors associated with depression in pooled data.

RESULTS

A significant increase in the prevalence of depression was noted in the 2021 survey compared to the 2020 survey (47.2% versus 40.3%; adjusted odds ratio (aOR): 1.40, 95% confidence interval (CI): 1.11-1.75). Depression was significantly higher among participants without a partner (aOR 1.92, 95% CI 1.45-2.53), with a monthly family income of <5000 BDT (aOR: 2.65, 95% CI 1.82-3.86) or 5000-10 000 BDT (aOR: 1.30, 95% CI 1.03-1.65), living alone (aOR 2.24, 95% CI 1.40-3.61), feeling isolated (aOR 3.15, 95% CI 2.49-3.98), with poor memory/concentration (aOR 2.02, 95% CI 1.58-2.57), with non-communicable chronic conditions (aOR 1.34, 95% CI 1.06-1.69), overwhelmed by COVID-19 (aOR 1.54, 95% CI 1.18-2.00), having difficulty earning (aOR 1.49, 95% CI 1.15-1.92) or obtaining food (aOR 1.56, 95% CI 1.17-2.09) during COVID-19 pandemic, communicating less frequently (aOR 1.35, 95% CI 1.07-1.70) and needing extra care (aOR 2.28, 95% CI 1.75-2.96) during the pandemic.

CONCLUSIONS

Policymakers and public health practitioners should provide immediate mental health support initiatives for this vulnerable population during the COVID-19 pandemic and beyond. Policymakers should also invest in creating safe places to practise mindful eating, exercise, or other refuelling activities as a means of preventing and managing depression.

Global prevalence of depression in older adults: A systematic review and meta-analysis of epidemiological surveys

BACKGROUND

The reported prevalence of depressive symptoms (depression hereafter) among older adults varied widely across different studies. This was a meta-analysis to systematically examine the global prevalence of depression among older populations and its associated factors.

METHODS

A systematic literature search was performed in PubMed, EMBASE, PsycINFO, and Web of Science. Due to the differences in demographic and clinical characteristics between studies, random-effects model was used to calculate the pooled prevalence of depression and its 95% confidence interval (95% CI).

RESULTS

In total, 55 studies with 59,851 individuals met the study criteria and were included in the analyses. The overall prevalence of depression was 35.1% (95%CI: 30.2-40.4%). Subgroup analyses revealed that different sampling methods (Q=10592.49, p = 0.037), Geriatric Depression Scale versions (Q=13712.55, p < 0.001) and income levels (Q=14.028, P < 0.001) were significantly associated with the pooled prevalence of depression in older adults. In the meta-regression analyses, time of survey (B=0.012, z = 2.30, p = 0.029) was positively associated, and mean age (B=-0.018, z = 2.10, p = 0.044) was negatively associated with the prevalence of depression in older populations. The funnel plot and Egger's test did not reveal any significant publication bias (Egger's test: t = 1.93, p = 0.059).

CONCLUSION

This meta-analysis found that over a third of older populations globally had depression. Effective preventive measures, regular screening and timely interventions are needed to address this highly prevalent public health problem among older adults.

Depression and Associated Factors Among the Elderly Population in an Urban Tertiary Geriatric Hospital in Bangladesh

Background: Geriatric depression becoming a serious concern worldwide, but no studies addressed depression among patients attending outpatient department of a tertiary geriatric care hospital in Bangladesh. Methods: This cross-sectional study was conducted in face-to-face interview using the Geriatric Depression Scale (GDS-15) to measure depression among 230 elderly outpatients (60-80 years old) who visited the hospital for medical reasons in Dhaka city; a variety of socio-demographic, behavioral, and psycho-social variables as well as history of chronic diseases were assessed to detect factors associated with depression. Results: The prevalence of depression was 81.7%; 52.6%, 25.2%, and 3.9% showed mild, moderate and severe depression (the GDS scores 5-8, 9-11, and 12-15), respectively. In logistic regression models, the associated factors included marital status, occupational status, educational status, physical activity, and history of cerebrovascular diseases or stroke. The prevalence of depression was generally higher than other reports elsewhere, and the reason behind this may include the use of the GDS-15 and the setting to carry out this study. Conclusion: Nationally representative investigations are warranted to further address depression among the elderly in Bangladesh; these findings would be helpful for future studies and intervention programs.

Physical function, ADL, and depressive symptoms in Chinese elderly: Evidence from the CHARLS

Background

Depressive symptoms are a serious public health problem that affects the mental health of older adults. However, current knowledge of the association between ADL disability and physical dysfunction and depressive symptoms in Chinese adults is insufficient. We intend to analyze the association between physical function, ADL, and depressive symptoms in older Chinese adults.

