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Brady SS, Arguedas A, Huling JD, Hellemann G, Lewis CE, Fok CS, Van Den Eeden SK, Markland AD. Discrimination and bladder health among women in the CARDIA cohort study: Life course and intersectionality perspectives. Soc Sci Med 2024; 341:116547. [PMID: 38159485 PMCID: PMC10840419 DOI: 10.1016/j.socscimed.2023.116547] [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: 02/04/2023] [Revised: 09/10/2023] [Accepted: 12/20/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE This study examines whether discriminatory experiences are associated with lower urinary tract symptoms (LUTS) and their impact among 972 women in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort study, which recruited participants from 4 cities in the United States. METHOD Exposure to discrimination was assessed 3 times (1992-93, 2000-01, 2010-11) and averaged across assessments. Participants separately reported whether they experienced discrimination on the basis of their gender, race or color, and socioeconomic position or social class. For each social identity, discrimination was assessed in 6-7 settings (e.g., when getting a job, medical care, or housing). At different time points, women who reported discriminatory experiences for a given social identity were asked how frequently the discrimination occurred and how stressful experience(s) were. Following the 2010-11 assessment, data on LUTS and their impact were collected. Women were classified into bladder health versus mild, moderate, or severe symptoms/impact clusters. RESULTS More Black than White women reported discriminatory experiences across all social identities and most settings. Perceived stress of discriminatory experiences did not differ between Black and White women. In analyses stratified by race and social identity, White women reported LUTS/impact with discriminatory experiences in more settings, more frequent discriminatory experiences across settings, and each additional social identity for which discrimination was experienced. Black women reported LUTS/impact with more frequent discriminatory experiences across settings. For Black women, greater perceived stress of both gender and race discrimination were associated with LUTS/impact. For White women, only greater perceived stress of race discrimination was associated with LUTS/impact. CONCLUSIONS This is one of the first studies to examine discrimination in relation to LUTS/impact. Additional research is needed to better understand differences in how discriminatory experiences based on potentially intersecting identities may be related to bladder health among women.
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Affiliation(s)
- Sonya S Brady
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Program in Health Disparities Research, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA.
| | - Andrés Arguedas
- Division of Biostatistics, University of Minnesota School of Public Health, University Office Plaza 2221 University Ave SE, Suite 200, Minneapolis, MN, 55414, USA.
| | - Jared D Huling
- Division of Biostatistics, University of Minnesota School of Public Health, University Office Plaza 2221 University Ave SE, Suite 200, Minneapolis, MN, 55414, USA.
| | - Gerhard Hellemann
- Department of Biostatistics, University of Alabama at Birmingham School of Public Health, Ryals Public Health Building (RPHB), 1665 University Boulevard, Birmingham, AL, 35233, USA.
| | - Cora E Lewis
- Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Ryals Public Health Building (RPHB), 1665 University Boulevard, Birmingham, AL, 35233, USA.
| | - Cynthia S Fok
- Department of Urology, University of Minnesota Medical School, Mayo Building 420 Delaware St. Se. MMC 394, Minneapolis, MN, 55454, USA.
| | - Stephen K Van Den Eeden
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway Oakland, CA, 94612, USA; Department of Urology, University of California, San Francisco, 400 Parnassus Ave, San Francisco, CA, 94143, USA.
| | - Alayne D Markland
- Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham School of Medicine, 933 19th Street South, CH19 201 Birmingham, AL, 35294, USA; Birmingham VA Medical Center, 700 19th St S, Birmingham, AL, 35233, USA.
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Guo W, Li YX, Zhang Y, Lv XR, Wang SX, Zhang SY, Wang ES, Chen XJ, Li Y. Risk analysis of depression among adult patients with epilepsy of different sex: a retrospective single-center study from China. Front Psychiatry 2023; 14:1283983. [PMID: 38111615 PMCID: PMC10725914 DOI: 10.3389/fpsyt.2023.1283983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 11/20/2023] [Indexed: 12/20/2023] Open
Abstract
Objective To determine sex differences in the prevalence of depression and assess the risk factors for depression among adult patients with epilepsy from the Dali area of China. Methods We retrospectively analyzed the clinical data of adult patients with epilepsy who visited the First Affiliated Hospital of Dali University from January 2017 to January 2022. Patient Health Questionnaire-9 was used to assess depressive symptoms in patients with epilepsy. The risk factors of depression were analyzed by binary logistic regression among different sex in patients with epilepsy. Results There were significant sex differences in depression in patients with epilepsy (p < 0.001), and females were 4.27 times more likely to suffer from depression than males (95% confidence interval: 3.70-4.92). The risk factors for depression among female patients with epilepsy included occupation (p < 0.001), years with epilepsy (p < 0.001), seizure frequency (p < 0.001), seizure type (p < 0.001), etiology (p < 0.001), number of antiseizure medications used (p < 0.001), antiseizure medications (p < 0.001), and electroencephalogram findings (p < 0.001). The risk factors for depression among male patients with epilepsy included age (p < 0.001), ethnicity (p < 0.001), occupation (p < 0.001), years with epilepsy (p < 0.001), seizure frequency (p < 0.001), seizure type (p < 0.001), etiology (p < 0.001), number of antiseizure medications used (p < 0.001), antiseizure medications (p < 0.001), and electroencephalogram findings (p < 0.001). Conclusion Adult female patients with epilepsy had a higher risk of depression than adult male patients with epilepsy. There were sex differences in the risk factors associated with depression among patients with epilepsy.
