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Schneider BC, Veckenstedt R, Karamatskos E, Scheunemann J, Moritz S, Jelinek L, Miegel F. Change in negative mental filter is associated with depression reduction in metacognitive training for depression in older adults (MCT-Silver). Sci Rep 2024; 14:17120. [PMID: 39054326 PMCID: PMC11272923 DOI: 10.1038/s41598-024-67063-0] [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: 02/07/2024] [Accepted: 07/08/2024] [Indexed: 07/27/2024] Open
Abstract
Identifying components of modularized psychological interventions that contribute to symptom reduction is essential to improving depression treatment. In a secondary analysis of a randomized controlled trial (RCT), session-specific effects of Metacognitive Training-Silver, a group intervention for older adults with depression, were investigated. Thirty-eight older adults with major depressive disorder or dysthymia participated in up to eight sessions of MCT-Silver. A clinical assessment of depressive symptoms (Hamilton Depression Rating Scale) as well as additional interviews and questionnaires administered as part of the RCT were completed at pre- and post-intervention. Depressive symptoms, negative (meta)cognitive beliefs, emotion regulation strategies and attitudes toward aging were assessed pre- and post-session. The rate of change in each variable per module, elevation following the module in which the variable was addressed, and the rate of change post module were examined via linear mixed models. Clinician-rated depressive symptoms were significantly reduced from pre- to post-intervention (Cohens d = 1.31). Self-reported depression and negative mental filter measured within sessions improved significantly over treatment, whereas black-and-white thinking improved after module #3 (Should Statements, All or Nothing Thinking and Acceptance). Module-specific within-session effects were found for overgeneralization (module #1: Mental Filter) and rumination (module #6: Rumination and Social Withdrawal). Improvement in mental filter in module #1 was significantly associated with depression reduction. This study provides initial evidence that MCT-Silver partially meets its aims of reducing depression and specific cognitive variables within and across sessions. Improvement of the instrument used to measure change may improve detection of module-specific effects.Trial registration: NCT03691402.
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Affiliation(s)
- Brooke C Schneider
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Ruth Veckenstedt
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Evangelos Karamatskos
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Jakob Scheunemann
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Franziska Miegel
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
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Bartova L, Fugger G, Dold M, Kautzky A, Bairhuber I, Kloimstein P, Fanelli G, Zanardi R, Weidenauer A, Rujescu D, Souery D, Mendlewicz J, Zohar J, Montgomery S, Fabbri C, Serretti A, Kasper S. The clinical perspective on late-onset depression in European real-world treatment settings. Eur Neuropsychopharmacol 2024; 84:59-68. [PMID: 38678879 DOI: 10.1016/j.euroneuro.2024.03.007] [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: 11/20/2023] [Revised: 03/17/2024] [Accepted: 03/18/2024] [Indexed: 05/01/2024]
Abstract
The clinical phenotype of the so-called late-onset depression (LOD) affecting up to 30% of older adults and yielding heterogeneous manifestations concerning symptoms, severity and course has not been fully elucidated yet. This European, cross-sectional, non-interventional, naturalistic multicenter study systematically investigated socio-demographic and clinical correlates of early-onset depression (EOD) and LOD (age of onset ≥ 50 years) in 1410 adult in- and outpatients of both sexes receiving adequate psychopharmacotherapy. In a total of 1329 patients (94.3%) with known age of disease onset, LOD was identified in 23.2% and was associated with unemployment, an ongoing relationship, single major depressive episodes, lower current suicidal risk and higher occurrence of comorbid hypertension. In contrast, EOD was related to higher rates of comorbid migraine and additional psychotherapy. Although the applied study design does not allow to draw any causal conclusions, the present results reflect broad clinical settings and emphasize easily obtainable features which might be characteristic for EOD and LOD. A thoughtful consideration of age of onset might, hence, contribute to optimized diagnostic and therapeutic processes in terms of the globally intended precision medicine, ideally enabling early and adequate treatment allocations and implementation of respective prevention programs.
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Affiliation(s)
- Lucie Bartova
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria; Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Gernot Fugger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria; Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria; Psychiatric Day Hospital University Hospital St. Poelten, Karl Landsteiner Private University of Health Sciences, Krems an der Donau, Austria
| | - Markus Dold
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria; Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Alexander Kautzky
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Isabella Bairhuber
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Philipp Kloimstein
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria; Center for Addiction Medicine, Foundation Maria Ebene, Frastanz, Austria
| | - Giuseppe Fanelli
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy; Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
| | - Raffaella Zanardi
- Vita-Salute San Raffaele University, Milano, Italy; Mood Disorders Unit, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Ana Weidenauer
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Dan Rujescu
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Daniel Souery
- PsyPluriel - Outpatient Department EPSYLON asbl - Epsylon Caring from Mental Health Brussels, Brussels, Belgium
| | | | - Joseph Zohar
- Psychiatric Division, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Stuart Montgomery
- Imperial College School of Medicine, University of London, London, United Kingdom
| | - Chiara Fabbri
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - Alessandro Serretti
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy; Department of Medicine and Surgery, Kore University of Enna, Enna, Italy
| | - Siegfried Kasper
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria; Center for Brain Research, Medical University of Vienna, Vienna, Austria.
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Fonseca L, Castro L, Rêgo G, Nunes R. Multidimensional Study of the Attitude towards Euthanasia of Older Adults with Mixed Anxiety-Depressive Disorder. Healthcare (Basel) 2024; 12:1078. [PMID: 38891153 PMCID: PMC11171529 DOI: 10.3390/healthcare12111078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/18/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
INTRODUCTION This study aims to verify if older adults with mixed anxiety-depressive disorder are more prone to euthanasia and identify factors that interfere with their satisfaction with health and capacity for well-informed decisions. MATERIAL AND METHODS The study applied a paper questionnaire composed of a sociodemographic section and a battery of scales (to assess depression, anxiety, cognitive performance, suicide risk, therapeutic adhesion, functionality, loneliness, attitude towards euthanasia, decision pattern, personality, empathy, and health status) in the Psychogeriatric Unity of Senhora da Oliveira Hospital in Portugal. The sample was collected by convenience to include patients and controls of the same age. Six months later, a reassessment was performed. Patients and controls were compared using descriptive statistics and a multiple-regression model. RESULTS A total of 114 patients and 25 controls were included. Eighty-one point six percent of patients had four or fewer years of schooling. Contrary to controls, they presented mild depressive and anxiety symptoms, loneliness feelings, worse cognitive performance, a more fragile personality, higher personal distress, and a poorer health state. No statistically significant differences were found between controls and patients regarding their attitudes towards euthanasia. Patients more favourable to euthanasia had higher empathic concern, conscientiousness, and fantasy, and lower personal distress. DISCUSSION AND CONCLUSION When addressing euthanasia in these patients, it is crucial to ensure they are fully self-determinate and that all the necessary treatment and support are available. It may not be the case when the educational level is low and a mild disease persists, significantly affecting their well-being and cognitive performance.
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Affiliation(s)
- Luís Fonseca
- Bioethics Department, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal; (G.R.); (R.N.)
- Psychogeriatrics Unity, Psychiatry Department, Senhora da Oliveira Hospital Guimarães, 4835-044 Guimarães, Portugal
| | - Luísa Castro
- Department of Community Medicine, Information and Health Decisions Sciences, MEDICIS, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal;
- Centre for Health Technology and Services Research (CINTESIS@RISE), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
| | - Guilhermina Rêgo
- Bioethics Department, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal; (G.R.); (R.N.)
| | - Rui Nunes
- Bioethics Department, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal; (G.R.); (R.N.)
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Huang S, Wang J, Zhang Y, Qiu Y, Wang H, Yu X, Wang Z, Lv X. Co-occurrence of depressive and anxious symptoms and their influence on self-rated health: a national representative survey among Chinese older adults. Aging Ment Health 2024:1-10. [PMID: 38745442 DOI: 10.1080/13607863.2024.2348613] [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: 09/22/2023] [Accepted: 04/23/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVES The prevalence of the co-occurrence of depressive and anxious symptoms (CO) and their influence on perceived overall health were not clear in community dwelling Chinese older adults. The aims of the study were to investigate the prevalence of CO and to explore its influence on self-rated health (SRH). METHOD This study included 12301 individuals aged ≥65 years from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a nationally representative survey of older adults in mainland China. Participants received face-to-face interviews and assessments of depressive symptoms and anxious symptoms via 10-item of the Center for Epidemiologic Studies Depression Scale (CES-D-10) and 7-item Generalized Anxiety Disorder Questionnaire (GAD-7), respectively. SRH was measured by self-reported. A logistic regression model was used to examine the association between CO and SRH after adjusting for confounding variables. RESULTS The average age was 83.4 (SD: 11.0) years and there were 6576 (53.5%) females. The age- and sex-standardized prevalence of depressive symptoms only (DSO) was 38.6%, anxious symptoms only (ASO) was 1.5%, and CO was 10.8%. Compared with those without depressive and anxious symptoms, the older adults with DSO or ASO were more likely to have significant influence on SRH. And particularly, CO was likely to produce the greatest decrement in the level of SRH. CONCLUSION CO was not rare in Chinese older adults nationwide. The older adults having CO had increased risk for lower level of SRH than having DSO or ASO. More attention should be given to CO among the older adults.
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Affiliation(s)
- Sicheng Huang
- NHC Key Laboratory of Mental Health, Peking University Institute of Mental Health Sixth Hospital, Beijing, China
| | - Jing Wang
- NHC Key Laboratory of Mental Health, Peking University Institute of Mental Health Sixth Hospital, Beijing, China
| | - Yunjing Zhang
- School of Public Health, Peking University, Beijing, China
| | - Yujia Qiu
- NHC Key Laboratory of Mental Health, Peking University Institute of Mental Health Sixth Hospital, Beijing, China
| | - Huali Wang
- NHC Key Laboratory of Mental Health, Peking University Institute of Mental Health Sixth Hospital, Beijing, China
| | - Xin Yu
- NHC Key Laboratory of Mental Health, Peking University Institute of Mental Health Sixth Hospital, Beijing, China
| | - Zhijiang Wang
- NHC Key Laboratory of Mental Health, Peking University Institute of Mental Health Sixth Hospital, Beijing, China
| | - Xiaozhen Lv
- NHC Key Laboratory of Mental Health, Peking University Institute of Mental Health Sixth Hospital, Beijing, China
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Liu C, Li L, Zhu D, Lin S, Ren L, Zhen W, Tan W, Wang L, Tian L, Wang Q, Mao P, Pan W, Li B, Ma X. Individualized prediction of cognitive test scores from functional brain connectome in patients with first-episode late-life depression. J Affect Disord 2024; 352:32-42. [PMID: 38360359 DOI: 10.1016/j.jad.2024.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/17/2024] [Accepted: 02/08/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND In the realm of cognitive screening, the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) are widely utilized for detecting cognitive deficits in patients with late-life depression (LLD), However, the interindividual variability in neuroimaging biomarkers contributing to individual-specific symptom severity remains poorly understood. In this study, we used a connectome-based predictive model (CPM) approach on resting-state functional magnetic resonance imaging data from patients with LLD to establish individualized prediction models for the MoCA and the MMSE scores. METHODS We recruited 135 individuals diagnosed with first-episode LLD for this research. Participants underwent the MMSE and MoCA tests, along with resting-state functional magnetic resonance imaging scans. Functional connectivity matrices derived from these scans were utilized in CPM models to predict MMSE or MoCA scores. Predictive precision was assessed by correlating predicted and observed scores, with the significance of prediction performance evaluated through a permutation test. RESULTS The negative model of the CPM procedure demonstrated a significant capacity to predict MoCA scores (r = -0.309, p = 0.002). Similarly, the CPM procedure could predict MMSE scores (r = -0.236, p = 0.016). The predictive models for cognitive test scores in LLD primarily involved the visual network, somatomotor network, dorsal attention network, and ventral attention network. CONCLUSIONS Brain functional connectivity emerges as a promising predictor of personalized cognitive test scores in LLD, suggesting that functional connectomes are potential neurobiological markers for cognitive performance in patients with LLD.
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Affiliation(s)
- Chaomeng Liu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Li Li
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Dandi Zhu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Shuo Lin
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Li Ren
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Wenfeng Zhen
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Weihao Tan
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Lina Wang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Lu Tian
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Qian Wang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Peixian Mao
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Weigang Pan
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Bing Li
- Hebei Provincial Mental Health Center, Baoding, China; Hebei Key Laboratory of Major Mental and Behavioral Disorders, Baoding, China; The Sixth Clinical Medical College of Hebei University, Baoding, China.
| | - Xin Ma
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
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Janssen NP, Hendriks GJ, Sens R, Lucassen P, Oude Voshaar RC, Ekers D, van Marwijk H, Spijker J, Bosmans JE. Cost-effectiveness of behavioral activation compared to treatment as usual for depressed older adults in primary care: A cluster randomized controlled trial. J Affect Disord 2024; 350:665-672. [PMID: 38244792 DOI: 10.1016/j.jad.2024.01.109] [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: 05/23/2023] [Revised: 12/23/2023] [Accepted: 01/09/2024] [Indexed: 01/22/2024]
Abstract
INTRODUCTION Depression in older adults is associated with decreased quality of life and increased utilization of healthcare services. Behavioral activation (BA) is an effective treatment for late-life depression, but the cost-effectiveness compared to treatment as usual (TAU) is unknown. METHODS An economic evaluation was performed alongside a cluster randomized controlled multicenter trial including 161 older adults (≥65 years) with moderate to severe depressive symptoms (PHQ-9 ≥ 10). Outcome measures were depression (response on the QIDS-SR), quality-adjusted life-years (QALYs) and societal costs. Missing data were imputed using multiple imputation. Cost and effect differences were estimated using bivariate linear regression models, and statistical uncertainty was estimated with bootstrapping. Cost-effectiveness acceptability curves showed the probability of cost-effectiveness at different ceiling ratios. RESULTS Societal costs were statistically non-significantly lower in BA compared to TAU (mean difference (MD) -€485, 95 % CI -3861 to 2792). There were no significant differences in response on the QIDS-SR (MD 0.085, 95 % CI -0.015 to 0.19), and QALYs (MD 0.026, 95 % CI -0.0037 to 0.055). On average, BA was dominant over TAU (i.e., more effective and less expensive), although the probability of dominance was only 0.60 from the societal perspective and 0.85 from the health care perspective for both QIDS-SR response and QALYs. DISCUSSION Although the results suggest that BA is dominant over TAU, there was considerable uncertainty surrounding the cost-effectiveness estimates which precludes firm conclusions.
