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Liang JH, Liu ML, Pu YQ, Huang S, Jiang N, Bao WW, Hu LX, Zhang YS, Gui ZH, Pu XY, Huang SY, Chen YJ. Cumulative inequality in social determinants of health in relation to depression symptom: An analysis of nationwide cross-sectional data from U.S. NHANES 2005-2018. Psychiatry Res 2024; 336:115894. [PMID: 38598946 DOI: 10.1016/j.psychres.2024.115894] [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: 07/21/2023] [Revised: 03/03/2024] [Accepted: 04/04/2024] [Indexed: 04/12/2024]
Abstract
Social determinants of health (SDoH) have been linked to a higher likelihood of experiencing mental health problems. This study aimed to investigate whether the accumulation of unfavorable SDoH is associated with depression symptom. Data was gathered from a representative population participating in the U.S. National Health and Nutrition Examination Survey spanning from 2005 to 2018. Self-reported SDoH were operationalized according to the criteria outlined in Healthy People 2030, with a cumulative measure of unfavorable SDoH calculated for analysis. The presence of depression symptom was identified using the Patient Health Questionnaire in a representative sample of 30,762 participants (49.2 % males) representing 1,392 million non-institutionalized U.S. adults, with 2,675 (8.7 %) participants showing depression symptom. Unfavorable SDoH were found to be significantly and independently associated with depression symptom. Individuals facing multiple unfavorable SDoHs were more likely to experience depression symptom (P for trend < 0.001). For instance, a positive association was observed in participants exposed to six or more unfavorable SDoHs with depression symptom (AOR = 3.537, 95 % CI: 1.781, 7.075, P-value < 0.001). The findings emphasize that the likelihood of developing depression symptom significantly increases when multiple SDoHs are present, compared to just a single SDoH.
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Affiliation(s)
- Jing-Hong Liang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, PR China
| | - Mei-Ling Liu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, PR China
| | - Ying-Qi Pu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, PR China
| | - Shan Huang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, PR China
| | - Nan Jiang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, PR China
| | - Wen-Wen Bao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, PR China
| | - Li-Xin Hu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, PR China
| | - Yu-Shan Zhang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, PR China
| | - Zhao-Huan Gui
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Occupational and Environmental Health, School of Public Health, 74 Zhongshan 2nd Rd., Yuexiu District, Guangzhou 510080, PR China
| | - Xue-Ya Pu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, PR China
| | - Shao-Yi Huang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, PR China
| | - Ya-Jun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, PR China.
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2
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Cook RM, Sackett CR, Wind SA. The Development of the Client Meaningful Experiences Scale. MEASUREMENT AND EVALUATION IN COUNSELING AND DEVELOPMENT 2022. [DOI: 10.1080/07481756.2022.2148110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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3
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Validation of the MMPI-A-RF for Youth with Mental Health Needs: a Systematic Examination of Clinical Correlates and Construct Validity. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2019. [DOI: 10.1007/s10862-019-09754-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Hinckley JD, Riggs P. Integrated Treatment of Adolescents with Co-occurring Depression and Substance Use Disorder. Child Adolesc Psychiatr Clin N Am 2019; 28:461-472. [PMID: 31076120 DOI: 10.1016/j.chc.2019.02.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Substance use disorders (SUDs) are commonly co-occurring among adolescents with depression. Integrated treatment is important given treatment implications and increased rates of suicidality. All adolescents should be screened for SUD using Screening, Brief Intervention, and Referral to Treatment. Review of randomized controlled trials in adolescents reveals motivational enhancement therapy/cognitive behavioral therapy is an evidence-based intervention and should be considered first-line treatment. If depression does not improve, fluoxetine should be considered, as it is well-tolerated in substance-involved adolescents with depression. Adolescents who do not show improvement in SUD or who have severe SUD should be referred to evidence-based SUD treatment.