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Affiliation(s)
- Wang Guo
- Clinical Medical School, Dali University, Dali, China
| | - Yu-xuan Li
- Clinical Medical School, Dali University, Dali, China
| | - Yi Zhang
- Clinical Medical School, Dali University, Dali, China
| | - Xue-rui Lv
- Clinical Medical School, Dali University, Dali, China
| | | | - Shuang-yuan Zhang
- Department of Neurology, The First Affiliated Hospital of Dali University, Dali, China
| | - En-si Wang
- Department of Neurology, The First Affiliated Hospital of Dali University, Dali, China
| | - Xin-jie Chen
- Department of Neurology, The First Affiliated Hospital of Dali University, Dali, China
| | - Yun Li
- Department of Neurology, The First Affiliated Hospital of Dali University, Dali, China
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Zhou F, He S, Shuai J, Deng Z, Wang Q, Yan Y. Social determinants of health and gender differences in depression among adults: A cohort study. Psychiatry Res 2023; 329:115548. [PMID: 37890404 DOI: 10.1016/j.psychres.2023.115548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 10/08/2023] [Accepted: 10/15/2023] [Indexed: 10/29/2023]
Abstract
The role of social determinants of health (SDoH) in gender differences in depression remains unclear among Chinese adults. We aimed to explore the association between SDoH and depression and investigate their role in explaining gender differences in depression. This prospective longitudinal cohort study used four wave surveys (2012, 2016, 2018, and 2020) of the China Family Panel Study (CFPS). Fourteen SDoH variables were assessed, and depression was measured using the 8-item short version of the Center for Epidemiologic Studies Depression Scale. The Cox proportional hazards regression and multiple mediation analysis were performed to estimate the effect sizes. The longitudinal sample included 18,874 participants aged 18-92 years (51.4 % males and 48.6 % females). Women had higher risk of depression than men. Unfavorable SDoH were associated with higher risk of depression. After including multiple SDoH in mediation analysis, multiple SDoH mediated 15.7 % of the total effect of gender on depression. In sum, SDoH significantly influenced depression, and specific factors explained gender differences in depression. Supporting women in education, employment, and community involvement could help reduce gender differences in depression.
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Affiliation(s)
- Feixiang Zhou
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan 410078, China
| | - Simin He
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan 410078, China
| | - Jingliang Shuai
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan 410078, China
| | - Zhihao Deng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan 410078, China
| | - Qi Wang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan 410078, China
| | - Yan Yan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan 410078, China.
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Stickley A, Shirama A, Sumiyoshi T. Perceived discrimination and mental health in the Japanese general population. Int J Soc Psychiatry 2023; 69:1790-1800. [PMID: 37300412 DOI: 10.1177/00207640231175248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Research has shown that discrimination is prevalent in many countries and associated with poorer mental health. However, little is known about discrimination and its effects in Japan. AIMS To address this deficit this study examined the association between perceived discrimination and mental health outcomes in the Japanese general population and the role of general stress in these associations. METHOD Data were analyzed from 1,245 individuals (age 18-89) that were collected in an online survey in 2021. Perceived discrimination was assessed with a single-item measure as was lifetime suicidal ideation. Depressive and anxiety symptoms were respectively measured with the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scale. General stress was assessed with the Perceived Stress Scale (PSS-14). Logistic regression was used to assess associations. RESULTS Perceived discrimination was prevalent (31.6%) in the study sample. In fully adjusted analyses discrimination was associated with all of the mental health outcomes/general stress with odds ratios (ORs) ranging from 2.78 (suicidal ideation) to 6.09 (general stress) among individuals with a high level of discrimination. When the analyses were adjusted for general stress (as a continuous score) there was a large reduction in the ORs although high discrimination continued to be significantly associated with anxiety (OR: 2.21), while a mid level of discrimination was related to depressive symptoms (OR: 1.87) and had a borderline association with suicidal ideation. CONCLUSION Perceived discrimination is common in the Japanese general population and associated with worse mental health, with stress possibly playing a role in this association.