Methods

The data obtained from the China Health and Retirement Longitudinal Survey (2015 and 2018) (CHARLS). This includes 3,431 in 2015 and 3,258 in 2018 over the age of 60. Comparing 2015 and 2018 data, multivariate logistic regression models were used to explore the relationship between physical function, ADL, and depressive symptoms in urban and rural older adults, adjusting for sociodemographic factors associated with depression in older adults.

Results

The prevalence of depressive symptoms among older adults in China was 33.8 percent in 2015 and 50.6 percent in 2018. In baseline data from 2015 and 2018, residence, gender, marital status, drinking, physical function, ADL, and self-rated health were all found to be significantly associated with depressive symptoms in older adults. The differences in physical function, ADL and depressive symptoms among older adults in 2015 and 2018 were further analyzed based on urban and rural stratification. Both physical dysfunction and ADL disability were significantly associated with depressive symptoms in rural older adults in 2015 and 2018. And in urban areas, ADL was found to be significantly associated with depressive symptoms in urban older adults. Multivariate logistic regression analysis demonstrated that ADL disability was significantly associated with depressive symptoms among older adults in both urban and rural areas. Physical dysfunction was only significant in rural areas with depressive symptoms. The alpha level was instead set to 0.05 for all statistical tests.

Conclusion

Rural, female, 60-70 years of age, primary school or below, married, non-smoking, non-drinking, physical dysfunction, ADL disability and self-rated poor health make-up a higher proportion of depressed older adults. ADL disability and physical dysfunction were more likely to be associated with depressive symptoms in rural Chinese older adults. Therefore, the physical and mental health of rural elderly should be of concern. The rural older adults should receive additional support from the government and society.

Prevalence and Family Determinants of Geriatric Depression Among Elderly People in Elderly Support Groups in Rwanda

Background

The 1994 Tutsi genocide in Rwanda significantly impacted family structure, with many people growing old alone and lacking social bonds and connections with family members. However, little is known about the contribution of the family environment to geriatric depression which was highlighted by WHO as a psychological problem with a 10% to 20% prevalence rate among the elderly worldwide. This study aims to investigate geriatric depression and associated family determinants among the elderly in Rwanda.

Methods

With a community-based cross-sectional study design, we assessed geriatric depression (GD), quality-of-life enjoyment and satisfaction (QLES), family support (FS), loneliness, neglect, and attitude toward grief in a convenience sample of 107 participants (M=72.32, SD=8.79) aged between 60 and 95 years who were recruited from three groups of elderly people supported by the NSINDAGIZA organization in Rwanda. SPSS (version 24) was used for statistical data analysis; differences across various sociodemographic variables were tested for significance by an independent t-test; the relationship between study variables was tested by Pearson correlation analysis; and multiple regression analysis was performed to model the contribution of independent variables to dependent variables.

Results

A total of 64.5% of the elderly scored above the threshold of the normal range of geriatric depression (SDS>49), with higher symptoms in women than in men. Multiple regression analysis indicated that family support and quality-of-life enjoyment and satisfaction were contributors to geriatric depression in the participants.

Conclusion

Geriatric depression was relatively common in our participants. It is associated with the quality of life and family support received. Hence, adequate family-based interventions are needed to improve the well-being of geriatric people in their respective families.

A Comparison between Healthy Lifestyle Behaviors and Physical Activity Levels of Elderly İndividuals Residing in the City Center and Rural, and Analyzing Their Relationship with Depression

ABSTRACT Purpose: Our study aimed to determine the differences in the levels of physical activity and healthy lifestyle behaviours in elderly individuals living in urban and rural and to examine their relationship with depression. Methods: Individuals who are over 65 and residing in the city and rural were included in the study. The Healthy Lifestyle Behaviour’s Scale-II, the Physical Activity Scale for the Elderly, and the Geriatric Depression Scale-15 were used on the participants Results: Healthy Lifestyle Behaviour’s Scale-II scores was no significant difference between the two groups (p=0.430). Physical Activity Scale for the Elderly score in rural (p= 0.001); Geriatric Depression Scale-15 score was statistically higher in the city (p= 0.01). While the relationship between the Healthy Lifestyle Behaviour’s Scale-II and Geriatric Depression Scale-15 scores was significant in both groups (p= 0.001 and p= 0.03), the relationship between the Elderly Physical Activity Scale-II and Geriatric Depression Scale-15 scores was significant only in the rural (p= 0.001). Conclusion: The elderly individuals in rural are more physically active than in city, the elderly living in city have higher depression levels. The factors affecting depression in the elderly living in cities need to be examined in detail.

A correlational study on pain and depression in geriatric patients scheduled for orthopaedic surgery

AIM

Pain is prevalent in geriatric patients and is not only a signal of physical diseases but also a symptom of mental health problems. This study aimed to explore the relationship between pain and depression in geriatric patients scheduled for orthopaedic surgery.