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Affiliation(s)
- Jesse D Hinckley
- Division of Substance Dependence, Department of Psychiatry, University of Colorado School of Medicine, 13001 East 17th Place, MS F570, Aurora, CO 80045, USA.
| | - Paula Riggs
- Division of Substance Dependence, Department of Psychiatry, University of Colorado School of Medicine, 13001 East 17th Place, MS F570, Aurora, CO 80045, USA
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Ranney ML, Pittman SK, Dunsiger S, Guthrie KM, Spirito A, Boyer EW, Cunningham RM. Emergency department text messaging for adolescent violence and depression prevention: A pilot randomized controlled trial. Psychol Serv 2018; 15:419-428. [PMID: 30382737 DOI: 10.1037/ser0000193] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This study's purpose was to evaluate feasibility and acceptability, obtain preliminary efficacy data, and evaluate predictors of improvement with iDOVE, a technology-augmented violence and depression prevention intervention for high-risk adolescents seen in the emergency department (ED). We conducted a pilot randomized controlled trial (RCT) with 116 English-speaking adolescents (ages 13-17 years), presenting to the ED for any reason, who reported past-year physical peer violence and current depressive symptoms. The cognitive-behavioral therapy- and motivational interviewing-based intervention consisted of a brief in-ED intervention session and 8 weeks of automated text-message daily mood queries and tailored responses. The control was a brief in-ED presentation and twice-weekly text messages on healthy behaviors. Follow-up was conducted at 8 and 16 weeks. Descriptive statistics, bivariate comparisons, mixed-effects longitudinal regression models, and latent class models (LCMs) were calculated. iDOVE had high acceptability and feasibility, with 86% of eligible youth consenting (n = 116), 95% completing 8-week follow-up, and 91% completing 16-week follow-up. High quantitative and qualitative satisfaction were reported by intervention and control participants. Comparing intervention to control, improved depressive symptoms (p = .07) and physical peer violence (p = .01) were observed among the more symptomatic youth in the intervention group (but no difference in symptoms between full intervention and control groups). LCMs showed that intervention responsiveness correlated with lower mood (measured through daily text messages) at Day 7 of the intervention. This RCT of a technology-augmented intervention shows high feasibility and acceptability and a promising signal of reduced violence among the highest-risk participants. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Affiliation(s)
- Megan L Ranney
- Emergency Digital Health Innovation Program, Department of Emergency Medicine, Alpert Medical School, Brown University
| | - Sarah K Pittman
- Emergency Digital Health Innovation Program, Department of Emergency Medicine, Alpert Medical School, Brown University
| | - Shira Dunsiger
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital
| | - Kate M Guthrie
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Alpert Medical School, Brown University
| | - Anthony Spirito
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University
| | - Edward W Boyer
- Department of Emergency Medicine, University of Massachusetts-Worcester
| | - Rebecca M Cunningham
- Injury Control Research Center, Department of Emergency Medicine, University of Michigan
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Ranney ML, Goldstick J, Eisman A, Carter PM, Walton M, Cunningham RM. Effects of a brief ED-based alcohol and violence intervention on depressive symptoms. Gen Hosp Psychiatry 2017; 46:44-48. [PMID: 28622815 PMCID: PMC5474937 DOI: 10.1016/j.genhosppsych.2017.01.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 01/12/2017] [Accepted: 01/14/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Depressive symptoms frequently co-exist in adolescents with alcohol use and peer violence. This paper's purpose was to examine the secondary effects of a brief alcohol-and-violence-focused ED intervention on depressive symptoms. METHOD Adolescents (ages 14-18) presenting to an ED for any reason, reporting past year alcohol use and aggression, were enrolled in a randomized control trial (control, therapist-delivered brief intervention [TBI], or computer-delivered brief intervention [CBI]). Depressive symptoms were measured at baseline, 3, 6, and 12months using a modified 10-item Center for Epidemiological Studies Depression Scale (CESD-10). Poisson regression was used (adjusting for baseline age, gender, and depressive symptoms) to compare depressive symptoms at follow-up. RESULTS Among 659 participants, higher baseline depressive symptoms, female gender, and age≥16 were associated with higher depressive symptoms over time. At 3months, CBI and TBI groups had significantly lower CESD-10 scores than the control group; at 6months, intervention and control groups did not differ; at 12months, only CBI had a significantly lower CESD-10 score than control. CONCLUSIONS A single-session brief ED-based intervention focused on alcohol use and violence also reduces depressive symptoms among at-risk youth. Findings also point to the potential efficacy of using technology in future depression interventions.
