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Haldar P, Tripathi M, Prasad K, Kant S, Dwivedi SN, Vibha D, Pandit AK, Srivastava AK, Kumar A, Ikram MA, Henning T. Association of obstructive sleep apnea and sleep quality with cognitive function: a study of middle-aged and elderly persons in India. Sleep Breath 2024; 28:975-987. [PMID: 38055152 DOI: 10.1007/s11325-023-02953-7] [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: 09/04/2023] [Revised: 10/28/2023] [Accepted: 11/20/2023] [Indexed: 12/07/2023]
Abstract
INTRODUCTION Symptoms of obstructive sleep apnea (OSA) and poor sleep quality affect around one in ten people in India. We aimed to determine if OSA symptoms and poor sleep quality are independently associated with cognition in middle-aged and elderly urban Indian populations. METHODS We studied the cross-sectional association between OSA symptoms (by Berlin Questionnaire), poor sleep quality (by Pittsburgh Sleep Quality Index), and cognitive function in adults ≥ 50 years. Using a standard neuropsychological battery for cognitive function, a G-factor was derived as the first rotated principal component assessing domains of information processing, memory, and executive function. The associations of exposures with cognitive measures were modeled using linear regression, adjusted for metabolic risk factors, lifestyle factors, and psychosocial problems, followed by stratified analysis by decadal age group. RESULTS A total of 7505 adults were enrolled. Excluding those with MMSE < 26 (n 710), of 6795 individuals (49.2% women), mean (SD) age 64.2 (9.0) years, 38.3% had high risk of OSA symptoms, and 15.9% had poor sleep quality. OSA symptoms were negatively associated with cognitive domains of information processing (adjusted beta coefficient of z-score - 0.02, p-value 0.006), memory (- 0.03, 0.014), and G-factor (- 0.11, 0.014) in full-model. Stratified analysis by age group showed significant adverse effects of OSA symptoms on cognition for middle-aged people (50-60 years) (- 0.26, 0.001), but not in later age groups. Poor sleep quality was also associated with lower cognitive scores for G-factor (- 0.48, < 0.001), memory (- 0.08, 0.005), and executive domains (- 0.12, < 0.001), but not with information domain. CONCLUSION The findings suggest that both symptoms of OSA and poor sleep quality have a direct adverse impact on cognition in an Indian setting. A modest effect of age on the relationship of OSA and cognition was also observed.
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Affiliation(s)
- Partha Haldar
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Kameshwar Prasad
- Rajendra Institute of Medical Sciences, Ranchi, 834009, Jharkhand, India.
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sada Nand Dwivedi
- Formerly at: Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Deepti Vibha
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Awadh Kishor Pandit
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Amit Kumar
- Rajendra Institute of Medical Sciences, Ranchi, 834009, Jharkhand, India
| | - MArfan Ikram
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Tiemeier Henning
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Shaw S, Kundu S, Chattopadhyay A, Rao S. Indoor air pollution and cognitive function among older adults in India: a multiple mediation approach through depression and sleep disorders. BMC Geriatr 2024; 24:81. [PMID: 38253994 PMCID: PMC10802029 DOI: 10.1186/s12877-024-04662-6] [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: 09/06/2023] [Accepted: 01/03/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Studies across multiple countries reveal that depression and sleep disorders can lead to cognitive decline. This study aims to speculate on the effect of different sources of indoor air pollution on cognition and to explore the mediation effect of depression and sleep disorders on cognition when exposed to indoor air pollution. We hypothesize that an older adult experiences higher cognitive decline from indoor pollution when mediated by depression and sleep disorders. METHODS We use data from Longitudinal Aging Study in India (LASI), 2017-2018, and employ a multiple mediation model to understand the relationship between indoor air pollution and cognition through sleep disorders and depression while adjusting for possible confounders. Sensitivity analysis was applied to see the effect of different sources of indoor pollution (cooking fuel, indoor smoke products, and secondhand smoke) on cognitive performance. RESULTS The effect of three sources of indoor pollutants on cognition increased when combined, indicating stronger cognitive decline. Unclean cooking practices, indoor smoke (from incense sticks and mosquito coils), and secondhand smoke were strongly associated with sleep disorders and depression among older adults. Indoor air pollution was negatively associated with cognitive health (β= -0.38) while positively associated with depression (β= 0.18) and sleep disorders (β= 0.038) acting as mediators. Sensitivity analysis explained 45% variability while adjusting for confounders. CONCLUSION The study lays a foundation for future investigations into the nexus of indoor pollution and mental health. It is essential to formulate policies to reduce exposure to varying sources of indoor air pollutants and improve screening for mental health services as a public health priority.