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Affiliation(s)
- Noortje P Janssen
- Behavioural Science Institute, Radboud University, 6525 XZ Nijmegen, the Netherlands; Department of Primary and Community Care, Research Institute of Health Sciences, Radboud University Medical Centre Nijmegen, 6525 EZ Nijmegen, the Netherlands; Institute for Integrated Mental Health Care Pro Persona, 6525 DX Nijmegen, the Netherlands.
| | - Gert-Jan Hendriks
- Behavioural Science Institute, Radboud University, 6525 XZ Nijmegen, the Netherlands; Institute for Integrated Mental Health Care Pro Persona, 6525 DX Nijmegen, the Netherlands
| | - Renate Sens
- Department of Health Sciences, VU University, 1081 HV Amsterdam, the Netherlands
| | - Peter Lucassen
- Department of Primary and Community Care, Research Institute of Health Sciences, Radboud University Medical Centre Nijmegen, 6525 EZ Nijmegen, the Netherlands
| | - Richard C Oude Voshaar
- University of Groningen, Department of Psychiatry, University Medical Centre Groningen, 9713 GZ Groningen, the Netherlands
| | - David Ekers
- Mental Health and Addictions Research Group, Tees Esk and Wear Valleys NHS FT/University of York, TS60SZ York, UK
| | - Harm van Marwijk
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, BN1 9PH Brighton, United Kingdom
| | - Jan Spijker
- Behavioural Science Institute, Radboud University, 6525 XZ Nijmegen, the Netherlands; Institute for Integrated Mental Health Care Pro Persona, 6525 DX Nijmegen, the Netherlands
| | - Judith E Bosmans
- Department of Health Sciences, VU University, 1081 HV Amsterdam, the Netherlands
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Johansson-Pajala RM, Alam M, K Gusdal A, Marmstål Hammar L, Boström AM. Trust and easy access to home care staff are associated with older adults' sense of security: a Swedish longitudinal study. Scand J Public Health 2024:14034948241236830. [PMID: 38517103 DOI: 10.1177/14034948241236830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
AIM Older adults are increasingly encouraged to continue living in their own homes with support from home care services. However, few studies have focused on older adults' safety in home care. This study explored associations between the sense of security and factors related to demographic characteristics and home care services. METHODS The mixed longitudinal design was based on a retrospective national survey. The study population consisted of individuals in Sweden (aged 65+ years) granted home care services at any time between 2016 and 2020 (n=82,834-94,714). Multiple ordinal logistic regression models were fitted using the generalised estimation equation method to assess the strength of relationship between the dependent (sense of security) and independent (demographics, health and care-related factors) variables. RESULTS The sense of security tended to increase between 2016 and 2020, and was significantly associated with being a woman, living outside big cities, being granted more home care services hours or being diagnosed/treated for depression (cumulative odds ratio 2-9% higher). Anxiety, poor health and living alone were most strongly associated with insecurity (cumulative odds ratio 17-64% lower). Aside from overall satisfaction with home care services, accessibility and confidence in staff influenced the sense of security most. CONCLUSIONS We stress the need to promote older adults' sense of security for safe ageing in place, as mandated by Swedish law. Home care services profoundly influence older adults' sense of security. Therefore, it is vital to prioritise continuity in care, establish trust and build relationships with older adults. Given the increasing shortage of staff, integrating complementary measures, such as welfare technologies, is crucial to promoting this sense of security.
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Affiliation(s)
| | - Moudud Alam
- School of Information and Engineering/Statistics, Dalarna University, Falun, Sweden
| | - Annelie K Gusdal
- School of Health, Care and Social Welfare, Mälardalen University, Sweden
| | - Lena Marmstål Hammar
- School of Health, Care and Social Welfare, Mälardalen University, Sweden
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Anne-Marie Boström
- Division of Nursing, Department of Neurobiology, Care Science and Society, Karolinska Institute, Stockholm, Sweden
- R&D unit, Stockholms Sjukhem, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden
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de Pinho LG, Fonseca C, Gawęda Ł, Lopes M, Schneider BC. Editorial: Non-pharmacological interventions for mental disorders. Front Psychol 2024; 15:1363348. [PMID: 38586291 PMCID: PMC10995289 DOI: 10.3389/fpsyg.2024.1363348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 03/01/2024] [Indexed: 04/09/2024] Open
Affiliation(s)
- Lara Guedes de Pinho
- Nursing Department, University of Évora, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, Évora, Portugal
| | - César Fonseca
- Nursing Department, University of Évora, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, Évora, Portugal
| | - Łukasz Gawęda
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Manuel Lopes
- Nursing Department, University of Évora, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, Évora, Portugal
| | - Brooke C. Schneider
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Nordeström F, Slaug B, Zingmark M, Granbom M, Rantanen T, Iwarsson S. Translation and Psychometric Evaluation of the University of Jyvaskyla Active Aging Scale (UJACAS) for Use in Sweden. J Cross Cult Gerontol 2024; 39:17-34. [PMID: 38252386 PMCID: PMC10914907 DOI: 10.1007/s10823-024-09496-8] [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] [Accepted: 01/13/2024] [Indexed: 01/23/2024]
Abstract
The objectives were to translate the University of Jyvaskyla Active Aging Scale (UJACAS) to Swedish, to establish semantic equivalence and evaluate psychometric properties for use among persons 55 years and older in Sweden. The UJACAS contains 17 items to be self-assessed regarding goals, abilities, opportunity, and activity. Psychometric properties content validity, data quality including floor and ceiling effects, test-retest reliability, internal consistency, and construct validity were evaluated with different samples in three phases, using state-of-the-art statistics. After translating and establishing semantic equivalence, content validity was assessed as high. With ICC = 0.88 (95% CI 0.80-0.93) test-retest reliability was moderate. Internal consistency was high (Cronbach alpha = 0.84-0.91), and 84% of the questions reached the cut-off value of 0.3 for corrected item-total correlation. Construct validity hypotheses were confirmed. Results indicate that the UJACAS is reliable and valid for use among persons 55 and older in Sweden.
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Affiliation(s)
- Frida Nordeström
- Department of Health Sciences, Lund University, Box 117, Lund, 22100, Sweden.
| | - Björn Slaug
- Department of Health Sciences, Lund University, Box 117, Lund, 22100, Sweden
| | - Magnus Zingmark
- Department of Health Sciences, Lund University, Box 117, Lund, 22100, Sweden
| | - Marianne Granbom
- Department of Health Sciences, Lund University, Box 117, Lund, 22100, Sweden
| | - Taina Rantanen
- Faculty of Sport and Health Sciences, Gerontology Research Centre, University of Jyvaskyla, Jyvaskyla University, Jyvaskyla, Finland
| | - Susanne Iwarsson
- Department of Health Sciences, Lund University, Box 117, Lund, 22100, Sweden
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Qin A, Xu L, Hu F, Qin W, Zhang X, Pei Z, Zhao Y, Fu J. Association between cognitive functioning and lifetime suicidal ideation among Chinese older adults: the mediating effect of depression. Eur Geriatr Med 2024; 15:225-234. [PMID: 38165610 DOI: 10.1007/s41999-023-00912-9] [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: 07/18/2023] [Accepted: 11/28/2023] [Indexed: 01/04/2024]
Abstract
PURPOSE Existing evidence indicates an association between cognitive functioning and both geriatric depression and suicidality, with mixed evidence regarding the direction of the relationship between cognitive functioning and aspects of geriatric lifetime suicidal ideation. This study aims to examine the relationship between cognitive functioning, depression, and suicide ideation and to explore the intermediary role of depression between cognitive functioning and suicidal ideation in the older adults. METHODS A multi-stage random cluster sampling method was used to collect a sample of 3896 individuals aged 60 and above. Descriptive statistics of the sample data were analyzed using one-way ANOVA, and then the correlation between variables was obtained by binary logistic regression analysis. SPSS macro program PROCESS V3.5 was used to test the mediating role of depression in the relationship between cognitive function and lifetime suicidal ideation. RESULTS The prevalence of lifetime suicidal ideation among older adults was 3.9%. Lifetime suicidal ideation was associated with depression (OR = 1.308, P < 0.001) but was not significantly correlated with cognitive function (OR = 0.972, P > 0.05). The relationship between cognitive function and depression was also supported in this study (β = - 0.0841, P < 0.001). Depression completely mediated the relationship between cognitive function and lifetime suicidal ideation. CONCLUSION There was no significant correlation between cognitive impairment in older adults and a heightened risk of lifetime suicidal ideation. However, this relationship was completely mediated by depression. It is crucial to prevent the onset of depression among older adults with cognitive impairment, as depression is strongly linked to lifetime suicidal ideation.
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Affiliation(s)
- Afei Qin
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012, Shandong, China
| | - Lingzhong Xu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012, Shandong, China
| | - Fangfang Hu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012, Shandong, China
| | - Wenzhe Qin
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012, Shandong, China
| | - Xiaohong Zhang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012, Shandong, China
| | - Zhongfei Pei
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012, Shandong, China
| | - Yan Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, 250012, Shandong, China
| | - Jing Fu
- Nursing Department of Qilu Hospital, Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong, China.
- Blood Purification Center of Qilu Hospital, Shandong University, Jinan, Shandong, China.
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Kassel MT, Kryza-Lacombe M, Insel PS, Rhodes E, Satre DD, Nelson JC, Tosun D, Mathews CA, Mackin RS. Hoarding Symptoms in Late Life Depression are Associated With Greater Executive Dysfunction and Disability and Poorer Response to Depression Treatment. Am J Geriatr Psychiatry 2024; 32:137-147. [PMID: 37770349 PMCID: PMC10872841 DOI: 10.1016/j.jagp.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 08/10/2023] [Accepted: 08/12/2023] [Indexed: 09/30/2023]
Abstract
OBJECTIVES Late life depression (LLD) and hoarding disorder (HD) are common in older adults and characterized by executive dysfunction and disability. We aimed to determine the frequency of co-occurring HD in LLD and examine hoarding severity as an additional contributor to executive dysfunction, disability, and response to psychotherapy for LLD. DESIGN Cross-sectional. SETTING Outpatient psychiatry program. PARTICIPANTS Eighty-three community-dwelling adults ages 65-90 with LLD. INTERVENTION Problem-solving therapy. MEASUREMENTS Measures of executive function, disability, depression, and hoarding severity were completed at post-treatment. Pearson's chi-squared tests evaluated group differences in rates of cognitive impairment, disability, and depression treatment response between participants with HD (LLD+HD) and LLD only. Separate linear regressions assessed associations between hoarding severity and executive function, disability, and psychotherapy response. Covariates included age, education, gender, and depression severity. RESULTS 30.1% (25/83) of LLD participants met HD criteria. Relative to LLD, LLD+HD participants demonstrated greater impairment rates on measures of executive function (Letter-Number-Sequencing, X2(1)=4.0, p = 0.045; Stroop-Interference, X2(1) = 4.8, p = 0.028). Greater hoarding severity was associated with poorer executive functioning performance (Letter-Number-Sequencing (t[70] = -2.1, β = -0.05, p = 0.044), Digit-Span (t[71] = -2.4, β = -0.07, p = 0.019), Letter-Fluency (t[ 71] = -2.8, β = -0.24, p = 0.006)). Rates of disability were significantly higher for LLD+HD (88.0%) than LLD (62.3%), (X2[1] = 5.41, p = 0.020) and higher hoarding severity was related to greater disability (t[72] = 2.97, β = 0.13, p = 0.004). Depression treatment response rates were significantly lower for LLD+HD (24.0%) compared to LLD (48.3%), X2(1) = 4.26, p = 0.039, and HD status predicted psychotherapy response, t(67) = -2.15, β = -15.6, p = 0.035. CONCLUSIONS We found 30.1% co-occurrence of HD in LLD, which was accompanied by greater executive dysfunction, disability, and poorer response to depression treatment. Results underscore the need for increased screening of hoarding behaviors in LLD and tailored interventions for this LLD+HD group.