METHODS

The study used a correlational and cross-sectional design. The study sample consisted of geriatric patients (n = 200) scheduled for orthopaedic surgery in a research and training hospital in northern Turkey. Data were collected by the researchers using the Geriatric Pain Measure and Geriatric Depression Scale. In the data analysis, descriptive statistics, Pearson's correlation, and hierarchical regression analysis were used.

RESULTS

The patients' mean age was 73.16 ± 8.27 years. It was found that 5.5% (n = 11) of the participants had mild pain, 45.5% (n = 91) had moderate pain, and 49% (n = 98) had severe pain. There was a positive and moderate significant relationship between the mean Geriatric Pain Measure and Geriatric Depression Scale scores (r = 0.479, P < 0.01). Age (β = 0.133; P < 0.05) and education (β = 2.484; P < 0.05) were statistically significantly associated with depression. There was a significant and positive relationship between depression and being dependent in activities of daily living (β = 5.098; P < 0.05).

CONCLUSION

This study demonstrated that geriatric patients who were older, illiterate, dependent in activities of daily living, and with higher levels of pain had higher depression. A multidisciplinary team approach including nurses should be utilised in pain management and it should not be ignored that severe pain may be associated with depression in geriatric patients.

Relationships between Plasma Concentrations of Testosterone and Dihydrotestosterone and Geriatric Depression Scale Scores in Men and Women Aged 60-65 Years-A Multivariate Approach with the Use of Quade's Test

The potential role of testosterone and dihydrotestosterone in the pathogenesis of depression in older subjects is poorly recognized and understood. The current study examines the symptoms of depression in males and females at the age of 60-65 using a short version (15 questions) of the Geriatric Depression Scale (GDS) questionnaire. Blood plasma levels of androgens were estimated by LC/MS/MS. Total GDS score calculated for males were not found to be significantly associated with plasma levels of testosterone or dihydrotestosterone. Older men with higher plasma testosteronemia were more likely to report being in good spirits most of the time, but more willing to stay at home than undertake outside activities. The men with higher plasma levels of dihydrotestosterone also perceived themselves as being in good spirits most of the time. Older men with higher testosterone were more likely to report having more problems with their memory than others. No significant associations were found between plasma levels of androgens and GDS scores in older women; however, some tendencies suggest that testosterone and dihydrotestosterone may act as antidepressants in older women.

The status of depression literacy and its relationship with quality of life among Iranian public population: a cross sectional study

BACKGROUND

This study was designed and conducted to determine the status of depression literacy (D-Lit) and its relationship with the quality of life across the Iranian population.

METHODS

This cross-sectional study was conducted in 2020 among 1382 participating from the general population in Gonabad, Iran. Participants were selected and recruited using a multistage sampling method. Data were collected using three sets of questionnaires (demographic section, D-Lit scale, and quality of life questionnaire). Data were analyzed by SPSS software version 24 and using independent samples t- test, Chi-square test, One-way ANOVA, and Pearson correlation.

RESULTS

Based on the results, the mean (± standard deviation) of D-Lit and quality of life were 44.14 (± 4.69) and 35.81 (± 5.17), respectively. Based on the results of Pearson correlation coefficient, there was a significant positive correlation between D-Lit and quality of life (r = 0.104, p < 0.001). D-Lit was significantly higher in those who reported having consulted with a psychiatrist compared with those who did not (p < 0.001). Participants with a family history of mental illness and those whose family members were referred to a psychologist for psychological issues had significantly higher levels of D-Lit than others (p < 0.001).

CONCLUSION

Based on the results of this study, some D-Lit projects should be improved. Also, the results revealed that D-Lit is a potential factor that can affect people's mental health status and enhance their quality of life. Therefore, it is necessary to develop appropriate educational programs to enhance D-Lit in the community and ultimately improve the quality of life in the community by reducing mental illness.

The impact of the COVID-19 pandemic on lifestyle patterns: Does gender matter?

Background

The COVID-19 pandemic has significantly impacted individuals to deviate from normal lifestyle behaviors. But, there is a paucity of studies conducted in Bangladesh assessing how lifestyle patterns (i.e., smoking, drug use, physical exercise) have changed after the pandemic, which was investigated in this study.

Methods

An online-based cross-sectional survey was conducted among a total of 756 Bangladeshi young adults between April 1 and 13, 2020. Lifestyle patterns data were collected based on two periods from the COVID-19 pandemic inception point in the country, (i) '1 year before', and (ii) '1 year after'. Basic descriptive statistics (i.e., frequency and percentages) and Chi-square tests were performed to examine the associations of the independent variables in relation to lifestyle patterns.

Results

A 0.2 and 4.7% reduction in smoking and physical exercise, respectively, was observed after the pandemic. But the prevalence of drug use was 1.5% before the COVID-19 pandemic, which rose to 1.9% during the pandemic; representing a 0.4% increment. The changes in lifestyle patterns before and during the COVID-19 pandemic was statistically significant only for physical exercise. Of the gender, male participants were more prevalent in smoking, drug use, and performing physical exercise in both periods.