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Affiliation(s)
- Subhojit Shaw
- Department of Population and Development, International Institute for Population Sciences, Deonar, Mumbai, 88, India
| | - Sampurna Kundu
- Centre of Social Medicine & Community Health, Jawaharlal Nehru University, New Delhi, Delhi, 110067, India
| | - Aparajita Chattopadhyay
- Department of Population and Development, International Institute for Population Sciences, Deonar, Mumbai, 88, India.
| | - Smitha Rao
- College of Social Work, The Ohio State University, Columbus, 43214, USA
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Singh V, Sutar RF, Gupta S, Pakhare AP, Kokane AM, Aravind BA, Gururaj G, Varghese M, Benegal V, Rao GN. A study of disability and socio-economic impact of mental morbidities from the state of Madhya Pradesh, India. Indian J Psychiatry 2023; 65:1297-1306. [PMID: 38298882 PMCID: PMC10826863 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_841_23] [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: 04/04/2022] [Revised: 04/22/2022] [Accepted: 11/07/2023] [Indexed: 02/02/2024] Open
Abstract
Background Disability associated with mental illness has a disproportionate impact on the work, social, and family responsibilities of an individual toward society. The evidence for disability in mental illnesses would help the clinician, caregivers, policymakers, and various stakeholders to come up with sustainable solutions not only to help fill the existing gaps in care but also to develop new avenues as per the specific needs of the population of Madhya Pradesh (MP). Aim To estimate the burden of disability related to mental illnesses in the state of MP. Materials and Methods A multi-site cross-sectional study was conducted in 2015-16 as part of National Mental Health Survey among adults above 18 years of age. Samples were selected using multi-stage, stratified, random cluster sampling based on probability proportionate to size. Six tehsils with one urban metro out of four districts from a total of 50 districts were selected in the state of MP. The Sheehan Disability Scale and socio-economic impact of illness (from selected questions from WHO-Disability Assessment Schedule-2.0) were used to assess mental morbidity and the subjective reporting of disability. Results The weighted prevalence of disability (n = 1011) was found as 10.2%, 13.1%, and 13.9%, respectively, in work/school, social life, and family/home domains. The weighted prevalence of moderate to extreme disability in the same domains was, respectively, 5.1%, 6.7%, and 7.3%. The presence of common mental disorders (CMDs) increases the odds of self-reported disability in work [odds ratio (OR) 2.48, 95% CI 1.35 to 4.59], social life (OR 2.74, 95% CI 1.50 to 5.07), and family domains (OR 3.03, 95% CI1.62 to 5.74). When combined with common mental disorders, tobacco use disorder further escalates the odds of self-reported disability in all three domains [OR 7.10, confidence interval (CI) 3.15 to 16.37; 4.93, CI 2.19 to 11.28; and 7.10, CI 2.78 to 19.25]. Currently, non-working persons had a higher disability in social life and family life domains (P = 0.003 and P = 0.021), respectively. Conclusion We report a substantial magnitude of disability in social, work, and family life domains. Participants having CMDs, female gender, and those non-working had more disabilities and would require targeted interventions.
