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Demirchyan A, Khachadourian V, Armenian HK, Goenjian AK. The course, trajectories and predictors of depression 23 years after the 1988 Spitak earthquake in Armenia: A prospective cohort study. Psychiatry Res 2022; 313:114640. [PMID: 35598565 DOI: 10.1016/j.psychres.2022.114640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/04/2022] [Accepted: 05/14/2022] [Indexed: 11/19/2022]
Abstract
There is a scarcity of long-term studies of depression after natural disasters. This prospective epidemiologic study evaluated the course of depression and factors associated with it among survivors 23-years post-earthquake. A geographically stratified subsample of 725 adults exposed to the Spitak earthquake was assessed for depression using DSM-III-R criteria in 1991 and 2012. Additionally, an adapted CES-D-16 scale was used to assess depressive symptoms in 2012. A fitted multi-nominal logistic regression model identified predictors of different trajectories of depression. For the whole group, the rate of clinical depression dropped from 51.5% in 1991 to 31.7% in 2012. Earthquake intensity and experiencing strong fear at baseline were strongly associated with chronic (depressed at both assessments, 18.1%) and recovered (depressed only in 1991, 33.5%) depression trajectories compared with the healthy group, with odds ratios (OR) over 4.0 and 3.0, respectively. Predictors distinguishing chronic depression included earthquake-related nuclear-family deaths (OR=3.79), chronic illnesses at baseline (OR=1.24), and social support (OR=0.91). Predictors of the late-onset trajectory (depressed only in 2012, 13.5% of the cohort) included post-earthquake trauma (OR=1.42), socioeconomic status (OR=0.45), and social support (OR=0.86). The factors associated with the different trajectories of depression provide guidance for planning more effective mental health interventions after disasters.
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Affiliation(s)
- Anahit Demirchyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia.
| | - Vahe Khachadourian
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Haroutune K Armenian
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Armen K Goenjian
- UCLA/Duke University National Center for Child Traumatic Stress, Department of Psychiatry and Biobehavioral Sciences, UCLA, CA, USA; Collaborative Neuroscience Network, CA, USA
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Hassem T. Evaluating the efficacy of an online depression screening tool in South Africa: A pilot study. S Afr J Psychiatr 2022; 28:1687. [PMID: 35281958 PMCID: PMC8905393 DOI: 10.4102/sajpsychiatry.v28i0.1687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 08/06/2021] [Indexed: 11/07/2022] Open
Abstract
Background A global increase of 16% in depression rates from 1990 to 2019 highlights the alarming situation in relation to increase in depression. Research has indicated that this rate is likely to increase as a result of the coronavirus disease 2019 (COVID-19) pandemic. In South Africa, the depression life-time prevalence rate is 9.47%. However, the lack of access to mental healthcare services leads to people not receiving much needed information and care. The growing accessibility to the Internet for South Africans offers a solution for the screening and access to self-help information for depression. The Center for Epidemiologic Studies Depression Scale (CESD)-R was adapted for online usage and a website, mddsa.co.za, was piloted in this regard. Aim This study reports on the efficacy of the online adapted CESD-R for use in South Africa by reporting on the reliability and criterion validity as well as the user friendliness of the website and the appropriateness of the instant feedback provided. Setting The study was conducted in South Africa during COVID lockdown level 1 and 2. Methods This study followed a quantitative, cross-sectional research design. A convenience sample of 21 individuals, above the age of 18, with a depression diagnosis and 86 individuals with no mental health diagnosis participated in the study. Participants accessed the screening instrument online at the website. Results Internal consistency reliability coefficients exceeded 0.80. T-test and sensitivity and specificity results attested to the accuracy of the tool. All items contributed well to the instrument, including the items that were culturally specific to South Africa. Feedback from participants indicated that the tool was easily comprehensible, the website was user friendly and the instant feedback provided was appropriate. Conclusion The online adapted CESD-R evidenced excellent reliability and criterion validity and was able to accurately screen for depression amongst South Africans. The website and the tool have the potential to be utilised to increase access to a screening instrument for individuals who display symptoms of depression and to enhance the opportunity for individuals to practise self-help.
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Affiliation(s)
- Tasneem Hassem
- Department of Psychology, Faculty of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
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Goenjian AK, Steinberg AM, Walling D, Bishop S, Karayan I, Pynoos R. 25-year follow-up of treated and not-treated adolescents after the Spitak earthquake: course and predictors of PTSD and depression. Psychol Med 2021; 51:976-988. [PMID: 31931901 PMCID: PMC8161430 DOI: 10.1017/s0033291719003891] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 07/29/2019] [Accepted: 12/06/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND There is a paucity of long-term prospective disaster studies of the psychological sequelae among survivors. METHODS At 1½ and 25 years after the Spitak earthquake, 142 early adolescents from two cities were assessed: Gumri (moderate-severe exposure) and Spitak (very severe exposure). The Gumri group included treated and not-treated subjects, while the Spitak group included not-treated subjects. Instruments included: DSM-III-R PTSD-Reaction Index (PTSD-RI); DSM-5 PTSD-Checklist (PCL); Depression Self-Rating Scale (DSRS); and Center for Epidemiological Studies-Depression Scale (CES-D). RESULTS (1) Between 1½ and 25 years, PTSD rates and mean scores decreased significantly in the three groups (over 50%). However, at 25 years 9.1-22.4% met DSM-5 PTSD criteria. (2) At 1½ years, the Spitak group had higher PTSD-RI (p < 0.001) and DSRS scores (p < 0.001) compared to the Gumri-not-treated group. At 25 years, the Spitak group that had experienced fewer post-earthquake adversities (p < 0.03), had a greater decrease in PTSD-RI scores (p < 0.02), and lower CES-D scores (p < 0.01). (3) Before treatment, PTSD-RI and DSRS scores did not differ between the Gumri-treated and not-treated groups. At 25-years, the Gumri-treated group showed a greater decrease in PTSD-RI scores (p < 0.03), and lower mean PTSD-RI (p < 0.02), PCL (p < 0.02), and CES-D (p < 0.01) scores. (4) Predictors of PTSD symptom severity at 25-years included: home destruction, treatment, social support, post-earthquake adversities, and chronic medical illnesses. CONCLUSION Post-disaster PTSD and depressive symptoms can persist for decades. Trauma-focused treatment, alleviation of post-disaster adversities, improving the social ecology, and monitoring for chronic medical illnesses are essential components of recovery programs.
