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Xu C, Miao L, Turner D, DeRubeis R. Urbanicity and depression: A global meta-analysis. J Affect Disord 2023; 340:299-311. [PMID: 37557989 DOI: 10.1016/j.jad.2023.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/29/2023] [Accepted: 08/04/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Previous meta-analyses have revealed that in adult and older adult populations of developed countries, depression is more prevalent in urban than rural areas. No meta-analyses have identified the effects of urbanicity on the general age demographic for developing countries. We conducted a meta-analysis of urban-rural differences in depression across all age demographics for developed and developing countries. METHODS PubMed and PsycINFO databases were searched for studies published between 1980 and 2020. Studies were included if they reported prevalences of urban and rural depression, or odds ratios comparing urban-rural depression prevalence. Studies were excluded for: nonrepresentative samples, non-standard measures of depression, and reporting continuous outcomes only. Meta-analytic models of urban-rural differences in the odds of depression were conducted across country development levels and age demographics. RESULTS From 1597 records screened and 302 full texts assessed for eligibility, 80 studies (N = 539,557) were included for meta-analysis. Urban residence was significantly associated with a higher prevalence of depression in developed countries (OR = 1.30, 95 % CI [1.17, 1.46], z = 4.75, p < .001), which was primarily driven by urban-rural differences in the general population age demographic (OR = 1.37, 95 % CI [1.22, 1.54], z = 5.38, p < .001). LIMITATIONS Studies reporting urban-rural differences in depression in terms of continuous symptom severity scores were not included. CONCLUSIONS Urbanicity appears to uniquely be associated with a higher prevalence of depression in developed countries, but not in developing countries.
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Affiliation(s)
- Colin Xu
- Department of Psychology, University of Pennsylvania, United States of America.
| | - Lucille Miao
- Department of Psychology, University of Pennsylvania, United States of America
| | - Devon Turner
- Department of Psychology, University of Pennsylvania, United States of America
| | - Robert DeRubeis
- Department of Psychology, University of Pennsylvania, United States of America
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Fu C, Cao L, Yang F. Prevalence and determinants of depressive symptoms among community-dwelling older adults in China based on differences in living arrangements: a cross-sectional study. BMC Geriatr 2023; 23:640. [PMID: 37817063 PMCID: PMC10563220 DOI: 10.1186/s12877-023-04339-6] [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: 03/24/2023] [Accepted: 09/21/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Older adults with different living arrangements may have different mental health statuses and different factors that influence their mental health. The aim of the present study is to investigate the prevalence and determinants of depressive symptoms among community-dwelling older adults in China based on differences in their living arrangements. METHODS Participants were 6,055 older adults from the 2015 China Health and Retirement Longitudinal Study. Depressive symptoms and their determinants were evaluated using the 10-item Center for Epidemiologic Studies Depression Scale and multivariate logistic regression analysis, respectively. RESULTS The prevalence of depressive symptoms among older adults living alone, as a couple, and with children was 47.8%, 33.2%, and 39.5%, respectively. The common risk factors for depressive symptoms were shorter sleep duration, poorer activities of daily living, and poorer self-rated health. Women, those with lower educational levels, and those suffering from chronic diseases had a higher risk of depressive symptoms among older adults living as a couple and those living with children. Smoking and participation in economic activities were also risk factors of depressive symptoms among older adults living with children and those living alone, respectively. CONCLUSIONS The findings suggest that older adults living as couples had the lowest prevalence of depressive symptoms, while those living alone had the highest prevalence of depressive symptoms. The determinants of depressive symptoms differed by living arrangement; hence, they should be considered in future interventions.
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Affiliation(s)
- Chang Fu
- Department of Health Service and Management, School of Public Health and Management, Binzhou Medical University, No.346 Guanhai Road, Yantai, Shandong, 264003, China
| | - Lianmeng Cao
- Department of Gastrointestinal Surgery Bariatric and Metabolic Surgery, Binzhou Medical University Hospital, No.661 2nd Huanghe Road, Binzhou, Shandong, 256603, China
| | - Fan Yang
- Department of Information Center, Xiangyang No.1 People's Hospital, Hubei University of Medicine, 15th Jiefang Road, Xiangyang, Hubei, 441000, China.