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Affiliation(s)
- Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Aya Shirama
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Tomiki Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
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Cunningham R, Imlach F, Haitana T, Every-Palmer S, Lacey C, Lockett H, Peterson D. It's not in my head: a qualitative analysis of experiences of discrimination in people with mental health and substance use conditions seeking physical healthcare. Front Psychiatry 2023; 14:1285431. [PMID: 37908598 PMCID: PMC10613695 DOI: 10.3389/fpsyt.2023.1285431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 10/04/2023] [Indexed: 11/02/2023] Open
Abstract
Introduction Clinician bias contributes to lower quality healthcare and poorer health outcomes in people with mental health and substance use conditions (MHSUC). Discrimination can lead to physical conditions being overlooked (diagnostic overshadowing) or substandard treatment being offered to people with MHSUC. This research aimed to utilise experiences of people with MHSUC to identify discrimination by clinicians, including the role of clinician's beliefs and assumptions in physical health service provision. Methods We surveyed people with MHSUC who accessed physical healthcare services. Of 354 eligible participants, 253 responded to open-ended questions about experiences of those services. Thematic descriptive analysis of survey responses was completed using existing stigma frameworks and inductive coding. Results One dominant theme from survey responses was that diagnostic overshadowing by clinicians was driven by clinician mistrust. Another theme was that clinicians assumed respondent's physical symptoms, including pain, were caused by MHSUC. This influenced decisions not to initiate investigations or treatment. Respondents perceived that clinicians focused on mental health over physical health, contributing to suboptimal care. Discussion Discrimination based on MHSUC leads to poor quality care. Health systems and clinicians need to focus quality improvement processes on access to and delivery of equitable physical healthcare to people with MHSUC, address stereotypes about people with MHSUC and improve integration of mental and physical healthcare.
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Affiliation(s)
- Ruth Cunningham
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Fiona Imlach
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Tracy Haitana
- Māori/Indigenous Health Institute (MIHI), University of Otago Christchurch, Christchurch, New Zealand
| | - Susanna Every-Palmer
- Department of Psychological Medicine, University of Otago Wellington, Wellington, New Zealand
| | - Cameron Lacey
- Māori/Indigenous Health Institute (MIHI), University of Otago Christchurch, Christchurch, New Zealand
| | - Helen Lockett
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Debbie Peterson
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
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Liang J, He P, Wu H, Xu X, Ji C. Characteristics of Depression Clinical Trials Registered on ClinicalTrials.gov. Int J Gen Med 2022; 15:8787-8796. [PMID: 36601647 PMCID: PMC9807170 DOI: 10.2147/ijgm.s394143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 12/19/2022] [Indexed: 12/29/2022] Open
Abstract
Background Mental disorders are among the leading causes of the global health-related burden, and depression is one of the most disabling mental disorders. The emergence of the COVID-19 pandemic has created an environment where many determinants of mental health are exacerbated. Many studies have been registered and conducted over the past 16 years, but how to choose the proper design for depression clinical trials remains the main concern. This study aimed to characterize the current status of global depression clinical trials registered on ClinicalTrials.gov. Methods We examined all the trials registered on ClinicalTrials.gov from 2007 to 2021. Results Overall, 7623 depression clinical trials were identified for analysis. Of those trials, 6402 (83.98%) were intervention trials and 1212 (15.90%) were observational trials. The majority of intervention types were behavioral (35.2%) and drug (28.55%), with very few procedures, dietary supplements, and diagnostic test studies. In addition, 55.53% of trials enrolled <100 participants. The proportions of trials registered in North America were higher than on other continents. Furthermore, the trials that involved only females (12.6%) were more than only males (0.87%) from 2019 to 2021. Conclusion Depression clinical trials registered on ClinicalTrials.gov were dominated by small sample size trials, and there is a lack of trials related to COVID-19. The choice of study design is crucial, and properly designed trials can help improve study efficiency and reduce the likelihood of study failure. Given the increased number of RCT trials, the trial quality is gradually improving over the years. In addition, depression trials concentrating on children and older adults need more scientific attention. Further studies related to COVID-19 are needed, given the great damage that causes to people's physical and mental health.