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Affiliation(s)
- Armen K. Goenjian
- Department of Psychiatry and Biobehavioral Sciences, UCLA/Duke University National Center for Child Traumatic Stress, University of California, Los Angeles, Los Angeles, CA, USA
- Collaborative Neuroscience Network, Garden Grove, CA, USA
- Psychiatric Outreach Program, Armenian Relief Society, Long Beach, CA, USA
| | - Alan M. Steinberg
- Department of Psychiatry and Biobehavioral Sciences, UCLA/Duke University National Center for Child Traumatic Stress, University of California, Los Angeles, Los Angeles, CA, USA
| | - David Walling
- Collaborative Neuroscience Network, Garden Grove, CA, USA
| | - Sheryl Bishop
- School of Nursing, University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Ida Karayan
- Psychiatric Outreach Program, Armenian Relief Society, Long Beach, CA, USA
| | - Robert Pynoos
- Department of Psychiatry and Biobehavioral Sciences, UCLA/Duke University National Center for Child Traumatic Stress, University of California, Los Angeles, Los Angeles, CA, USA
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Khachadourian V, Truzyan N, Harutyunyan A, Petrosyan V, Davtyan H, Davtyan K, van den Boom M, Thompson ME. People-centred care versus clinic-based DOT for continuation phase TB treatment in Armenia: a cluster randomized trial. BMC Pulm Med 2020; 20:105. [PMID: 32334553 PMCID: PMC7183136 DOI: 10.1186/s12890-020-1141-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 04/08/2020] [Indexed: 11/20/2022] Open
Abstract
Background WHO’s directly observed therapy (DOT) strategy for tuberculosis (TB) treatment depends upon a well–organized healthcare system. This study sought to evaluate the effectiveness of self-administered drug intake supported by a family member versus in-clinic DOT. Methods This open–label, nationally-representative stratified cluster randomized controlled non–inferiority trial with two parallel equal arms involved drug–susceptible pulmonary TB patients in the continuation treatment phase. We randomly assigned outpatient–TB–centres (52 clusters) to intervention and control arms. The intervention included an educational/counseling session to enhance treatment adherence; weekly visits to outpatient–TB–centres to receive medication, and daily SMS medication reminders and phone calls to track adherence and record side effects. Controls followed clinical DOT at Outpatient–TB–centres. Both groups participated in baseline and 4–5 months follow–up surveys. The trial’s non–inferiority comparisons include: treatment success as the clinical (primary) outcome and medication adherence (self–reported), knowledge, depressive symptoms, stigma, quality of life, and social support as non–clinical (secondary) outcomes. Results Per–protocol analysis showed that the intervention (n = 187) and control (n = 198) arms achieved successful treatment outcome of 92.0 and 92.9%, respectively, indicating that the treatment success in the intervention group was non–inferior to DOT. Knowledge, depression, stigma, quality of life, and social support also showed non–inferiority, demonstrating substantial improvement over time for knowledge (change in the intervention = 1.05: 95%CL (0.49, 1.60); change in the control = 1.09: 95%CL (0.56, 1.64)), depression score (change in the intervention = − 3.56: 95%CL (− 4.99, − 2.13); change in the control = − 1.88: 95% CL (− 3.26, − 0.49)) and quality of life (change in the intervention = 5.01: 95%CL (− 0.64, 10.66); change in the control = 7.29: 95%CL (1.77, 12.81)). The intervention resulted in improved treatment adherence. Conclusions This socially empowering alternative strategy might be a preferable alternative to DOT available to patients in Armenia and in other countries. Further research evaluating cost effectiveness of the intervention and generalizability of the results is warranted. Trial registration Clinicaltrials.gov: NCT02082340, March 10, 2014.
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Affiliation(s)
- Vahe Khachadourian
- Avedisian Onanian Centre for Health Services Research & Development, Gerald and Patricia Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia. .,Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, USA.
| | - Nune Truzyan
- Avedisian Onanian Centre for Health Services Research & Development, Gerald and Patricia Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - Arusyak Harutyunyan
- Avedisian Onanian Centre for Health Services Research & Development, Gerald and Patricia Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - Varduhi Petrosyan
- Avedisian Onanian Centre for Health Services Research & Development, Gerald and Patricia Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - Hayk Davtyan
- National Tuberculosis Control Centre, Ministry of Health of the Republic of Armenia, Yerevan, Armenia
| | - Karapet Davtyan
- National Tuberculosis Control Centre, Ministry of Health of the Republic of Armenia, Yerevan, Armenia
| | - Martin van den Boom
- Joint Tuberculosis, HIV & Viral Hepatitis Programme, Division of Health Emergencies and Communicable Diseases, WHO/Europe, Copenhagen, Denmark
| | - Michael E Thompson
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, USA
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Han X, Li Q, Wang C, Li Y. The Association of Occupational Stress and Depressive Symptoms among Employed Persons with Benign Breast Disease: The Mediating Role of Psychological Capital. Psychopathology 2019; 52:205-211. [PMID: 31437833 DOI: 10.1159/000501164] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 05/18/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND To evaluate the association between depressive symptoms and occupational stress, and the possibility of psychological capital (PsyCap) in alleviating depressive symptoms and occupational stress, we investigated the mediating role of PsyCap on the association between depressive symptoms and occupational stress among employed persons with benign breast disease (BBD) diagnosed by using ultrasonography. METHODS A cross-sectional survey was conducted in 371 employed persons with BBD. Self-administered questionnaires, including the items of depressive symptoms, occupational stress, the 24-item Psychological Capital Questionnaire, as well as the age, education, marital status, occupation, monthly income, and weekly working hours, were obtained from all patients. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to measure the depressive symptoms, an effort-reward imbalance model was used to assess occupational stress, while 24-item Psychological Capital Questionnaire measurements were used to measure the PsyCap. Baron and Kenny's technique was used to test the mediating effect of PsyCap. RESULTS In total, 62% of employed persons with BBD had scores equal to or above the cutoff point (CES-D ≥16). Overcommitment was not significantly correlated with PsyCap (r = -0.096, p = 0.066). Depressive symptoms were positively correlated with the effort-reward ratio (ERR) (β = 0.327, p < 0.001) in model 2, and it was negatively correlated with PsyCap (β = -0.339, p < 0.001) in model 3. PsyCap associated with ERR mediated the depressive symptoms. CONCLUSIONS Besides the medical intervention, the management of depressive symptoms and decrease in occupational stress should be considered to alleviate the depressive symptoms associated with employed persons with BBD. PsyCap is an active resource for relieving depressive symptoms and reducing occupational stress in persons with BBD.
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Affiliation(s)
- Xu Han
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Qiaobei Li
- Department of Ultrasonic Diagnosis, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Chunyan Wang
- Department of Ultrasonic Diagnosis, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yinyan Li
- Department of Ultrasonic Diagnosis, The First Affiliated Hospital of China Medical University, Shenyang, China,
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Jiang L, Wang Y, Zhang Y, Li R, Wu H, Li C, Wu Y, Tao Q. The Reliability and Validity of the Center for Epidemiologic Studies Depression Scale (CES-D) for Chinese University Students. Front Psychiatry 2019; 10:315. [PMID: 31178764 PMCID: PMC6537885 DOI: 10.3389/fpsyt.2019.00315] [Citation(s) in RCA: 120] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 04/24/2019] [Indexed: 01/30/2023] Open
Abstract
Aims: Depression is prevalent among university students worldwide, and the prevalence appears to be increasing. As an intermediate stage between being healthy and having depression, students with subthreshold depression could develop worsening depression or recover with intervention to prevent depression. The Center for Epidemiologic Studies Depression Scale (CES-D) is a useful tool to assess subthreshold depression. The primary purpose of the current study was to evaluate the psychometric characteristics of CES-D in Chinese university students. Secondly, we aimed to describe the prevalence of subthreshold depression among the student sample and examine its demographic correlates. Methods: A total of 2,068 university students participated in the study, and they were asked to respond to the Chinese CES-D, Beck Depression Inventory-II (BDI-II), and Positive and Negative Affect Schedule (PANAS). The factor structure was evaluated by conducting exploratory (EFA) and confirmatory factor analysis (CFA) using a structural equation modeling approach. The reliability was assessed by calculating Cronbach's alpha, inter-item correlation, and item-total correlation coefficients. The prevalence of subthreshold depression was calculated and demographic correlates of gender, grade, and major were examined by multiple regression. Results: The final sample included 1,920 participants. The EFA results suggested extraction of three factors (somatic symptoms, negative affect, and anhedonia) that account for 52.68% of total variance. The CFA results suggested that the newly derived model with 14 items was the best fit for our data. Six items were removed from the original scale (item 9, 10, 13, 15, 17, and 19). The Cronbach's alpha of the 14-item CES-D was 0.87. The prevalence of subthreshold depression among university students reached 32.7% for the 20-item CES-D and 31% for the 14-item CES-D, although there was no significant difference of prevalence in gender, grade, and major. Conclusions: The CES-D has good reliability and validity for assessing subthreshold depression in Chinese university students.