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Xu J, Zhang H, Zhang T, Sun J, Shi Q, Liu J, Tian G, Zhang B, Wang H, Wu Q, Kang Z. The "jolly fat" for the middle-aged and older adults in China, was education level considered? J Affect Disord 2022; 317:347-353. [PMID: 36057286 DOI: 10.1016/j.jad.2022.08.093] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/10/2022] [Accepted: 08/26/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Several studies have found a negative association between obesity and depression in Chinese middle-aged and elderly, suggesting the existence of "jolly fat". This study aims to investigate whether "jolly fat" is applicable among middle-aged and elderly with different education levels, and to provide a new perspective for depression screening and obesity interventions in middle-aged and older adults. METHODS 10,018 individuals aged 45 years and over in China Family Panel Study (2018) were selected for analysis. A short version of Center for Epidemiological Research Depression Scale was used to assess depression. Body mass index was applied to define obesity status. Subgroup analysis of multiple logistic regression was performed to explore whether the relationship between obesity and depression was influenced by education levels. RESULTS The prevalence of obesity and depression was 9.02 % and 22.96 % among participants. Obesity reduced the probability of depression in middle-aged and elderly with primary school education or below (OR = 0.71, 95 % CI = 0.56-0.91) while not affecting those with junior high school education or above (OR = 0.80, 95 % CI = 0.57-1.13). LIMITATIONS The results cannot be interpreted as causality due to the cross-sectional design. Besides, we cannot directly measure the body composition of the participants. CONCLUSIONS "Jolly fat" existed among middle-aged and elderly with low education, but not in those with junior high school education or above. Health care providers need to monitor the psychological status of low-educated middle-aged and older adults who are seen as needing to lose weight, while the underweight group should be the key target of depression screening.
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Affiliation(s)
- Jinpeng Xu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Hongyu Zhang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Ting Zhang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Jiale Sun
- Xuzhou Center for Disease Control and Prevention, Xuzhou, China
| | - Qi Shi
- School of Health Management, Harbin Medical University, Harbin, China
| | - Jian Liu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Guomei Tian
- Department of Nuclear Medicine, The Fourth Hospital of Harbin Medical University, Harbin, China
| | - Bokai Zhang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Haixin Wang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Qunhong Wu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Zheng Kang
- School of Health Management, Harbin Medical University, Harbin, China.
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Mu TY, Xu RX, Xu JY, Dong D, Zhou ZN, Dai JN, Shen CZ. Association between self-care disability and depressive symptoms among middle-aged and elderly Chinese people. PLoS One 2022; 17:e0266950. [PMID: 35404987 PMCID: PMC9000112 DOI: 10.1371/journal.pone.0266950] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 03/22/2022] [Indexed: 12/16/2022] Open
Abstract
Objective In the context of an increased focus on geriatric depression in recent years, this study examined the associations between different types of self-care disability, the number of self-care disabilities, and depressive symptoms among middle-aged and elderly Chinese people. Method The data for this study were extracted from the follow-up survey (conducted in 2018) of the China Health and Retirement Longitudinal Study (CHARLS). The sample comprised 10808 participants aged 45 years and older. The Activities of Daily Living (ADL) scale and the Center for Epidemiological Studies Depression (CESD-10) Scale were used to assess self-care disability and depressive symptoms, respectively. Result The prevalence of depressive symptoms and self-care disability among the surveyed residents was 45.1% and 23.4%, respectively. Overall, there was a significant positive association between self-care disability and depressive symptoms. Participants who reported having a self-care disability in relation dressing, bathing, transferring in and out of bed, using the toilet, and controlling urination and defecation were found to have a significantly higher risk of depressive symptoms. In addition, participants with a greater cumulative quantity of self-care disabilities had a higher risk of depressive symptoms, and higher CESD-10 scores. Conclusion Self-care disability is a risk factor for depressive symptoms among middle-aged and elderly Chinese people. A positive correlation between the number of self-care disabilities and the risk of depressive symptoms was found.