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Affiliation(s)
- Vijender Singh
- Department of Psychiatry, All India Institute of Medical Science, Bhopal, Madhya Pradesh, India
| | - Roshan F. Sutar
- Department of Psychiatry, All India Institute of Medical Science, Bhopal, Madhya Pradesh, India
| | - Suruchi Gupta
- Department of Community and Family Medicine, All India Institute of Medical Science, Bhopal, Madhya Pradesh, India
| | - Abhijit P. Pakhare
- Department of Community and Family Medicine, All India Institute of Medical Science, Bhopal, Madhya Pradesh, India
| | - Arun M. Kokane
- Department of Community and Family Medicine, All India Institute of Medical Science, Bhopal, Madhya Pradesh, India
| | - B. A. Aravind
- Department of Epidemiology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Gopalkrishna Gururaj
- Department of Epidemiology, WHO Collaborative Centre for Injury Prevention and Safety Promotion, Centre for Public Health, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Mathew Varghese
- Department of Psychiatry, Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Vivek Benegal
- Department of Psychiatry, Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Girish N. Rao
- Department of Epidemiology, Centre for Public Health, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Kommula Y, Purcell JJ, Callow DD, Won J, Pena GS, Smith JC. Emotional processing and positive affect after acute exercise in healthy older adults. Psychophysiology 2023; 60:e14357. [PMID: 37306291 DOI: 10.1111/psyp.14357] [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: 07/30/2022] [Revised: 05/12/2023] [Accepted: 05/16/2023] [Indexed: 06/13/2023]
Abstract
The well-elucidated improvement of mood immediately after exercise in older adults presumably involves adaptations in emotion-processing brain networks. However, little is known about effects of acute exercise on appetitive and aversive emotion-related network recruitment in older adults. The purpose of this study was to determine the effect of acute exercise, compared to a seated rest control condition, on pleasant and unpleasant emotion-related regional activation in healthy older adults. Functional MRI data were acquired from 32 active older adults during blocked presentations of pleasant, neutral and unpleasant images from the International Affective Pictures System. fMRI data were collected after participants completed 30 min of moderate to vigorous intensity cycling or seated rest, performed in a counterbalanced order across separate days in a within-subject design. The findings suggest three ways that emotional processing in the brain may be different immediately after exercise (relative to immediately after rest): First, reduced demands on emotional regulation during pleasant emotional processing as indicated by lower precuneus activation for pleasant stimuli; second, reduced processing of negative emotional stimuli in visual association areas as indicated by lower activation for unpleasant stimuli in the bilateral fusiform and ITG; third, an increased recruitment in activation associated with regulating/inhibiting unpleasant emotional processing in the bilateral medial superior frontal gyrus (dorsomedial prefrontal cortex), angular gyri, supramarginal gyri, left cerebellar crus I/II and a portion of right dorsolateral prefrontal cortex. Overall, these findings support that acute exercise in active older adults alters activation in key emotional processing and regulating brain regions.
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Affiliation(s)
- Yash Kommula
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, Maryland, USA
- Program in Neuroscience and Cognitive Science, University of Maryland, College Park, Maryland, USA
| | - Jeremy J Purcell
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, Maryland, USA
- Maryland Neuroimaging Center, University of Maryland, College Park, Maryland, USA
| | - Daniel D Callow
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, Maryland, USA
- Program in Neuroscience and Cognitive Science, University of Maryland, College Park, Maryland, USA
| | - Junyeon Won
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Gabriel S Pena
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, Maryland, USA
| | - J Carson Smith
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, Maryland, USA
- Program in Neuroscience and Cognitive Science, University of Maryland, College Park, Maryland, USA
- Maryland Neuroimaging Center, University of Maryland, College Park, Maryland, USA
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Taib NI, Arinell H, Öster C, Ramklint M. Mental disorders in former street-working boys. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02282-w. [PMID: 37598108 DOI: 10.1007/s00787-023-02282-w] [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: 06/06/2022] [Accepted: 07/31/2023] [Indexed: 08/21/2023]
Abstract
The continuity of mental disorders in street-working children is rarely studied. This study therefore investigated homotypic continuity, recurrence of the same disorder, and heterotypic continuity, when a new disorder follows on the previous, of mental disorders from childhood to adulthood in street-working boys from Duhok City, Kurdistan Region of Iraq. Mental disorders were assessed by structured diagnostic interviews in 40 street-working boys in 2004-2005 and again in 2021, when the participants' mean ages were 12.1 (SD 1.8) and 29.7 (SD 2.3), respectively. Mental disorders were common; 24 participants (60%) satisfied the criteria for at least one diagnosis at baseline and 28 (70%) at follow-up. Comorbidity increased from 1.2 (SD 1.4) disorders initially to 2.5 (SD 1.8) at follow-up. Only anxiety disorders showed homotypic continuity. Depressive disorders exhibited the greatest increase over time whereas externalizing disorders exhibited a decreasing tendency. The number of mental disorders in adulthood was related to the number of mental disorders in childhood but not to the number of childhood traumas experienced, having previously worked for more than two hours per day, having worked for over two years on the streets, or having at least one dead parent as a child. Parental ratings on the Child Behaviour Check List (CBCL) from childhood were also unrelated to the number of adult disorders. More longitudinal studies with bigger samples of both genders are needed to fully evaluate the continuity of mental disorders in street-working children and to determine whether the number of mental disorders in childhood is a stronger predictor of being mentally disordered in adult life than psychosocial risk factors or experiences of internalizing or externalizing symptoms in childhood.