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Affiliation(s)
- Lijun Jiang
- Department of Public Health and Preventive Medicine, School of Basic Medicine, Jinan University, Guangzhou, China.,Division of Medical Psychology and Behavior Science, School of Basic Medicine, Jinan University, Guangzhou, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yining Zhang
- International School, Jinan University, Guangzhou, China
| | - Rui Li
- International School, Jinan University, Guangzhou, China
| | - Huailiang Wu
- International School, Jinan University, Guangzhou, China
| | - Chenyi Li
- International School, Jinan University, Guangzhou, China
| | - Yunlin Wu
- International School, Jinan University, Guangzhou, China
| | - Qian Tao
- Division of Medical Psychology and Behavior Science, School of Basic Medicine, Jinan University, Guangzhou, China.,Center for Brain Science and Brain-Inspired Intelligence, Guangdong-Hong Kong-Macao Greater Bay Area, Guangzhou, China
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Jung JI, Son JS, Kim YO, Chae CH, Kim CW, Park HO, Lee JH, Shin YH, Ha JC. Changes of depression and job stress in workers after merger without downsizing. Ann Occup Environ Med 2018; 30:54. [PMID: 30181882 PMCID: PMC6114831 DOI: 10.1186/s40557-018-0266-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 08/07/2018] [Indexed: 11/10/2022] Open
Abstract
Background Since the 1980s, restructuring, which includes downsizing, closures, mergers, and privatization, has expanded worldwide, and various studies have investigated its effect on health. However, previous studies have mainly focused on restructuring accompanied by massive lay-offs, and the effect of a merger on workers’ health is still controversial. This study aims to investigate changes in worker depression and job stress after a merger without downsizing, which is unusual in Korea. Methods Repeated surveys were done in April 2014, April 2015, and April 2016 involving the participation of 209 subjects. Participants were divided into two groups, which were comprised of blue-collar workers (104) and white-collar workers (105). Sociodemographic characteristics, including age, education level, job tenure, gender, marital status, smoking status, and alcohol consumption, were measured via a survey. To determine the level of depression, the Korean version of the Center for Epidemiologic Studies Depression Scale (CES-D) was employed, and to investigate job stress, the Korean Occupational Stress Scale-Short Form (KOSS-SF) was used. For statistical analyses, Pearson’s chi-square test, the Student’s t-test, and repeated measure analysis of variance (ANOVA) were performed. Results The results showed that depression (CES-D, F[2, 400] = 0.466, p = 0.628) was changed but without significance and job stress (KOSS-SF, F[1.899, 379.831] = 3.192, p = 0.045) were significantly different. The between-group difference in the CES-D score between the blue- and white-collar workers by survey administration time was not statistically significant (F = 0.316, p = 0.574). The interaction between the survey time and occupational group was also not statistically significant (F = 0.967, p = 0.381). The between-group difference in the KOSS-SF total score was not statistically significant (F = 1.132, p = 0.289), and the interaction between the survey administration time and occupational group was also not significant (F = 0.817, p = 0.437). In the job stress subgroup analyses Job insecurity and Lack of reward showed a significant difference by survey administration time. Conclusion This study showed that a merger without massive downsizing can cause negative health effects such as an changes in depression and increase in job stress. To improve the health of workers, both the immediate negative effects on health, and the long-term effects or their resolution over time should be considered prior to the merger.
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Affiliation(s)
- Jun Ick Jung
- Department of Occupational and Environmental Medicine, Samsung Changwon hospital, Sungkyunkwan University School of Medicine, 158, Paryong-ro, Masanhoewon-gu, Changwon-si, Gyeongsangnam-do 51353 Republic of Korea
| | - Jun Seok Son
- Department of Occupational and Environmental Medicine, Samsung Changwon hospital, Sungkyunkwan University School of Medicine, 158, Paryong-ro, Masanhoewon-gu, Changwon-si, Gyeongsangnam-do 51353 Republic of Korea
| | - Young Ouk Kim
- Department of Occupational and Environmental Medicine, Samsung Changwon hospital, Sungkyunkwan University School of Medicine, 158, Paryong-ro, Masanhoewon-gu, Changwon-si, Gyeongsangnam-do 51353 Republic of Korea
| | - Chang Ho Chae
- Department of Occupational and Environmental Medicine, Samsung Changwon hospital, Sungkyunkwan University School of Medicine, 158, Paryong-ro, Masanhoewon-gu, Changwon-si, Gyeongsangnam-do 51353 Republic of Korea
| | - Chan Woo Kim
- Department of Occupational and Environmental Medicine, Samsung Changwon hospital, Sungkyunkwan University School of Medicine, 158, Paryong-ro, Masanhoewon-gu, Changwon-si, Gyeongsangnam-do 51353 Republic of Korea
| | - Hyoung Ouk Park
- Department of Occupational and Environmental Medicine, Samsung Changwon hospital, Sungkyunkwan University School of Medicine, 158, Paryong-ro, Masanhoewon-gu, Changwon-si, Gyeongsangnam-do 51353 Republic of Korea
| | - Jun Ho Lee
- Department of Occupational and Environmental Medicine, Samsung Changwon hospital, Sungkyunkwan University School of Medicine, 158, Paryong-ro, Masanhoewon-gu, Changwon-si, Gyeongsangnam-do 51353 Republic of Korea
| | - Young Hoo Shin
- Department of Occupational and Environmental Medicine, Samsung Changwon hospital, Sungkyunkwan University School of Medicine, 158, Paryong-ro, Masanhoewon-gu, Changwon-si, Gyeongsangnam-do 51353 Republic of Korea
| | - Jea Chul Ha
- Department of Occupational and Environmental Medicine, Samsung Changwon hospital, Sungkyunkwan University School of Medicine, 158, Paryong-ro, Masanhoewon-gu, Changwon-si, Gyeongsangnam-do 51353 Republic of Korea
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Association between organizational justice and depressive symptoms among securities company workers. Ann Occup Environ Med 2018; 31:e7. [PMID: 31543968 PMCID: PMC6751775 DOI: 10.35371/aoem.2019.31.e7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 05/24/2019] [Indexed: 11/23/2022] Open
Abstract
Background The organizational justice model can evaluate job stressor from decision-making process, attitude of managerial or senior staff toward their junior workers, and unfair resource distribution. Stress from organizational injustice could be harmful to workers' mental health. The purpose of this study is to explore the association between organizational justice and depressive symptoms in a securities company. Methods To estimate organizational justice, a translated Moorman's organizational justice evaluation questionnaire (Korean) was employed. Cronbach's α coefficient was estimated to assess the internal consistency of the translated questionnaire. To assess depressive symptoms, the Center for Epidemiologic Studies Depression (CES-D) scale was used. The link between the sub-concepts of the organizational justice model and depressive symptoms was assessed utilizing multiple logistic regression models. Results The risk of depressive symptoms was significantly higher among workers with higher levels of all subcategory of organizational injustice. In the full adjusted model odds ratio (OR) of higher level of procedural injustice 2.79 (95% confidence interval [CI], 1.58–4.90), OR of the higher level of relational injustice 4.25 (95% CI, 2.66–6.78), OR of higher level of distributional injustice 4.53 (95% CI, 2.63–7.83) respectively. Cronbach's α coefficient of the Korean version was 0.93 for procedural justice, 0.93 for relational justice, and 0.95 for distributive justice. Conclusions A higher level of organizational injustice was linked to higher prevalence of depressive symptoms among workers in a company of financial industry.