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Affiliation(s)
- Juan Liang
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, 310053, People’s Republic of China
| | - Peijie He
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, 310053, People’s Republic of China
| | - Hanting Wu
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, 310053, People’s Republic of China
| | - Xiujuan Xu
- Tongde Hospital of Zhejiang Province, Hangzhou, 310012, People’s Republic of China
| | - Conghua Ji
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, 310053, People’s Republic of China,The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310006, People’s Republic of China,Correspondence: Conghua Ji, Email
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The neuroanatomy of social trust predicts depression vulnerability. Sci Rep 2022; 12:16724. [PMID: 36202831 PMCID: PMC9537537 DOI: 10.1038/s41598-022-20443-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 09/13/2022] [Indexed: 12/01/2022] Open
Abstract
Trust attitude is a social personality trait linked with the estimation of others’ trustworthiness. Trusting others, however, can have substantial negative effects on mental health, such as the development of depression. Despite significant progress in understanding the neurobiology of trust, whether the neuroanatomy of trust is linked with depression vulnerability remains unknown. To investigate a link between the neuroanatomy of trust and depression vulnerability, we assessed trust and depressive symptoms and employed neuroimaging to acquire brain structure data of healthy participants. A high depressive symptom score was used as an indicator of depression vulnerability. The neuroanatomical results observed with the healthy sample were validated in a sample of clinically diagnosed depressive patients. We found significantly higher depressive symptoms among low trusters than among high trusters. Neuroanatomically, low trusters and depressive patients showed similar volume reduction in brain regions implicated in social cognition, including the dorsolateral prefrontal cortex (DLPFC), dorsomedial PFC, posterior cingulate, precuneus, and angular gyrus. Furthermore, the reduced volume of the DLPFC and precuneus mediated the relationship between trust and depressive symptoms. These findings contribute to understanding social- and neural-markers of depression vulnerability and may inform the development of social interventions to prevent pathological depression.
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Mukhopadhyay S, Banerjee D, Rao TSS. “The Elephant in the Room”: Neglected Construct of Occupational Sexism. JOURNAL OF PSYCHOSEXUAL HEALTH 2021. [DOI: 10.1177/26318318211017293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Sanchari Mukhopadhyay
- Department of Integrative Medicine, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Debanjan Banerjee
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - T. S. Sathyanarayana Rao
- Department of Psychiatry, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
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What Are the Experiences of Emotional Labor and Workplace Violence that Are More Harmful to Health in Korean Workforce? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218019. [PMID: 33143335 PMCID: PMC7663120 DOI: 10.3390/ijerph17218019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 10/18/2020] [Accepted: 10/19/2020] [Indexed: 11/16/2022]
Abstract
(1) Background: This study aims to investigate the impact of emotional labor and workplace violence on sleep disturbance, depression, and health status in workers. (2) Methods: Data from 34,742 participants of the 2011–2014 Korean Working Conditions Survey were included in this study. We compared the incidence of sleep disturbance, depression, and health status according to emotional labor and workplace violence and used logistic regression to analyze factors that affect health status. (3) Results: Emotional laborers were more likely to experience sleep disturbance, depression and anxiety, and muscle pain. Workers who have experienced workplace violence were more likely to experience depression and anxiety, abdominal pain, and sleep disturbance. (4) Conclusion: Emotional labor and workplace violence have a grave impact on physical and mental health, with particularly greater effects on mental health. In addition, workplace violence has a greater health impact than emotional labor. The findings of this study suggest the need to implement programs that stabilize and heal workers who have experienced emotional labor and to enforce regulations and policies to protect workers from verbal and physical abuse.
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Vigod SN, Rochon PA. The impact of gender discrimination on a Woman's Mental Health. EClinicalMedicine 2020; 20:100311. [PMID: 32211599 PMCID: PMC7082643 DOI: 10.1016/j.eclinm.2020.100311] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 02/25/2020] [Indexed: 11/05/2022] Open
Affiliation(s)
- Simone N. Vigod
- Women's College Research Institute, Women's College Hospital, 76 Grenville Street, Toronto, Ontario M5S 1B2, Canada
- Department of Psychiatry, Faculty of Medicine University of Toronto, Toronto, Ontario, Canada
| | - Paula A. Rochon
- Women's College Research Institute, Women's College Hospital, 76 Grenville Street, Toronto, Ontario M5S 1B2, Canada
- Department of Medicine, Faculty of Medicine University of Toronto, Toronto, Ontario, Canada
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