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Affiliation(s)
- Michelle T Kassel
- Mental Illness Research, Education, and Clinical Centers (MTK, MKL, ER, RSM), San Francisco Veterans Affairs Health Care System, San Francisco, CA; Department of Psychiatry and Behavioral Sciences (MTK, MKL, PSI, ER, DDS, JCN, RSM), University of California San Francisco, San Francisco, CA.
| | - Maria Kryza-Lacombe
- Mental Illness Research, Education, and Clinical Centers (MTK, MKL, ER, RSM), San Francisco Veterans Affairs Health Care System, San Francisco, CA; Department of Psychiatry and Behavioral Sciences (MTK, MKL, PSI, ER, DDS, JCN, RSM), University of California San Francisco, San Francisco, CA
| | - Philip S Insel
- Department of Psychiatry and Behavioral Sciences (MTK, MKL, PSI, ER, DDS, JCN, RSM), University of California San Francisco, San Francisco, CA
| | - Emma Rhodes
- Mental Illness Research, Education, and Clinical Centers (MTK, MKL, ER, RSM), San Francisco Veterans Affairs Health Care System, San Francisco, CA; Department of Psychiatry and Behavioral Sciences (MTK, MKL, PSI, ER, DDS, JCN, RSM), University of California San Francisco, San Francisco, CA
| | - Derek D Satre
- Department of Psychiatry and Behavioral Sciences (MTK, MKL, PSI, ER, DDS, JCN, RSM), University of California San Francisco, San Francisco, CA; Division of Research (DDS), Kaiser Permanente Northern California, Oakland, CA
| | - J Craig Nelson
- Department of Psychiatry and Behavioral Sciences (MTK, MKL, PSI, ER, DDS, JCN, RSM), University of California San Francisco, San Francisco, CA
| | - Duygu Tosun
- Department of Radiology and Biomedical Imaging (DT), University of California San Francisco, San Francisco, CA
| | - Carol A Mathews
- Department of Psychiatry and Center for OCD, Anxiety and Related Disorders (CAM), University of Florida, Gainesville, FL
| | - R Scott Mackin
- Mental Illness Research, Education, and Clinical Centers (MTK, MKL, ER, RSM), San Francisco Veterans Affairs Health Care System, San Francisco, CA; Department of Psychiatry and Behavioral Sciences (MTK, MKL, PSI, ER, DDS, JCN, RSM), University of California San Francisco, San Francisco, CA
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12
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Wang Y, Liao J, Chen H, Tao L, Liu J. Association of perceived discrimination with the risk of depression among US older adults: A prospective population-based cohort study. Heliyon 2024; 10:e23843. [PMID: 38226276 PMCID: PMC10788503 DOI: 10.1016/j.heliyon.2023.e23843] [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: 08/17/2023] [Revised: 11/22/2023] [Accepted: 12/13/2023] [Indexed: 01/17/2024] Open
Abstract
Aims Association between perceived discrimination and depression has been demonstrated in some sources of discrimination, such as age, sex, and race. However, the effects of perceived discrimination both in any domain and each domain on development of depression are still unclear. We aimed to estimate the association of any and each domain of perceived discrimination with the risk of depression among US older adults. Methods We did a population-based cohort study using eight waves (from 2006 to 2020) of data from the Health and Retirement Study (HRS), a nationally representative study of US older adults aged 51 years and above. Perceived discrimination was measured by the shortened 5-item version of Williams' discrimination scale, including five domains (less courtesy, service setting, not smart, threatened or harassed, and medical setting). Depressive symptoms were assessed with shortened 8-item version of the Center for Epidemiological Depression scale (8-item CES-D). Cox proportional hazards models were used to estimate the crude and adjusted hazards ratio (HRs) and their 95 % confidence intervals (CIs) between perceived discrimination and risk of depression, after controlling for potential confounders. Results A total of 18502 participants were included in our final analyses. 42.8 % of them had any perceived discrimination at baseline, and the most prevalent perceived discrimination was feeling less courtesy, which was observed in 5893 people (31.6 %). During a median of 9.8 years follow-up, 44.7 % of participants developed depression. The risk of depression was 46 % (adjusted HR: 1.46, 95 % CI: 1.39-1.52) higher among people with perceived discrimination than those without. The associations between perceived discrimination in each domain and risk of depression were all prominent. Conclusions Both any and each domain of perceived discrimination were associated with an increased risk of depression. Considering the high prevalence of perceived discrimination and the following poor health outcomes, our findings suggested the integrated measures of providing public education and diversified communication to reduce discrimination, as well as accessible emotional supports to prevent depression are urgently needed.
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Affiliation(s)
- Yaping Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Jiaojiao Liao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, No. 49, Huayuan North Road, Haidian District, Beijing, 100191, China
| | - Hongguang Chen
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), No.35, Xueyuan Road, Haidian District, Beijing, 100191, China
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), No.35, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Liyuan Tao
- Department of Epidemiology, Harvard TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China
- Institute for Global Health and Development, Peking University, No.5, Yiheyuan Road, Haidian District, Beijing, 100871, China
- Department of Global Health and Population, Harvard TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
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Schneider BC, Veckenstedt R, Karamatskos E, Ahlf-Schumacher J, Gehlenborg J, Schultz J, Moritz S, Jelinek L. Efficacy and moderators of metacognitive training for depression in older adults (MCT-Silver): A randomized controlled trial. J Affect Disord 2024; 345:320-334. [PMID: 37865342 DOI: 10.1016/j.jad.2023.10.118] [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: 03/20/2023] [Revised: 09/28/2023] [Accepted: 10/16/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND Up to 79 % of older adults with depression do not receive treatments commensurate with guideline recommendations. Metacognitive Training-Silver (MCT-Silver) is a low-intensity group training, which aims to reduce depressive symptoms by targeting (meta)cognitive beliefs. METHODS A randomized controlled trial comparing MCT-Silver (n = 41) to cognitive remediation (n = 39) was conducted with older adults with major depressive disorder and/or dysthymia. Clinician-rated depression (Hamilton Depression Rating Scale [HDRS, primary outcome]), self-reported depression (Beck Depression Inventory-II [BDI-II]), negative cognitive beliefs, positive metacognitive beliefs, rumination, health status, quality of life, and neurocognitive functioning were assessed at baseline, eight weeks (post) and three months (follow-up). RESULTS Both groups demonstrated moderate to large reductions in depression. No superior effects of MCT-Silver on clinician-rated depression (HDRS) were detected. MCT-Silver led to greater reductions in self-reported depression and rumination at post- and follow-up. Despite this, scores at post- and follow-up assessments were similar for both groups. MCT-Silver's effect on depressive symptoms was moderated by baseline rumination, positive metacognitive beliefs and previous treatment experience. MCT-Silver was evaluated as superior according to patient appraisals. LIMITATIONS Conclusions are limited by divergent findings on measures of depression and that the study was conducted during the COVID-19 pandemic. CONCLUSIONS Whereas no superior effect of MCT-Silver was found for the primary outcome, there was a significant effect of MCT-Silver for self-reported depression and rumination. Patients endorsing rumination and positive metacognitive beliefs as well as those without previous psychological treatment may benefit more from MCT-Silver.
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Affiliation(s)
- Brooke C Schneider
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
| | - Ruth Veckenstedt
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Evangelos Karamatskos
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Jana Ahlf-Schumacher
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Josefine Gehlenborg
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Josephine Schultz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
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Hansen RS, Scheel-Hincke LL, Jeune B, Ahrenfeldt LJ. Sex differences in vision and hearing impairments across age and European regions : Findings from SHARE. Wien Klin Wochenschr 2024; 136:55-63. [PMID: 37280394 DOI: 10.1007/s00508-023-02223-2] [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: 01/23/2023] [Accepted: 05/07/2023] [Indexed: 06/08/2023]
Abstract
AIM Although sensory impairments are common conditions among older people, research often fails to consider the role of sex. We examined sex differences in vision impairment and hearing impairment across age and European regions. METHODS We conducted a cross-sectional study based on a pooled sample of 65,656 females and 54,881 males aged 50 years and older participating in the Survey of Health, Ageing and Retirement in Europe (SHARE) from 2004-2020. Logistic regression models with robust standard errors providing odds ratios (OR) and 95% confidence intervals (CI) were used to examine associations. RESULTS European females had generally higher odds of vision impairment (OR 1.16, 95% CI 1.12-1.21) but lower odds of hearing impairment than European males (OR 0.70, 95% CI 0.67-0.73). The female disadvantage in vision increased with advancing age, whereas the female advantage in hearing decreased. No overall sex difference in vision was found in northern Europe, but females had more vision impairments than males in southern (OR 1.23, 95% CI 1.14-1.32), western (OR 1.14, 95% CI 1.08-1.21) and eastern (OR 1.10, 95% CI 1.02-1.20) Europe. Females were healthier than males in terms of hearing in all regions, with the largest female advantage in northern Europe (OR 0.58, 95% CI 0.53-0.64). CONCLUSION Our findings demonstrate an overall consistent pattern of sex differences in sensory impairments across Europe showing an increasing female disadvantage in vision and a decreasing female advantage in hearing with advancing age.
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Affiliation(s)
- Rikke Syrak Hansen
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000, Odense C, Denmark
| | - Lasse Lybecker Scheel-Hincke
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000, Odense C, Denmark
| | - Bernard Jeune
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000, Odense C, Denmark
| | - Linda Juel Ahrenfeldt
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000, Odense C, Denmark.
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Lee H, Kim J, Zrínyi M. Mental health effects of adult children's outmigration on older parents in Central and Eastern Europe. Aging Ment Health 2024; 28:353-359. [PMID: 37811709 DOI: 10.1080/13607863.2023.2260327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 09/11/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE To examine the association between adult children's migration and depression among older parents in Central and Eastern Europe (CEE) and explore the role of intergenerational support in contributing to their depression. METHODS Data are from the eighth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE), pooling a study sample of 11 CEE countries, with a cross-sectional design. Analysis of covariance (ANCOVA) and hierarchical linear regression were conducted using a study sample of 9133 respondents. RESULTS Older adults whose children migrated over 500 km were more likely to experience depression compared to those with no migrant child or all children within 500 km. Among intergenerational support, frequent parent-child contact mitigated the effects of migration on depression in older parents with all their children who migrated over 500 km. CONCLUSION This study suggests that older parents with migrant children over 500 km away should be considered a vulnerable population at risk for mental health in CEE countries. It is crucial for local governments and policymakers to address these challenges through improving integrated mental health and social programs for better mental health outcomes among older adults in CEE countries.
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Affiliation(s)
- Hayoung Lee
- Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - Jaeshin Kim
- Dankook Center for Dispute Resolution, Dankook University, Yongin, South Korea
| | - Miklós Zrínyi
- Faculty of Health Sciences, University of Pécs, Pécs, Hungary
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Rollwage M, Habicht J, Juechems K, Carrington B, Viswanathan S, Stylianou M, Hauser TU, Harper R. Using Conversational AI to Facilitate Mental Health Assessments and Improve Clinical Efficiency Within Psychotherapy Services: Real-World Observational Study. JMIR AI 2023; 2:e44358. [PMID: 38875569 PMCID: PMC11041479 DOI: 10.2196/44358] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 05/31/2023] [Accepted: 10/20/2023] [Indexed: 06/16/2024]
Abstract
BACKGROUND Most mental health care providers face the challenge of increased demand for psychotherapy in the absence of increased funding or staffing. To overcome this supply-demand imbalance, care providers must increase the efficiency of service delivery. OBJECTIVE In this study, we examined whether artificial intelligence (AI)-enabled digital solutions can help mental health care practitioners to use their time more efficiently, and thus reduce strain on services and improve patient outcomes. METHODS In this study, we focused on the use of an AI solution (Limbic Access) to support initial patient referral and clinical assessment within the UK's National Health Service. Data were collected from 9 Talking Therapies services across England, comprising 64,862 patients. RESULTS We showed that the use of this AI solution improves clinical efficiency by reducing the time clinicians spend on mental health assessments. Furthermore, we found improved outcomes for patients using the AI solution in several key metrics, such as reduced wait times, reduced dropout rates, improved allocation to appropriate treatment pathways, and, most importantly, improved recovery rates. When investigating the mechanism by which the AI solution achieved these improvements, we found that the provision of clinically relevant information ahead of clinical assessment was critical for these observed effects. CONCLUSIONS Our results emphasize the utility of using AI solutions to support the mental health workforce, further highlighting the potential of AI solutions to increase the efficiency of care delivery and improve clinical outcomes for patients.
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Affiliation(s)
| | | | | | | | | | | | - Tobias U Hauser
- Limbic Limited, London, United Kingdom
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, University College London, London, United Kingdom
- Department of Psychiatry and Psychotherapy, Medical School and University Hospital, Eberhard Karls University of Tübingen, Tubingen, Germany
- German Center for Mental Health (DZPG), Tubingen, Germany
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Bai R. Impact of financial literacy, mental budgeting and self control on financial wellbeing: Mediating impact of investment decision making. PLoS One 2023; 18:e0294466. [PMID: 37963159 PMCID: PMC10645357 DOI: 10.1371/journal.pone.0294466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/31/2023] [Indexed: 11/16/2023] Open
Abstract
The topic of financial wellbeing is a current concern within the realm of personal and household finance. This study aims to examine the influence of cognitive factors, specifically financial literacy, mental budgeting, and self-control, on subjective financial wellbeing. While there exist multiple determinants of financial wellbeing, this research focuses on these particular cognitive factors. The present study aims to examine the mediating role of investment decision-making behavior in the association between cognitive factors and financial well-being. The study employed Partial Least Squares Structural Equation Modeling (PLS-SEM) to analyze the data collected from a sample of 449 Chinese university students, with the aim of assessing the empirical associations. The results indicate that financial literacy, mental budgeting, and self-control exert a favorable and noteworthy influence on an individual's financial well-being. The results indicate that individuals with a greater degree of financial literacy are more prone to achieving superior financial well-being. Moreover, individuals who practice mental budgeting, a technique that entails mentally classifying and monitoring their expenditures, demonstrate elevated levels of financial well-being. Likewise, the exercise of self-regulation is identified as a pivotal element that impacts an individual's financial wellbeing. The findings indicate that there is evidence to support the mediator, investment decision-making behavior. This mediator partially mediates the association between the independent variables, namely financial literacy, mental budgeting, and self-control, and financial well-being. The results suggest that individuals with elevated levels of financial literacy, proficient mental budgeting skills, and self-regulatory abilities are inclined towards demonstrating favorable investment decision-making conduct. Consequently, this contributes to their general financial welfare. In general, the study's theoretical implications augment the current knowledge repository, while its practical implications provide feasible perspectives for policymakers, financial institutions, and individuals to foster financial wellness and enhance financial results.
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Affiliation(s)
- Ruofan Bai
- School of Accountancy, Henan Institute of Economics and Trade, Zhengzhou, Henan, China
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18
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Cermakova P, Csajbók Z. Household crowding in childhood and trajectories of depressive symptoms in mid-life and older age. J Affect Disord 2023; 340:456-461. [PMID: 37573892 DOI: 10.1016/j.jad.2023.08.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 08/15/2023]
Abstract
AIMS We aimed to investigate the association of household crowding in childhood with trajectories of depressive symptoms in middle-aged and older adults. METHODS We studied 47,010 participants (56 % women, 63 years at baseline) from SHARE. Using multinomial logistic regression, we estimated odds ratio (OR) with 95 % confidence interval (CI) for the association of household crowding in childhood (number of household members/number of rooms at the age of 10) with trajectories of depressive symptoms (EURO-D scale), which were generated with growth mixture modeling. We adjusted for resources in childhood, sociodemographic and health-related characteristics in mid-life and older age and tested effect modification by sex. RESULTS We identified four trajectories of depressive symptoms: constantly low (n = 33,969), decreasing (n = 5595), increasing (n = 5574) and constantly high (n = 1872). When compared to the those with constantly low depressive symptoms and adjusting for all covariates, household crowding in childhood was associated with greater odds of constantly high (OR 1.12; 95 % CI 1.08-1.17), decreasing (OR 1.11; 95 % CI 1.07-1.15) and increasing (OR 1.09; 95 % CI 1.06-1.13) depressive symptoms. The associations were stronger in women than in men. CONCLUSIONS Prevention of household crowding in childhood may ameliorate the development of constant as well as transient depressive symptoms during ageing. The effect can be stronger in women than in men.
