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Liu T, Wang Z, Kang X, Wang X, Ren G, Lv Y, Li J, Liu Y, Liang S, Nie Y, Luo H, Pan Y. Causal relationships between psychological disorders and functional gastrointestinal disorders: a bidirectional two-sample Mendelian randomization study. Eur J Gastroenterol Hepatol 2024; 36:1267-1274. [PMID: 38973539 DOI: 10.1097/meg.0000000000002825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/09/2024]
Abstract
BACKGROUND AND AIMS Observational studies have shown bidirectional associations between psychological disorders (e.g. depression and anxiety) and functional gastrointestinal disorders. However, whether the relationships are causal is uncertain. Here, we used a bidirectional two-sample Mendelian randomization method to investigate the association between psychological disorders and functional gastrointestinal disorders (FGIDs). METHODS We obtained genome-wide association study summary statistics for two common psychological disorders: depression (170 756 cases) and anxiety (31 977 cases), as well as for three common FGIDs: functional dyspepsia with 6666 cases, constipation with 26 919 cases, and irritable bowel syndrome (IBS) with 7053 cases. These summary statistics were retrieved from several publicly available genome-wide association study databases. The inverse variance weighted method was used as the main Mendelian randomization method. RESULTS Inverse variance weighted Mendelian randomization analyses showed statistically significant associations between genetically predicted depression and risk of functional dyspepsia [odds ratio (OR): 1.40, 95% confidence interval (CI): 1.08-1.82], constipation (OR: 1.28, 95% CI: 1.13-1.44), and IBS (OR: 1.51, 95% CI: 1.37-1.67). Genetically predicted anxiety was associated with a higher risk of IBS (OR: 1.13, 95% CI: 1.10-1.17) instead of functional dyspepsia and constipation. In addition, genetically predicted IBS instead of functional dyspepsia and constipation was associated with a higher risk of depression (OR: 1.33, 95% CI: 1.12-1.57) and anxiety (OR: 2.05, 95% CI: 1.05-4.03). CONCLUSION Depression is a causal risk factor for three common FGIDs. A bidirectional causal relationship between IBS and anxiety or depression was also identified.
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Affiliation(s)
- Tangyi Liu
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China
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Wu Y, Su B, Zhong P, Zhao Y, Chen C, Zheng X. Association between chronic disease status and transitions in depressive symptoms among middle-aged and older Chinese population: Insights from a Markov model-based cohort study. J Affect Disord 2024; 363:445-455. [PMID: 39032710 DOI: 10.1016/j.jad.2024.07.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 06/27/2024] [Accepted: 07/16/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND The relationship between chronic disease status (CDS) and transitions in depressive symptoms (DS) remains unclear. This study explores the association between CDS and DS transitions. METHODS This cohort study analyzed data from 8175 participants aged 45+, sourced from China Family Panel Studies (2016, 2018, 2020). DS were assessed using a brief version of Center for Epidemiologic Studies Depression Scale (CES-D). CDS was categorized into healthy, single disease, and multimorbidity. Markov models were used to estimate state transition intensities, mean sojourn times and hazard ratios (HRs). RESULTS DS transitions occurred between adjacent and non-adjacent states, but transition intensity between adjacent states was higher than among non-adjacent states. Self-transition intensities of severe-DS, mild-DS, and non-DS progressively increased, with average durations of 1.365, 1.482, and 7.854 years, respectively. Both single disease and multimorbidity were significantly associated with an increased risk of transitioning from non-DS to mild-DS, with multimorbidity showing a stronger association. In contrast, HRs for single diseases transitioning from mild-DS to severe-DS were significantly lower than 1. Furthermore, their HRs were almost <1 in recovery transitions but not statistically significant. LIMITATIONS Specific chronic diseases and their combinations were not analyzed. CONCLUSIONS The progression of DS exhibits various pathways. CDS is associated with DS transitions, but the roles of single disease and multimorbidity may differ across different DS progression stages. Both conditions were significantly linked to the risk of new-onset DS, with multimorbidity posing a greater association. However, this relationship is not observed in other progression stages. These findings could provide insights for early prevention and intervention for DS.
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Affiliation(s)
- Yu Wu
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, No. 31, Road 3rd, Bei-Ji-Ge, Dongcheng District, Beijing 100730, China
| | - Binbin Su
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, No. 31, Road 3rd, Bei-Ji-Ge, Dongcheng District, Beijing 100730, China
| | - Panliang Zhong
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, No. 31, Road 3rd, Bei-Ji-Ge, Dongcheng District, Beijing 100730, China
| | - Yihao Zhao
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, No. 31, Road 3rd, Bei-Ji-Ge, Dongcheng District, Beijing 100730, China
| | - Chen Chen
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, No. 31, Road 3rd, Bei-Ji-Ge, Dongcheng District, Beijing 100730, China
| | - Xiaoying Zheng
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, No. 31, Road 3rd, Bei-Ji-Ge, Dongcheng District, Beijing 100730, China; APEC Health Science Academy, Peking University, Beijing, China.
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Tian J, Wang HY, Peng SH, Tao YM, Cao J, Zhang XG. Experiences of older people with multimorbidity regarding self-management of diseases: A systematic review and qualitative meta-synthesis. Int J Nurs Pract 2024; 30:e13289. [PMID: 39075877 DOI: 10.1111/ijn.13289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/03/2024] [Accepted: 07/13/2024] [Indexed: 07/31/2024]
Abstract
AIM This qualitative systematic review aimed to consolidate existing evidence on the self-management experience of older patients with multimorbidity worldwide. METHODS Nine databases were searched, for papers published from database inception to April 2023. The systematic review was conducted according to the systematic review method of qualitative evidence by the Joanna Briggs Institute (JBI). RESULTS Seven studies were included. Finally, four themes and 12 subthemes were formed: (1) physical level: reduced physical function and lack of coordinated care; (2) psychological level: mental state of anxiety and positive attitude towards life; (3) social level: technical support, support from family, support from healthcare workers and support from others; and (4) practical level: economic burden, lifestyle changes, self-care in daily life and compliance was much lower than expected. CONCLUSIONS To improve self-management in older people with multimorbidity, nurses should provide more guidance to patients to improve their self-management skills, and clinicians should recommend effective self-management behaviours.
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Affiliation(s)
- Jing Tian
- West China Second Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hong Yan Wang
- Southwest University, Chongqing, China
- Sichuan Nursing Vocational College, Chengdu, Sichuan, China
| | - Si Han Peng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yan Min Tao
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jun Cao
- Sichuan Nursing Vocational College, Chengdu, Sichuan, China
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Li Q, Song C, Zhou H, Li J, Chen M. Sex differences in the relationship of intraindividual difference in estimated glomerular filtration rate by cystatin C and creatinine and depressive symptoms among middle-aged and older adults in China. J Affect Disord 2024; 369:103-109. [PMID: 39341290 DOI: 10.1016/j.jad.2024.09.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 08/27/2024] [Accepted: 09/25/2024] [Indexed: 09/30/2024]
Abstract
BACKGROUND The estimated glomerular filtration rate based on cystatin C (eGFRcys) and creatinine (eGFRcr) may differ substantially within an individual. The clinical implications of these differences (eGFRdiff) for depressive symptoms risk are unknown and whether it differed by sex are also unknown. METHODS The prospective cohort study enrolled 3443 participants aged ≥45 years from the 2011-2020 waves of the China Health and Retirement Longitudinal Study. The eGFRdiff was calculated by eGFRcys minus eGFRcr at baseline. Depressive symptoms were measured by the ten-item Center for Epidemiologic Studies Depression Scale. Unadjusted and adjust logistic regression models were used to investigate the relationship between eGFRdiff and depressive symptoms. RESULTS 1628 (47.3 %) females and 1815 (52.7 %) males were analyzed in the present study. When considering eGFRdiff as a continuous variable, multivariate logistic regression analysis showed that higher eGFRdiff was associated with reduced depressive symptoms in females (OR = 0.985, 95%CI 0.976-0.995, p-value = 0.020), not in males (OR = 0.996, 95%CI 0.988-1.003, p-value = 0.280). The associations remained similar when comparing individuals across different eGFRdiff categories. CONCLUSIONS In this 9-year follow-up cohort study, baseline eGFRdiff was negatively associated with depressive symptoms among community-dwelling middle-aged and older females, but not males. Monitoring eGFRdiff could have clinical utility in identifying the risk of accelerated depressive symptoms progression in females.
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Affiliation(s)
- Qing Li
- National Clinical Research Center for Geriatrics, The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, China; Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Chengxiang Song
- Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu 610041, China; Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Hao Zhou
- Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Junli Li
- Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu 610041, China.
| | - Mao Chen
- Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu 610041, China; Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China.