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Affiliation(s)
- Nezar Ismet Taib
- Department of Medical Sciences, Child and Adolescent Psychiatry, Uppsala University Hospital, 751 85, Uppsala, Sweden.
| | - Hans Arinell
- Department of Medical Sciences, Child and Adolescent Psychiatry, Uppsala University Hospital, 751 85, Uppsala, Sweden
- Department of Medical Sciences, Psychiatry, Uppsala University Hospital, 751 85, Uppsala, Sweden
| | - Caisa Öster
- Department of Medical Sciences, Psychiatry, Uppsala University Hospital, 751 85, Uppsala, Sweden
| | - Mia Ramklint
- Department of Medical Sciences, Child and Adolescent Psychiatry, Uppsala University Hospital, 751 85, Uppsala, Sweden
- Department of Medical Sciences, Psychiatry, Uppsala University Hospital, 751 85, Uppsala, Sweden
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Haldar P, Prasad K, Kant S, Dwivedi SN, Vibha D, Pandit AK, Srivastava AK, Kumar A, Ikram MA, Henning T. Metabolic risk factors and psychosocial problems independently explain poor sleep quality and obstructive sleep apnea symptoms among adults in urban India. Sleep Breath 2023; 27:1541-1555. [PMID: 36280653 DOI: 10.1007/s11325-022-02725-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/27/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
STUDY OBJECTIVES To determine if metabolic risk factors are associated with poor sleep quality and obstructive sleep apnea-like symptoms (OSA symptoms) independent of psychosocial problems and demographic and lifestyle factors in older Indian adults. METHODOLOGY We analyzed baseline data from adults (≥ 50 years) from a population-based cohort, the LoCARPoN study, in India. Variables were grouped as (a) demographic and lifestyle factors such as smoking, alcohol use, and physical activity; (b) psychosocial problems including symptoms of depression, anxiety, and perceived stress; and (c) metabolic risk factors including glycated hemoglobin, high-density lipoprotein, low-density lipoprotein, total cholesterol, body mass index, and hypertension. Variables were examined as predictors of poor sleep quality and OSA symptoms. Groups of variables were added stepwise to a logistic regression. Variance explained by nested models was quantified using McFadden's pseudo R2, and change was formally tested with the log-likelihood ratio test. RESULTS Among 7505 adults, the prevalence of poor sleep quality was 16.9% (95% CI: 16.0, 17.7), and OSA symptoms were present in 7.0% (95% CI: 6.4, 7.6). Psychosocial problems had a strong independent association with both poor sleep quality (pseudo R2 increased from 0.10 to 0.15, p < 0.001) and more OSA symptoms (pseudo R2 increased from 0.08 to 0.10, p < 0.001). Metabolic risk factors had a modest independent association with sleep quality (pseudo R2 increased from 0.14 to 0.15, p < 0.01), but a strong association with OSA symptoms (pseudo R2 increased from 0.08 to 0.10, p < 0.001). CONCLUSION Psychosocial and metabolic risk factors were independently associated with sleep quality and OSA symptoms. This fact implied that OSA symptoms may affect both mental health and physical health. Our findings have public health implications because the number and proportion of the elderly in India is increasing, while the prevalence of metabolic risk factors and psychosocial problems is high already. These facts have the potential to exacerbate not only the burden of sleep disorders and OSA symptoms but also associated cardiovascular and neurologic sequelae, further stretching the Indian health-care system.
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Affiliation(s)
- Partha Haldar
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Kameshwar Prasad
- Rajendra Institute of Medical Sciences, Ranchi, 834009, Jharkhand, India.
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sada Nand Dwivedi
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Deepti Vibha
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Awadh Kishor Pandit
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Amit Kumar
- Rajendra Institute of Medical Sciences, Ranchi, 834009, Jharkhand, India
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Tiemeier Henning
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Global prevalence of depression in older adults: A systematic review and meta-analysis of epidemiological surveys. Asian J Psychiatr 2023; 80:103417. [PMID: 36587492 DOI: 10.1016/j.ajp.2022.103417] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/10/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022]
Abstract
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.