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Affiliation(s)
- Pavla Cermakova
- Second Faculty of Medicine, Charles University Prague, Czechia; National Institute of Mental Health, Klecany, Czechia
| | - Zsófia Csajbók
- Faculty of Humanities, Charles University Prague, Czechia.
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19
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de Pinho LG, Silva C, Fonseca C, Morgado B, Lopes M, Moritz S, Jelinek L, Schneider BC. A randomized controlled trial to evaluate the efficacy of metacognitive training for older adults with depression (MCT-Silver) in Portugal: study protocol. Front Psychol 2023; 14:1167860. [PMID: 38022953 PMCID: PMC10644621 DOI: 10.3389/fpsyg.2023.1167860] [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: 02/16/2023] [Accepted: 09/18/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Depression is one of the most common psychological disorders in later life. Although psychological interventions are recommended by treatment guidelines, most older adults with depression remain untreated. The aim of this study is to evaluate the efficacy of the Portuguese version of Metacognitive Training for Depression in later life (MCT-Silver). Methods This is a study protocol of an observer-blind, parallel-group, randomized controlled trial to compare the efficacy of MCT-Silver with a treatment as usual (TAU) control group among older adults (age 65 years and older) with depressive symptoms according to the Montgomery-Asberg Depression Scale. Participants will be tested at three assessment time points (baseline, immediately following the intervention [8 weeks], and 3 months after the intervention). The primary outcome is change in self-rated depression symptoms assessed by the Beck Depression Inventory (BDI-II). Secondary outcomes include clinician-rated depression, self-esteem, dysfunctional beliefs, metacognitive beliefs, ruminations, attitudes toward aging and quality of life. A self-designed subjective appraisal rating scale consisting of 21-items will be used to assess participant acceptance of MCT-Silver. Discussion MCT-Silver is an innovative intervention, which aims to reduce dysfunctional thoughts as well as depression-related behaviors and coping strategies through the metacognitive perspective. Until now, the training has only been tested in Germany. It is expected that after 8 weeks of treatment and 3 months later, the experimental group will demonstrate significant reductions in depressive symptoms, metacognitive beliefs, dysfunctional attitudes and ruminative responses compared to the TAU group. Moreover, quality of life, self-esteem, and attitudes towards aging will be significantly improved in MCT-Silver compared to the TAU group. Clinical trial registration ClinicalTrials.gov, NCT05640492.
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Affiliation(s)
- Lara Guedes de Pinho
- Department of Nursing, University of Évora, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Évora, Portugal
| | - Celso Silva
- Comprehensive Health Research Centre (CHRC), Évora, Portugal
- Higher School of Health, Polytechnic Institute of Beja, Beja, Portugal
| | - César Fonseca
- Department of Nursing, University of Évora, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Évora, Portugal
| | - Bruno Morgado
- Universitat Rovira i Virgili, Tarragona, Spain
- Hospital Garcia de Orta, Almada, Portugal
| | - Manuel Lopes
- Department of Nursing, University of Évora, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Évora, Portugal
| | - Steffen Moritz
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lena Jelinek
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Adams C, Gringart E, Strobel N. Theory-based behaviour change intervention to promote mental health help-seeking among older adults in Australia: Initial dissemination and acceptability. Australas J Ageing 2023; 42:603-608. [PMID: 36919253 DOI: 10.1111/ajag.13185] [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: 05/29/2022] [Revised: 11/06/2022] [Accepted: 02/09/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVE Rates of help-seeking for mental health problems among older adults are low and initiatives to increase help-seeking in older populations are limited. To our knowledge, no interventions have aimed to promote help-seeking among older adults by tapping internal motivations to seek help. In this paper, we describe the development of a theory-based intervention designed to promote mental health help-seeking among older adults in Australia, using an internal motivation paradigm. METHODS The intervention was co-designed through a consultative process with nine key stakeholders who represented five main groups: primary health-care providers, mental health professionals, health-care executives, community organisations and consumers. Development was an iterative process, based on best practice guidelines. Nineteen older adults (≥65 years) provided feedback on the acceptability of the intervention. RESULTS The intervention consisted of a help-seeking brochure with behaviour change messages based on the Theory of Planned Behaviour (TPB). Messages targeted older adults' attitudes towards help-seeking, subjective norms, perceived behavioural control and barriers to seeking help. Most participants (74%) responded with agree/strongly agree to 10 items measuring the acceptability of the intervention, indicating the intervention is relevant, clear, appropriate and appealing. CONCLUSIONS The present intervention appears to be an acceptable way to promote help-seeking for mental health problems among older adults. A larger, robust trial is warranted to determine the effectiveness of the intervention in improving help-seeking attitudes, intentions and behaviour. The intervention has the potential to increase older adults' engagement with mental health support and improve health outcomes in this population.
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Affiliation(s)
- Claire Adams
- School of Arts and Humanities, Edith Cowan University, Perth, Western Australia, Australia
- Kurongkurl Katitjin, Edith Cowan University, Perth, Western Australia, Australia
| | - Eyal Gringart
- School of Arts and Humanities, Edith Cowan University, Perth, Western Australia, Australia
| | - Natalie Strobel
- Kurongkurl Katitjin, Edith Cowan University, Perth, Western Australia, Australia
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Chlapecka A, Wolfová K, Fryčová B, Cermakova P. Educational attainment and anxiety in middle-aged and older Europeans. Sci Rep 2023; 13:13314. [PMID: 37587157 PMCID: PMC10432412 DOI: 10.1038/s41598-023-40196-4] [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: 05/12/2023] [Accepted: 08/06/2023] [Indexed: 08/18/2023] Open
Abstract
We examined the relationship between educational attainment (EA) and anxiety symptoms in a sample of 77,792 individuals (median age = 64 years, 55% female) from the Survey of Health, Ageing and Retirement in Europe. Using logistic regression, we estimated odds ratio (OR) with 95% confidence interval (CI) for the association between EA (7 educational levels based on International Standard Classification of Education) and anxiety symptoms (12 or more points from the shortened 5-item version of the Beck Anxiety Inventory), adjusting for sociodemographic and health-related factors. We further explored whether the relationship varied by region, sex and age group. Independent of sociodemographic and health-related factors, higher levels of EA were associated with lower odds of anxiety symptoms. The magnitude of this association plateaued at first stage of tertiary education (OR 0.40; 95% CI 0.35-0.47, p < 0.001). The association was stronger in females, middle-aged individuals and in Central and Eastern Europe while not apparent in Northern Europe. Our findings suggest that individuals with higher education might be protected against anxiety throughout life. The protective effect of education against anxiety symptoms is more pronounced in less egalitarian regions and in females.
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Affiliation(s)
- Adam Chlapecka
- Third Faculty of Medicine, Charles University Prague, 100 00, Prague, Czech Republic.
- Department of Neurology and Centre of Clinical Neuroscience, General University Hospital and First Faculty of Medicine, Charles University in Prague, 128 21, Prague, Czech Republic.
| | - Katrin Wolfová
- Third Faculty of Medicine, Charles University Prague, 100 00, Prague, Czech Republic
- National Institute of Mental Health, 250 67, Klecany, Czech Republic
- Second Faculty of Medicine, Charles University Prague, 150 06, Prague, Czech Republic
| | - Barbora Fryčová
- Second Faculty of Medicine, Charles University Prague, 150 06, Prague, Czech Republic
| | - Pavla Cermakova
- National Institute of Mental Health, 250 67, Klecany, Czech Republic
- Second Faculty of Medicine, Charles University Prague, 150 06, Prague, Czech Republic
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22
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Cermakova P, Fryčová B, Novák D, Kuklová M, Wolfová K, Kučera M, Janoušková M, Pekara J, Šeblová J, Seblova D. Depression in healthcare workers during COVID-19 pandemic: results from Czech arm of HEROES Study. Sci Rep 2023; 13:12430. [PMID: 37528158 PMCID: PMC10394070 DOI: 10.1038/s41598-023-39735-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 07/30/2023] [Indexed: 08/03/2023] Open
Abstract
The pandemic due to COVID-19 brought new risks for depression of health care workers, which may have differently influenced men and women. We aimed to investigate (1) whether health care workers in Czechia experienced an increase in depression during the COVID-19 pandemic, (2) which factors contributed the most to this change, and (3) whether the magnitude of the associations differed by gender. We studied 2564 participants of the Czech arm of the international COVID-19 HEalth caRe wOrkErS (HEROES) Study. Online questionnaire was administered to health care workers in summer 2020 (wave 0) and spring 2021 (wave 1). Depression was defined by reaching 10 or more points on the Patient Health Questionnaire. Logistic regression investigated the association of participant´s characteristics with depression and multivariable decomposition for non-linear models assessed, to what extent the characteristic explained the change in depression occurrence. The prevalence of depression increased twice during the pandemic (11% in wave 0 and 22% in wave 1). Stress accounted for 50% of the difference, experience of death due to COVID-19 for 15% and contact with COVID-19 patients for 14%. Greater resilience and sufficient personal protective equipment were strongly associated with lower occurrence of depression. The protective association of resilience with depression was stronger in men than in women. We conclude that interventions to promote mental health of health care workers in future health crisis should aim at decreasing stress and enhancing resilience. They should be delivered especially to individuals who have contact with the affected patients and may face their death.
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Affiliation(s)
- Pavla Cermakova
- Department of Epidemiology, Second Faculty of Medicine, Charles University Prague, V Úvalu 84, 150 06, Prague 5, Czechia.
- National Institute of Mental Health, Klecany, Czechia.
| | - Barbora Fryčová
- Department of Epidemiology, Second Faculty of Medicine, Charles University Prague, V Úvalu 84, 150 06, Prague 5, Czechia
| | - David Novák
- Department of Epidemiology, Second Faculty of Medicine, Charles University Prague, V Úvalu 84, 150 06, Prague 5, Czechia
| | - Marie Kuklová
- Department of Epidemiology, Second Faculty of Medicine, Charles University Prague, V Úvalu 84, 150 06, Prague 5, Czechia
- National Institute of Mental Health, Klecany, Czechia
- Faculty of Science, Charles University Prague, Prague, Czechia
| | - Katrin Wolfová
- Department of Epidemiology, Second Faculty of Medicine, Charles University Prague, V Úvalu 84, 150 06, Prague 5, Czechia
- National Institute of Mental Health, Klecany, Czechia
| | - Matěj Kučera
- Department of Epidemiology, Second Faculty of Medicine, Charles University Prague, V Úvalu 84, 150 06, Prague 5, Czechia
- National Institute of Mental Health, Klecany, Czechia
- Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Miroslava Janoušková
- Department of Epidemiology, Second Faculty of Medicine, Charles University Prague, V Úvalu 84, 150 06, Prague 5, Czechia
- Third Faculty of Medicine, Charles University Prague, Prague, Czechia
| | | | - Jana Šeblová
- Department of Epidemiology, Second Faculty of Medicine, Charles University Prague, V Úvalu 84, 150 06, Prague 5, Czechia
- Paediatric Emergency Department, Motol University Hospital, Prague, Czechia
| | - Dominika Seblova
- Department of Epidemiology, Second Faculty of Medicine, Charles University Prague, V Úvalu 84, 150 06, Prague 5, Czechia
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Anderson DJ, Aucoin A, Toups CR, Cormier D, McDonald M, Hasoon J, Viswanath O, Kaye AD, Urits I. Lower Urinary Tract Symptoms in Depression: A Review. Health Psychol Res 2023; 11:81040. [PMID: 37465591 PMCID: PMC10351871 DOI: 10.52965/001c.81040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
Lower Urinary Tract Symptoms (LUTS) are frequently present in the general population as patients age with approximately a third of individuals experiencing LUTS during their lifetime. LUTS can be further defined as having any of the following symptoms: urinary hesitancy, straining, nocturia, increased urination frequency, and dysuria. LUTS has the potential for patients to contribute their symptoms to what can normally occur as we age. This can lead to a decrease in patients seeking care and could negatively impact patients' health-related quality of life (HRQL). In conjunction with LUTS, we obtained from our analysis that LUTS and depression are closely related and worsening depressive symptoms may increase the severity of LUTS. We also discerned three categories of factors that can yield major depression namely adversity, internalizing, and externalizing factors. Within these categories, trauma, social support, genetic factors, and minimal education appeared to increase the risk of depression in patients. With the recent increase in mental health awareness and more access to mental health care amid the COVID-19 Pandemic, further screening, and collaboration between providers to treat both urological and psychiatric symptoms could improve patient outcomes. It is important for providers to have an increased understanding of the mental and physical impact both LUTS and depression can have on patients' wellbeing. This has the potential to help patients be more open about their symptoms with the aim of better addressing LUTS and depression to positively impact their HRQL.