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Jeon SW, Kim YK. Application of Assessment Tools to Examine Mental Health in Workplaces: Job Stress and Depression. Psychiatry Investig 2018; 15:553-560. [PMID: 29865780 PMCID: PMC6018143 DOI: 10.30773/pi.2016.10.24] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 10/24/2016] [Indexed: 11/27/2022] Open
Abstract
Despite the fact that the lifetime and yearly prevalence rates of mental illness continue rising, such diseases have only been acknowledged as involved in workplace health issue since the 2000s. Additionally, while the number of recognized cases of mental illnesses is rather low compared to their prevalence, they have a high likelihood of causing significant problems, including fatalities. Many workers are terrified of losing their jobs due to mental illness and therefore attempt to hide their mental health problems. For this reason, clinicians involved in occupational and environmental medicine should focus on interviews or screenings to identify such hidden mental health problems. More specifically, it would be helpful to evaluate job stress and depression in workplaces to ensure appropriate preventive actions and thereby reduce the prevalence of mental illness. Job stress not only causes mental illness and dissatisfaction with work, but also can increase the prevalence and morbidity of medical diseases, as well as other physical health problems. Depression is a major contributor to work loss and absence with effects surpassing almost all of the chronic medical disorder. These facts show why measure of job stress and depression should be highlighted in the occupational settings. This article introduces a variety of assessment tools to examine mental health, particularly stress and depression, in workplaces. These tools can be used by clinicians or professionals involved in the mental health, occupational safety, or health service fields for running diagnostics or screening tests.
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Affiliation(s)
- Sang Won Jeon
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yong-Ku Kim
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
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Kim JS, Zhang Y, Chang Y, Ryu S, Guallar E, Shin YC, Shin H, Lim SW, Cho J. Subclinical Hypothyroidism and Incident Depression in Young and Middle-Age Adults. J Clin Endocrinol Metab 2018; 103:1827-1833. [PMID: 29408972 DOI: 10.1210/jc.2017-01247] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 01/26/2018] [Indexed: 02/10/2023]
Abstract
BACKGROUND The role of subclinical hypothyroidism in the development of depression remains controversial. We examined the prospective association between subclinical hypothyroidism and incident depressive symptoms. METHODS We conducted a prospective cohort study of 220,545 middle-age adults without depression who had undergone at least two comprehensive health examinations between 1 January 2011 and 31 December 2014. Thyroid-stimulating hormone, free triiodothyronine (FT3), and free thyroxine (FT4) levels were measured using an electrochemiluminescent immunoassay. The study outcome was incident depressive symptoms, defined as a Center for Epidemiologic Studies-Depression score >16. RESULTS During a median follow-up period of 2 years, incident depressive symptoms occurred in 7323 participants. The multivariable-adjusted hazard ratio for incident depressive symptoms comparing subclinical hypothyroid and euthyroid participants was 0.97 (95% confidence interval, 0.87 to 1.09). Similarly, among euthyroid participants (n = 87,822), no apparent association was found between thyroid hormone levels and an increased risk of incident depressive symptoms. CONCLUSIONS No apparent association was found between subclinical hypothyroidism and incident depressive symptoms in a large prospective cohort of middle-age men and women.
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Affiliation(s)
- Ji Sun Kim
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
| | - Yiyi Zhang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Yoosoo Chang
- Center for Cohort Study, Total Healthcare Center, Kangbuk Samsung Hospital, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Republic of Korea
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seungho Ryu
- Center for Cohort Study, Total Healthcare Center, Kangbuk Samsung Hospital, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Republic of Korea
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Eliseo Guallar
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Young-Chul Shin
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hocheol Shin
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Se-Won Lim
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Juhee Cho
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Center for Cohort Study, Total Healthcare Center, Kangbuk Samsung Hospital, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Republic of Korea
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11
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Yang H, Lei X, Zhong M, Zhou Q, Ling Y, Jungkunz M, Yi J. Psychometric Properties of the Chinese Version of the Brief Borderline Symptom List in Undergraduate Students and Clinical Patients. Front Psychol 2018; 9:605. [PMID: 29755392 PMCID: PMC5934523 DOI: 10.3389/fpsyg.2018.00605] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 04/10/2018] [Indexed: 01/17/2023] Open
Abstract
The brief version of the Borderline Symptom List (BSL-23) is a self-rated scale developed from the initial 95-item version of Borderline Symptom List (BSL-95). The current study aimed to evaluate the psychometric properties of the Chinese version of the BSL-23. A total of 570 undergraduate students and 323 clinical patients completed the BSL-23, the borderline subscale of the Personality Diagnostic Questionnaire (PDQ-4+), the Center for Epidemiologic Studies Depression Scale (CES-D), the Barratt Impulsiveness Scale, 11th version (BIS-11), the Childhood Trauma Questionnaire (CTQ) and the Attachment Style Questionnaire (ASQ). A Confirmatory Factor Analysis (CFA) was conducted to test the one-factor structure of the BSL-23. Cronbach’s alpha, Omega coefficient, Split-Half coefficient, Mean Inter-Item Correlation (MIC) and test-retest reliability were also measured. The correlations between the BSL-23 and other psychological variables were used to assess criterion-related validity and convergent validity. Participants who scored ≥ 5 on the borderline subscale of the PDQ-4+ were placed into the borderline personality disorder (BPD) screening-positive group, while the others were placed into the screening-negative group. Independent sample t-tests were performed to examine the differences in BSL-23 scores between the BPD screening-positive group and the BPD screening-negative group. The CFA results supported the one-factor structure of the BSL-23 in both samples. The internal consistency was high both in the undergraduate sample (Cronbach’s α = 0.93, Omega = 0.95, Split-Half coefficient = 0.89, MIC = 0.38) and the clinical sample (Cronbach’s α = 0.97, Omega = 0.97, Split-Half coefficient = 0.96, MIC = 0.56). The test-retest reliability within 2 weeks was 0.62. The BSL-23 displayed moderate to high correlations with the PDQ-4+-Borderline subscale, the CES-D, the BIS-11, the CTQ and the ASQ (r = 0.35 – 0.70). In addition, the BSL-23 discriminated between the BPD screening-positive and the BPD screening-negative participants, and also between the patient sample and undergraduate sample. In conclusion, the Chinese version of the BSL-23 has satisfactory psychometric properties to assess BPD symptoms.
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Affiliation(s)
- Huihui Yang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiaoxia Lei
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Mingtian Zhong
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Qi Zhou
- Department of Business Administration, School of Business, Sun Yat-sen University, Guangzhou, China
| | - Yu Ling
- Education Institute, Hunan Agricultural University, Changsha, China
| | - Martin Jungkunz
- Central Institute of Mental Health, Clinic of Psychosomatic and Psychotherapeutic Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Central Institute of Mental Health, Institute for Psychiatric and Psychosomatic Psychotherapy/Psychosomatic Medicine and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Jinyao Yi
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute, Central South University, Changsha, China
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12
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Jang SH, Woo YS, Hong JW, Yoon BH, Hwang TY, Kim MD, Lee SY, Bahk WM. Use of a smartphone application to screen for depression and suicide in South Korea. Gen Hosp Psychiatry 2017. [PMID: 28622818 DOI: 10.1016/j.genhosppsych.2017.03.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE This is a cross-sectional study using a free depression and suicide screening smartphone application, which contains the data from the Center for Epidemiological Studies-Depression (CES-D) and a Suicide Behaviors Questionnaire-Revised (SBQ-R). METHOD The free application was downloaded worldwide from Apple's App Store and Android Market, and the participants who downloaded the application were actively measured. RESULTS The subjects totaled 208,683 men and women. 72.6% of the subjects were females, and 81.4% of the subjects were aged between 10 and 29years. In total, 25.7% of the participants were recorded CES-D positive, and there were differences among the groups based on sex (χ2=1065.82, p<0.001), age (χ2=1420.75, p<0.001), and psychiatric history (χ2=1502.21, p<0.001). The highest score of CES-D, 40.69±15.79 and that of SBQ-R, 13.68±4.97 was reported by the participants with a history of schizophrenia. The characteristics associated with suicide were as follows: depression (OR 8.92, 95% CI: 8.71-9.13), female (OR 1.39, 95% CI: 1.36-1.43), 30-49 age group (OR 2.51, 95% CI: 2.29-2.72), 50 or older age group (OR 1.48, 95% CI: 1.35-1.61), and psychiatric history (OR 1.98, 95% CI: 1.89-2.06). CONCLUSION The smartphone application may be a useful tool for screening depression and suicide.