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Qiu D, He J, Zhang C, Li Y, Ling Z, Shen M, Xiao S. Associations between frailty, depression and risk of hospitalisation for infection: A large prospective cohort study. J Affect Disord 2024; 361:104-112. [PMID: 38857629 DOI: 10.1016/j.jad.2024.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 06/01/2024] [Accepted: 06/05/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND There is a considerable lack of epidemiological evidence on whether frailty, and frailty comorbid depression could increase the risk of infections in older adults. This study aimed to examine the prospective association between frailty, depression, and risk of infections. METHODS A total of 308,892 eligible participants were included. Linked hospital admission records (HES) were used to identify a primary or secondary diagnosis of depression, and infection. Frailty was assessed by Fried frailty phenotype indicators. Cox proportional hazard model was conducted to examine the associated risk between frailty, depression, comorbid frailty and depression and risk of incident infections. Results were stratified by age and gender. RESULTS During the follow-up, 74,749 (24.19 %) incident any infection cases were identified, the incidence density of any infection was 17.29/1000 person years. Frailty alone (HR = 1.38, 95 % CI: 1.33-1.43), depression alone (HR = 1.90, 95 % CI: 1.86-1.94), and comorbid frailty and depression (HR = 1.91, 95 % CI: 1.82-1.99) were associated with greater risks of any infections relative to participants with neither frailty nor depression. The associations between frailty alone, depression alone, comorbid frailty and depression, and any infections/most infection subtypes were significant for all age strata in both male and female. LIMITATIONS Frailty phenotype was assessed through the adapted Fried criteria, based on a mix of self-reported and objective measurements. CONCLUSION Frailty, depression, and comorbid frailty and depression were significantly associated with increased risk of incident infections.
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Affiliation(s)
- Dan Qiu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
| | - Jun He
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06510, USA.
| | - ChengCheng Zhang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
| | - Yilu Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
| | - Zhen Ling
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
| | - Minxue Shen
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China; Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
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Huang J, Xu T, Dai Y, Li Y, Tu R. Age-related differences in the number of chronic diseases in association with trajectories of depressive symptoms: a population-based cohort study. BMC Public Health 2024; 24:2496. [PMID: 39272102 PMCID: PMC11396400 DOI: 10.1186/s12889-024-19975-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 09/03/2024] [Indexed: 09/15/2024] Open
Abstract
BACKGROUND The number of chronic diseases has been associated with changes in depressive symptoms over time among middle-aged and older adults. This study aimed to explore the association between the number of chronic diseases and trajectories of depressive symptoms and the role of age in this association. METHODS A total of 12,974 middle-aged and older Chinese adults (≥ 45 years) participated in the China Health and Retirement Longitudinal Study (CHARLS) in waves 2011, 2013, 2015, 2018, and 2020. The number of chronic diseases was determined by self-reported hospital diagnosis of hypertension, dyslipidemia, diabetes, cancer, chronic lung diseases, liver disease, heart diseases, stroke, kidney diseases, digestive diseases, emotional, nervous, or psychiatric problems, memory-related disease, arthritis or rheumatism, asthma, and then obtaining the total number of chronic diseases. Depressive symptoms were measured by the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10). Group-based trajectory modeling (GBTM) was adopted to capture the trajectories of depressive symptoms over time. Multinomial logistic regressions were conducted to examine the association between the number of chronic diseases and trajectories of depressive symptoms and the role of age in this association. RESULTS Four distinct trajectories of depressive symptoms were observed in 34.68% individuals in mild, 40.76% in moderate, 19.41% in increasing, and 5.15% in severe group. Compared to participants without chronic diseases, those with one, two, three or more chronic diseases had a 1.81, 3, and 7.49-fold higher risk of developing severe depressive symptom trajectory, respectively. Moreover, the association between the number of chronic diseases and severe depressive symptoms trajectory differed by age (45-59 and ≥ 60 years) (P for interaction < 0.05). CONCLUSION Participants with middle age may play a promoting role in the association between the number of chronic disease and severe depressive symptoms. The severe depressive symptoms intervention may be more beneficial for middle-aged adults.
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Affiliation(s)
- Jinghong Huang
- School of Health Management, Fujian Medical University, Fuzhou, China
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Tianwei Xu
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Yue Dai
- School of Health Management, Fujian Medical University, Fuzhou, China
| | - Yueping Li
- Fujian Medical University Library, Fuzhou, Fujian, China
| | - Raoping Tu
- School of Health Management, Fujian Medical University, Fuzhou, China.
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Pinheiro Guedes L, Sousa-Uva M, Gusmão R, Martinho C, Matias Dias C, Da Conceição V, Gomes Quelhas C, Saldanha Resendes D, Gaio V. Long-term Exposure to Ambient Air Pollution and its Association with Mental Well-Being, Depression and Anxiety: A Nationally Representative Study. ACTA MEDICA PORT 2024; 37:589-600. [PMID: 39037122 DOI: 10.20344/amp.21245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 05/10/2024] [Indexed: 07/23/2024]
Abstract
INTRODUCTION Exposure to ambient air pollution may play a role in the onset of common mental disorders like depressive and anxiety disorders. The association of long-term exposure to particles smaller than 10 μm (PM10) with these diseases remains unclear. This study aimed to estimate the association of long-term exposure to PM10 with mental well-being and the frequency of probable diagnosis of common mental disorders. METHODS A nationally representative cross-sectional study was done in mainland Portugal. Long-term exposure was estimated through one-year average concentrations of PM10, calculated with data from the Portuguese Environment Agency, attributed individually considering individuals' postal codes of residence. The mental well-being and the probable diagnosis of common mental disorders were ascertained through the five-item Mental Health Inventory scale. Linear and Robust Poisson regression models were computed to estimate change percentages, prevalence ratios (PR), and their 95% confidence intervals (95% CI). RESULTS The median (interquartile range) concentration of PM10 was 18.6 (15.3 - 19.3) μg/m3. The mental well-being score was 72 (56 - 84) points, on a scale from 0 to 100. A probable diagnosis of common mental disorders was found in 22.7% (95% CI: 20.0 to 25.6). Long-term exposure to PM10 was associated with a non-statistically significant decrease in the mental well-being score [for each 10 μg/m³ increment in one-year average PM10 concentrations, there was a 2% (95% CI: -8 to 4) decrease], and with a non-statistically significant increase in the common mental health frequency (PR = 1.012, 95% CI: 0.979 to 1.045). CONCLUSION We did not find statistically significant associations between long-term exposure to PM10 and mental well-being or the frequency of probable diagnosis of common mental disorders. These results may be explained by the reduced variability in the exposure values, given the geographical distribution and functioning of the network of air quality monitoring stations. This study contributes with evidence for low levels of air pollutants, being one of the first to adjust for individual and aggregate-level variables. Moreover, to the best of our knowledge, this was the first nationally representative, population-based study conducted on the Portuguese population using real-life data. Maintaining a robust and nationwide air quality monitoring network is essential for obtaining quality exposure data.
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Affiliation(s)
- Lara Pinheiro Guedes
- Department of Epidemiology. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisbon. & Public Health Unit. Unidade Local de Saúde Tâmega e Sousa. Amarante. & EPIUnit. Instituto de Saúde Pública. Universidade do Porto. Porto. Portugal
| | - Mafalda Sousa-Uva
- Department of Epidemiology. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisbon. & Public Health Research Center. Escola Nacional de Saúde Pública. Universidade NOVA de Lisboa. Lisbon. & Comprehensive Health Research Center. Universidade NOVA de Lisboa. Lisbon. Portugal
| | - Ricardo Gusmão
- EPIUnit. Instituto de Saúde Pública. Universidade do Porto. Porto. & Laboratory for Integrative and Translational Research in Population Health (ITR). Universidade do Porto. Porto. & Department of Public Health and Forensic Sciences, and Medical Education. Faculdade de Medicina. Universidade do Porto. Porto. Portugal
| | - Clarisse Martinho
- Public Health Unit. Unidade Local de Saúde Tâmega e Sousa. Amarante. Portugal
| | - Carlos Matias Dias
- Department of Epidemiology. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisbon. & Public Health Research Center. Escola Nacional de Saúde Pública. Universidade NOVA de Lisboa. Lisbon. & Comprehensive Health Research Center. Universidade NOVA de Lisboa. Lisbon. Portugal
| | - Virgínia Da Conceição
- EPIUnit. Instituto de Saúde Pública. Universidade do Porto. Porto. & Laboratory for Integrative and Translational Research in Population Health (ITR). Universidade do Porto. Porto. Portugal
| | - Carlos Gomes Quelhas
- Public Health Unit Amélia Leitão. Agrupamento de Centros de Saúde de Cascais. Cascais. Portugal
| | | | - Vânia Gaio
- Department of Epidemiology. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisbon. & Public Health Research Center. Escola Nacional de Saúde Pública. Universidade NOVA de Lisboa. Lisbon. & Comprehensive Health Research Center. Universidade NOVA de Lisboa. Lisbon. Portugal
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Peng MM, Liang Z, Wang P. Lifestyle factors, physical health, and life satisfaction under different changes in depressive symptoms among Chinese community-dwelling older adults: A longitudinal analysis. Int J Soc Psychiatry 2024; 70:1062-1074. [PMID: 38824394 DOI: 10.1177/00207640241255573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2024]
Abstract
BACKGROUND The study aims to investigate the long-term impact of lifestyle-related factors and physical health on life satisfaction and depressive symptoms among Chinese community-dwelling older adults. METHODS Using data from the China Health and Retirement Longitudinal Study (CHARLS), the analytic sample of this study included 1,068 older adults who had participated in the surveys in both 2011 and 2018. Multivariate regression was employed to analyze both cross-sectional and longitudinal relationships between lifestyle-related factors, physical health, and subjective well-being - specifically depressive symptoms and life satisfaction. Additionally, the model tested how these factors correlate with life satisfaction across different groups of depressive symptom changes among older adults, categorized as not at risk of depression, intermittent depression, and chronic depression. RESULTS Multimorbidity was significantly related to baseline and follow-up depressive risk in older adults. Shorter sleep duration was associated with baseline depression risk. Current alcohol drinkers reported significantly more severe depressive symptoms than non-drinkers. At baseline, current smokers were more likely to have a lower degree of life satisfaction than nonsmokers. Among older adults with chronic depression at the 7-year follow-up, former smokers tended to have lower life satisfaction than nonsmokers. CONCLUSIONS Our findings identified drinking alcohol and having a shorter sleep duration as modifiable lifestyle-related risk factors for late-life depression and smoking as a detrimental factor for life satisfaction in older Chinese adults. Multimorbidity was a significant predictor of more depressive symptoms. Our findings have implications for future psychosocial interventions that target the alleviation of depressive symptoms and the promotion of life satisfaction in older Chinese people based on their different long-term mental and physical health conditions.