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Affiliation(s)
| | - Alise Aucoin
- Department of Anesthesiology Louisiana State University Health
| | - Colton R Toups
- Department of Anesthesiology Louisiana State University Health
| | - Devin Cormier
- Department of Anesthesiology Louisiana State University Health
| | | | - Jamal Hasoon
- Department of Anesthesia, Critical Care, and Pain Medicine Beth Israel Deaconess Medical Center, Harvard Medical School
| | - Omar Viswanath
- Department of Anesthesia, Critical Care, and Pain Medicine Beth Israel Deaconess Medical Center, Harvard Medical School
| | - Alan D Kaye
- Department of Anesthesiology Louisiana State University Health
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Shao H, Li N, Chen M, Zhang J, Chen H, Zhao M, Yang J, Xia J. A voxel-based morphometry investigation of brain structure variations in late-life depression with insomnia. Front Psychiatry 2023; 14:1201256. [PMID: 37275990 PMCID: PMC10232904 DOI: 10.3389/fpsyt.2023.1201256] [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: 04/06/2023] [Accepted: 04/28/2023] [Indexed: 06/07/2023] Open
Abstract
Background Late-life depression (LLD) is linked to various medical conditions and influenced by aging-related processes. Sleep disturbances and insomnia symptoms may be early indicators or risk factors for depression. Neuroimaging studies have attempted to understand the neural mechanisms underlying LLD, focusing on different brain networks. This study aims to further delineate discriminative brain structural profiles for LLD with insomnia using MRI. Methods We analyzed 24 cases in the LLD with insomnia group, 26 cases in the LLD group, and 26 in the healthy control (HC) group. Patients were evaluated using the Hamilton Depression Rating Scale (HAMD-17), Hamilton Anxiety Rating Scale (HAMA), Mini-Mental State Examination (MMSE), and Pittsburgh Sleep Quality Index (PSQI). Structural MRI data were gathered and analyzed using voxel-based morphometry (VBM) to identify differences in gray matter volume (GMV) among the groups. Correlation analyses were conducted to explore the relationships between GMV and clinical characteristics. Results Significant difference in sex distribution was observed across the groups (p = 0.029). However, no significant differences were detected in age and MMSE scores among the groups. LLD with insomnia group exhibited significantly higher HAMA (p = 0.041) and PSQI scores (p < 0.05) compared to the LLD group. ANOVA identified significant difference in GMV of anterior lobe of cerebellum (peak MNI coordinate: x = 52, y = -40, z = -30) among HC, LLD, and LLD with insomnia. Post-hoc two-sample t-tests revealed that the significant difference in GMV was only found between the LLD group and the HC group (p < 0.05). The mean GMV in the cerebellum was positively correlated with HAMA scale in LLD patients (r = 0.47, p < 0.05). Conclusion There is significant difference in GMV in the LLD group, the association between late-life depression and insomnia may be linked to anxiety. This study provides insights into the discriminative brain structural profiles of LLD and LLD with insomnia, advancing the understanding of the underlying neural mechanisms and potential targets for intervention.
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Affiliation(s)
- Heng Shao
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Na Li
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Meiling Chen
- Department of Clinical Psychology, The First People’s Hospital of Yunnan Province, Kunming, China
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Jie Zhang
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Department of MRI, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Hui Chen
- Department of Clinical Psychology, The First People’s Hospital of Yunnan Province, Kunming, China
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Minjun Zhao
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Department of Geriatrics, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Jingjing Yang
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Department of Geriatrics, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Jian Xia
- School of Medicine, Kunming University of Science and Technology, Kunming, China
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Thams F, Brassen S. The need to change: Is there a critical role of midlife adaptation in mental health later in life? eLife 2023; 12:82390. [PMID: 37141113 PMCID: PMC10159621 DOI: 10.7554/elife.82390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 04/26/2023] [Indexed: 05/05/2023] Open
Abstract
Although late-life depression (LLD) is a serious health problem and more common than dementia in people over 60, it is underdiagnosed and undertreated. The cognitive-emotional etiology of LLD is particularly poorly understood. This is in contrast to the now extensive literature from psychology and cognitive neuroscience on the characteristics of emotionally healthy aging. This research consistently shows a change in emotional processing in older adults that is modulated by prefrontal regulation. Lifespan theories explain this change in terms of neurocognitive adaptation to limited opportunities and resources that typically occur in the second half of life. Epidemiological data on an increase in well-being after a low point around age 50 suggest that the majority of people seem quite capable of making this adaptation, even though empirical evidence for a causal modulation of this so called 'paradox of aging' and for the role of the midlife dip is still lacking. Intriguingly, LLD is associated with deficits in emotional, cognitive, and prefrontal functions similar to those shown to be crucial for healthy adaptation. Suspected causes of these deficits, such as white matter lesions or affective instability, become apparent as early as midlife when internal and external changes as well as daily challenges set in. Based on these findings, we propose that some individuals who develop depression at older ages may not have been able to successfully implement self-regulatory adaptation at midlife. Here, we review the current evidence and theories on successful aging, the neurobiology of LLD, and well-being across the lifespan. Drawing on recent advances in lifespan theories, emotion regulation research, and cognitive neuroscience, we propose a model of successful versus unsuccessful adaptation that emphasizes the increasing need for implicit habitual control and resource-based regulatory choice during midlife.
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Affiliation(s)
- Friederike Thams
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefanie Brassen
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Tomás JM, Sentandreu-Mañó T, Martínez-Gregorio S. Does depression mediate the pain-frailty relationship? Latent variables approach. Geriatr Nurs 2023; 51:388-393. [PMID: 37127015 DOI: 10.1016/j.gerinurse.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/09/2023] [Accepted: 04/11/2023] [Indexed: 05/03/2023]
Abstract
Frailty is highly prevalent among older adults. This study aims to add evidence to the mediational role of depression in the pain-frailty relationship. Data came from a sample of 2578 Spanish older adults recruited from the Survey of Health, Aging, and Retirement in Europe (SHARE). A set of competing structural equation models were performed: (a) independent prediction, (b) full mediation, and (c) partial mediation. Results showed a better fit for the partial mediation model. This model was extended including covariates. The effects of pain and depression remained relevant in the final model, which explained 91% of the frailty variance. These findings support the relevance of the pain-depression dyad in frailty development. Although the pain shows a direct impact on frailty, this association is partially mediated by depression. The interplay of these conditions could be crucial for treatment effectiveness.
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Affiliation(s)
- José M Tomás
- Department of Methodology for the Behavioral Sciences, University of Valencia, Valencia, Spain
| | | | - Sara Martínez-Gregorio
- Department of Methodology for the Behavioral Sciences, University of Valencia, Valencia, Spain
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27
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Alshammari MK, Alotaibi NM, Al Suroor SN, Al Saed RS, Al-Hamoud AA, Alluwaif MA, Alamry MA, Alshehri NM, Alfaidi BE, Alzahrani RA, Almutiri BB, Alosaimi YS, Alosman AS, Alharbi AA, Alenezi AM. Global Advancement in Pharmacy Services for Mental Health: A Review for Evidence-Based Practices. Healthcare (Basel) 2023; 11:healthcare11081082. [PMID: 37107916 PMCID: PMC10137606 DOI: 10.3390/healthcare11081082] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 04/29/2023] Open
Abstract
The symptoms of psychiatric infirmities have variability, and selected drug regimens for mental illness are comparatively complex and individualized; therefore, pharmacy services vary with respect to patients, diseases, healthcare settings, community structures, and countries. Clinical pharmacy services for mental health (MH) are continuously being upgraded. A structured search of the literature was performed in the Cochrane, PubMed (Medline), PsycINFO, Google scholar, Scopus, Science Direct, and Springer Links databases. The title and abstract of each retrieved article were evaluated for relevance. To remove uncertainty and ambiguity, the full-text articles were retrieved and examined for relevance. The articles were further assessed on the basis of inclusion and exclusion criteria. Narrative synthesis was performed, creating new categories and relevant subcategories and further subsections. The articles and the results were assessed for quality and bias. Pharmacists have a range of expertise in psychiatric care. The services can be classified as conventional, extended, and advanced pharmacy services. Conventional services include the quality use of medicines in healthcare settings and medication support services in communities that ensure medication adherence. Pharmacists perform extended roles in collaborative medication therapy management, multidisciplinary community mental health teams, collaborative care, patient education, home medication review, hospital-to-home transit, and screening services. In the USA, the role of pharmacists was advanced by prescribing as collaborative and interim prescribers. Australia launched an accredited program for psychiatric first-aid pharmacists. Pharmacists can provide mental care to rural populations using health technology. The role of pharmacists in MH is appreciated either independently or as a team member. Patients and healthcare providers rank the services of pharmacists in MH highly. Still, there is a margin for improvement in the training of pharmacists. Pharmacists cannot provide sufficient time to their patients. Public awareness about the role of pharmacists in MH needs more attention. Moreover, the training of psychiatric pharmacists should be standardized around the world.
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Affiliation(s)
| | - Nawaf M Alotaibi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Northern Border University, Rafha 73213, Saudi Arabia
| | | | - Rami Saleh Al Saed
- Department of Pharmacy, Maternity and Children Hospital Dammam, Dammam 63400, Saudi Arabia
| | - Aliaa Ali Al-Hamoud
- Department of Pharmacy, Maternity and Children Hospital Dammam, Dammam 63400, Saudi Arabia
| | - Mawahb Ahmed Alluwaif
- Department of Pharmacy, Maternity and Children Hospital Dammam, Dammam 63400, Saudi Arabia
| | - Mona Awadh Alamry
- Department of Pharmacy, Khamis Mushait General Hospital, Khamis Mushait 62441, Saudi Arabia
| | | | - Bashaier Eed Alfaidi
- Department of Pharmacy, Umluj General Hospital, Ministry of Health, Northern Region, Umluj City 48312, Saudi Arabia
| | | | | | - Yousef Saud Alosaimi
- Department of Pharmacy, Dr. Sulaiman Al Habib Hospital, Riyadh 14926, Saudi Arabia
| | - Amal Saeed Alosman
- Department of Pharmacy, King Khalid University, South Zone, Abha 62541, Saudi Arabia
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Trends, Patterns and Associated User Characteristics of Antidepressant Prescriptions in Older Adults: A Nationwide Descriptive Cohort Study in Denmark. Drugs Aging 2023; 40:355-368. [PMID: 36920735 DOI: 10.1007/s40266-023-01018-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND AND OBJECTIVE Antidepressant use in older adults (≥ 65 years) is understudied in large population-based samples, particularly in recent years and regarding user characteristics. We aimed to describe the trends, patterns, and associated user characteristics of all antidepressant prescriptions redeemed by older adults at community pharmacies in Denmark during 2015-2019. METHODS This register-based study used a cross-sectional design to characterize antidepressant prescription trends and patterns, and a cohort design to describe user characteristics associated with antidepressant prescription initiation. We used descriptive statistics to characterize trends and patterns, and Poisson regression for analyzing user characteristics. RESULTS During the years 2015-2019, 17.9% of 1.2 million older adults redeemed 4.84 million antidepressant prescriptions, where 48.5% were selective serotonin reuptake inhibitors, followed by noradrenergic and specific serotonergic antidepressants (26.2%), serotonin-norepinephrine reuptake inhibitors (12.7%), tricyclic antidepressants (11.2%), and others (1.4%). Amitriptyline and nortriptyline, considered potentially inappropriate medications, were among the 10 most frequently redeemed antidepressants. Only 60.5% of prescriptions had a treatment indication of depression. Prescription-proportion trends by drug classes and individual antidepressants remained consistent. A higher incidence rate ratio (IRR) and 95% confidence interval (CI) of initiating antidepressants was associated with female sex (IRR 1.20, 95% CI 1.07-1.34), older age (e.g., 81-85 years vs. 65-70 years: IRR 1.74, 95% CI 1.44-2.11), living in rural areas (North Denmark vs. Capital Region: IRR 1.31, 95% CI 1.09-1.58), and having somatic and psychiatric diagnoses (e.g., per one psychiatric diagnosis: IRR 1.10, 95% CI 1.05-1.15), while a lower ratio was associated with being non-Western (vs. Danish: IRR 0.50, 95% CI 0.28-0.89) and having hospital contacts for psychiatric treatment (per each contact: IRR 0.96, 95% CI 0.93-1.00). CONCLUSION SSRIs were the most commonly redeemed antidepressants, with consistent trends in Danish older adults. Besides clinical conditions, sociodemographics, e.g., sex, age, ethnicity, and place of residence, may influence antidepressant use.
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Li C, Wu M, Qiao G, Gao X, Hu T, Zhao X, Zhu X, Yang F. Effectiveness of continuity of care in reducing depression symptoms in elderly: A systematic review and meta-analysis. Int J Geriatr Psychiatry 2023; 38:e5894. [PMID: 36814066 DOI: 10.1002/gps.5894] [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: 09/04/2022] [Accepted: 02/19/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Depression affects 10%-20% of older adults worldwide. The course of late-life depression (LLD) is often chronic, with a poor long-term prognosis. Lower treatment adherence, stigma, and suicide risk lead to significant challenges in the continuity of care (COC) for patients with LLD. Elderly patients with chronic diseases can benefit from COC. As a common chronic disease of the elderly, whether depression can also benefit from COC has not been systematically reviewed. METHODS Systematic literature search in Embase, Cochrane Library, Web of Science, Ovid, PubMed and Medline. Randomized Controlled Trials (RCTs) on the intervention effects of COC and LLD, published on 12 April 2022, were selected. Two independent researchers made research choices based on consensus. An RCT with COC as an intervention measure for the elderly with depression 60 years old was the inclusion criteria. RESULTS A total of 10 RCTs involving 1557 participants were identified in this study. The findings showed that: (1) COC significantly reduced depressive symptoms compared to usual care (standardized mean difference [SMD] = -0.47, 95% confidence interval: -0.63 to -0.31), with the best improvement at 3- to 6-month follow-up; (2) The reduction in depressive symptoms was more pronounced for patients with comorbid chronic conditions with LLD (SMD = -0.93, 95% CI: -1.18 to -0.68); (3) COC was more effective than other regions for LLD in Europe and the Americas (SMD = -0.84, 95% CI: -1.07 to -0.61); and (4) COC had a positive impact on the quality of life of patients with LLD (SMD = 0.21, 95% CI: 0.02-0.40). LIMITATIONS The included studies included several multi-component interventions with widely varying methods. Therefore, it was almost impossible to analyze which of these interventions had an impact on the assessed outcomes. CONCLUSIONS This meta-analysis shows that COC can significantly reduce depressive symptoms and improve quality of life in patients with LLD. However, when treating and caring for patients with LLD, health care providers should also pay attention to timely adjustments of intervention plans according to follow-up, synergistic interventions for multiple co-morbidities, and actively learning from advanced COC programs at home and abroad to improve the quality and effectiveness of services.