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Affiliation(s)
- Megan L. Ranney
- Department of Emergency Medicine, Alpert Medical, School, Brown University, Rhode Island Hospital, 593 Eddy St, Claverick 2, Providence, RI 02903,Injury Prevention Center of Rhode Island Hospital, 593 Eddy St., Providence, RI 02903,Corresponding Author: Megan L. Ranney MD MPH, Department of Emergency Medicine, Alpert Medical School, Brown University, Rhode Island Hospital, 593 Eddy St, Claverick 2, Providence, RI 02903, Phone: 401-444-2557, Fax: 401-444-2249,
| | - Jason Goldstick
- Department of Emergency Medicine, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, Michigan, 48105,Injury Research Center, University of Michigan, University of Michigan School of Medicine, 2800 Plymouth Road, NCRC 10-G080, Ann Arbor, Michigan, 48109
| | - Andria Eisman
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109
| | - Patrick M. Carter
- Department of Emergency Medicine, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, Michigan, 48105,Injury Research Center, University of Michigan, University of Michigan School of Medicine, 2800 Plymouth Road, NCRC 10-G080, Ann Arbor, Michigan, 48109,Michigan Youth Violence Prevention Center, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, Michigan, 48109
| | - Maureen Walton
- Injury Research Center, University of Michigan, University of Michigan School of Medicine, 2800 Plymouth Road, NCRC 10-G080, Ann Arbor, Michigan, 48109,Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Bldg. 16, Ann Arbor, MI 48109-2800
| | - Rebecca M. Cunningham
- Department of Emergency Medicine, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, Michigan, 48105,Injury Research Center, University of Michigan, University of Michigan School of Medicine, 2800 Plymouth Road, NCRC 10-G080, Ann Arbor, Michigan, 48109,Michigan Youth Violence Prevention Center, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, Michigan, 48109
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The Impact of Single Mothers' Health Insurance Coverage on Behavioral Health Services Utilization by Their Adolescent Children. J Behav Health Serv Res 2017; 45:46-56. [PMID: 28255681 DOI: 10.1007/s11414-017-9550-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Adolescents living in single-mother households are more likely to have behavioral health conditions, but are less likely to utilize any behavioral health services. Using nationally representative mother-child pair data pooled over 6 years from the National Survey on Drug Use and Health, the study finds that when single mothers were uninsured, their adolescent children were less likely to utilize any behavioral health services, even when the children themselves were covered by insurance. The extension of health coverage under the Affordable Care Act (ACA) to uninsured single mothers could improve the behavioral health of the adolescent population.
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Abstract
Research shows that the majority of adolescents with substance use disorders also have other cooccurring psychiatric disorders, which has been associated with poorer treatment outcomes. Despite considerable consensus that treatment of cooccurring disorders should be integrated or concurrent, most such youth do not receive it. In addition to systemic and economic barriers, few studies have been conducted that inform evidence-based integrated treatment approaches. This article provides a review of current research from which empirically derived principles of integrated treatment can originate and which have informed the development of at least one evidence-based model of integrated mental health and substance treatment.