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Affiliation(s)
- Man-Man Peng
- Department of Social Work, The Chinese University of Hong Kong, Shatin, NT, China
| | - Zurong Liang
- Department of Sociology, Zhejiang University, Hangzhou, China
| | - Pengfei Wang
- School of Public Health, Fudan University, Shanghai, China
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Reaume SV, Dubin JA, Perlman C, Ferro MA. An Epidemiological Study of Physical-Mental Multimorbidity in Youth: Une étude épidémiologique de la morbidité physique-mentale chez les jeunes. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2024:7067437241271713. [PMID: 39149998 DOI: 10.1177/07067437241271713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
OBJECTIVE This epidemiological study estimated the lifetime prevalence of chronic physical illness (i.e., an illness that lasted or was expected to last ≥6 months) and 6-month prevalence of mental disorder and multimorbidity (i.e., ≥1 physical illness and ≥1 mental disorder) in youth. Associations between physical illness and mental disorder were quantified, including the number of illnesses. Secondary objectives examined factors associated with mental disorder, after controlling for physical illness. METHODS Data come from 10,303 youth aged 4-17 years in the 2014 Ontario Child Health Study (OCHS). Physical illness was measured using a list of chronic conditions developed by Statistics Canada. Mental disorders were measured using the OCHS Emotional Behavioural Scales. The Health Utility Index Mark III assessed overall functional health. RESULTS Weighted prevalence estimates showed 550,090 (27.8%) youth had physical illness, 291,986 (14.8%) had mental disorder, and 108,435 (5.4%) had multimorbidity. Physical illness was not associated with mental disorder. However, youth with 2 physical illnesses, as compared to no physical illnesses, had increased odds of having any mental (OR = 1.75 [1.08, 2.85]), mood (OR = 2.50 [1.39, 4.48]) and anxiety disorders (OR = 2.40 [1.33, 4.31]). Mean functional health scores demonstrated a dose-response association across health status categories, with the highest scores among healthy youth and the lowest scores among multimorbid youth (all p < .05). CONCLUSION Chronic physical illness and mental disorders are prevalent in youth. Youths with 2 physical illnesses have a higher likelihood of mental disorders. Higher functional health scores protected against all mental disorders. Mental health interventions for youth should promote strong overall functional health.
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Affiliation(s)
- Shannon V Reaume
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Joel A Dubin
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
- Department of Statistics and Actuarial Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Christopher Perlman
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Mark A Ferro
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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Shiner CT, Li I, Millard M, Mahoney AEJ. Chronic health conditions and disability are prevalent among community users of a digital mental health service: a scoping survey. Disabil Rehabil Assist Technol 2024:1-10. [PMID: 39126196 DOI: 10.1080/17483107.2024.2389208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 07/30/2024] [Indexed: 08/12/2024]
Abstract
Objectives: Digital interventions can offer accessible and scalable treatment for chronic conditions, though often focus separately on physical or mental health. People accessing digital health services may live with multiple conditions or experience overlapping symptoms. This study aimed to describe the breadth and characteristics of chronic health conditions and self-reported disability among routine users of a digital mental health service, and to examine related motivations to engage with digital mental health interventions. Methods: A cross-sectional survey of adults registered with a digital mental health service in the Australian community (THIS WAY UP) was conducted. Participant demography, chronic health conditions, self-reported disability and motivations for accessing digital treatment were collected and analyzed descriptively. Results: 366 participants responded (77% female, mean age 50 ± 15 years). 71.6% of participants (242/338) reported ≥1 chronic health condition and one-third reported multimorbidity (112/338, 33.1%). Chronic pain, musculoskeletal and connective tissue disorders were most common. 26.9% of respondents (90/334) reported a disability, most commonly physical disabilities. 95% of those with chronic conditions reported negative mental health effects and 46% reported heightened interest in digital mental health treatments because of their condition. Primary motivations for digital service use were receiving a recommendation from a health professional and service accessibility. Discussion: People who access digital mental health services in routine care report high rates of heterogenous chronic illness and related disability. There is interest in accessible digital treatments to support mental health at scale among people who live with varied chronic conditions and disabilities.
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Affiliation(s)
- Christine T Shiner
- Clinical Research Unit for Anxiety and Depression (CRUfAD), St Vincent's Hospital Sydney and the University of New South Wales, Sydney, Australia
- School of Clinical Medicine, University of New South Wales, Sydney, Australia
- Department of Rehabilitation, St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia
| | - Ian Li
- Clinical Research Unit for Anxiety and Depression (CRUfAD), St Vincent's Hospital Sydney and the University of New South Wales, Sydney, Australia
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Michael Millard
- Clinical Research Unit for Anxiety and Depression (CRUfAD), St Vincent's Hospital Sydney and the University of New South Wales, Sydney, Australia
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Alison E J Mahoney
- Clinical Research Unit for Anxiety and Depression (CRUfAD), St Vincent's Hospital Sydney and the University of New South Wales, Sydney, Australia
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
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Knudsen AM, Dalgård Dunvald AC, Hangaard S, Hejlesen O, Kronborg T. The Effectiveness of Collaborative Care Interventions for the Management of Patients With Multimorbidity: Protocol for a Systematic Review, Meta-Analysis, and Meta-Regression Analysis. JMIR Res Protoc 2024; 13:e58296. [PMID: 39115256 PMCID: PMC11342003 DOI: 10.2196/58296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 07/02/2024] [Accepted: 07/09/2024] [Indexed: 08/26/2024] Open
Abstract
BACKGROUND Collaborative care interventions have been proposed as a promising strategy to support patients with multimorbidity. Despite this, the effectiveness of collaborative care interventions requires further evaluation. Existing systematic reviews describing the effectiveness of collaborative care interventions in multimorbidity management tend to focus on specific interventions, patient subgroups, and settings. This necessitates a comprehensive review that will provide an overview of the effectiveness of collaborative care interventions for adult patients with multimorbidity. OBJECTIVE This systematic review aims to systematically assess the effectiveness of collaborative care interventions in comparison to usual care concerning health-related quality of life (HRQoL), mental health, and mortality among adult patients with multimorbidity. METHODS Randomized controlled trials evaluating collaborative care interventions designed for adult patients (18 years and older) with multimorbidity compared with usual care will be considered for inclusion in this review. HRQoL will be the primary outcome. Mortality and mental health outcomes such as rating scales for anxiety and depression will serve as secondary outcomes. The systematic search will be conducted in the CENTRAL, PubMed, CINAHL, and Embase databases. Additional reference and citation searches will be performed in Google Scholar, Web of Science, and Scopus. Data extraction will be comprehensive and include information about participant characteristics, study design, intervention details, and main outcomes. Included studies will be assessed for limitations according to the Cochrane Risk of Bias tool. Meta-analysis will be conducted to estimate the pooled effect size. Meta-regression or subgroup analysis will be undertaken to explore if certain factors can explain the variation in effect between studies, if feasible. The certainty of evidence will be evaluated using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. RESULTS The preliminary literature search was performed on February 16, 2024, and yielded 5255 unique records. A follow-up search will be performed across all databases before submission. The findings will be presented in forest plots, a summary of findings table, and in narrative format. This systematic review is expected to be completed by late 2024. CONCLUSIONS This review will provide an overview of pooled estimates of treatment effects across HRQoL, mental health, and mortality from randomized controlled trials evaluating collaborative care interventions for adults with multimorbidity. Furthermore, the intention is to clarify the participant, intervention, or study characteristics that may influence the effect of the interventions. This review is expected to provide valuable insights for researchers, clinicians, and other decision-makers about the effectiveness of collaborative care interventions targeting adult patients with multimorbidity. TRIAL REGISTRATION International Prospective Register of Systematic Reviews (PROSPERO) CRD42024512554; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=512554. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/58296.