Conclusion

It is suggested to increase awareness concerning adverse effects of drug use and not performing physical exercise, where the gender-based focus is highly appreciated.

Gender differences and determinants of late-life depression in China: A cross-sectional study based on CHARLS

BACKGROUND

Literature related to within-gender differences in depression among older individuals in China is sparse, and often limited to specific provinces.

METHODS

We analyzed data on 8104 participants from the fourth waves of the China Health and Retirement Longitudinal Study (CHARLS). Using logistic regressions, we identified the correlates of depressive symptoms among older individuals, both in the aggregate and along gender lines. Additionally, we examined the interaction between other covariates and gender.

RESULTS

The prevalence of late-life depression symptoms among females was 45.79%, which was higher than among males (31.13%, P < 0.01). Living in a rural area, earned income, education level, tobacco use and number of chronic diseases were correlated with depression in both genders (P < 0.05), with no interaction (P_int > 0.050). Social activities were correlated with depression in males but not in females (P_int = 0.373), inverse in their 70s (P_int = 0.020) group. The correlation between daily sleep duration and depression is stronger in females than in males (P_int ≤ 0.020). Female who drunk <1 per month decreased their prevalence of depression, but it increased in males (P_int = 0.001). Taking part in LTPA and being a religious believer were correlated with depression in females (P < 0.05), but not in males (P_(LTPA)int = 0.009; P_{(religious believers)int} = 0.033).

LIMITATIONS

Since only analyzed one wave of data, we could not conclude that there was causation.

CONCLUSIONS

Geriatric depression is a serious mental health issue in China. There is, an urgent need for prevention and intervention activities for older individuals, and these needs diverge along gender lines.

Psychometric Properties of the Short-Form Geriatric Depression Scale (GDS-SF) and Its Associated Factors among the Elderly in Bangladesh

Background: This study aimed to (1) evaluate the psychometric properties of a Comprehensive Short-Form Geriatric Depression Scale (GDS-SF) and (2) examine the associated factors of GDS-SF among the elderly. Methods: A cross-sectional study was conducted from November 2019 to April 2020 in Dhaka City Corporation, Bangladesh. Data of 377 elderly were collected, including socio-demographic characteristics, social supports, comorbidities, sleep behaviours, and depression (as measured by the GDS-SF). We used the principal component analysis, correlation analysis, and logistic regression analysis to validate GDS-SF, and explore its associations. Results: The GDS-SF was reliable and homogeneous with Cronbach’s alpha = 0.836, and McDonald’s Omega = 0.841, with no floor/ceiling effects. The questionnaire demonstrated a good construct validity with item-scale convergent validity and KMO measure of sampling adequacy (0.869 for the total sample, 0.838 for the community subsample, and 0.851 for the slum subsample). In the multivariate model, older people had a higher likelihood of moderate and severe depression (OR, 1.06; 95% CI, 1.00, 1.12; p = 0.048). The likelihood of having moderate and severe depression was lower in men (OR, 0.48; 95% CI, 0.28, 0.85; p = 0.011) and those satisfied with their children’s support (OR, 0.17; 95% CI, 0.08, 0.35; p < 0.001), compared with their counterparts, respectively. Conclusions: The GDS-SF is a reliable and valid survey tool for evaluating depression in Bangladeshi older adults. Age, gender, and satisfaction with children’s support were predictors of depression.

Malnutrition and other risk factors of geriatric depression: a community-based comparative cross-sectional study in older adults in rural Bangladesh

BACKGROUND

Malnutrition and depression are highly prevalent in older adults and can lead to disparaging outcomes. Analytical studies on geriatric depression (GD) and its association with malnutrition are very scarce in Bangladesh, although the size of the older population is increasing fast in the country. The current study aimed to assess the association between malnutrition and depression and associated risk factors in rural older adults.

METHODS

A community-based comparative cross-sectional study was conducted in 600 older adult residents (aged ≥60 years) of three rural communities of Bangladesh from January to October 2019. The study enrolled two groups of participants; 300 depressed as cases and another 300 non-depressed older adults as a comparison group matching their age and living area. We used a semi-structured questionnaire to collect data through a face-to-face interview. Geriatric Depression Scale-15 was used to determine depression, and a score of ≥5 was considered as depressed. We used the Bangla version of the Mini-Nutritional Assessment-Short Form to assess nutritional status, which comprised questions related to appetite, weight loss, mobility, recent illness/stress, dementia/depression, and BMI, and considered a score of 0-7 as the cutoff score for malnutrition. Measures included baseline and personal characteristics, malnutrition, GD, and its associated risk factors. A binary logistic regression model was fitted to identify variables associated with the risk of GD.