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Affiliation(s)
- Seung-Ho Jang
- Department of Psychiatry, School of Medicine, Wonkwang University, Iksan, Republic of Korea
| | - Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jeong-Wan Hong
- Department of Psychiatry, Iksan Hospital, Iksan, Republic of Korea
| | - Bo-Hyun Yoon
- Department of Psychiatry, Naju National Hospital, Naju, Republic of Korea
| | - Tae-Yeon Hwang
- Department of Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - Moon-Doo Kim
- Department of Psychiatry, College of Medicine, Jeju National University, Jeju, Republic of Korea
| | - Sang-Yeol Lee
- Department of Psychiatry, School of Medicine, Wonkwang University, Iksan, Republic of Korea.
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Ylli A, Miszkurka M, Phillips SP, Guralnik J, Deshpande N, Zunzunegui MV. Clinically relevant depression in old age: An international study with populations from Canada, Latin America and Eastern Europe. Psychiatry Res 2016; 241:236-41. [PMID: 27183110 DOI: 10.1016/j.psychres.2016.04.096] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 02/15/2016] [Accepted: 04/25/2016] [Indexed: 10/21/2022]
Abstract
Our aim is to assess cross-national variations in prevalence of clinically relevant depression and to examine the relationships of social and health factors with depression in five diverse populations of older adults, from Canada, Brazil, Colombia and Albania. We used the data from the International Mobility in Aging Study. Clinically relevant depression was defined as a score of ≥16 on the Center for Epidemiologic Study Depression Scale (CES-D). Poisson regressions with robust covariance correction were used to estimate prevalence ratios associated with potential risk factors. Prevalence of clinically relevant depression across research sites varied widely, being consistently higher in women than in men. It was lowest in men from Brazil (6.3%) and highest in women from Albania (46.6%). Low education and insufficient income, living alone, multiple chronic conditions, and poor physical performance were all significantly associated with depression prevalence. Poor physical performance was more strongly associated with depression in men than in women. Similar factors are associated with clinically relevant depression among men and women and across research sites. The large variation in depression prevalence population rates is unexplained by the classical individual factors considered in the study suggesting the impact of country characteristics on depression among older populations.
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Affiliation(s)
- Alban Ylli
- Institute of Public Health, Tirana, Albania; University of Medicine, Tirana, Albania.
| | - Malgorzata Miszkurka
- Institut de recherche en Santé Publique de l'Université de Montréal (IRSPUM), Montréal, Canada
| | - Susan P Phillips
- Department of Family Medicine, Queens University, Kingston, Ontario, Canada
| | - Jack Guralnik
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, USA
| | - Nandini Deshpande
- School of Rehabilitation Therapy, Queens University, Kingston, Ontario, Canada
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Khachadourian V, Armenian H, Demirchyan A, Melkonian A, Hovanesian A. A post-earthquake psychopathological investigation in Armenia: methodology, summary of findings, and follow-up. DISASTERS 2016; 40:518-533. [PMID: 26578424 DOI: 10.1111/disa.12166] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The post-earthquake psychopathological investigation (PEPSI) was designed to probe the short-and long-term effects of the earthquake in northern Armenia on 7 December 1988 on survivors' mental and physical health. Four phases of this study have been conducted to date, and, overall, more than 80 per cent of a sub-sample of 1,773 drawn from an initial cohort of 32,743 was successfully followed during 2012. This paper describes the methodology employed in the evaluation, summarises previous findings, details the current objectives, and examines the general characteristics of the sample based on the most recent follow-up phase outcomes. Despite a significant decrease in psychopathology rates between 1990 and 2012, prevalence rates of post-traumatic stress disorder and depression among study participants in 2012 were greater than 15 and 26 per cent, respectively. The paper also notes the strengths and limitations of the study vis-à-vis future research and highlights the importance and potential practical implications of similar assessments and their outcomes.
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Affiliation(s)
- Vahe Khachadourian
- Research Associate at the College of Health Sciences, American University of Armenia, Armenia
| | - Haroutune Armenian
- Professor at the Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, United States
| | - Anahit Demirchyan
- Senior Research Specialist at the College of Health Sciences, American University of Armenia, Armenia
| | | | - Ashot Hovanesian
- Chief Executive Officer at Synergy International Systems, United States
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15
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Jankowski KS. Morningness-eveningness and depressive symptoms: Test on the components level with CES-D in Polish students. J Affect Disord 2016; 196:47-53. [PMID: 26897456 DOI: 10.1016/j.jad.2016.02.015] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 02/06/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND The study aimed to elucidate previously observed associations between morningness-eveningness and depressive symptomatology in university students. Relations between components of depressive symptomatology and morningness-eveningness were analysed. METHODS Nine hundred and seventy-four university students completed Polish versions of the Centre for Epidemiological Studies - Depression scale (CES-D; Polish translation appended to this paper) and the Composite Scale of Morningness. Principal component analysis (PCA) was used to test the structure of depressive symptoms. Pearson and partial correlations (with age and sex controlled), along with regression analyses with morning affect (MA) and circadian preference as predictors, were used. RESULTS PCA revealed three components of depressive symptoms: depressed/somatic affect, positive affect, interpersonal relations. Greater MA was related to less depressive symptoms in three components. Morning circadian preference was related to less depressive symptoms in depressed/somatic and positive affects and unrelated to interpersonal relations. Both morningness-eveningness components exhibited stronger links with depressed/somatic and positive affects than with interpersonal relations. Three CES-D components exhibited stronger links with MA than with circadian preference. In regression analyses only MA was statistically significant for positive affect and better interpersonal relations, whereas more depressed/somatic affect was predicted by lower MA and morning circadian preference (relationship reversed compared to correlations). LIMITATIONS Self-report assessment. CONCLUSIONS There are three groups of depressive symptoms in Polish university students. Associations of MA with depressed/somatic and positive affects are primarily responsible for the observed links between morningness-eveningness and depressive symptoms in university students. People with evening circadian preference whose MA is not lowered have less depressed/somatic affect.