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Affiliation(s)
- Zachary D Robinson
- Child and Adolescent Psychiatry, Children's Hospital Colorado, University of Colorado Hospital, University of Colorado School of Medicine, 13001 East 17th Place, Campus Box F546, Building 500, Room E2322, Aurora, CO 80045, USA.
| | - Paula D Riggs
- Division of Substance Dependence, Department of Psychiatry, University of Colorado School of Medicine, Building 400, Mail Stop F478, Aurora, CO 80045, USA
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Abstract
Adolescent substance use is common and is associated with serious mental, physical, and social risks, warranting systematic screening in the primary care setting. It is important for clinicians to become familiar with Screening, Brief Intervention, and Referral to Treatment (SBIRT), including administration of validated screening tools to identify level of risk associated with substance use and application of appropriate brief interventions. Positive reinforcement and brief advice is indicated for those adolescents with no or minimal risk for a substance use disorder. Providing a brief intervention using motivational interviewing strategies with subsequent close clinical follow-up is warranted when an adolescent meets criteria for a mild to moderate substance use disorder. Referral to treatment is recommended in cases of severe substance use. Immediate action, including breaking confidentiality, may be necessary when an adolescent's behavior raises acute safety concerns. Making time to interview adolescents alone is essential. It is also important to review the limitations of confidentiality with patients and parents/guardians and offer them strategies to discuss sensitive issues with their adolescents. Available resources for adolescents, parents/guardians, and clinicians regarding the risks of adolescent substance use and evidence-based treatment options can be used to support implementation of SBIRT in adolescent primary care.
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Giordano GN, Ohlsson H, Kendler KS, Winkleby MA, Sundquist K, Sundquist J. Age, period and cohort trends in drug abuse hospitalizations within the total Swedish population (1975-2010). Drug Alcohol Depend 2014; 134:355-361. [PMID: 24300899 PMCID: PMC3909834 DOI: 10.1016/j.drugalcdep.2013.11.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 11/04/2013] [Accepted: 11/05/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND The societal consequences of drug abuse (DA) are severe and well documented, the World Health Organization recommending tracking of population trends for effective policy responses in treatment of DA and delivery of health care services. However, to correctly identify possible sources of DA change, one must first disentangle three different time-related influences on the need for treatment due to DA: age effects, period effects and cohort effects. METHODS We constructed our main Swedish national DA database (spanning four decades) by linking healthcare data from the Swedish Hospital Discharge Register to individuals, which included hospitalisations in Sweden for 1975-2010. All hospitalized DA cases were identified by ICD codes. Our Swedish national sample consisted of 3078,129 men and 2921,816 women. We employed a cross-classified multilevel logistic regression model to disentangle any net age, period and cohort effects on DA hospitalization rates. RESULTS We found distinct net age, period and cohort effects, each influencing the predicted probability of hospitalisation for DA in men and women. Peak age for DA in both sexes was 33-35 years; net period effects showed an increase in hospitalisation for DA from 1996 to 2001; and in birth cohorts 1968-1974, we saw a considerable reduction (around 75%) in predicted probability of hospitalisation for DA. CONCLUSIONS The use of hospital admissions could be regarded as a proxy of the population's health service use for DA. Our results may thus constitute a basis for effective prevention planning, treatment and other appropriate policy responses.
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Affiliation(s)
- Giuseppe N Giordano
- Center for Primary Health Care Research, Lund University, Jan Waldenströmsgata 35, CRC, building 28, floor 11, entrance 72, Malmö University Hospital, Malmö, S-205 02, Sweden.
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Jan Waldenströmsgata 35, CRC, building 28, floor 11, entrance 72, Malmö University Hospital, Malmö, S-205 02, Sweden
| | - Kenneth S Kendler
- Virginia Commonwealth University School of Medicine, PO Box 980126 Richmond, VA 23298, USA
| | | | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Jan Waldenströmsgata 35, CRC, building 28, floor 11, entrance 72, Malmö University Hospital, Malmö, S-205 02, Sweden; Stanford Prevention Research Center, MSOB, Stanford, CA 94305, USA
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Jan Waldenströmsgata 35, CRC, building 28, floor 11, entrance 72, Malmö University Hospital, Malmö, S-205 02, Sweden; Stanford Prevention Research Center, MSOB, Stanford, CA 94305, USA
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