RESULTS

The study found no significant difference in gender (male Vs. female) between depressed (44.0% Vs. 56.0%) and non-depressed (46.0% Vs. 54.0%) older individuals. The study revealed that malnutrition was significantly (p < 0.01) higher in depressed (56.0%) than in non-depressed (18.0%) rural older adults. The malnourished older adults had around three times (AOR = 3.155; 95% CI: 1.53-6.49, p = 0.002) more risk of having depression than the well-nourished older individuals. Older adults who were unemployed (AOR = 4.964; 95% CI: 2.361-10.440; p = 0.0001) and from lower and middle class (AOR = 3.654; 95% CI: 2.266-7.767; p = 0.001) were more likely to experience depression. Older adults having a 'poor diet' were more likely to experience depression (AOR = 3.384; 95% CI: 1.764-6.703; p = 0.0001). The rural older adults who were single (AOR = 2.368; 95% CI: 1.762-6.524; p = 0.001) and tobacco users (AOR = 2.332; 95% CI: 1.663-5.623; p = 0.003) were found more likely to experience depression.

CONCLUSIONS

A significant association between malnutrition and depression was evident by the current study in the rural older individuals of Bangladesh. It will be a prolific initiative if policymakers merge malnutrition and the risk factors associated with geriatric depression in providing universal health care for better health and well-being of the rural older populations.

Loneliness and mental health outcomes among South Asian older adult immigrants in the United States: a cross-sectional study

BACKGROUND

There is growing concern of mental health issues among South Asian immigrant populations, although limited disaggregated data on determinants of these issues exists. The aim of this study was to examine factors associated with mental health outcomes among South Asian older adult immigrants living in New York City (NYC).

METHODS

Data were sourced from a needs assessment among self-identified South Asians aged 60+ conducted by an NYC-based frontline agency and nonprofit organization. Variables assessed included the 9-item Patient Health Questionnaire, degree of difficulty experienced due to depression, loneliness, emotional distress, as well as sociodemographic, living situation, acculturation, general health, and financial related indicators.

RESULTS

Among the 682 responses, 9.4% of participants displayed symptoms of mild or moderate depression (16% of Caribbean-origin, 10% of Pakistani, 9% of Bangladeshi, and 8% of Indian participants). About a third of participants (29.9%) reported feeling lonely sometimes and 39.1% experienced any type of emotional distress. When compared to those with excellent or very good self-rated health, having fair, poor, or terrible self-rated health was associated with a greater adjusted odds ratio (AOR) of having mild or moderate depression (AOR: 8.42, 95% confidence interval [CI]: 22.09) and experiencing emotional distress (AOR: 3.03, 95% CI: 1.88-4.94). Those experiencing emotional distress were more likely to be younger (AOR: 0.97, 95% CI: 0.95-1.00) and live alone (AOR: 2.06, 95% CI: 1.21-3.53).

DISCUSSION

Findings support the need for tailored mental health interventions targeting concerns, such as poor self-rated health, among South Asian older adult immigrants, as well as specific subpopulations such as Indo-Caribbeans who may be experiencing a disproportionate burden.

WITHDRAWN: Health risk assessment of rural older population

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Depression and suicidality among Bangladeshi students: Subject selection reasons and learning environment as potential risk factors

PURPOSE

This study examined the role of subject-selection reasons and learning environment factors in students' depression and suicidality.

DESIGN AND METHODS

This study surveyed 960 students from five different Bangladeshi universities using questions concerning socio-demographics, lifestyles, subject-selection reasons, learning and academic environment, suicidal behaviors, and the Bangla Patient Health Questionnaire.

FINDINGS

Approximately half of the participants were depressed (47.7%), and just over a quarter reported past-year suicidality (28.5%). Risk factors for both depression and suicidal behavior included not studying at their desired institute, selecting subjects based on future career prospects (rather than choosing what they want to study), not having a study-friendly and research-friendly environment, and unsupportive teachers.

PRACTICAL IMPLICATIONS

The findings will help in formulating policies for educational institutions as well as providing benchmark data for further studies.

How Has the COVID-19 Pandemic Changed BMI Status and Physical Activity - Its Associations with Mental Health Conditions, Suicidality: An Exploratory Study

BACKGROUND

The COVID-19 pandemic has psycho-socially impacted people of all age groups. The consequences related to this crisis may increase the suicide mortality rate as reported in prior pandemics. Although many studies have been conducted identifying suicidal behavior attributing factors, there is a lack of knowledge on the associations of body mass index (BMI) and physical activities, their changes, and suicidal behavior, which were explored herein for the first time.

METHODS

An online-based, cross-sectional study was carried out with a total of 324 Bangladeshi people (mean age = 26.99 ± 8.17 years). The measures included questions on socio-demographics, health-related variables, physical activities-related variables, and mental health problems (eg, depression, anxiety and suicidal behavior).