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Affiliation(s)
- Anne-Maj Knudsen
- Department of Health Science and Technology, Aalborg University, Gistrup, Denmark
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark
| | - Ann-Cathrine Dalgård Dunvald
- Department of Clinical Pharmacology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Stine Hangaard
- Department of Health Science and Technology, Aalborg University, Gistrup, Denmark
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark
| | - Ole Hejlesen
- Department of Health Science and Technology, Aalborg University, Gistrup, Denmark
| | - Thomas Kronborg
- Department of Health Science and Technology, Aalborg University, Gistrup, Denmark
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark
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12
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Sun D, Gao Y, Xu B, Xiang L, Liu W, Luo H, Wu IXY. Association of coffee consumption with cardiometabolic multimorbidity: A prospective cohort study in the UK biobank. Nutr Metab Cardiovasc Dis 2024:S0939-4753(24)00301-6. [PMID: 39277537 DOI: 10.1016/j.numecd.2024.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 07/27/2024] [Accepted: 08/02/2024] [Indexed: 09/17/2024]
Abstract
BACKGROUND AND AIMS Previous observational studies have investigated the association between coffee consumption and single cardiometabolic disease. Yet, the extent to which coffee might confer health advantages to individuals with a singular cardiometabolic disease remains unclear. This study aimed to further investigate the association of coffee consumption and the onset and progression from single cardiometabolic disease to cardiometabolic multimorbidity (CMM). METHODS AND RESULTS This prospective cohort study included 185,112 participants from the UK Biobank who were enrolled between 2006 and 2010 and followed up until 2020. Coffee consumption was collected using a 24-h dietary questionnaire. CMM was defined as the coexistence of at least two cardiometabolic diseases, including type 2 diabetes (T2D), coronary heart disease (CHD) and stroke. Cox proportional hazards and multi-state models estimated the associations between coffee consumption and CMM. During a median follow-up of 11.4 years, 1585 participants developed CMM. Compared with nonconsumers, coffee consumers had lower risks for the transitions from baseline to single cardiometabolic disease, with the respective lowest hazard ratios and 95% confidence intervals (CIs) for the transitions from baseline to T2D, CHD and stroke after multivariable adjustment being 0.79 (CI, 0.72-0.87), 0.91 (CI, 0.86-0.97) and 0.87 (CI, 0.78-0.96). Coffee consumption resulted in a significant reduction in the risk of the transitions from CHD and stroke to CMM, with the lowest estimates were 0.56 (CI, 0.43-0.73) and 0.60 (CI, 0.43-0.83). Similar associations were observed in unsweetened coffee. Sugar-sweetened coffee was associated with some transitions at low levels of consumption. The associations between artificially sweetened coffee and CMM were less consistent. CONCLUSIONS Coffee consumption was associated with lower risk for almost all transition phases of CMM development and consistent findings were observed with unsweetened coffee.
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Affiliation(s)
- Dingkui Sun
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, No. 168-2, Tongzipo Road, Yuelu District, Changsha, Hunan 410000, China
| | - Yinyan Gao
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, No. 168-2, Tongzipo Road, Yuelu District, Changsha, Hunan 410000, China
| | - Boya Xu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, No. 168-2, Tongzipo Road, Yuelu District, Changsha, Hunan 410000, China
| | - Linghui Xiang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, No. 168-2, Tongzipo Road, Yuelu District, Changsha, Hunan 410000, China
| | - Wenqi Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, No. 168-2, Tongzipo Road, Yuelu District, Changsha, Hunan 410000, China
| | - Han Luo
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, No. 168-2, Tongzipo Road, Yuelu District, Changsha, Hunan 410000, China
| | - Irene X Y Wu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, No. 168-2, Tongzipo Road, Yuelu District, Changsha, Hunan 410000, China; Hunan Provincial Key Laboratory of Clinical Epidemiology, Central South University, No. 168-2, Tongzipo Road, Yuelu District, Changsha, Hunan 410000, China.
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13
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Alfaqeeh M, Alfian SD, Abdulah R. Sociodemographic Factors, Health-Risk Behaviors, and Chronic Conditions Are Associated with a High Prevalence of Depressive Symptoms: Findings from the Indonesian Family Life Survey-5. Behav Med 2024:1-11. [PMID: 39045841 DOI: 10.1080/08964289.2024.2375205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 06/02/2024] [Accepted: 06/21/2024] [Indexed: 07/25/2024]
Abstract
Depression is a significant public health challenge. However, limited research exists regarding the risk of sociodemographic factors, health-risk behavior, and chronic conditions in relation to the development of depression in Indonesia. This study assesses the prevalence of depressive symptoms in adolescents and adults, and identifies its potential associations with sociodemographic factors, health-risk behaviors, and chronic conditions. A national cross-sectional population-based survey was performed, using the Indonesian Family Life Survey (IFLS-5), to assess depressive symptoms in respondents aged 15 years and older. Depression was evaluated using the Center for Epidemiologic Studies-Depression (CES-D) scale, and potential associations with sociodemographic factors, health-risk behaviors, and chronic conditions were examined using logistic regression analysis. The study revealed a high prevalence of depressive symptoms, with the highest incidence observed in the age group of 25-34 years. Factors such as unmarried status, younger age, good physical activity, and having chronic conditions showed associations with depression. These findings have implications for developing public mental health strategies to reduce the prevalence of depression in Indonesia.
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Affiliation(s)
- Mohammed Alfaqeeh
- Master Program in Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia
| | - Sofa D Alfian
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia
- Center for Health Technology Assessment, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Rizky Abdulah
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia
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Lai LC, Huang DM, Peng J, Cao XY, Feng XL, Tao PY, Pan X, Pan QN, Fan DJ, Lu SY, Li CL, Pan YF, Dong PX, Chai YD, Huang P, Wu HC, Huang HQ. Depressive symptom mediates the association between the number of chronic diseases and cognitive impairment: a multi-center cross-sectional study based on community older adults. Front Psychiatry 2024; 15:1404229. [PMID: 39086730 PMCID: PMC11288913 DOI: 10.3389/fpsyt.2024.1404229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 06/27/2024] [Indexed: 08/02/2024] Open
Abstract
Objective The purpose of this study was to understand the relationship between the multiple chronic conditions (MCC), mental health and cognitive function of older adults in the community, and to propose a hypothesis that depressive symptom mediate the number of chronic diseases and cognitive impairment in older adults. Method Participants aged 65 years and older from 35 communities in 14 cities in Guangxi, China were recruited. The residents' depressive symptom (PHQ-9) and cognitive status (AD-8) were evaluated, Chi-square test was used to explore the effects of different socio-demographic characteristics on depressive symptom and cognitive impairment. Pearson correlation analysis and the process model 4 were used to explore the relationship between the number of chronic diseases, depressive symptom and cognitive impairment. Result A total of 11,582 older adults were included in our analysis. The rate of MCC reaching 26.53%. Hypertension combined with diabetes accounts for the highest proportion of two chronic diseases (13.2%). Among the combination of three chronic diseases, the highest incidence of coexisting hypertension combined with cervical/lumbar spondylosis, and rheumatoid arthritis (7.1%). In this study, depression symptoms accounted for 12.9% of older adults aged 65 and above, and cognitive impairment accounted for 27.4%. Female, older age, reside in urban areas, lower educational levels, no spouse, live alone, and MCC were risk factors for depressive symptom and cognitive impairment in older adults (P<0.05). Depressive symptom had a mediating effect in the number of chronic diseases and cognitive impairment, and the mediating effect (1.109) accounted for 44.13% of the total effect (0.247). Conclusion The mental health of the older adult needs to be taken seriously, and improving depressive symptom can reduce the occurrence of cognitive impairment in older patients with MCC to a certain extent.