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Affiliation(s)
- Chaoyang Li
- College of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Man Wu
- College of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Guiyuan Qiao
- College of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Xiaolian Gao
- College of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Ting Hu
- College of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Xueyang Zhao
- College of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Xinhong Zhu
- College of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Fen Yang
- College of Nursing, Hubei University of Chinese Medicine, Wuhan, China
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Calvey B, Maguire R, de Andrade Moral R, McHugh Power J. Health asymmetry as a predictor of depressive symptomatology over time among older European adults: A growth curve analysis. J Psychosom Res 2023; 166:111158. [PMID: 36731198 DOI: 10.1016/j.jpsychores.2023.111158] [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: 09/11/2022] [Revised: 01/10/2023] [Accepted: 01/16/2023] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Subjective (SH) and objective health (OH) measures are associated with depressive symptomatology in older adults. We explored whether the discrepancy between SH and OH (operationalised as 'health asymmetry' with four categories: 'health optimistic', 'health pessimistic' and 'good health realistic' and 'poor health realistic') may also relate to depressive symptomatology 1) cross-sectionally, and 2) longitudinally, among older European adults. METHODS Adults (n = 26,520), aged 50+, from 11 European countries, were assessed over six waves of data collection (2006-2020) in the SHARE study. A hierarchical multi-level growth curve model explored whether health asymmetry was associated with depressive symptomology at baseline, and with depressive symptom trajectories across time, accounting for country of origin. RESULTS At baseline, 11.8% of older adults were classified as health pessimistic, with 15.5% being health optimistic, 42.9% being poor health realistic and 29.8% being good health realistic. A positive linear trend in depressive symptomatology was noted across 14 years of SHARE data (β = 0.11, p < .001). Health pessimists displayed higher levels of depressive symptoms than both health realistic groups and health optimists. However, health pessimists experienced a less steep increase in depressive symptoms across time (β = -0.10, p < .001), relative to good health realists. CONCLUSION Health pessimists experience elevated levels of depressive symptoms, but show less growth in depressive symptomatology than expected. Further research is required to understand the underlying causes of the varying depressive symptom trajectories among these groups.
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Affiliation(s)
- Bill Calvey
- Hamilton Institute, Maynooth University, Maynooth, Co. Kildare, Ireland.
| | - Rebecca Maguire
- Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland
| | - Rafael de Andrade Moral
- Hamilton Institute, Maynooth University, Maynooth, Co. Kildare, Ireland; Department of Mathematics and Statistics, Maynooth University, Co. Kildare, Ireland
| | - Joanna McHugh Power
- Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland
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Singer S, Sievers L, Scholz I, Taylor K, Blanck J, Maier L. Who seeks psychodynamic psychotherapy in community-based practices? Patient characteristics examined in a large sample of applications for reimbursement of psychotherapy in Germany. PSYCHODYNAMIC PRACTICE 2023. [DOI: 10.1080/14753634.2023.2182702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Affiliation(s)
- Susanne Singer
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre of Johannes Gutenberg University, Mainz, Germany
| | - Luisa Sievers
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre of Johannes Gutenberg University, Mainz, Germany
| | - Ida Scholz
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre of Johannes Gutenberg University, Mainz, Germany
| | - Katherine Taylor
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre of Johannes Gutenberg University, Mainz, Germany
| | - Julian Blanck
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre of Johannes Gutenberg University, Mainz, Germany
| | - Lena Maier
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre of Johannes Gutenberg University, Mainz, Germany
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Psychopathology, Personality and Depression after Acute Coronary Syndrome: A Network Analysis in an Italian Population. Diagnostics (Basel) 2023; 13:diagnostics13050915. [PMID: 36900060 PMCID: PMC10000947 DOI: 10.3390/diagnostics13050915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/15/2023] [Accepted: 02/21/2023] [Indexed: 03/05/2023] Open
Abstract
Several biopsychosocial factors are associated with the onset of a Major Depressive Episode (MDE) after cardiovascular events. However, little is known of the interaction between trait- and state-like symptoms and characteristics and their role in predisposing cardiac patients to MDEs. Three hundred and four subjects were selected among patients admitted for the first time at a Coronary Intensive Care Unit. Assessment comprised personality features, psychiatric symptoms and general psychological distress; the occurrences of MDEs and Major Adverse Cardiovascular Events (MACE) were recorded during a two-year follow-up period. Network analyses of state-like symptoms and trait-like features were compared between patients with and without MDEs and MACE during follow-up. Individuals with and without MDEs differed in sociodemographic characteristics and baseline depressive symptoms. Network comparison revealed significant differences in personality features, not state-like symptoms: the group with MDEs displayed greater Type D personality traits and alexithymia as well as stronger associations between alexithymia and negative affectivity (edge differences between negative affectivity and difficulty identifying feelings was 0.303, and difficulty describing feelings was 0.439). The vulnerability to depression in cardiac patients is associated with personality features but not with state-like symptoms. Personality evaluation at the first cardiac event may help identify individuals more vulnerable to development of an MDE, and they could be referred to specialist care in order to reduce their risk.
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Tan W, Ouyang X, Huang D, Wu Z, Liu Z, He Z, Long Y. Disrupted intrinsic functional brain network in patients with late-life depression: Evidence from a multi-site dataset. J Affect Disord 2023; 323:631-639. [PMID: 36521664 DOI: 10.1016/j.jad.2022.12.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 12/04/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Late-life depression (LLD) is a common and serious mental disorder, whose neural mechanisms are not yet fully understood. In this study, we aimed to characterize LLD-related changes in intrinsic functional brain networks using a large, multi-site sample. METHODS Using resting-state functional magnetic resonance imaging, the edge-based functional connectivity (FC) as well as multiple topological brain network metrics at both global and nodal levels were compared between 206 LLD patients and 210 normal controls (NCs). RESULTS Compared with NCs, the LLD patients had extensive alterations in the intrinsic brain FCs, especially significant decreases in FCs within the default mode network (DMN) and within the somatomotor network (SMN). The LLD patients also showed alterations in several global brain network metrics compared with NCs, including significant decreases in global efficiency, local efficiency, clustering coefficient, and small-worldness, as well as a significantly increased characteristic path length. Moreover, significant alterations in nodal network metrics (increased nodal betweenness and decreased nodal efficiency) were found in patients with LLD, which mainly involved the DMN and SMN. Post-hoc subgroup analyses indicated that the above changes in FC strengths were present in both first-episode, drug-naïve (FEDN) and non-FEDN patients, and were correlated with depression severity in the FEDN patients. Moreover, changes in FC strengths were found in both the early/late-onset (depression starts before/after the age of 50) patients, while altered topological metrics were found in only the late-onset patients. CONCLUSIONS These results may help to strengthen our understanding of the underlying neural mechanisms and biological heterogeneity in LLD.
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Affiliation(s)
- Wenjian Tan
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xuan Ouyang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Danqing Huang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhipeng Wu
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhening Liu
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhong He
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Clinical Research Center For Medical Imaging in Hunan Province, Changsha, Hunan, China.
| | - Yicheng Long
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
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Greenblatt-Kimron L, Shinan-Altman S, Alperin M, Levkovich I. Depression and Medicine Use among Older Adults during the COVID-19 Pandemic: The Role of Psychosocial Resources and COVID-19 Perceived Susceptibility. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3398. [PMID: 36834090 PMCID: PMC9961318 DOI: 10.3390/ijerph20043398] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
A relationship was found between the COVID-19 pandemic and depression among older adults and between depressed mood and increased use of antidepressant medication among older adults during the pandemic. With the aim of broadening the understanding of these relationships, the study examined whether COVID-19 perceived susceptibility mediates the relationship between psychosocial resources (optimism and perceived social support) and depressive symptoms and medication use. Participants included 383 older adults (M = 71.75, SD = 6.77) reporting on socio-demographics, health characteristics, depression, optimism, social support, and COVID-19 perceived susceptibility. Medication use was retrieved from participants medical files. Lower optimism, lower social support, and higher COVID-19 perceived susceptibility were associated with greater depression, related with higher medication use. The findings emphasize the buffering effect of psychosocial resources on the adverse effects of depression affecting older adults during the COVID-19 pandemic, and consequently, the increased use of medication in this population. Practitioners should focus interventions on enhancing optimism and expanding social support among older adults. Moreover, interventions focused on alleviating depression among older adults should aim at improving perceptions of perceived susceptibility in the older population.
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Affiliation(s)
| | - Shiri Shinan-Altman
- Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Mordechai Alperin
- Department of Family Medicine, The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3200003, Israel
- Clalit Health Services, Haifa and Western Galilee District, Tel Aviv 6209804, Israel
| | - Inbar Levkovich
- Faculty of Graduate Studies, Oranim Academic College of Education, Kiryat Tivon 3600600, Israel
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Meynet S, Beaudoin M, Smedig A. Promouvoir la santé mentale des personnes âgées avec des incapacités physiques : revue systématique des interventions proposées à domicile et en établissement. Rech Soins Infirm 2023; 151:18-29. [PMID: 37015854 DOI: 10.3917/rsi.151.0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
Introduction : Promoting the mental health of vulnerable elderly patients is a public health priority.Context : In many cases, mental health interventions for elderly people are not appropriate for those with multiple physical disabilities.Objectives : This article aims to provide gerontology professionals with an overview of the types of interventions available based on their practice setting (home or long-term care facility) and the characteristics of the people who use them (over 75 years old with physical disabilities).Method : A systematic literature review was conducted using the PsycInfo, PubMed, and Cochrane databases, using data ranging from 2001-2022. All interventions aimed at addressing mental health issues were included, regardless of their research methodology.Results : A total of 18 studies were included in this systematic review. The methodological limitations of these studies had a negative impact on our ability to draw conclusions and generalizations about the results of this review. However, the social and psychological support interventions studied seem to hold much promise.Discussion : The provision of personalized support seems to be an important factor in determining the success of an intervention, whether at home or in a long-stay facility.Conclusion : Further studies are needed to provide evidence of the effectiveness of these interventions.
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36
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Therapy Strategies for Late-life Depression: A Review. J Psychiatr Pract 2023; 29:15-30. [PMID: 36649548 DOI: 10.1097/pra.0000000000000678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Depression in the elderly requires different treatment options because therapies that are commonly used for depression in younger patients show different effects later in life. Treatment options for late-life depression (LLD) are summarized in this article. METHODS A literature search in Medline/PubMed performed in June 2020 identified 83 relevant studies. RESULTS Pharmacotherapy with selective serotonin reuptake inhibitors can be an effective first-line treatment in LLD, but >50% of elderly patients do not adequately respond. Switching to other selective serotonin reuptake inhibitors or augmenting with mood stabilizers or antipsychotics is often effective in achieving a therapeutic benefit. Severely depressed patients with a high risk of suicidal behavior can be treated with electroconvulsive therapy. Psychotherapy provides a measurable benefit alone and when combined with medication. LIMITATIONS LLD remains an underrepresented domain in research. Paucity of data concerning the effect of specific therapies for LLD, heterogeneity in the quality of study designs, overinterpretation of results from meta-analyses, and discrepancies between study results and guideline recommendations were often noted. CONCLUSIONS Treating LLD is complex, but there are several treatment options with good efficacy and tolerability. Some novel pharmaceuticals also show promise as potential antidepressants, but evidence for their efficacy and safety is still limited and based on only a few trials conducted to date.
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Cui L, Wang Y, Cao L, Wu Z, Peng D, Chen J, Yang H, Rong H, Liu T, Fang Y. Age of onset for major depressive disorder and its association with symptomatology. J Affect Disord 2023; 320:682-690. [PMID: 36183820 DOI: 10.1016/j.jad.2022.09.096] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/31/2022] [Accepted: 09/20/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The age of onset (AOO) is a key factor for heterogeneity in major depressive disorder (MDD). Looking at the effect of AOO on symptomatology may improve clinical outcomes. This study aims to examine whether and how AOO affects symptomatology using a machine learning approach and latent profile analysis (LPA). METHODS The study enrolled 915 participants diagnosed with MDD from eight hospitals across China. Depressive symptoms were assessed using the 17-item Hamilton Depression Rating Scale. The relationship between symptom profiles and AOO was explored using Random Forest. The effect of AOO on symptom clusters and subtypes was investigated using multiple linear regression and LPA. A continuous AOO indicator was used to conduct the analyses. RESULTS Based on the Random Forest, symptom profiles were closely associated with AOO. The regression model showed that the severity of neurovegetative symptoms was positively associated with AOO (β = 0.18, p < 0.001), and the severity of cognitive-behavioral symptoms was negatively associated with AOO (β = -0.12, p < 0.001). LPA demonstrated that the subgroups characterized by suicide and guilt had earlier onset of depression. The subgroup with the lowest global severity of depression had the latest onset. LIMITATIONS AOO was recalled retrospectively. The relative scarcity of participants with childhood and adolescence onset depression. CONCLUSIONS AOO has an important impact on symptomatology. The findings may enhance clinical evaluations for MDD and assist clinicians in promoting earlier detection and individualized care in vulnerable individuals.
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Affiliation(s)
- Lvchun Cui
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Yun Wang
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Lan Cao
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Zhiguo Wu
- Department of Psychiatry and Psychology, Shanghai Deji Hospital affiliated to Qingdao University, Shanghai 200331, China
| | - Daihui Peng
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Jun Chen
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Haichen Yang
- Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen 518020, China
| | - Han Rong
- Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen 518020, China
| | - Tiebang Liu
- Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen 518020, China
| | - Yiru Fang
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai 200031, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai 201108, China.
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Torres Z, Oliver A, Tomás JM. Mapping Protective Performance of Social Network Types on Health and Quality of Life in Older People in European Regions. J Aging Health 2022:8982643221142078. [DOI: 10.1177/08982643221142078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objectives: To identify social network profiles using Latent Profile Analysis (LPA), to study the relationships of these profiles with health markers, mental health, quality of life, and cognitive functioning, and to compare profiles across European regions. Methods: 27,272 participants from the Wave 8 of the SHARE project, aged 65 or older (M = 74.95, SD = 7.17) from Europe. Statistical analyses included LPAs followed by MANOVAs to compare the profiles and the health markers. Results: Five profiles were identified: family, friends, spouse, diverse, and others. A no network group was also added. The prevalence of the specific profiles differed across European regions. Individuals with no network and those categorized into the others profile presented the worst health outcomes. Discussion: The “friends” network is more protective toward cognitive functioning and physical health and the “spouse” and “family” ones are more protective toward mental health. The variability according to European regions is discussed.