RESULTS

About 41.0% and 29.3% of the participants reported being depressed and anxious, respectively, whereas suicidal behavior after the pandemic's inception was found to be 6.5%. Although the role of BMI status either prior to or during the pandemic in mental health conditions was not statistically significant, the changes of BMI status were (that is, those with decreasing BMI status compared to no change in BMI status were at greater risk of depression and anxiety, which was followed by increasing BMI status). Besides having no outside space for exercise and performing more physical activities prior to the pandemic were reported to increase anxiety levels, but no significant associations between changes in physical exercise frequency and other mental health problems were observed.

CONCLUSION

In summary, the present findings showed that people with either decreased or increased BMI status after the inception of the pandemic were at greater risk of mental instabilities, which is a concern which should be considered when adopting any preventive approaches.

How Has the COVID-19 Pandemic Changed BMI Status and Physical Activity - Its Associations with Mental Health Conditions, Suicidality: An Exploratory Study

BACKGROUND

The COVID-19 pandemic has psycho-socially impacted people of all age groups. The consequences related to this crisis may increase the suicide mortality rate as reported in prior pandemics. Although many studies have been conducted identifying suicidal behavior attributing factors, there is a lack of knowledge on the associations of body mass index (BMI) and physical activities, their changes, and suicidal behavior, which were explored herein for the first time.

METHODS

An online-based, cross-sectional study was carried out with a total of 324 Bangladeshi people (mean age = 26.99 ± 8.17 years). The measures included questions on socio-demographics, health-related variables, physical activities-related variables, and mental health problems (eg, depression, anxiety and suicidal behavior).

RESULTS

About 41.0% and 29.3% of the participants reported being depressed and anxious, respectively, whereas suicidal behavior after the pandemic's inception was found to be 6.5%. Although the role of BMI status either prior to or during the pandemic in mental health conditions was not statistically significant, the changes of BMI status were (that is, those with decreasing BMI status compared to no change in BMI status were at greater risk of depression and anxiety, which was followed by increasing BMI status). Besides having no outside space for exercise and performing more physical activities prior to the pandemic were reported to increase anxiety levels, but no significant associations between changes in physical exercise frequency and other mental health problems were observed.

CONCLUSION

In summary, the present findings showed that people with either decreased or increased BMI status after the inception of the pandemic were at greater risk of mental instabilities, which is a concern which should be considered when adopting any preventive approaches.

Depression among older adults: a systematic review of South Asian countries

The world's population has been evolving rapidly; every country in the world is facing this drastic progression in the number and the percentage of the elderly in their net population. As the chronological age advances, physiological and psychosocial decline will be evident among all older adults. The potentially relevant literature was identified using appropriate search terms in electronic databases such as PubMed MEDLINE, Scopus, ProQuest, Web of Science, CINAHL, IndMed, and Google Scholar. Articles published from 2006 to 2019, reported the prevalence and the risk factors for depression among older adults living in the community, old age homes, or hospitals of the South Asian countries. Articles were published in the languages other than English and those reporting the categorised or mean depressive scores were excluded from the review. After quality check for all the retrieved articles from different databases, 120 articles were included for the meta-analysis. The data were extracted based on a validated data extraction form, and the reviewer contacted the authors for clarification of the missing data whenever required. The estimates were pooled using the random effect model for meta-analyses. Sub-group and sensitivity analyses were also performed. The overall pooled estimate (random effect models) of the prevalence of depression among the elderly was 42.0% (95% CI: 0.38-0.46), Chi-squared P-value <0.001, and I² 99.14%. The pooled estimate of the prevalence was higher in the community settings than the old age homes (44.0%; 95% CI: 39.0-49.0 vs. 42.0%; 95% CI: 34.0-49.0). Depression is a common problem among the elderly population and the pooled estimate of depression would give directions to the healthcare providers, policymakers, and future researchers to plan some measures (either pharmacological or non-pharmacological interventions) to effectively tackle the burden of geriatric depression in the future.

Estimating the familial risk of psychiatric illnesses: A review of family history scores

A history of psychiatric illnesses in family members of those diagnosed to have an illness has been of significant interest both in research and in clinical practice. Almost all of the major psychiatric illnesses have a familial component to them, perhaps influenced by genetics and a shared environment or their combination. Systematic attempts have been made to quantify these familial risks, as obtained from family history (FH) of psychiatric illnesses. The methods range from a simple dichotomous or count scores to those quantifying as weighted risks such as the Family history density (FHD) measures. This article reviews the available literature on such FH methods and discusses their advantages and limitations. Validation studies have shown that FHD measures may be preferred over dichotomous measures as indicators of familial risk. However, the FHD method has certain limitations, like mostly relying on categorical diagnosis and ignoring other familial risk factors. By critically analysing various existing density measures based on 'ideal characteristics', we suggest a modified version of FHD that would benefit psychiatric research.