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Affiliation(s)
- Li-Chong Lai
- Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Dong-Mei Huang
- Rehabilitation Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Jie Peng
- Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Xiao-Ying Cao
- Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Xiao-Ling Feng
- Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Pin-Yue Tao
- Anesthesiology Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Xiao Pan
- Ear, Nose, Throat, Head and Neck Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Qi-Ni Pan
- Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Deng-Jing Fan
- Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Shu-Yu Lu
- Anesthesiology Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Cai-Li Li
- Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Yan-Fei Pan
- Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Peng-Xin Dong
- Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Yi-Dan Chai
- Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Ping- Huang
- Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Hai-Chen Wu
- Nursing Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Hui-Qiao Huang
- Party Committee Office, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
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15
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Zhou L, Wang W, Ma X. The bidirectional association between the disability in activities of daily living and depression: a longitudinal study in Chinese middle-aged and older adults. BMC Public Health 2024; 24:1884. [PMID: 39010036 PMCID: PMC11247890 DOI: 10.1186/s12889-024-19421-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 07/09/2024] [Indexed: 07/17/2024] Open
Abstract
AIM Depression and disability in activities of daily living (ADL) are common in middle-aged and older adults. This study investigated the bidirectional relationship between depression and disability in ADL in Chinese middle-aged and older adults. METHODS Data from a baseline study of 17,596 participants from the China Health and Retirement Longitudinal Study (CHARLS) and two follow-up visits at 4 and 7 years were included. We designed Study A and Study B to explore the interaction between depression and disability in ADL in middle-aged and older people. RESULTS Individuals with disability in ADL at baseline had adjusted odds ratios (ORs) of 1.331 (1.118, 1.584) and 1.969 (1.585, 2.448) for developing depression compared with those without disability in ADL at the 4- and 7-year follow-ups, respectively. Individuals with depression at baseline had adjusted ORs of 1.353 (1.127, 1.625) and 1.347 (1.130, 1.604), respectively, for developing disability in ADL 4 and 7 years later. CONCLUSIONS There was a bidirectional relationship between depression and disability in ADL. Depression increased the risk of disability in ADL, but this risk did not increase with time, whereas the effect of disability in ADL on depression increased with time.
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Affiliation(s)
- Lina Zhou
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, P. R. China
| | - Wei Wang
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, P. R. China.
| | - Xiancang Ma
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, P. R. China
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16
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Sowan W, Yagil D, Cohen M. Self-employed people with chronic health conditions: Business maintenance and well-being. Stress Health 2024:e3445. [PMID: 39003602 DOI: 10.1002/smi.3445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/18/2024] [Accepted: 07/05/2024] [Indexed: 07/15/2024]
Abstract
Chronic health conditions (CHCs) involve physical, psychological, and social challenges and can have a significant negative impact on work ability, which can then affect performance and job satisfaction. However, the various effects of CHCs on business operations and maintenance among self-employed workers are understudied. This study examined four common CHCs that are characterised by persistent symptoms and can prompt major life changes: respiratory disease, heart conditions, inflammatory bowel disease, and cancer survivorship. Groups were compared regarding the CHC's impact on business maintenance (declining in income and activity, and slowing business growth), and well-being. A sample of 294 self-employed workers with these CHCs completed questionnaires about how their conditions affect their businesses, physical symptoms, and well-being. The four CHCs had substantial negative effects on business maintenance. Differences were found in reported changes in income, activity, and growth between individuals with inflammatory bowel disease and cancer. No differences in well-being occurred among self-employed people with different CHCs. In the overall sample, work absences and slowing business growth were negatively associated with well-being. Although the groups differed in the severity of symptoms, threat to life, and treatment regimen, the CHCs had similar effects on most business maintenance factors and well-being. Moreover, the results indicate that the inability to maintain a business can negatively affect well-being.
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Affiliation(s)
- Wafaa Sowan
- School of Social Work, University of Haifa, Haifa, Israel
| | - Dana Yagil
- Department of Human Services, University of Haifa, Haifa, Israel
| | - Miri Cohen
- School of Social Work, University of Haifa, Haifa, Israel
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17
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Ge H, Dong S, Su W, Guan W, Yu Q, Liu Y, Qi Y, Sun X, Zhang H, Ma G. Relationship between social participation and depressive symptoms in patients with multimorbidity: the chained mediating role of cognitive function and activities of daily living. BMC Public Health 2024; 24:1844. [PMID: 38987791 PMCID: PMC11234698 DOI: 10.1186/s12889-024-19157-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 06/14/2024] [Indexed: 07/12/2024] Open
Abstract
OBJECTIVE The potential mechanisms linking social participation and depressive symptoms in Chinese individuals with multimorbidity are not yet fully understood. This study aims to explore how cognitive function and activities of daily living (ADLs) mediate the relationship between social participation and depressive symptoms in individuals with multimorbidity. METHODS We selected 3782 participants with multimorbidity from the 2018 China Health and Retirement Longitudinal Study. Data related to social participation, cognitive function, ADLs, and depressive symptoms were extracted. Regression and Bootstrap analyses were used to explore the sequential mediating effects of social participation, cognitive function, ADLs, and depressive symptoms. RESULTS (1) There was a significant correlation between social participation, cognitive function, activities of daily living, and depressive symptoms (p < 0.01). (2) Social participation directly affected depressive symptoms (β = -0.205, p < 0.05). (3) Cognitive function (β = -0.070, p < 0.01) and activities of daily living (β = -0.058, p < 0.01) played separate mediating roles in the effect of social participation on depressive symptoms. (4) Cognitive function and activities of daily living had a chain-mediated role in the relationship between social participation and depressive symptoms in patients with multimorbidity (β = -0.020, p < 0.01). CONCLUSION A chained mediating effect was found between cognitive function, ADLs, social participation, and depressive symptoms in patients with multimorbidity. Social participation was found to improve the cognitive function of patients with multimorbidity, which in turn enhanced their daily life activities and ultimately alleviated their depressive symptoms.
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Affiliation(s)
- Huaiju Ge
- School of Public Health, Shandong Second Medical University, Weifang, Shandong, China
| | - Shihong Dong
- School of Public Health, Shandong Second Medical University, Weifang, Shandong, China
| | - Wenyu Su
- School of Public Health, Shandong Second Medical University, Weifang, Shandong, China
| | - Weimin Guan
- School of Public Health, Shandong Second Medical University, Weifang, Shandong, China
| | - Qing Yu
- School of Public Health, Shandong Second Medical University, Weifang, Shandong, China
| | - Yan Liu
- Shandong Cancer Research Institute (Shandong Tumor Hospital), Jinan, Shandong, China
| | - Yuantao Qi
- Shandong Cancer Research Institute (Shandong Tumor Hospital), Jinan, Shandong, China
| | - Xialing Sun
- School of Public Health, Shandong Second Medical University, Weifang, Shandong, China
| | - Huiqing Zhang
- The First Affiliated Hospital of Shandong Second Medical University (Weifang People's Hospital), Weifang, Shandong, China.
| | - Guifeng Ma
- School of Public Health, Shandong Second Medical University, Weifang, Shandong, China.
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18
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Cheng C, Christensen M. Interventions Addressing Symptoms in Older Adults with Multimorbidity: An Umbrella Review. J Multidiscip Healthc 2024; 17:3181-3192. [PMID: 39006878 PMCID: PMC11246035 DOI: 10.2147/jmdh.s452426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 02/07/2024] [Indexed: 07/16/2024] Open
Abstract
This umbrella review was to synthesize the summarized evidence-based research regarding interventions addressing symptoms in older populations with multimorbidity. Three databases including PsycINFO, MEDLINE, and CINAHL were searched systematically. The JBI Methodology for Umbrella Reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements were used to report this review. Six reviews published between 2016 and 2010 were included for analysis. Interventions were mixed and included components on health-related behaviors, body systems or functions, activities and participation domains, and the environment. Outcomes concerning physiological/clinical functioning were most reported. The evidence regarding the symptoms-related interventions was mixed, but all showed promising outcomes compared with usual care or not. To sum up, this umbrella review reveals the lack of strong empirical evidence for the effectiveness of intervention addressing symptoms in older adults with multimorbidity. It highlights the need to evaluate the established approach of interventions further to support this population.
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Affiliation(s)
- Cheng Cheng
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, SAR, People’s Republic of China
- School of Nursing, Fudan University, Xuhui, Shanghai, People’s Republic of China
| | - Martin Christensen
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, SAR, People’s Republic of China
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Ni Z, Zhu X, Tian K, Chen Q, Yang Y, Xie S. Depressive symptoms of older adults with chronic diseases: the mediating roles of activities of daily living and economic burden of diseases. Front Psychol 2024; 15:1387677. [PMID: 39015326 PMCID: PMC11249773 DOI: 10.3389/fpsyg.2024.1387677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 06/18/2024] [Indexed: 07/18/2024] Open
Abstract
Objective To explore the mediating roles of activities of daily living (ADL) and economic burden of diseases in the relationship between chronic diseases and depressive symptoms of older adults. Methods The data were sourced from China Health and Retirement Longitudinal Study (CHARLS). The number of chronic diseases, ADL, out-of-pocket medical expenses and the Center for Epidemiological Studies Depression Scale (CES-D) were selected as measuring indexes. Mediation analysis was conducted to explore the potential mediating roles of ADL and economic burden of diseases in the association between chronic diseases and depressive symptoms. Results The number of chronic diseases, ADL, economic burden of diseases and depressive symptoms of older adults were significantly correlated with each other. ADL and economic burden of diseases individually mediated the relationship between the number of chronic diseases and depressive symptoms, accounting for 31.460% and 5.471% of the total effect, respectively. Additionally, ADL and economic burden of diseases demonstrated a chain mediating effect in this relationship, contributing to 0.759% of the total effect. Conclusion The chain-mediated model effectively elucidated the mediating roles of ADL and economic burden of diseases in the association between chronic diseases and depressive symptoms among older adults. The study underscores the need for policymakers to focus attentively on the mental health of older adults with chronic diseases. Enhancing the capacity for ADL and strengthening social security to mitigate the economic burden of diseases are recommended strategies to alleviate depressive symptoms in older adults.