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16
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Kwon SI, Son JS, Kim YO, Chae CH, Kim JH, Kim CW, Park HO, Lee JH, Jung JI. Association between serum vitamin D and depressive symptoms among female workers in the manufacturing industry. Ann Occup Environ Med 2015; 27:28. [PMID: 26693028 PMCID: PMC4676810 DOI: 10.1186/s40557-015-0083-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 12/03/2015] [Indexed: 12/23/2022] Open
Abstract
Background Vitamin D has been known to maintain the body’s balance of calcium and phosphorus as well as skeletal health. There has been increasing emphasis on the importance of vitamin D as recent studies have been reporting the specific functions of vitamin D in the cerebral nervous system and the association between the level of serum vitamin D and depressive symptoms. However, there is currently a paucity of research investigating the association between serum vitamin D and depressive symptoms in Korean subjects. Consequently, this study has aimed to determine the level of serum vitamin D and explore the association between serum vitamin D and depressive symptoms in Korean female workers. Method A medical examination, questionnaire, anthropometric measurements, and a blood test were conducted between February 3 and March 7, 2014 in 1054 subjects among female workers in the manufacturing industry who underwent physical examinations in a university hospital. From this data, we identified the level of serum vitamin D and investigated the association between serum vitamin D deficiency and depressive symptoms. Results The average serum vitamin D level of the 1054 subjects was 9.07 ± 3.25 ng/mL, and the number of subjects in the serum vitamin D deficiency group with less than 10 ng/mL was 721 (68.4 %). The odds ratio of the depressive symptom group with a CES-D score of 16 or above being in the deficiency group with a serum vitamin D level less than 10 ng/mL was found to be 1.55 (95 % CI = 1.15–2.07). Conclusion 68.4 % of female workers in the manufacturing industry were in the deficiency group with serum vitamin D levels less than 10 ng/mL. Additionally, we identified an association between serum vitamin D deficiency and depressive symptoms. In the future, if serum vitamin D deficiency is checked regularly in workers, we expect to achieve better outcomes in managing their depressive symptoms.
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Affiliation(s)
- Soon Il Kwon
- Department of Occupational and Environmental Medicine, Samsung Changwon Medical Center, Sungkyunkwan University School of Medicine, Changwon City, Republic of Korea
| | - Jun Seok Son
- Department of Occupational and Environmental Medicine, Samsung Changwon Medical Center, Sungkyunkwan University School of Medicine, Changwon City, Republic of Korea
| | - Young Ouk Kim
- Department of Occupational and Environmental Medicine, Samsung Changwon Medical Center, Sungkyunkwan University School of Medicine, Changwon City, Republic of Korea
| | - Chang Ho Chae
- Department of Occupational and Environmental Medicine, Samsung Changwon Medical Center, Sungkyunkwan University School of Medicine, Changwon City, Republic of Korea
| | - Ja Hyun Kim
- Department of Occupational and Environmental Medicine, Samsung Changwon Medical Center, Sungkyunkwan University School of Medicine, Changwon City, Republic of Korea
| | - Chan Woo Kim
- Department of Occupational and Environmental Medicine, Samsung Changwon Medical Center, Sungkyunkwan University School of Medicine, Changwon City, Republic of Korea
| | - Hyoung Ouk Park
- Department of Occupational and Environmental Medicine, Samsung Changwon Medical Center, Sungkyunkwan University School of Medicine, Changwon City, Republic of Korea
| | - Jun Ho Lee
- Department of Occupational and Environmental Medicine, Samsung Changwon Medical Center, Sungkyunkwan University School of Medicine, Changwon City, Republic of Korea
| | - Jun Ick Jung
- Department of Occupational and Environmental Medicine, Samsung Changwon Medical Center, Sungkyunkwan University School of Medicine, Changwon City, Republic of Korea
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17
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Zhang Y, Ting RZW, Lam MHB, Lam SP, Yeung RO, Nan H, Ozaki R, Luk AOY, Kong APS, Wing YK, Sartorius N, Chan JCN. Measuring depression with CES-D in Chinese patients with type 2 diabetes: the validity and its comparison to PHQ-9. BMC Psychiatry 2015; 15:198. [PMID: 26281832 PMCID: PMC4538746 DOI: 10.1186/s12888-015-0580-0] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 08/04/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The validity of the 20-item Center for Epidemiological Studies Depression (CES-D) scale for depression screening in Hong Kong Chinese patients with type 2 diabetes remains unknown. We aimed to validate CES-D, compare its psychometric properties with the 9-item Patient Health Questionnaire (PHQ-9), and explore whether one of the two is more suitable for depression screening in Chinese patients with type 2 diabetes. METHODS Between June 2010 and July 2011, 545 consecutive Chinese patients with type 2 diabetes who underwent structured comprehensive assessments completed the CES-D and PHQ-9. Forty patients were retested within 2-4 weeks by telephone interview and 97 patients were randomly selected to undergo the Mini International Neuropsychiatric Interview (MINI) by psychiatrists for clinical diagnosis of depression. RESULTS The internal consistency (Cronbach's α) of CES-D was 0.85, with a test-retest correlation coefficient of 0.64. The area under the curve for CES-D compared to the clinical diagnosis of major depression was 0.85. A cut-off score of ≥21 for CES-D provided the optimal balance between sensitivity (78.3 %) and specificity (74.3 %) and identified 17.8 % (n = 97) of patients with depression. CES-D and PHQ-9 showed moderate agreement in depression screening (Cohen's Kappa: 0.45). Compared to non-depressed patients, those who screened positive by PHQ-9 had a higher HbA1c whereas the glycemic differences were not significant when using CES-D. CONCLUSION The CES-D is a valid screening tool for depression in Chinese type 2 diabetic patients although the PHQ-9 was more discriminative in identifying those with suboptimal glycemic control.
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Affiliation(s)
- Yuying Zhang
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China. .,Asia Diabetes Foundation, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Rose Z W Ting
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Marco H B Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Siu-Ping Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Roseanne O. Yeung
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China ,Hong Kong Institute of Diabetes and Obesity, Hong Kong SAR, China ,Asia Diabetes Foundation, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Hairong Nan
- Hong Kong Institute of Diabetes and Obesity, Hong Kong SAR, China.
| | - Risa Ozaki
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China. .,Hong Kong Institute of Diabetes and Obesity, Hong Kong SAR, China.
| | - Andrea O Y Luk
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China. .,Hong Kong Institute of Diabetes and Obesity, Hong Kong SAR, China. .,Asia Diabetes Foundation, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Alice P S Kong
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China. .,Hong Kong Institute of Diabetes and Obesity, Hong Kong SAR, China. .,Asia Diabetes Foundation, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Yun-Kwok Wing
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Norman Sartorius
- The Association for the Improvement of Mental Health Programmes, Geneva, Switzerland.
| | - Juliana C N Chan
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China. .,Hong Kong Institute of Diabetes and Obesity, Hong Kong SAR, China. .,Asia Diabetes Foundation, The Chinese University of Hong Kong, Hong Kong SAR, China.
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18
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Giloyan A, Harutyunyan T, Petrosyan V. Visual impairment and depression among socially vulnerable older adults in Armenia. Aging Ment Health 2015; 19:175-81. [PMID: 24898137 DOI: 10.1080/13607863.2014.920298] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Visual impairment in older adults is a major public health problem. Untreated visual impairment might negatively impact physical and psychological health. This study assessed the association between visual impairment and depression among socially vulnerable older adults (those aged 50 and above) in Armenia. METHOD The survey and eye screenings were carried out among 339 participants who were the residents of retirement homes and single older adults in the households. The study team used Golovin-Sivtsev chart and cycloplegic skiascopy to measure visual impairment and Center for Epidemiologic Studies Depression scale to measure depression. RESULTS The prevalence of visual impairment in the sample was 13.3%. Almost 24.0% of participants reported depression symptoms. Participants living in the retirement homes had substantially higher rates of visual impairment (21.5%) and depression (28.0%) than those living in households (9.3% and 15.0%, respectively). The odds of having depression were higher among those with visual impairment compared to those without after adjusting for confounders (OR = 2.75; 95% CI: 1.29-5.87). Having at least one non-communicable disease was associated with depression (OR = 2.47; 95% CI: 1.28-4.75). Living in the retirement home was marginally significantly associated with having depression. Other confounders included age, gender, education, physical activity, and smoking. CONCLUSION Visual impairment was significantly associated with depression in socially vulnerable older adults in Armenia. Timely eye screenings in similar population groups could lead to early detection of visual impairment and prevention of visual loss and associated mental health problems.