Suicidal Behavior and Flood Effects in Bangladesh: A Two-Site Interview Study

Background

Bangladeshi flood survivors are reported with such higher mental disorders that are not ever observed in any other cohorts. Although there are a few studies that assessed mental disorders, suicide or suicidal behaviors are not investigated yet. Hence, the present study for the first time investigated suicidal behaviors and its relationship with socio-demographics, flood effects and psychopathology.

Methods

A cross-sectional interview study was carried out between November and December 2019, after 4/5 months of the flood occurrence. Two completely affected villages from two districts residing in two parts of the country were randomly selected (whereas Manikganj district was less affected by the recent flood compared to Kurigram), and a total of 348 flood survivors were interviewed (45.53 ± 14.85 years). Questions related to basic socio-demographics, flood effects, psychological impacts, and suicidal behaviors were asked in the interviews.

Results

In the total sample, 57.5% of flood survivors reported having suicidal ideation, whereas 5.7% and 2.0% madea suicide plan and suicide attempt, respectively. Within two study sites, participants belonging to Kurigram reported significantly higher suicidal ideation compared to Manikganj (84.8% vs 33.2%, χ² = 94.475, p<0.001). Belonging to a lower-class family, having less education, and less earning members in the family, being affected severely by the flood, suffering from depression, anxiety, and PTSD, and experiencing financial threat, and economic hardship were suicidal behavior risk factors in the total sample.

Conclusion

Considering the present findings (ie, suicidality commensurately increases with flood effects), a multi-sectoral policy and its effective implementation should be adopted for alleviating the flood-related psychological burdens.

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Prevalence and correlates of depressive symptoms among Rohingya (forcibly displaced Myanmar nationals or FDMNs) older adults in Bangladesh amid the COVID-19 pandemic

BACKGROUND

Depression is globally a crucial communal psychiatric disorder, which is more common in older adults. The situation is considerably worse among millions of older (forcibly displaced Myanmar nationals or FDMNs) Rohingya adults, and the coronavirus disease-2019 (COVID-19) pandemic may exacerbate the already existing precarious situation. The present study investigated depressive symptoms and their associated factors in older adult Rohingya FDMNs in Cox Bazar, Bangladesh, during the COVID-19 pandemic.

METHOD

A total of 416 older adults aged 60 years and above residing in Rohingya camps situated in the South Eastern part of Bangladesh were interviewed using a 15-item Geriatric Depression Scale (GDS-15) in Bengali language. Chi-square test was performed to compare the prevalence of depressive symptoms within different categories of a variable and a binary logistic regression model was performed to determine the factors associated with depressive symptoms.

RESULTS

More than 41% of Rohingya older adults had depressive symptoms (DS). Socio-demographic and economic factors such as living alone, dependency on family for living, poor memory, feelings of being left out, difficulty in getting medicine and routine medical care during COVID-19, perception that older adults are at highest risk of COVID-19 and pre-existing non-communicable chronic conditions were found to be significantly associated with developing DS. Higher DS was also evident among older female Rohingya FDMNs.

CONCLUSION

DS are highly prevalent in older Rohingya FDMNs during COVID-19. The findings of the present study call for immediate arrangement of mental health care services and highlight policy implications to ensure the well-being of older FDMNs.

Exploring depressive symptoms and its associates among Bangladeshi older adults amid COVID-19 pandemic: findings from a cross-sectional study

PURPOSE

Depression, one of the most common mental disorders, is up-surging worldwide amid the ongoing coronavirus disease 2019 (COVID-19) pandemic, especially among the older population. This study aims to measure prevalent depressive symptoms and its associates among older adults amid the COVID-19 pandemic in Bangladesh.

METHODS

This cross-sectional study was carried out among 1032 older Bangladeshi adults, aged 60 years and above, through telephone interviews in October 2020. We used a semi-structured questionnaire to collect data on participants' socio-demographic and lifestyle characteristics, pre-existing medical conditions, and COVID-19-related information. Meanwhile, depressive symptoms were measured using the 15-item Geriatric Depression Scale (GDS-15). The binary logistic regression model was used to identify the factors associated with depressive symptoms.

RESULTS

Two-in-five participants showed depressive symptoms on the GDS-15 scale. Poor socioeconomic characteristic such as low family income, dependency on the family for living, recipient of financial support during the pandemic was associated with higher odds of depressive symptoms. Participants with pre-existing medical conditions had 91% higher odds of depressive symptoms. Social isolation, captured in terms of living alone (aOR = 2.11, 95% CI 1.11-4.01), less frequent communication during pandemic (aOR = 1.55, 95% CI 1.07-2.26), perceived loneliness (aOR = 2.25, 95% CI 1.47-3.45), and isolation from others (aOR = 2.45, 95% CI 1.62-3.70) were associated with higher odds of depressive symptoms.