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Affiliation(s)
- Zihan Ni
- School of Elderly Care Services and Management, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xiuyuan Zhu
- School of Elderly Care Services and Management, Nanjing University of Chinese Medicine, Nanjing, China
| | - Kan Tian
- School of Elderly Care Services and Management, Nanjing University of Chinese Medicine, Nanjing, China
| | - Qing Chen
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yi Yang
- School of Public Health, Fudan University, Shanghai, China
- National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Shiyu Xie
- School of Elderly Care Services and Management, Nanjing University of Chinese Medicine, Nanjing, China
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Coiffier O, Tondo P, Joyeux-Faure M, Tamisier R, Amrani K, Cornu JC, Terrail R, Caussé C, Bailly S, Pépin JL. Multidimensional phenotyping to distinguish among distinct obstructive sleep apnea, chronic obstructive pulmonary disease, and overlap syndrome phenotypes. Sleep Med 2024; 119:281-288. [PMID: 38718597 DOI: 10.1016/j.sleep.2024.04.038] [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: 02/11/2024] [Revised: 03/14/2024] [Accepted: 04/29/2024] [Indexed: 06/18/2024]
Abstract
OBJECTIVE/BACKGROUND Chronic obstructive pulmonary disease (COPD), obstructive sleep apnea (OSA) and their comorbid association called Overlap Syndrome (OS) are frequent chronic diseases with high individual and societal burdens. Precise descriptions of the respective symptoms, comorbidities, and medications associated with these three conditions are lacking. We used a multidimensional phenotyping approach to identify relevant phenotypes characterizing these 3 disorders. PATIENTS/METHODS 308 patients with OSA, COPD and OS were prospectively assessed using a combination of body shape measurements and multidimensional questionnaires evaluating sleep, fatigue, depression and respiratory symptoms. Comorbidities and medications were confirmed by physicians. Patients made home blood pressure self-measurements using a connected wearable device to identify undiagnosed or uncontrolled hypertension. RESULTS Three distinct relevant phenotypes were identified. OSA patients were round in shape with a balanced waist-to-hip ratio, frequent witnessed apneas, nocturia, daytime sleepiness, depression, and high diastolic blood pressure. COPD patients had a thinner body shape with a high waist-to-hip ratio, complained mainly of fatigue, and exhibited a higher resting heart rate. OS patients were round in shape with a balanced waist-to-hip ratio, reported little sleepiness and depression, but had impaired sleep and the highest rate of cardio-metabolic comorbidities. Diminished fitness-to-drive was most apparent in patients with OSA and OS. Home blood pressure measurements identified undiagnosed hypertension in 80 % of patients and in nearly 80 % of those with hypertension it was uncontrolled by their current medications. CONCLUSIONS Our systematic multidimensional phenotyping approach identified distinct body shapes, symptoms, and comorbidity profiles among patients with OSA, COPD, and OS.
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Affiliation(s)
- Ophélie Coiffier
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2 Laboratory, Grenoble, France
| | - Pasquale Tondo
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2 Laboratory, Grenoble, France; Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Marie Joyeux-Faure
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2 Laboratory, Grenoble, France; Pole Thorax et Vaisseaux, Laboratoire EFCR (Explorations Fonctionnelles Cardiovasculaire et Respiratoire), CHU Grenoble Alpes, Grenoble, France
| | - Renaud Tamisier
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2 Laboratory, Grenoble, France; Pole Thorax et Vaisseaux, Laboratoire EFCR (Explorations Fonctionnelles Cardiovasculaire et Respiratoire), CHU Grenoble Alpes, Grenoble, France
| | - Khier Amrani
- Pneumology Department, Verdun Hospital, Verdun, France
| | | | - Robin Terrail
- Pole Thorax et Vaisseaux, Laboratoire EFCR (Explorations Fonctionnelles Cardiovasculaire et Respiratoire), CHU Grenoble Alpes, Grenoble, France
| | | | - Sebastien Bailly
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2 Laboratory, Grenoble, France; Pole Thorax et Vaisseaux, Laboratoire EFCR (Explorations Fonctionnelles Cardiovasculaire et Respiratoire), CHU Grenoble Alpes, Grenoble, France
| | - Jean-Louis Pépin
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2 Laboratory, Grenoble, France; Pole Thorax et Vaisseaux, Laboratoire EFCR (Explorations Fonctionnelles Cardiovasculaire et Respiratoire), CHU Grenoble Alpes, Grenoble, France.
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van der Veen S, Evans N, Widdershoven G, Huisman M. The BigMove Intervention for People With Physical and Mental Health Conditions: A First Evaluation of Self-Perceived Health, Quality of Life, Coping and Mental and Social Functioning. Int J Integr Care 2024; 24:12. [PMID: 39131909 PMCID: PMC11312720 DOI: 10.5334/ijic.8317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 07/25/2024] [Indexed: 08/13/2024] Open
Abstract
Background The BigMove intervention aims to improve the functioning and quality of life of people with physical and mental health conditions via an integrated care approach. This pilot study evaluates the impact of the intervention on self-perceived health (SPH), quality of life (QoL), active coping behaviour, and mental and social functioning. Methods Data were analysed from N = 457 participants who had been referred to the intervention by their general practitioner (mean age 48.98 years; 76% female). Three patient-reported and one clinician-rated measures were used: SPH, QoL (MANSA), active coping behaviour (UPCC-ACT), mental and social functioning (HoNOS). Pre- and post-intervention measurements (from 2011 to 2018) were compared using paired-samples t-tests. Due to missing data, analyses were conducted with 205-257 participants per completed outcome. Associations with age and sex were assessed using repeated-measures ANOVA. Clinically relevant change was evaluated with the Edwards-Nunnally index and standard error of measurement (SEM) scores. Results Post-intervention, there were statistically significant improvements for all outcomes (p < 0.0001) with moderate to large effect sizes (d = 0.41 to 1.02). The observed changes in outcomes can be considered as clinically relevant improvements. Conclusion This pilot study provides preliminary evidence that the intervention has positive effects on SPH, QoL, active coping behaviour, and mental and social functioning.
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Affiliation(s)
- Sabina van der Veen
- Department of Ethics, Law and Humanities, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Institute, Amsterdam, Netherlands
- Faculty of Social Sciences, Institute of Psychology, Health, Medical and Neuropsychology unit, Leiden University, Leiden, Netherlands
| | - Natalie Evans
- Department of Ethics, Law and Humanities, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Institute, Amsterdam, Netherlands
| | - Guy Widdershoven
- Department of Ethics, Law and Humanities, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Institute, Amsterdam, Netherlands
| | - Martijn Huisman
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
- Faculty of Social Sciences, Department of Sociology, VU University, Amsterdam, Netherlands
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22
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Hu Z, Tang L, Xu X, Zhan Y. Association between physical activity and psychosocial status in adults with epilepsy: Results from the 2022 National health Interview survey. Epilepsy Behav 2024; 156:109836. [PMID: 38761448 DOI: 10.1016/j.yebeh.2024.109836] [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: 01/21/2024] [Revised: 05/11/2024] [Accepted: 05/11/2024] [Indexed: 05/20/2024]
Abstract
OBJECTIVE The study aimed to investigate the association between physical activity and the four dimensions of psychosocial status in adults with epilepsy. METHODS The data of individuals with epilepsy utilized in this cross-sectional study were derived from the 2022 National Health Interview Survey(NHIS). Physical activity was analyzed based on walking, moderate or vigorous intensity physical activity and the 2018 Physical Activity Guidelines (PAG) for Americans. The psychosocial status of the participants was assessed using self-report questionnaires that evaluated life satisfaction, symptoms of depression and anxiety, and social functioning. A multivariate ordinal regression model was employed to estimate odds ratios (ORs) and corresponding 95% confidence intervals (CIs) following adjustment for potential confounding factors. RESULTS In total of 424 individuals with epilepsy(mean age:48.0 years; male: 40.6 %) were included in this study. About 39.9 % of the participants met the 2018 PAG for aerobic activity. After controlling for potential confounding factors, individuals who adhered to the 2018 PAG for aerobic activity were found to have a higher likelihood of reporting increased life satisfaction (OR, 0.39; 95 % CI: 0.21, 0.71), decreased symptoms of depression (OR, 0.53; 95 % CI: 0.30, 0.94), and improved social functioning (OR, 0.42; 95 % CI: 0.24, 0.74). However, no significant association was observed between physical activity and anxiety symptoms among individuals with epilepsy. CONCLUSIONS This study emphasizes that moderate to vigorous physical activity enhances psychosocial health in individuals with epilepsy. Nevertheless, it is important to note that a causal relationship cannot be inferred from these findings, and further verification through randomized controlled trials is necessary.