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Mehdi S, Manohar K, Shariff A, Kinattingal N, Wani SUD, Alshehri S, Imam MT, Shakeel F, Krishna KL. Omega-3 Fatty Acids Supplementation in the Treatment of Depression: An Observational Study. J Pers Med 2023; 13:jpm13020224. [PMID: 36836458 PMCID: PMC9962071 DOI: 10.3390/jpm13020224] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 01/16/2023] [Accepted: 01/22/2023] [Indexed: 01/31/2023] Open
Abstract
Depression is a common mood disorder characterized by persistent sadness and loss of interest. Research suggests an association between the inclusion of omega-3 fatty acids in the diet and a reduced risk for depression. The present study evaluated the effectiveness of omega-3 fatty acid supplements in alleviating depressive symptoms in patients with mild to moderate depression. A total of 165 patients suffering from mild to moderated depression were randomized to receive omega-3 fatty acid supplementation, an antidepressant (single agent), or a combination of an antidepressant and omega-3 fatty acid supplementation. The clinical features of depression were assessed using the Hamilton Depression Rating Scale (HDRS) during the follow-up period. A statistically significant improvement in depressive symptoms was observed from baseline to first, second and third follow-ups within each treatment arm as measured by HRDS scores (p = 0.00001). Further, the HDRS scores at the third follow-up were significantly lower in patients on combination therapy of omega-3 fatty acid supplement and antidepressants (arm-3) than the patients on the omega-3 fatty acid supplement alone (arm-1) [Q = 5.89; p = 0.0001] or the patients taking an antidepressant alone (arm 2) [Q = 4.36; p = 0.0068]. The combination of an omega-3 fatty acid supplement and an antidepressant elicited significantly higher improvement in depressive symptoms than the supplement or the antidepressant alone.
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Affiliation(s)
- Seema Mehdi
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher education and Research, Mysuru 570015, India
| | - Kishor Manohar
- Department of Psychiatry, JSS Medical College and Hospital, JSS Academy of Higher Education & Research, Mysuru 570015, India
| | - Atiqulla Shariff
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru 570015, India
| | - Nabeel Kinattingal
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher education and Research, Mysuru 570015, India
| | - Shahid Ud Din Wani
- Department of Pharmaceutical Sciences, School of Applied Science and Technology, University of Kashmir, Srinagar 190006, India
| | - Sultan Alshehri
- Department of Pharmaceutical Sciences, College of Pharmacy, AlMaarefa University, Ad Diriyah 13713, Saudi Arabia
| | - Mohammad T. Imam
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | - Faiyaz Shakeel
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Kamsagara L. Krishna
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher education and Research, Mysuru 570015, India
- Correspondence:
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Wang S, Lu T, Sun J, Huang L, Li R, Wang T, Yu C. Long-term trends in the incidence of depressive disorders in China, the United States, India and globally: A comparative study from 1990 to 2019. Front Psychol 2023; 13:1066706. [PMID: 36733872 PMCID: PMC9888314 DOI: 10.3389/fpsyg.2022.1066706] [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: 10/11/2022] [Accepted: 12/30/2022] [Indexed: 01/19/2023] Open
Abstract
Background Depressive disorders have become an increasingly significant public health issue. This study is intended to show the trend of the incidence of depressive disorders in China, the United States, India and the world from 1990 to 2019, as well as the impact of age, period and cohort on it. Methods Extracting incidence data from the Global Burden of Disease Study 2019, we determined trends in the age-standardized incidence rate (ASIR) using Joinpoint regression. An age-period-cohort analysis was implemented to describe the effects of age, period, and cohort, as well as the long-term tendencies. Results From 1990 to 2019, the ASIR of depressive disorders in China was lower than that in the United States; India is lower than the United States in the first 5 years, showing a downward trend. The incidence in India and the United States is higher than the global average. The ASIR of women in the three countries is higher than that of men. In China, the elderly, early period and people born around 1954 have a higher risk of depressive disorders. In the United States, young people born around 1999 have a higher risk of depressive disorders. India is similar to China. Conclusion From 1990 to 2019, the age effect of China as a whole increased, and the period became stable, and the cohort effect declined. The overall age and period effects of the United States reduced, while the cohort effect increased. The age effect in India increased, while the period and cohort effects decreased. Depressive disorders are becoming ever more serious worldwide, and we'd better take measures to reduce its incidence according to the cohort effect of each age group.