CONCLUSIONS

Our study found a sizeable proportion of study participants with depressive symptoms amidst the ongoing pandemic. The findings of the present study call for the urgent need for mental health support package targeting this vulnerable group of population.

Financial threat, hardship and distress predict depression, anxiety and stress among the unemployed youths: A Bangladeshi multi-city study

INTRODUCTION

Unemployment has a contributory role in the development of mental health problems and in Bangladesh there is increasing unemployment, particularly among youth. Consequently, the present study investigated depression, anxiety, and stress among recent graduates in a multi-city study across the country.

METHODS

A cross-sectional study was conducted among 988 Bangladeshi graduate jobseekers in six major cities of the country between August to November 2019. The measures included socio-demographics and life-style factors, study and job-related information, Economic Hardship Questionnaire, Financial Threat Scale, Financial Well-Being Scale, and Depression Anxiety Stress Scale-21.

RESULTS

Depression, anxiety and stress rates among the present sample were 81.1% (n = 801), 61.5% (n = 608) and 64.8% (n = 640) respectively. Factors related to gender, age, socioeconomic conditions, educational background, lack of extra-curricular activities, and high screen activity were significant risk factors of depression, anxiety, and stress. Structural equation modeling indicated that (while controlling for age, daily time spent on sleep study, and social media use), financial threat was moderately positively related to depression, anxiety, and stress. Financial hardship was weakly positively associated with depression, anxiety, and stress, whereas financial wellbeing was weakly negatively associated with depression, anxiety, and stress.

LIMITATIONS

Due to the nature of the present study (i.e., cross-sectional study) and sampling method (i.e., convenience sampling), determining causality between the variables is not possible.

CONCLUSIONS

The present results emphasized the important detrimental role of financial troubles on young people's mental health by showing that financial problems among unemployed youth predict elevated psychiatric distress in both men and women.

Depression literacy and awareness programs among Bangladeshi students: An online survey

BACKGROUND

Preventing depression and helping individuals to become more resilient to depression, awareness-related programs have been suggested. To implement such programs, depression literacy (D-Lit) assessment is needed. However, little information is known about it in Bangladesh, and this gap was addressed - in the present study.

METHODS

An online-based cross-sectional survey was carried out among 404 university students (62.6% male; 69.3% undergraduates, mean age = 22.35 ± 2.69 years). The survey included questions asking about socio-demographics, personal and family depression history, its' stigma and related programs, and the 20-item Bangla Depression Literacy questionnaire.

RESULTS

The results showed a mean score of 9.30 (SD = 2.75; out of total 20 scores) on the Bangla D-Lit scale. Participants had very limited knowledge of the psychotic symptoms, impact, and management subscales. Moreover, nine items out of the total twenty-items were answered correctly by at least 50% of the participants. There were no significant D-Lit score differences based on gender and past-year personal history, and family depression history. Structural equation modeling indicated that having knowledge about depression and attending depression seminars were positively related to elevated depression literacy.

LIMITATIONS

The study has some limitations due to its cross-sectional study nature and modest sample size. In addition, there the assessment of depression did not use a validated psychometric instrument and the D-Lit comprises multiple-choice responses so the real rate of depression literacy may be even lower than that found because participants could have guessed answers that they did not know.

CONCLUSIONS

Findings from this study suggest that depression literacy was low in the population studied and the findings here will help to facilitate mental health literacy awareness programs in the context of Bangladeshi students as well as those outside the country.

Prevalence and Drivers of Self-Medication Practices among Savar Residents in Bangladesh: A Cross-Sectional Study

BACKGROUND

Self-medication practice (SMP) is widely adopted among residents of such countries as Bangladesh. However, the major determinants of SMP have only scarcely been evaluated. Therefore, this cross-sectional study aimed to fill this knowledge gap by assessing the prevalence and determining factors of SMP.

METHODS

A convenience sample of individuals residing in Savar (Dhaka, Bangladesh) >16 years of age and suffering from an illness >2 months underwent face-to-face interviews during January-February, 2019.

RESULTS

Among 520 interviewees fulfilling entry criteria, the prevalence of SMP was reported as 60.2%. Drug shops, previous knowledge or prescription, and consulting with peers (friends or relatives) were the most sought sources of SMP, whereas simple illness, higher consulting fees, unsatisfactory health-care services, and delayed access were reported as the motives. From the regression analysis, the sociodemographic risk factors of SMP were reported as being older (compared to <18 years), married, illiterate (compared to having higher education), having engaged in any occupation (ie, service, business, homemaker, and others compared to student), and suffering from chronic illness.

CONCLUSION

SMP is highly prevalent and exhibits significant socioeconomic determinants. Development of proper health care-access systems and public education should be implemented to reduce the rate of SMP.