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Affiliation(s)
- Zhao Hu
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Lu Tang
- Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Xiaowei Xu
- Department of Neurology, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China.
| | - Yiqiang Zhan
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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23
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Maier HB, Borchert A, Neyazi A, Moschny N, Schülke R, Bundies GL, Folsche T, Gaspert A, Seifert J, Bleich S, Scherf-Clavel M, Unterecker S, Deckert J, Frieling H, Weber H. Risk Phenotypes, Comorbidities, Pharmacotherapy, and Electroconvulsive Therapy (ECT) in a Cohort with Difficult-to-Treat Depression in Comparison to an Unmedicated Control Group. PHARMACOPSYCHIATRY 2024; 57:191-203. [PMID: 38698605 PMCID: PMC11233224 DOI: 10.1055/a-2292-1438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 03/11/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND Approximately 15-25% of depressed patients suffer from difficult-to-treat depression (DTD). Patients with DTD require a thorough examination to avoid the oversight of treatable (psychiatric/somatic) comorbidities or (pseudo-)resistance to antidepressant drugs (ADs). Polymorphisms of the cytochrome P450 (CYP) enzymes 2D6 and 2C19, which play a major role in the metabolism of ADs, may contribute to resistance to ADs. Patients with DTD might benefit from electroconvulsive therapy (ECT). METHODS We enrolled 109 patients with DTD and 29 untreated depressed controls (UDC). We assessed risk phenotypes, comorbidities, and treatment, including ECT. We also performed pharmacokinetic analyses of CYP2D6 and CYP2C19. RESULTS DTD patients significantly more often suffered from comorbid psychiatric diseases, especially ICD-10: F40-F48 (DTD:40.4%, UDC:17.2%, OR 11.87, p=0.011) than UDC patients. DTD patients receiving ECT were more likely to achieve remission (37.7% vs. 11.8%, OR=3.96, p=0.023). Treatment with ADs did not differ between remitters and non-remitters. No significant differences were observed in the distribution of CYP2D6 and CYP2C19 variants between both groups. CONCLUSION Patients with DTD appear to experience comorbid neurotic stress and somatoform disorders (ICD-10: F40 - F48) more frequently. Therefore, a comprehensive differential diagnosis is crucial when patients do not respond sufficiently to antidepressant medication. Genotyping CYP2D6 and CYP2C19 should be considered.
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Affiliation(s)
- Hannah B. Maier
- Department of Psychiatry, Social Psychiatry, and Psychotherapy,
Hannover Medical School, Germany
| | - Anton Borchert
- Department of Psychiatry, Social Psychiatry, and Psychotherapy,
Hannover Medical School, Germany
| | - Alexandra Neyazi
- Department of Psychiatry, Social Psychiatry, and Psychotherapy,
Hannover Medical School, Germany
- Department of Psychiatry and Psychotherapy, Otto von Guericke
University Magdeburg, Germany
| | - Nicole Moschny
- Department of Psychiatry, Social Psychiatry, and Psychotherapy,
Hannover Medical School, Germany
| | - Rasmus Schülke
- Department of Psychiatry, Social Psychiatry, and Psychotherapy,
Hannover Medical School, Germany
| | - Gabriel L. Bundies
- Department of Psychiatry, Social Psychiatry, and Psychotherapy,
Hannover Medical School, Germany
| | - Thorsten Folsche
- Department of Psychiatry, Social Psychiatry, and Psychotherapy,
Hannover Medical School, Germany
| | - Anastasia Gaspert
- Department of Psychiatry, Social Psychiatry, and Psychotherapy,
Hannover Medical School, Germany
| | - Johanna Seifert
- Department of Psychiatry, Social Psychiatry, and Psychotherapy,
Hannover Medical School, Germany
| | - Stefan Bleich
- Department of Psychiatry, Social Psychiatry, and Psychotherapy,
Hannover Medical School, Germany
| | - Maike Scherf-Clavel
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of
Mental Health, University Hospital of Würzburg, Germany
| | - Stefan Unterecker
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of
Mental Health, University Hospital of Würzburg, Germany
| | - Jürgen Deckert
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of
Mental Health, University Hospital of Würzburg, Germany
| | - Helge Frieling
- Department of Psychiatry, Social Psychiatry, and Psychotherapy,
Hannover Medical School, Germany
| | - Heike Weber
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of
Mental Health, University Hospital of Würzburg, Germany
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Blanchet C, Peralta M, de Maio Nascimento M, Gouveia ÉR, Ferrari G, Ribeiro TD, Marques A. Grip strength buffers the harmful association between multimorbidity and depression among middle-aged and older adults. Arch Gerontol Geriatr 2024; 122:105391. [PMID: 38428268 DOI: 10.1016/j.archger.2024.105391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/18/2024] [Accepted: 02/27/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Grip strength (GS) is associated to both multimorbidity and depression, however its possible moderating effect is unknown. This study aimed to investigate GS moderating effect on the association between multimorbidity and depression. METHODS Data from SHARE wave 8 was used. Participant were 41457 middle-aged and older adults (17954 men) from 18 European countries. A regression analysis was conducted for the moderating effect of sex- and age-specific GS quartiles (W) on the association between number of chronic diseases (X1) or multimorbidity (X2) and depression symptoms (Y). RESULTS More chronic diseases were associated with greater depressive symptomatology (men: B = 0.39, 95 % CI: 0.35, 0.42; women: B = 0.42, 95 % CI: 0.39, 0.45). On the other hand, being in a higher GS quartile was associated with fewer depression symptoms, and this association was stronger the higher the quartile was. Having a higher GS represented a decrease in depression symptoms associated with multimorbidity for men (quartile 1: B = 0.85, 95 % CI = 0.74, 0.95 vs. quartile 4: B = 0.49, 95 % CI = 0.38, 0.61) and women (quartile 1: B = 1.08, 95 %CI = 0.97, 1.19 vs. quartile 4: B = 0.59, 95 %CI: 0.47, 0.70). CONCLUSIONS Strategies aiming to reduce the impact of multimorbidity on mental health should promote muscle-strengthening physical activity among middle-aged and older adults.
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Affiliation(s)
| | - Miguel Peralta
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal; ISAMB, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | | | - Élvio R Gouveia
- Department of Physical Education and Sport, University of Madeira, Funchal, Portugal; Laboratory of Robotics and Engineering Systems (LARSYS), Interactive Technologies Institute, Funchal, Portugal
| | - Gerson Ferrari
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago, Chile
| | - Tiago D Ribeiro
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | - Adilson Marques
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal; ISAMB, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
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25
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Anindya K, Zhao Y, Hoang T, Lee JT, Juvekar S, Krishnan A, Mbuma V, Sharma T, Ng N. Interrelationships between physical multimorbidity, depressive symptoms and cognitive function among older adults in China, India and Indonesia: A four-way decomposition analysis. Arch Gerontol Geriatr 2024; 122:105386. [PMID: 38640878 DOI: 10.1016/j.archger.2024.105386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 02/07/2024] [Accepted: 02/23/2024] [Indexed: 04/21/2024]
Abstract
OBJECTIVE This paper explores the role of depressive symptoms (mediator/moderator) in the association between physical multimorbidity (exposure) and cognitive function (outcome) among older adults in the three most populous middle-income countries. METHODS This study used cross-sectional data from China (2015 China Health and Retirement Longitudinal Study), India (2017/2018 Longitudinal Ageing Study in India), and Indonesia (2014/2015 Indonesian Family Life Survey), with a total sample of 73,199 respondents aged ≥ 45 years. Three domains of cognitive tests were harmonised across surveys, including time orientation, word recall, and numeracy. The four-way decomposition analysis assessed the mediation and interaction effects between exposure, mediator/moderator, and outcome, adjusted for covariates. RESULTS The mean age of the respondents (in years) was slightly younger in Indonesia (56.0, SD = 8.8) than in China (59.5, SD = 9.3) and India (60.0, SD = 10.5). The proportion of male respondents was 49.3 % in China, 47.3 % in India, and 47.5 % in Indonesia. Respondents in China had the highest mean cognitive function z scores (54.7, SD = 19.9), followed by India (51.1, SD = 20.0) and Indonesia (51.0, SD = 18.4). Physical multimorbidity was associated with lower cognitive function in China and India (p < 0.0001), with 48.4 % and 40.0 % of the association explained by the mediating effect of depressive symptoms ('overall proportion due to mediation'). The association was not found in Indonesia. CONCLUSION Cognitive functions were lower among individuals with physical multimorbidity, and depressive symptoms mainly explained the association. Addressing depressive symptoms among persons with physical multimorbidity is likely to have not only an impact on their mental health but could prevent cognitive decline.