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Affiliation(s)
- Ting-Yu Mu
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
- Nursing College, Anhui University of Chinese Medicine, Hefei, Anhui Province, China
| | - Ri-Xiang Xu
- School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
- * E-mail: (CZS); (RXX)
| | - Jia-Yi Xu
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Die Dong
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Zhi-Nan Zhou
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Jia-Ning Dai
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Cui-Zhen Shen
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
- * E-mail: (CZS); (RXX)
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Influence of External Natural Environment Including Sunshine Exposure on Public Mental Health: A Systematic Review. PSYCHIATRY INTERNATIONAL 2022. [DOI: 10.3390/psychiatryint3010008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 pandemic has been raging around the world and public health measures such as lockdowns have forced people to go out less often, reducing sunlight exposure time, green space use, and physical activity. It is well known that exercise has a positive impact on mental health, but the impact of external environmental factors such as sunlight exposure and green space use on mental health has not been systematically reviewed. In this review, we categorized the major factors that may affect people’s mental health into (1) external environmental factors such as exposure to sunlight and green spaces, (2) internal life factors such as physical activity and lifestyle, and (3) mixed external and internal factors, and systematically examined the relationship between each factor and people’s mental health. The results showed that exposure to sunlight, spending leisure time in green spaces, and physical activity each had a positive impact on people’s mental health, including depression, anxiety, and stress states. Specifically, moderate physical activity in an external environment with sunlight exposure or green space was found to be an important factor. The study found that exposure to the natural environment through sunbathing and exercise is important for people’s mental health.
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Fan X, Guo X, Ren Z, Li X, He M, Shi H, Zha S, Qiao S, Zhao H, Li Y, Pu Y, Liu H, Zhang X. The prevalence of depressive symptoms and associated factors in middle-aged and elderly Chinese people. J Affect Disord 2021; 293:222-228. [PMID: 34217959 DOI: 10.1016/j.jad.2021.06.044] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 06/06/2021] [Accepted: 06/19/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND This study aimed to evaluate the prevalence of depressive symptoms and associated factors in middle-aged and elderly people in China. METHODS Data were obtained from the China Family Panel Studies (CFPS) 2018. We selected 16,767 respondents over the age of 45 as samples for research and analysis. A short version of the Center for Epidemiological Research Depression Scale (CES-D) was used to assess depressive symptoms. Chi-square test and multiple logistic regression analysis were used to explore the related factors of depressive symptoms. Back Propagation neural network model was established to examine the ranking of influencing factors of depressive symptoms. RESULTS There was 24.1% prevalence of depressive symptoms among the respondents. The 14 important variables affecting depressive symptoms were screened out with the multivariable logistic regression. Based on the BP neural network to rank the degree of importance, the top five important variables were determined, which were subjective well-being (100.0%), self-reported health (92.0%), life satisfaction (83.4%), ADL disability (74.0%), and marital status (69.7%). LIMITATIONS This study was a cross-sectional study, and causality cannot be determined. CONCLUSIONS The prevalence of depressive symptoms in middle-aged and elderly Chinese people was high. Subjective quality of life evaluation, health condition and marital status were important factors that have an impact on depressive symptoms.
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Affiliation(s)
- Xinwen Fan
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xia Guo
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Zheng Ren
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xiangrong Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Minfu He
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hong Shi
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Shuang Zha
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Shuyin Qiao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hanfang Zhao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Yuyu Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Yajiao Pu
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hongjian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Xiumin Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China.
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Childhood disadvantage, education, and psychological distress in adulthood: A three-wave population-based study. J Affect Disord 2018; 229:206-212. [PMID: 29324368 DOI: 10.1016/j.jad.2017.12.051] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 12/14/2017] [Accepted: 12/27/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND We assessed the mediating role of education in the association between childhood disadvantage and psychological distress in adulthood using longitudinal data collected in three waves, from 1994 to 2008, in the framework of the Tromsø Study (N = 4530), a cohort that is representative of men and women from Tromsø. METHODS Education was measured at a mean age of 54.7 years, and psychological distress in adulthood was measured at a mean age of 61.7 years. Ordinary least square regression analysis was used to assess the associations between childhood disadvantage, education, and psychological distress in adulthood. The indirect effects and the proportion (%) of indirect effects of childhood disadvantage (via education) on psychological distress in adulthood were assessed by mediation analysis. RESULTS Childhood disadvantage was associated with lower education and higher psychological distress in adulthood (p < 0.05). Lower education was associated with a higher psychological distress in adulthood (p < 0.05). A minor proportion (7.51%, p < 0.05) of the association between childhood disadvantage and psychological distress in adulthood was mediated by education. LIMITATIONS Childhood disadvantages were measured retrospectively. CONCLUSION The association between childhood disadvantage and psychological distress in adulthood is primarily independent of education.
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