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Affiliation(s)
- Zaira Torres
- Department of Methodology for the Behavioral Sciences, University of Valencia, Valencia, Spain
| | - Amparo Oliver
- Department of Methodology for the Behavioral Sciences, University of Valencia, Valencia, Spain
| | - José M. Tomás
- Department of Methodology for the Behavioral Sciences, University of Valencia, Valencia, Spain
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Tolstrup Wester C, Lybecker Scheel-Hincke L, Bovil T, Andersen-Ranberg K, Juel Ahrenfeldt L, Christian Hvidt N. Prayer frequency and COVID-19 vaccine hesitancy among older adults in Europe. Vaccine 2022; 40:6383-6390. [PMID: 36182618 PMCID: PMC9510066 DOI: 10.1016/j.vaccine.2022.09.044] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/03/2022] [Accepted: 09/14/2022] [Indexed: 01/27/2023]
Abstract
AIM Differences in levels of vaccine uptake have emerged across Europe, and this may partly be explained by religious beliefs. Our aim is to study the association between religiosity, measured by prayer frequency, and vaccine hesitancy, and to examine how this association varies across European countries and regions. METHODS This study was based on 42,583 adults aged 50 years and above from 27 European countries in the Survey of Health, Ageing and Retirement in Europe (SHARE), waves 1-8, and the 2nd SHARE COVID-19 Survey. Logistic regression models were used to investigate the associations. RESULTS Participants were more likely to be vaccine-hesitant when praying 'weekly or less' (odds ratio (OR) 1.32 95 % confidence interval (CI) 1.23-1.42) or daily (OR 1.78 95 % CI 1.65-1.92). Praying 'weekly or less' was associated with increased vaccine hesitancy in Southern Europe (OR 1.48 95 % CI 1.17-1.87) and Central and Eastern (OR 1.35 95 % CI 1.24-1.47) Europe, while daily praying was associated with vaccine hesitancy in Western (OR 1.77 95 % CI 1.51-2.08), Southern (OR 1.30 95 % CI 1.03-1.64), Central and Eastern (OR 1.89 95 % CI 1.73-2.06) and Northern (OR 2.75 95 % CI 1.54-4.89) Europe. CONCLUSIONS These findings provide support for an association between daily prayer frequency and COVID-19 vaccine hesitancy, with a consistent pattern across European regions.
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Affiliation(s)
- Christian Tolstrup Wester
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, 5000 Odense, Denmark.
| | - Lasse Lybecker Scheel-Hincke
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, 5000 Odense, Denmark
| | - Tine Bovil
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, 5000 Odense, Denmark
| | - Karen Andersen-Ranberg
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, 5000 Odense, Denmark; Geriatric Research Unit, Department of Public Health, University of Southern Denmark, 5000 Odense, Denmark
| | - Linda Juel Ahrenfeldt
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, 5000 Odense, Denmark
| | - Niels Christian Hvidt
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, 5000 Odense, Denmark; Academy of Geriatrich Cancer Research (AgeCare), Odense University Hospital, 5000 Odense, Denmark
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Čermaková P, Andrýsková L, Brázdil M, Marečková K. Socioeconomic deprivation in early life and symptoms of depression and anxiety in young adulthood: mediating role of hippocampal connectivity. Psychol Med 2022; 52:2671-2680. [PMID: 33327969 PMCID: PMC9647532 DOI: 10.1017/s0033291720004754] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 10/22/2020] [Accepted: 11/19/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Experience of early-life socioeconomic deprivation (ELSD) may increase the risk of mental disorders in young adulthood. This association may be mediated by structural and functional alterations of the hippocampus. METHODS We conducted a prospective cohort study on 122 participants of the European Longitudinal Study of Pregnancy and Childhood. Information about ELSD was collected via questionnaire from mothers during the first 18 months of participants' lives. At age 23-24, participants underwent examination by structural magnetic resonance imaging, resting-state functional connectivity and assessment of depressive symptoms (Mood and Feelings Questionnaire) and anxiety (Spielberger State-Trait Anxiety Inventory). The association of ELSD with brain outcomes in young adulthood was assessed with correlations, linear regression (adjusting for sex, socioeconomic position and mother's mental health) and moderated mediation analysis. RESULTS Higher ELSD was associated with greater depressive symptoms (B = 0.22; p = 0.001), trait anxiety (B = 0.07; p = 0.02) and lower global connectivity of the right hippocampus (B = -0.01; p = 0.02). These associations persisted when adjusted for covariates. In women, lower global connectivity of the right hippocampus was associated with stronger trait anxiety (B = -4.14; p = 0.01). Global connectivity of the right hippocampus as well as connectivity between the right hippocampus and the left middle temporal gyrus mediated the association between ELSD and trait anxiety in women. Higher ELSD correlated with a lower volume of the right hippocampus in men, but the volume of the right hippocampus was not related to mental health. CONCLUSIONS Early preventive strategies targeted at children from socioeconomically deprived families may yield long-lasting benefits for the mental health of the population.
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Affiliation(s)
- Pavla Čermaková
- Third Faculty of Medicine, Charles University Prague, Prague, Czech Republic
- National Institute of Mental Health, Klecany, Czech Republic
- Second Faculty of Medicine, Charles University Prague, Prague, Czech Republic
| | | | - Milan Brázdil
- Brain and Mind Research, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Klára Marečková
- Third Faculty of Medicine, Charles University Prague, Prague, Czech Republic
- Brain and Mind Research, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
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Belvederi Murri M, Cattelani L, Chesani F, Palumbo P, Triolo F, Alexopoulos GS. Risk Prediction Models for Depression in Community-Dwelling Older Adults. Am J Geriatr Psychiatry 2022; 30:949-960. [PMID: 35821215 DOI: 10.1016/j.jagp.2022.05.017] [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: 02/21/2022] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To develop streamlined Risk Prediction Models (Manto RPMs) for late-life depression. DESIGN Prospective study. SETTING The Survey of Health, Ageing and Retirement in Europe (SHARE) study. PARTICIPANTS Participants were community residing adults aged 55 years or older. MEASUREMENTS The outcome was presence of depression at a 2-year follow up evaluation. Risk factors were identified after a literature review of longitudinal studies. Separate RPMs were developed in the 29,116 participants who were not depressed at baseline and in the combined sample of 39,439 of non-depressed and depressed subjects. Models derived from the combined sample were used to develop a web-based risk calculator. RESULTS The authors identified 129 predictors of late-life depression after reviewing 227 studies. In non-depressed participants at baseline, the RPMs based on regression and Least Absolute Shrinkage and Selection Operator (LASSO) penalty (34 and 58 predictors, respectively) and the RPM based on Artificial Neural Networks (124 predictors) had a similar performance (AUC: 0.730-0.743). In the combined depressed and non-depressed participants at baseline, the RPM based on neural networks (35 predictors; AUC: 0.807; 95% CI: 0.80-0.82) and the model based on linear regression and LASSO penalty (32 predictors; AUC: 0.81; 95% CI: 0.79-0.82) had satisfactory accuracy. CONCLUSIONS The Manto RPMs can identify community-dwelling older individuals at risk for developing depression over 2 years. A web-based calculator based on the streamlined Manto model is freely available at https://manto.unife.it/ for use by individuals, clinicians, and policy makers and may be used to target prevention interventions at the individual and the population levels.
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Affiliation(s)
- Martino Belvederi Murri
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara (MBM), Ferrara, Italy
| | - Luca Cattelani
- Department of Computer Science and Engineering, University of Bologna (LC, FC), Bologna, Italy; Faculty of Medicine and Health Technologies, Tampere University (LC), Tampere, Finland; Institute of Biomedicine, University of Eastern Finland (LC), Kuopio, Finland
| | - Federico Chesani
- Department of Computer Science and Engineering, University of Bologna (LC, FC), Bologna, Italy
| | - Pierpaolo Palumbo
- Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi", University of Bologna (PP), Bologna, Italy
| | - Federico Triolo
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet (FT), Stockholm, Sweden
| | - George S Alexopoulos
- Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medicine (GA), White Plains, NY.
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Zhang YW, Wang J, Fang TH. The effect of horticultural therapy on depressive symptoms among the elderly: A systematic review and meta-analysis. Front Public Health 2022; 10:953363. [PMID: 36091570 PMCID: PMC9449424 DOI: 10.3389/fpubh.2022.953363] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/05/2022] [Indexed: 01/24/2023] Open
Abstract
Objective This systematic review and meta-analysis aimed to assess the effectiveness of horticultural therapy on depressive symptoms in the elderly and determine the potential moderators of the intervention effect. Methods In early June 2022, randomized controlled trials and Quasi-experimental studies were searched on Web of Science, PsycINFO, CINAHL, EMBASE, Medline, PubMed, CNKI, WANFANG DATA, and CQVIP. Three independent authors proposed the following inclusion criterion for this study: the elderly with applied horticultural therapy intervention compared to non-HT intervention. From a total of 3,068 records, only 34 studies met the inclusion criteria. After the full-text screening, 13 studies were included in the analysis. An assessment of the risk of bias was conducted using RoBINS-I and RoB 2 tools. The comprehensive Meta-Analysis 3.3 tool was used for the meta-analysis. Results Meta-analysis suggested that mean depression scores of elderly people who underwent horticultural therapy intervention were significantly lower than those who did not receive HT therapy. More significant effects were found for the elderly with mean age equal to or over 75 years instead of younger than 75 years, in randomized controlled trials instead of quasi-experimental studies, for studies with more than 20 participants receiving horticultural therapy at the same time and place instead of equal to or fewer than 20 horticultural therapy participants. Conclusions This evidence supported that horticultural therapy had a significant positive effect on the depressive symptoms outcomes for the elderly. Therefore, our data revealed that horticultural therapy could be considered as a part of therapy in depressive symptoms reduction programs. Due to the high degree of heterogeneity and the limited number of studies, a future review is warranted to determine the effects of horticultural therapy on depressive symptoms reduction in the elderly. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=272464, identifier: CRD42021272464.
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Singer S, Blanck J, Scholz I, Büttner M, Maier L. Hängen die Stundenkontingente für ambulante Psychotherapie zur Behandlung von Depressionen mit deren Schweregrad zusammen? DER NERVENARZT 2022; 93:1143-1149. [PMID: 35947172 PMCID: PMC9630213 DOI: 10.1007/s00115-022-01374-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/13/2022] [Indexed: 11/28/2022]
Abstract
Fragestellung Vor dem Hintergrund der Debatte um eine mögliche Festlegung des Leistungsumfangs für ambulante Psychotherapie anhand der Diagnose haben wir untersucht, ob in der aktuellen Versorgungspraxis bei Patienten mit Depressionen die Anzahl der beantragten sowie die der vom Gutachter befürworteten Stunden mit dem Schweregrad der Erkrankung zusammenhängen. Methode Aus einer Zufallsstichprobe von 1000 Anträgen auf Kostenübernahme für ambulante analytische oder tiefenpsychologisch fundierte Psychotherapie wurden jene herausgesucht, in denen eine Depressionsdiagnose mit Schweregradeinschätzung (ICD-10 F32 oder F33) entweder im Bericht oder auf dem Antragsformular kodiert worden war. Die Zahl der beantragten und der befürworteten Stunden pro Antrag wurde extrahiert. Bei Umwandlungs- und Fortführungsanträgen wurden dabei auch die im Vorfeld stattgefundenen Therapiestunden berücksichtigt. Ein möglicher Zusammenhang des Schweregrads der Depression mit der Zahl der beantragten bzw. der vom Gutachter befürworteten Stunden wurde anhand von Spearman-Rangkorrelationen überprüft. Ergebnisse Insgesamt 521 Anträge (52 %) enthielten eine F32- und/oder eine F33-Diagnose. Davon waren 63 (12 %) als leicht kodiert, 349 (67 %) als mittelgradig und 50 (10 %) als schwer. Im Median wurden 75 h bei leichter sowie je 50 h bei mittelgradiger bzw. bei schwerer Depression beantragt, wobei die Zahlen innerhalb der Gruppen stark variierten (10 bis 327 h) und der Zusammenhang zwischen Schweregrad und beantragter Stundenzahl gering war (Rho −0,10). Die befürworteten Stundenkontingente waren im Median 74 (leichte Depression), 50 (mittelgradig) und 50 (schwer) Stunden, auch hier war die Spannweite hoch (0 bis 327 h) und die Korrelation gering (Rho −0,11). Diskussion Es gibt keine Anhaltspunkte dafür, dass Psychotherapeuten die benötigten Stundenkontingente allein anhand des Schweregrads der Diagnose festlegen.
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Affiliation(s)
- Susanne Singer
- Abt. Epidemiologie und Versorgungsforschung, Institut für Medizinische Biometrie, Epidemiologie und Informatik (IMBEI), Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Obere Zahlbacher Straße 69, 55131, Mainz, Deutschland.
- , Mainz, Deutschland.
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Cross-sectional associations of personal efforts and beliefs and depressive symptoms among older adults in India. Sci Rep 2022; 12:13194. [PMID: 35915137 PMCID: PMC9343383 DOI: 10.1038/s41598-022-17578-1] [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: 04/20/2022] [Accepted: 07/27/2022] [Indexed: 11/21/2022] Open
Abstract
Whilst there is growing evidence on the increased vulnerability of older adults to depression, there is limited research on potentially mitigative factors against symptoms of depression at a population level. This research examined associations of possible protective factors (personal efforts and beliefs) and depressive symptoms among older adults in India. This cross-sectional study used data from the Longitudinal Aging Study in India with 31,464 respondents aged 60 years and above. Depressive symptoms were assessed using the 10-item Centre for Epidemiologic Studies Depression Scale. Multivariable linear regression was used while exploring the associated factors of depressive symptoms. The mean score of depressive symptoms was 2.94 (CI 2.92, 2.96). Older adults who engaged in moderate [aCoef: −0.11, CI −0.18, −0.05], vigorous [aCoef: −0.09, CI −0.16, −0.03], or both types of physical activity [aCoef: −0.10, CI −0.19, −0.02] had lower likelihood of depressive symptoms in comparison to those who were physically inactive. Older adults who participated in social activities were less likely to have depressive symptoms [aCoef: −0.44, CI −0.50, −0.39] compared to their socially inactive counterparts. Further, older adults who perceived religion as very important [aCoef: −0.29, CI −0.41, −0.17], who had high life satisfaction [aCoef: −0.78, CI −0.82, −0.73], who had good self-perceived health [aCoef: −0.29, CI −0.33, −0.25] and those who had high self-perceived social standing [aCoef: −0.39, CI −0.47, −0.31] had lower likelihood of depressive symptoms in comparison to their respective counterparts. Physical activity, social participation, voluntary work and financial contribution to family, religiosity, life satisfaction, self-perceived health and self-perceived social standing are associated with lower likelihood of depressive symptoms among community-dwelling older adults in this study. Future longitudinal studies should explore these factors that can guide interventions against depression in old age.