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Affiliation(s)
- Aida Giloyan
- a Garo Meghrigian Institute for Preventive Ophthalmology , School of Public Health , American University of Armenia , Yerevan , Armenia
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19
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Khachadourian V, Truzyan N, Harutyunyan A, Thompson ME, Harutyunyan T, Petrosyan V. People-centered tuberculosis care versus standard directly observed therapy: study protocol for a cluster randomized controlled trial. Trials 2015; 16:281. [PMID: 26093675 PMCID: PMC4479352 DOI: 10.1186/s13063-015-0802-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 06/08/2015] [Indexed: 11/10/2022] Open
Abstract
Background Tuberculosis is a major public health concern resulting in high rates of morbidity and mortality worldwide, particularly in low- and middle-income countries. Tuberculosis requires a long and intensive course of treatment. Thus, various approaches, including patient empowerment, education and counselling sessions, and involvement of family members and community workers, have been suggested for improving treatment adherence and outcome. The current randomized controlled trial aims to evaluate the effectiveness over usual care of an innovative multicomponent people-centered tuberculosis-care strategy in Armenia. Methods/design Innovative Approach to Tuberculosis care in Armenia is an open-label, stratified cluster randomized controlled trial with two parallel arms. Tuberculosis outpatient centers are the clusters assigned to intervention and control arms. Drug-sensitive tuberculosis patients in the continuation phase of treatment in the intervention arm and their family members participate in a short educational and counselling session to raise their knowledge, decrease tuberculosis-related stigma, and enhance treatment adherence. Patients receive the required medications for one week during the weekly visits to the tuberculosis outpatient centers. Additionally, patients receive daily Short Message Service (SMS) reminders to take their medications and daily phone calls to assure adherence and monitoring of treatment potential side effects. Control-arm patients follow the World Health Organization - recommended directly observed treatment strategy, including daily visits to tuberculosis outpatient centers for drug-intake. The primary outcome is physician-reported treatment outcome. Patients’ knowledge, depression, quality of life, within-family tuberculosis-related stigma, family social support, and self-reported adherence to tuberculosis treatment are secondary outcomes. Discussion Improved adherence and tuberculosis treatment outcomes can strengthen tuberculosis control and thereby forestall tuberculosis and multidrug resistant tuberculosis epidemics. Positive findings on effectiveness of this innovative tuberculosis treatment people-centered approach will support its adoption in countries with similar healthcare and economic profiles. Trial registration ClinicalTrials.gov registration number: NCT02082340. Date of registration: 4 March 2014.
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Affiliation(s)
- Vahe Khachadourian
- School of Public Health, American University of Armenia, 40 Marshal Baghramyan Ave, Yerevan, 0019, Armenia.
| | - Nune Truzyan
- School of Public Health, American University of Armenia, 40 Marshal Baghramyan Ave, Yerevan, 0019, Armenia.
| | - Arusyak Harutyunyan
- School of Public Health, American University of Armenia, 40 Marshal Baghramyan Ave, Yerevan, 0019, Armenia.
| | - Michael E Thompson
- Department of Public Health Sciences, College of Health and Human Services, University of North Carolina at Charlotte, 9201 University City Boulevard, CHHS 427D, Charlotte, NC, 28223-0001, USA.
| | - Tsovinar Harutyunyan
- School of Public Health, American University of Armenia, 40 Marshal Baghramyan Ave, Yerevan, 0019, Armenia.
| | - Varduhi Petrosyan
- School of Public Health, American University of Armenia, 40 Marshal Baghramyan Ave, Yerevan, 0019, Armenia.
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20
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Yang L, Jia CX, Qin P. Reliability and validity of the Center for Epidemiologic Studies Depression Scale (CES-D) among suicide attempters and comparison residents in rural China. BMC Psychiatry 2015; 15:76. [PMID: 25886490 PMCID: PMC4426543 DOI: 10.1186/s12888-015-0458-1] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 03/26/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression is an important public health problem and is closely associated with suicidal behavior in the population. Although the Center for Epidemiologic Studies Depression Scale (CES-D) is widely used for assessment of depression, the psychometric characteristics of this scale have not been explored in studies of suicide attempters and local residents in rural areas. METHODS In this study, reliability and validity of CES-D were assessed in 409 suicide attempters and 409 comparison residents from rural China and through internal consistency analysis and confirmatory factor analysis (CFA). RESULTS Cronbach's alpha values of the CES-D were 0.940 and 0.895 in, respectively, suicide attempters and comparison residents. CES-D scores were significantly correlated with the scores of Trait Anxiety Inventory (TAI) and Beck Hopelessness Scale (BHS) in both the suicide attempters and the comparison residents. Confirmatory factor analyses indicated that 3-factor structure (positive affect, interpersonal problems, depressive mood and somatic symptoms combined) with 14 items (excluding items 9, 10, 13, 15, 17, and 19) had the best fit in these two populations. CONCLUSIONS The CES-D scale has satisfactory reliability and validity when used for assessing depression in suicide attempters and comparison residents in rural China.
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Affiliation(s)
- Li Yang
- Department of Epidemiology, Shandong University School of Public Health, Jinan, 250012, Shandong, China.
| | - Cun-Xian Jia
- Department of Epidemiology, Shandong University School of Public Health, Jinan, 250012, Shandong, China. .,Shandong University Center for Suicide Prevention Research, Jinan, 250012, Shandong, China.
| | - Ping Qin
- Shandong University Center for Suicide Prevention Research, Jinan, 250012, Shandong, China. .,National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
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Prospective study of predictors of poor self-rated health in a 23-year cohort of earthquake survivors in Armenia. J Epidemiol Glob Health 2015; 5:265-74. [PMID: 26231402 PMCID: PMC7320530 DOI: 10.1016/j.jegh.2014.12.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 10/23/2014] [Accepted: 12/21/2014] [Indexed: 11/24/2022] Open
Abstract
Long-term prospective studies exploring general health outcomes among disaster survivors are rare. Self-rated health (SRH) – a proven correlate of morbidity and mortality prognosis – was used to investigate predictors of perceived health status among a 23-year cohort of survivors of 1988 Spitak earthquake in Armenia. A geographically-stratified subsample of 725 adults from a larger initial cohort was followed during the period of 1990–2012. A logistic regression model identified predictors of SRH. Adjusted relative risks for the long-term predictors of SRH were calculated. The rate of poor SRH among the survivors was 18.8%, fair 56.5%, and good/excellent 24.7%. In the fitted model, long-term risk factors of poor SRH included baseline body mass index, baseline multi-morbidity, number of experienced stressful life events, and perceived poor living standards during the post-earthquake decade, while participation in sports in the early 1990s was a protective factor. Short-term protective factors included socio-economic status score, social support, employment and dignity, while current household size was a risk factor for poor SRH. No association was found between earthquake exposure severity and SRH after 23 years. However, the identified predictors included a number of modifiable lifestyle, material and psychological factors. Thus, interventions targeting these factors could have a long-lasting impact on disaster victims’ health status.