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Pengpid S, Peltzer K. Prevalence and correlates of major depressive disorder among a national sample of middle-aged and older adults in India. Aging Ment Health 2023; 27:81-86. [PMID: 35037808 DOI: 10.1080/13607863.2021.2024796] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Objectives: This study aimed to assess the prevalence and correlates of major depressive disorder (MDD) among middle-age and older adults in India.Methods: The cross-sectional sample consisted of 72,262 persons (45 years and older) from the 2017 to 2018 Longitudinal Ageing Study in India (LASI) Wave 1. MDD is defined using DSM-5 criteria and measured with the CIDI-SF. Logistic regression was used to evaluate the associations with MDD.Results: The prevalence of past 12-month MDD was 7.6%, 8.1% among women and 7.0% among men, and 8.2% in persons 60 years and older. In the final adjusted model, food insecurity, having 3-6 discrimination experiences, ill-treatment, victim of violent crime, disaster exposure, unsafe home/neighbourhood, poor childhood health, hypertension, stroke, tobacco use, and physical pain were positively associated with MDD. Being male, married, high socioeconomic status, living in urban areas, high spirituality/religiosity, health insurance and medium social network were negatively associated with MDD.Conclusion: Almost one in ten middle-aged and older adults in India had MDD and several associated factors were identified.
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Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand.,Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa
| | - Karl Peltzer
- Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa.,Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
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Translation and validation of the Tamil version of depression anxiety stress scales-21. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Perianayagam A, Prina M, Selvamani Y, Gudekar D, Salvi S, Varghese M, Dandona R. Sub-national patterns and correlates of depression among adults aged 45 years and older: findings from wave 1 of the Longitudinal Ageing Study in India. Lancet Psychiatry 2022; 9:645-659. [PMID: 35843255 PMCID: PMC9375859 DOI: 10.1016/s2215-0366(22)00186-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 04/22/2022] [Accepted: 05/04/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Depression is a major public health challenge linked with several poor health outcomes and disabilities among adults aged 45 years and older in India. We aimed to describe the prevalence of depression and its association with a variety of sociodemographic correlates and co-existing health conditions for this age group in India and its states. METHODS In this prospective cohort study, data from wave 1 (baseline) of the Longitudinal Ageing Study in India were used to estimate the national and subnational state level age-standardised prevalence of depression-major depressive episodes-using the internationally validated Composite International Diagnostic Interview-Short Form (CIDI-SF) scale. Hierarchical mixed effect multivariate logistic regression models were used to study the sociodemographic correlates and co-existing health conditions of major depressive episodes among the nationally representative sample of 72 250 adults aged 45 years and older from 35 states or union territories (except the state of Sikkim). Associations between depression and self-rated health, co-morbid conditions, functional health, and life satisfaction measures were also examined. FINDINGS A total of 40 335 (58·3%) females and 29 407 (41·7%) males aged 45 to 116 years (median age 58 years) participated. The overall age-standardised prevalence of depression based on CIDI-SF scale was 5·7% (95% CI 5·5-5·8) compared with 0·5% (0·5-0·6) self-reported prevalence of depression among adults aged 45 years and older in India. Wide sub-national variations were seen in depression prevalence, ranging from 0·8% (95% CI 0·3-1·3) in Mizoram state to 12·9% (11·6-14·2) in Madhya Pradesh. Prevalence was higher in females (6·3% [95% CI 6·1-6·6] vs 4·3% [4·1-4·6]) for India, and this higher prevalence was more pronounced in some of the northern states. The risk of depression was higher in those residing in rural areas, widowed, with no or low education, and in the poorest quintile. Depression showed a strong positive association with poor self-rated health (OR 2·39 [95% CI 2·21-2·59]; p<0·0001), with one or more limitations in the activities of daily living (ADL; OR 1·60 [1·46-1·75]; p<0·0001), instrumental ADL limitations (OR 1·51 [1·40-1·64]; p<0·0001), and low cognitive judgment of life satisfaction (OR 1·94 [95% CI 1·78-2·10]; p<0·0001). INTERPRETATION Despite the substantial burden, depression remains undiagnosed and strongly linked with poor health and wellbeing outcomes in adults aged 45 years and older in India. The ageing population of India and the subnational variations amplify the implications of this new evidence to address the substantial gaps in prevention and treatment of depression. FUNDING LASI was funded by the Ministry of Health and Family Welfare, Government of India, the National Institute of Ageing, USA and the United Nations Population Fund, India.