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Mulalint T, Seeherunwong A, Wanitkun N, Tongsai S. Determinants of continuing mental health service use among older persons diagnosed with depressive disorders in general hospitals: latent class analysis and GEE. BMC Health Serv Res 2022; 22:899. [PMID: 35818042 PMCID: PMC9275052 DOI: 10.1186/s12913-022-08250-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 06/23/2022] [Indexed: 11/10/2022] Open
Abstract
Background Prevalence of depression in older persons was a leading cause of disability. This group has the lowest access to service and retention in care compared to other age groups. This study aimed to explore continuing mental health service use and examined the predictive power of the mental health service delivery system and individual factors on mental health service use among older persons diagnosed with depressive disorders. Methods We employed an analytic cross-sectional study design of individual and organizational variables in 12 general hospitals selected using multi-stratified sampling. There were 3 clusters comprising community hospitals, advanced and standard hospitals, and university hospitals. Participants in each group were 150 persons selected by purposive sampling. We included older persons with a first or recurring diagnosis of a depressive disorder in the last 6 to 12 months of the data collection date. Data at the individual level included socio-demographic characteristics, Charlson Comorbidity Index, Attitude toward Depression and its treatment, and perceived social support. Data at the organizational level had hospital level, nurse competency, nurse-patient ratio, and appointment reminders. Descriptive statistics, Pearson chi-square test, latent class analysis (LCA), and marginal logistic regression model using generalized estimating equation (GEE) were used to analyze the data. Results The continuing mental health service use among older persons diagnosed with depressive disorders was 54%. The latent class analysis of four variables in the mental health services delivery organization yielded distinct and interpretable findings in two groups: high and low resource organization. The marginal logistic multivariable regression model using GEE found that organizational group and attitude toward depression and its treatment were significantly associated with mental health service use (p-value = 0.046; p-value = 0.003). Conclusions The findings suggest that improving continuing mental health services use in older persons diagnosed with depressive disorders should emphasize specialty resources of the mental health services delivery system and attitude toward depression and its treatment.
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Affiliation(s)
- Thida Mulalint
- D.N.S. Candidate, Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | - Acharaporn Seeherunwong
- Department of Mental Health and Psychiatric Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand.
| | - Napaporn Wanitkun
- Department of Surgical Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | - Sasima Tongsai
- Office for Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Subjective Assessments of Quality of Life Are Independently Associated with Depressive Symptoms among Older Adults Enrolled in Primary Care in Chile. J Pers Med 2022; 12:jpm12071063. [PMID: 35887560 PMCID: PMC9322959 DOI: 10.3390/jpm12071063] [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: 04/29/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 11/17/2022] Open
Abstract
In Chile, depressive symptoms are highly prevalent among Chilean older adults, and research that examines the factors associated with them is scarce. This study aimed to determine if subjective assessments of quality of life are associated with positive screen for depressive symptoms among older adults enrolled in primary care in Chile. The participants of the study were people aged 70 years or more enrolled in primary care centers in three Chilean cities. The 15-item Geriatric Depression Scale was used to determine depressive symptoms. Multivariate logistic models were used to determine the associations. Overall, 17.28% men, and 26.47% women (p = 0.003) screened positive for depression. Subjective assessments of quality of life, including self-perceived health, memory, quality of life, and pain, were associated with a positive screen for depression. Only 17.65% of men and 43.55% of women who screened positive for depressive symptoms reported a diagnosis of depression. Assessments of quality of life in health checks of older adults in primary care could contribute to narrow the diagnosis and treatment gap by improving the ability to identify those who are more likely to experience depressive symptoms.
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Caballero-Domínguez CC, Pedrozo-Pupo JC, Campo-Arias A. Depression among COVID-19 survivors in Colombia. PSYCHOL HEALTH MED 2022:1-8. [PMID: 35658752 DOI: 10.1080/13548506.2022.2085879] [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] [Indexed: 10/18/2022]
Abstract
The COVID-19 survivors are at high risk of meeting the criteria for depression. However, few studies have explored its prevalence and associated factors. The study aimed to know the frequency and variables associated with depression among COVID-19 survivors in Santa Marta, Colombia. A sample of COVID-19 survivors was included. Depression was quantified with the Patient Health Questionnaire (PHQ-9, α = 0.85). Three hundred and thirty survivors participated in the research. They were aged between 18 and 89 years, 61.5% were women, and 49.7% of participants scored above the cut-off point for depression. Depression was associated with female gender, younger age, COVID moderate or severe, and having presented symptoms for more than three weeks. In conclusion, depression occurs in half of the COVID-19 survivors and is higher in younger, women and who report more severe symptoms. Longitudinal studies can provide further information on the long-term impact on the mental health of COVID-19 survivors.
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Affiliation(s)
| | - John Carlos Pedrozo-Pupo
- Programa de Medicina, Facultad de Ciencias de la Salud, Universidad del Magdalena, Santa Marta, Colombia
| | - Adalberto Campo-Arias
- Programa de Medicina, Facultad de Ciencias de la Salud, Universidad del Magdalena, Santa Marta, Colombia
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Perna L, Trares K, Perneczky R, Tato M, Stocker H, Möllers T, Holleczek B, Schöttker B, Brenner H. Risk of Late-Onset Depression and Cognitive Decline: Results From Inflammatory Proteome Analyses in a Prospective Population-Based Cohort Study. Am J Geriatr Psychiatry 2022; 30:689-700. [PMID: 34961662 DOI: 10.1016/j.jagp.2021.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Research suggests that inflammation is linked to both late-onset depression (LOD) and cognitive decline, and that LOD might have biological underpinnings differentiating it from recurrent depression. Evidence from inflammatory proteome analyses in large prospective cohorts is scarce. The aim of this study was to assess whether and which inflammation-related biomarkers are associated with LOD, recurrent depression, and cognitive decline due to vascular pathology (vascular dementia). DESIGN Ongoing population-based cohort study of older adults followed for up to 17 years with regard to clinical diagnosis of various age-related diseases (ESTHER study, n = 9,940). SETTING Longitudinal cohort started in 2000-2002 in a community setting in Saarland, a southwestern German state. PARTICIPANTS Subgroup of randomly selected participants of the ESTHER study (n = 1,665). MEASUREMENTS Inflammatory biomarkers were measured with the Olink Target 96 in baseline samples. RESULTS Out of 78 biomarkers interleukin 10 (IL-10) and C-C chemokine ligand 4 (CCL4) were associated with significantly increased risk of LOD after multiple testing correction. Hazard ratios (95-confidence interval) per 1 standard deviation increase were 1.37 (1.15-1.63) for IL-10 and 1.34 (1.13-1.59) for CCL4. None of the inflammatory markers was associated with recurrent depression. The dose-response analysis showed a similar monotonic risk increase for LOD and vascular dementia with increasing IL-10 levels. CONCLUSION These results suggest that inflammatory markers are involved in the etiology of LOD, but not of recurrent depression and that LOD and vascular dementia might share common inflammatory etiology with respect to IL-10.
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Affiliation(s)
- Laura Perna
- Department of Translational Research in Psychiatry (LP), Max Planck Institute of Psychiatry, Munich, Germany; Division of Mental Health of Older Adults (LP, RP, MT), Department of Psychiatry and Psychotherapy, University Hospital, LMU, Munich, Germany; Division of Clinical Epidemiology and Aging Research (LP, KT, HS, TM, BH, BS, HB), German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Kira Trares
- Division of Clinical Epidemiology and Aging Research (LP, KT, HS, TM, BH, BS, HB), German Cancer Research Center (DKFZ), Heidelberg, Germany; Network Aging Research (NAR) (KT, HS, TM, BS, HB), Heidelberg University, Heidelberg, Germany; Medical Faculty (KT, HS), Heidelberg University, Heidelberg, Germany
| | - Robert Perneczky
- Division of Mental Health of Older Adults (LP, RP, MT), Department of Psychiatry and Psychotherapy, University Hospital, LMU, Munich, Germany; Ageing Epidemiology (AGE) Research Unit (RP), School of Public Health, Imperial College London, UK; German Center for Neurodegenerative Diseases (DZNE) (RP), Munich, Germany; Munich Cluster for Systems Neurology (SyNergy) (RP), Munich, Germany
| | - Maia Tato
- Division of Mental Health of Older Adults (LP, RP, MT), Department of Psychiatry and Psychotherapy, University Hospital, LMU, Munich, Germany
| | - Hannah Stocker
- Division of Clinical Epidemiology and Aging Research (LP, KT, HS, TM, BH, BS, HB), German Cancer Research Center (DKFZ), Heidelberg, Germany; Network Aging Research (NAR) (KT, HS, TM, BS, HB), Heidelberg University, Heidelberg, Germany; Medical Faculty (KT, HS), Heidelberg University, Heidelberg, Germany
| | - Tobias Möllers
- Division of Clinical Epidemiology and Aging Research (LP, KT, HS, TM, BH, BS, HB), German Cancer Research Center (DKFZ), Heidelberg, Germany; Network Aging Research (NAR) (KT, HS, TM, BS, HB), Heidelberg University, Heidelberg, Germany
| | - Bernd Holleczek
- Division of Clinical Epidemiology and Aging Research (LP, KT, HS, TM, BH, BS, HB), German Cancer Research Center (DKFZ), Heidelberg, Germany; Saarland Cancer Registry (BH), Saarbrücken, Germany
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research (LP, KT, HS, TM, BH, BS, HB), German Cancer Research Center (DKFZ), Heidelberg, Germany; Network Aging Research (NAR) (KT, HS, TM, BS, HB), Heidelberg University, Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research (LP, KT, HS, TM, BH, BS, HB), German Cancer Research Center (DKFZ), Heidelberg, Germany; Network Aging Research (NAR) (KT, HS, TM, BS, HB), Heidelberg University, Heidelberg, Germany
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Goh YS, Ow Yong QYJ, Soo SC, Wan PCJ, Ng VCK. Experiences and challenges faced by community mental health workers when providing care to people with mental health conditions: A qualitative descriptive study. Int J Ment Health Nurs 2022; 31:591-600. [PMID: 35075757 DOI: 10.1111/inm.12977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/23/2021] [Accepted: 01/10/2022] [Indexed: 12/14/2022]
Abstract
The global prevalence of mental health conditions and the associated wide treatment gaps have led to increased demand for quality mental healthcare services. In Singapore, despite a shift towards a joint provision of mental healthcare in hospitals and the community, experiences of mental healthcare teams in such hospital-community partnerships have remained unclear. Through a qualitative descriptive approach, this study explored community mental health workers' experiences and perceptions of working with partners from tertiary hospitals and other community organisations. Eighteen participants were individually interviewed with a semi-structured question guide through video conferencing. This study was guided by the 32-item checklist from the Consolidated Criteria for Reporting Qualitative Research. Data were subjected to Braun and Clark's six-step thematic analysis. Three themes emerged: (i) the need for supportive partners, due to institutional and legal challenges faced in the participants' liaison with hospital partners and other community organisations; (ii) the need for a supportive organisation, whose presence and importance were revealed by the interviews; and (iii) the necessity of advanced training, identified by the participants as a contributor to their professional growth. The findings highlighted the importance of inter-sectoral communication and positive effects of a robust organisational support system. Accordingly, hospitals and community mental healthcare organisations should consider strengthening networking and boosting case discussions through regular inter-sectoral meetings that would prioritise the clients' continuity of care. Furthermore, opportunities for advanced trainings should be created for community-based mental healthcare workers.
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Affiliation(s)
- Yong-Shian Goh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Qing Yun Jenna Ow Yong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Shuenn-Chiang Soo
- National University Hospital, National University Health System, Singapore, Singapore
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Yu Q, Wang Z, Li Z, Liu X, Oteng Agyeman F, Wang X. Hierarchical Structure of Depression Knowledge Network and Co-word Analysis of Focus Areas. Front Psychol 2022; 13:920920. [PMID: 35664156 PMCID: PMC9160970 DOI: 10.3389/fpsyg.2022.920920] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 04/29/2022] [Indexed: 12/02/2022] Open
Abstract
Contemporarily, depression has become a common psychiatric disorder that influences people's life quality and mental state. This study presents a systematic review analysis of depression based on a hierarchical structure approach. This research provides a rich theoretical foundation for understanding the hot spots, evolutionary trends, and future related research directions and offers further guidance for practice. This investigation contributes to knowledge by combining robust methodological software for analysis, including Citespace, Ucinet, and Pajek. This paper employed the bibliometric methodology to analyze 5,000 research articles concerning depression. This current research also employed the BibExcel software to bibliometrically measure the keywords of the selected articles and further conducted a co-word matrix analysis. Additionally, Pajek software was used to conduct a co-word network analysis to obtain a co-word network diagram of depression. Further, Ucinet software was utilized to calculate K-core values, degree centrality, and mediated centrality to better present the research hotspots, sort out the current status and reveal the research characteristics in the field of depression with valuable information and support for subsequent research. This research indicates that major depressive disorder, anxiety, and mental health had a high occurrence among adolescents and the aged. This present study provides policy recommendations for the government, non-governmental organizations and other philanthropic agencies to help furnish resources for treating and controlling depression orders.
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Affiliation(s)
- Qingyue Yu
- College of Computer Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Zihao Wang
- College of Medicine, Jiangsu University, Zhenjiang, China
| | - Zeyu Li
- Jingjiang College of Jiangsu University, Zhenjiang, China
| | - Xuejun Liu
- College of Computer Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | | | - Xinxing Wang
- School of Management, Jiangsu University, Zhenjiang, China
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