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Khachadourian V, Armenian HK, Demirchyan A, Goenjian A. Loss and psychosocial factors as determinants of quality of life in a cohort of earthquake survivors. Health Qual Life Outcomes 2015; 13:13. [PMID: 25890107 PMCID: PMC4336679 DOI: 10.1186/s12955-015-0209-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 01/17/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the existing evidence of a long lasting effect of disaster related experiences on physical and psychological health, few studies have evaluated long-term quality of life (QOL) outcomes of disaster survivors and the factors associated with such outcomes. METHODS 23 years after the 1988 Spitak earthquake in Armenia, the associations of demographic characteristics, trauma exposure and psychosocial variables on QOL were explored among a cohort of 725 exposed individuals. The EQ-5D-5 L instrument was applied to measure QOL of participants. Multivariate linear and ordinal logistic regressions were applied to evaluate the determinants of QOL and its underlying five domains (mobility, self-care, usual activity, pain/discomfort, and anxiety/depression). RESULTS Older age, current depression, post-traumatic stress disorder and anxiety symptoms were negatively associated with QOL. Additionally, those with severe losses (who did not receive any financial/material aid) had significantly poorer QOL outcomes, with higher odds of mobility difficulties (OR = 1.86, p < 0.05), self-care difficulties (OR = 2.85, p < 0.05), and mood problems (OR = 2.69, p < 0.05). However, those with severe earthquake related losses who received financial/material aid reported less self-care difficulties (OR = 0.21, p < 0.05) usual activity difficulties (OR = 0.40, p < 0.05), and mood problems (OR = 0.44, p < 0.05). Finally, each unit increase in current social support score was found to be significantly associated with a better QOL outcome and better self-reported outcomes across all underlying domains of QOL. CONCLUSIONS These findings suggest that earthquake related loss and concurrent psychopathology symptoms can have adverse impact on the QOL of survivors. They also indicate that well-targeted post-disaster financial/material aid and social support should be considered as means for improving the long-term QOL outcomes of disaster survivors.
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Affiliation(s)
- Vahe Khachadourian
- School of Public Health, American University of Armenia, Yerevan, Armenia.
| | - Haroutune K Armenian
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA, USA.
| | - Anahit Demirchyan
- School of Public Health, American University of Armenia, Yerevan, Armenia.
| | - Armen Goenjian
- Department of Psychiatry and Biobehavioral Sciences, UCLA/Duke University National Center for Child Traumatic Stress, UCLA, Los Angeles, CA, USA.
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Demirchyan A, Goenjian AK, Khachadourian V. Factor Structure and Psychometric Properties of the Posttraumatic Stress Disorder (PTSD) Checklist and DSM-5 PTSD Symptom Set in a Long-Term Postearthquake Cohort in Armenia. Assessment 2014; 22:594-606. [PMID: 25348800 DOI: 10.1177/1073191114555523] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Psychometric properties of the Armenian-language posttraumatic stress disorder (PTSD) Checklist-Civilian version (PCL-C) and the DSM-5 PTSD symptom set were examined in a long-term cohort of earthquake survivors. In 2012, 725 survivors completed the instruments. Item-/scale-level analysis and confirmatory factor analysis (CFA) were performed for both scales. In addition, exploratory factor analysis (EFA) was conducted for DSM-5 symptoms. Also, the differential internal versus external specificity of PTSD symptom clusters taken from the most supported PTSD structural models was examined. Both scales had Cronbach's alpha greater than .9. CFA of PCL-C structure demonstrated an excellent fit by a four-factor (reexperiencing, avoidance, numbing, and hyperarousal) model known as numbing model; however, a superior fit was achieved by a five-factor model (Elhai et al.). EFA yielded a five-factor structure for DSM-5 symptoms with the aforementioned four domains plus a negative state domain. This model achieved an acceptable fit during CFA, whereas the DSM-5 criteria-based model did not. The Armenian-language PCL-C was recommended as a valid PTSD screening tool. The study findings provided support to the proposed new classification of common mental disorders, where PTSD, depression, and generalized anxiety are grouped together as a subclass of distress disorders. Recommendations were made to further improve the PTSD diagnostic criteria.
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Affiliation(s)
| | - Armen K Goenjian
- UCLA/Duke University National Center for Child Traumatic Stress, University of California, Los Angeles, CA, USA Collaborative Neuroscience Network, Garden Grove, CA, USA
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Demirchyan A, Petrosyan D, Armenian HK. Rate and predictors of postpartum depression in a 22-year follow-up of a cohort of earthquake survivors in Armenia. Arch Womens Ment Health 2014; 17:229-37. [PMID: 24435250 DOI: 10.1007/s00737-013-0404-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Accepted: 12/26/2013] [Indexed: 11/26/2022]
Abstract
Disasters have serious long-term impact on mental health for those exposed. The aim of this study was to identify predictors of postpartum depression among survivors of the 1988 devastating earthquake in Armenia. A nested case-control design was applied to investigate postpartum depression in a large-scale cohort of survivors followed between 1990 and 2012. From an original group of 725 adults who were assessed for psychopathology in 1990, 146 women reported having a delivery after the earthquake and were included in this study. Women with postpartum depression were identified using Edinburgh Postnatal Depression Scale. A logistic regression model was fitted to identify the predictors of postpartum depression. Of the 146 women, 19 (13.0%) had postpartum depression. Five independent predictors of postpartum depression were identified: number of woman's stressful life events (odds ratio (OR)=2.06), her prior history of postpartum depression (OR=16.98), delivering sick/dead neonate (OR=13.65), poor living standards during the post-earthquake decade (OR=5.77), and perceiving oneself reliable in 1990 (OR=0.24). Anxiety in 1990 was marginally significantly related to the outcome (OR=3.75). The rate of postpartum depression in this 22-year cohort was similar to that among the Armenian general population. Earthquake exposure was not related to postpartum depression, indicating that the impact of disaster-related trauma diminishes over time. The identified predictors provided evidence to develop interventions targeting groups of women most prone to postpartum depression under such circumstances.
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Affiliation(s)
- Anahit Demirchyan
- School of Public Health, American University of Armenia, 40 Marshal Baghramian Avenue, Yerevan, 0019, Armenia,
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Gender differences in predictors of self-rated health in Armenia: a population-based study of an economy in transition. Int J Equity Health 2012; 11:67. [PMID: 23151068 PMCID: PMC3544611 DOI: 10.1186/1475-9276-11-67] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 11/11/2012] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Self-rated health is a widely used health outcome measure that strongly correlates with physical and mental health status and predicts mortality. This study identified the set of predictors of fair/poor self-rated health in adult female and male populations of Armenia during a period of long-lasting socio-economic transition to a market economy. METHODS Differences in self-rated health were analyzed along three dimensions: socioeconomic, behavioral/attitudinal, and psychosocial. The study utilized data from a 2006 nationwide household health survey that used a multi-stage probability proportional to size cluster sampling with a combination of interviewer-administered and self-administered surveys. Both female and male representatives of a household aged 18 and over completed the self-administered survey. Multivariate odds ratios (OR) for fair/poor self-rated health were calculated for different sets of variables and logistic regression models fitted separately for women and men to identify the determinants of fair/poor self-rated health. RESULTS Overall, 2310 women and 462 men participated in the survey. The rate of fair/poor self-rated health was 61.8% among women and 59.7% among men. For women, the set of independent predictors of fair/poor self-rated health included age, unemployment, poverty, low affordability of healthcare, depression, and weak social support. For men, the set included age, lower education, depression, weak social support, and drinking alcohol less than once a week. For both genders, depression and weak social support demonstrated the strongest independent association with fair/poor self-rated health. CONCLUSIONS The prevalence of fair/poor self-rated health was similar among men and women in this study, but the sets of independent predictors of perceived health differed somewhat, possibly, reflecting lifestyle differences between men and women in Armenia. Nevertheless, psychosocial variables were the strongest predictors of fair/poor self-rated health for both genders, indicating the importance of improving the country's psychosocial environment through social reforms and poverty reduction.
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