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Affiliation(s)
- Arokiasamy Perianayagam
- International Institute for Population Sciences, Mumbai, India; National Council of Applied Economic Research, Delhi, India
| | - Matthew Prina
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, UK
| | - Y Selvamani
- International Institute for Population Sciences, Mumbai, India
| | - Dipika Gudekar
- International Institute for Population Sciences, Mumbai, India
| | - Supriya Salvi
- International Institute for Population Sciences, Mumbai, India
| | - Mathew Varghese
- Department of Psychiatry, National Institute of Mental Health Sciences and Neurosciences, Bengaluru, India
| | - Rakhi Dandona
- Public Health Foundation of India, Gurugram, India; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
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Coelho-Júnior HJ, Calvani R, Panza F, Allegri RF, Picca A, Marzetti E, Alves VP. Religiosity/Spirituality and Mental Health in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies. Front Med (Lausanne) 2022; 9:877213. [PMID: 35646998 PMCID: PMC9133607 DOI: 10.3389/fmed.2022.877213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/19/2022] [Indexed: 12/03/2022] Open
Abstract
Objectives The present study investigated the association between religious and spiritual (RS) practices with the prevalence, severity, and incidence of mental health problems in older adults. Methods We conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies that investigated older adults aged 60+ years and assessed RS using valid scales and questions from valid scales, and mental health according to validated multidimensional or specific instruments. Studies were retrieved from MEDLINE, LILACS, SCOPUS, CINAHL, and AgeLine databases until July 31, 2021. The risk of bias was evaluated using the Newcastle-Ottawa Quality Assessment Scale (NOS). A pooled effect size was calculated based on the log odds ratio (OR) and Z-scores. This study is registered on PROSPERO. Results One hundred and two studies that investigated 79.918 community-dwellers, hospitalized, and institutionalized older adults were included. Results indicated that high RS was negatively associated with anxiety and depressive symptoms, while a positive association was observed with life satisfaction, meaning in life, social relations, and psychological well-being. Specifically, people with high spirituality, intrinsic religiosity, and religious affiliation had a lower prevalence of depressive symptoms. In relation to longitudinal analysis, most studies supported that high RS levels were associated with a lower incidence of depressive symptoms and fear of death, as well as better mental health status. Conclusion Findings of the present study suggest that RS are significantly associated with mental health in older adults. People with high RS levels had a lower prevalence of anxiety and depressive symptoms, as well as reported greater life satisfaction and psychological well-being, better social relations, and more definite meaning in life. Data provided by an increasing number of longitudinal studies have supported most of these findings.
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Affiliation(s)
- Hélio José Coelho-Júnior
- Università Cattolica del Sacro Cuore, Institute of Internal Medicine and Geriatrics, Rome, Italy
- Department of Gerontology, Catholic University of Brasília, Brasília, Brazil
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
- *Correspondence: Hélio José Coelho-Júnior
| | - Riccardo Calvani
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
| | - Francesco Panza
- National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Bari, Italy
| | - Riccardo F. Allegri
- Department of Cognitive Neurology, Instituto de Investigaciones Neurológicas Fleni, Buenos Aires, Argentina
- Department of Neurosciences, Universidad de la Costa (CUC), Barranquilla, Colombia
| | - Anna Picca
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
| | - Emanuele Marzetti
- Università Cattolica del Sacro Cuore, Institute of Internal Medicine and Geriatrics, Rome, Italy
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
| | - Vicente Paulo Alves
- Department of Gerontology, Catholic University of Brasília, Brasília, Brazil
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Jayasankar P, Manjunatha N, Rao GN, Gururaj G, Varghese M, Benegal V. Epidemiology of common mental disorders: Results from "National Mental Health Survey" of India, 2016. Indian J Psychiatry 2022; 64:13-19. [PMID: 35400745 PMCID: PMC8992756 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_865_21] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/06/2021] [Accepted: 11/30/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Despite their higher prevalence, the Common Mental Disorders (CMDs) are under-recognized and under-treated resulting in huge disability. India, home to one-fifth of the global population, could offer insights for organizing better services for CMDs. However, the prevalence and resultant disability in the general population is unknown, and consequently, gaps in management or plan for services are enormous, by default overlooked. AIM Estimating the current prevalence, disability, socioeconomic impact, and treatment gap of CMDs in a nationally representative sample from India. We attempt to identify the missed opportunities and list priorities for planning. METHODOLOGY The National Mental Health Survey of India (2016) is a multisite nationwide household survey conducted across India using a uniform methodology. Overall, 39,532 adults were surveyed with a response rate of 88%. Diagnoses are based on the Mini International Neuropsychiatric Interview 6.0.0. CMDs for this analysis include depressive and anxiety disorders (generalized anxiety disorder, social phobia, agoraphobia, panic disorder, obsessive-compulsive disorder, and posttraumatic stress disorder). RESULTS The weighted prevalence of current CMDs was 5·1% (95% CI: 5.06-5.13). Prevalence was highest in females, among the 40-59 years of age group, and in metros. Nearly 60% of them reported disabilities of varying severity. The treatment gap was 80·4%. On average, patients and their families spent ₹1500/month towards the treatment of CMDs. CONCLUSIONS This survey gives valuable insights regarding the disability and treatment gap due to CMDs and is imperative for reframing mental health policies and planning interventions. This study also suggests an international investigation to understand the difference in the prevalence of CMDs in developing versus developed countries.
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Affiliation(s)
- Pavithra Jayasankar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Narayana Manjunatha
- Department of Psychiatry, Tele-Medicine Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Girish N Rao
- Department of Epidemiology, Centre for Public Health, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Gopalkrishna Gururaj
- Department of Epidemiology, WHO Collaborative Centre for Injury Prevention and Safety Promotion, Centre for Public Health, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Mathew Varghese
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Vivek Benegal
- Department of Psychiatry, Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Philip S, Gajera G, Nirisha PL, Sivakumar PT, Barikar MC, Panday P, Patley R, Chander R, Sinha P, Basavarajappa C, Manjunatha N, Kumar CN, Math SB. Future-Proofing Geriatric Mental Health Care Services in India: Training and Policy Directions. Indian J Psychol Med 2021; 43:S134-S141. [PMID: 34732966 PMCID: PMC8543623 DOI: 10.1177/02537176211032342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND A burgeoning rise in the elderly subpopulation is being noted in India. This rise has already earned the designation as a shining nation by the United Nations/World Health Organization. This growth will take the elderly subpopulation to 324 million persons above 60 years by 2050. The mental health needs of this subpopulation are varied and nuanced compared to that of the general population. The risk and prevalence of mental health morbidity are also greater. There is an urgent need to gear up the health care systems. CONSIDERATIONS Various aspects of the ongoing demographic transitions are considered alongside available health information. Legislative mandates and laws are also reviewed to provide context to qualify the action points and recommendations. Recommendations, India must act urgently to strengthen health care delivery systems in a concurrent multipronged approach. These efforts should focus on developing trained Human Resources and adequate infrastructural resources. Review mechanisms to inform on required updates on best practices and evidence-based medicine must also be incorporated and developed to perform periodically.
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Affiliation(s)
- Sharad Philip
- Dept. of Psychiatry, NIMHANS, Bengaluru, Karnataka, India. 2Geriatric Clinic and Services, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Gopi Gajera
- Dept. of Psychiatry, NIMHANS, Bengaluru, Karnataka, India. 2Geriatric Clinic and Services, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - P Lakshmi Nirisha
- Dept. of Psychiatry, NIMHANS, Bengaluru, Karnataka, India. 2Geriatric Clinic and Services, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Palanimuthu Thangaraju Sivakumar
- Dept. of Psychiatry, NIMHANS, Bengaluru, Karnataka, India. 2Geriatric Clinic and Services, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Malathesh C Barikar
- Dept. of Psychiatry, NIMHANS, Bengaluru, Karnataka, India. 2Geriatric Clinic and Services, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Praveen Panday
- Dept. of Psychiatry, NIMHANS, Bengaluru, Karnataka, India. 2Geriatric Clinic and Services, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Rahul Patley
- Dept. of Psychiatry, NIMHANS, Bengaluru, Karnataka, India. 2Geriatric Clinic and Services, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Rakesh Chander
- Dept. of Psychiatry, NIMHANS, Bengaluru, Karnataka, India. 2Geriatric Clinic and Services, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Preeti Sinha
- Dept. of Psychiatry, NIMHANS, Bengaluru, Karnataka, India. 2Geriatric Clinic and Services, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Chethan Basavarajappa
- Dept. of Psychiatry, NIMHANS, Bengaluru, Karnataka, India. 2Geriatric Clinic and Services, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Narayana Manjunatha
- Dept. of Psychiatry, NIMHANS, Bengaluru, Karnataka, India. 2Geriatric Clinic and Services, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Channaveerachari Naveen Kumar
- Dept. of Psychiatry, NIMHANS, Bengaluru, Karnataka, India. 2Geriatric Clinic and Services, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Suresh Bada Math
- Dept. of Psychiatry, NIMHANS, Bengaluru, Karnataka, India. 2Geriatric Clinic and Services, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
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