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Affiliation(s)
- Kanya Anindya
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Yang Zhao
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia; The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Thanh Hoang
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - John Tayu Lee
- Nossal Institute for Global Health, The University of Melbourne, Melbourne, Australia; Department of Primary Care and Public Health, School of Public Health, Imperial College London, United Kingdom; College of Health and Medicine, Australian National University, Canberra, Australia
| | - Sanjay Juvekar
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India
| | - Anand Krishnan
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Vanessa Mbuma
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Tarishi Sharma
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Nawi Ng
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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26
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Komatsu K, Kimura S, Kiryu Y, Watanabe A, Kinai E, Oka S, Kimura S, Fujitani J, Ogata M, Minamimoto R, Hotta M, Yokoyama K, Noguchi T, Imai K. Prevalence and associated factors of low vigor in patients living with HIV and hemophilia in Japan: A cross-sectional observational study. Glob Health Med 2024; 6:174-182. [PMID: 38947408 PMCID: PMC11197162 DOI: 10.35772/ghm.2023.01108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 04/14/2024] [Accepted: 04/30/2024] [Indexed: 07/02/2024]
Abstract
People living with human immunodeficiency virus (HIV) are at high risk of mental health problems. However, little is known about this risk in HIV-infected patients with hemophilia (HPH) who contracted the virus through blood products. This cross-sectional, observational study assessed patients' mood states and the factors associated with them among Japanese HPH to evaluate the need for psychosocial support. HPH completed self-administered questionnaires (Profile of Mood States [POMS] and General Health Questionnaire-28), neuropsychological tests, and brain magnetic resonance imaging (MRI) and fluorodeoxyglucose positron emission tomography/computerized tomography scans. HIV-infected patients with no hemophilia (HPnH) completed POMS and neuropsychological tests. Socio-demographic characteristics and HIV- and hemophilia-related data were obtained from participants' medical records and interviews. A Mann-Whitney U test and chi-squared analyses were conducted. Fifty-six HPH and 388 HPnH completed the questionnaires and neuropsychological tests. HPH had a significantly lower prevalence of tension-anxiety (HPH, 7%; HPnH, 18%; p = 0.049) and a significantly higher prevalence of low vigor (HPH, 63%; HPnH, 32%; p < 0.001). Low vigor in HPH was significantly associated with impaired executive function (low vigor, 66%; high vigor, 33%; p = 0.019) and a social dysfunction score ≥ 3 (moderate; low vigor, 26%; high vigor, 5%; p = 0.047). Our results highlight the high prevalence of low vigor among HPH, leading to impairments in executive and social functions. Therefore, healthcare workers need to pay attention to the vigor, executive function, and social function of HPH.
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Affiliation(s)
- Kensuke Komatsu
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
- Faculty of Human Sciences, Wako University, Tokyo, Japan
| | - Sota Kimura
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoko Kiryu
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Aki Watanabe
- Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Ei Kinai
- Department of Laboratory Medicine, Tokyo Medical University Hospital, Tokyo, Japan
| | - Shinichi Oka
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Kimura
- The Center for Education and Research of Infection Prevention and Control, Tokyo Healthcare University, Tokyo, Japan
| | - Junko Fujitani
- Department of Rehabilitation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mikiko Ogata
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ryogo Minamimoto
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masatoshi Hotta
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kota Yokoyama
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Radiology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tomoyuki Noguchi
- Department of Radiology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Koubun Imai
- Department of Psychiatry, Hitachi Medical Education and Research Center, University of Tsukuba Hospital, Ibaraki, Japan
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Xi J, Li PWC, Yu DSF. Multimorbidity: The need for a consensus on its operational definition. J Adv Nurs 2024. [PMID: 38887124 DOI: 10.1111/jan.16292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 06/06/2024] [Indexed: 06/20/2024]
Affiliation(s)
- Jing Xi
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Polly Wai-Chi Li
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Doris Sau-Fung Yu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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28
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Hong HC, Kim YM. Multimorbidity and its Associated Factors in Korean Shift Workers: Population-Based Cross-Sectional Study. JMIR Public Health Surveill 2024; 10:e55014. [PMID: 38857074 PMCID: PMC11196912 DOI: 10.2196/55014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/11/2024] [Accepted: 05/14/2024] [Indexed: 06/11/2024] Open
Abstract
BACKGROUND Multimorbidity is a crucial factor that influences premature death rates, poor health, depression, quality of life, and use of health care. Approximately one-fifth of the global workforce is involved in shift work, which is associated with increased risk for several chronic diseases and multimorbidity. About 12% to 14% of wage workers in Korea are shift workers. However, the prevalence of multimorbidity and its associated factors in Korean shift workers are rarely reported. OBJECTIVE This study aimed to assess multimorbidity prevalence, examine the factors associated with multimorbidity, and identify multimorbidity patterns among shift workers in Korea. METHODS This study is a population-based cross-sectional study using Korea National Health and Nutrition Examination Survey data from 2016 to 2020. The study included 1704 (weighted n=2,697,228) Korean shift workers aged 19 years and older. Multimorbidity was defined as participants having 2 or more chronic diseases. Demographic and job-related variables, including regular work status, average working hours per week, and shift work type, as well as health behaviors, including BMI, smoking status, alcohol use, physical activity, and sleep duration, were included in the analysis. A survey-corrected logistic regression analysis was performed to identify factors influencing multimorbidity among the workers, and multimorbidity patterns were identified with a network analysis. RESULTS The overall prevalence of multimorbidity was 13.7% (302/1704). Logistic regression indicated that age, income, regular work, and obesity were significant factors influencing multimorbidity. Network analysis results revealed that chronic diseases clustered into three groups: (1) cardiometabolic multimorbidity (hypertension, dyslipidemia, diabetes, coronary heart disease, and stroke), (2) musculoskeletal multimorbidity (arthritis and osteoporosis), and (3) unclassified diseases (depression, chronic liver disease, thyroid disease, asthma, cancer, and chronic kidney disease). CONCLUSIONS The findings revealed that several socioeconomic and behavioral factors were associated with multimorbidity among shift workers, indicating the need for policy development related to work schedule modification. Further organization-level screening and intervention programs are needed to prevent and manage multimorbidity among shift workers. We also recommend longitudinal studies to confirm the effects of job-related factors and health behaviors on multimorbidity among shift workers in the future.
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Affiliation(s)
- Hye Chong Hong
- Department of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | - Young Man Kim
- College of Nursing, Jeonbuk National University, Jeonju, Republic of Korea
- Research Institute of Nursing Science, Jeonbuk National University, Jeonju, Republic of Korea
- Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju, Republic of Korea
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Sternberg A, Bethge M, Ober J, Weier L, Benninghoven D. [Sensitivity and specificity of the PHQ-9 for identifying suicidality in medical rehabilitation]. DIE REHABILITATION 2024; 63:180-188. [PMID: 38552642 DOI: 10.1055/a-2192-3688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
PURPOSE Suicidality is rarely assessed in patients treated in German rehabilitation centers, although individuals with physical and mental impairments have an increased risk for suicidality. The item 9 of the 9-item depression module of the Patient Health Questionnaire (PHQ-9) asks about the desire to be dead or to harm oneself and could be used as a possible screening for suicidality. The Columbia Suicide Severity Rating Scale (C-SSRS) is a standardized interview to assess suicidality. We assessed the prevalence of suicidality in orthopedic and cardiac rehabilitation using the C-SSRS and the PHQ-9, examined the diagnostic accuracy of the item 9 of the PHQ-9 and of the PHQ-9 total score for identifying suicidality and surveyed the acceptance of the suicidality assessment by the rehabilitants. METHODS Study participants were screened with the PHQ-9 and subsequently interviewed using C-SSRS. Sensitivity and specificity of the item 9 of the PHQ-9 and the PHQ-9 total score were tested for the presence of suicidality assessed with the C-SSRS and in a sensitivity analysis for the presence of nonspecific active suicidal ideation (item 2 of the C-SSRS). We calculated the area under the curve (AUC) to predict the ability of the PHQ-9 to discriminate between individuals with and without acute suicidality. Screening and interview were evaluated by the rehabilitants. RESULTS Among 405 study participants, the prevalence of acute suicidality measured by the C-SSRS was 0.5%. 4% reported nonspecific active suicidal ideation on the C-SSRS. 10.4% reported suicidal ideation on item 9 of the PHQ-9. The sensitivity of item 9 and the PHQ-9 total score for identifying acute suicidality was only 50.0% (95% CI: 1.3% to 98.7%). However, item 9 was sensitive (81.3%, 95% CI: 54.4% to 96.0%) and specific (92.5%, 95% CI: 89.5% to 95.0%) for identifying nonspecific active suicidal ideation. Estimators for sensitivity were highly uncertain because of the low prevalence of acute suicidality. Addressing suicidality was rated as useful and helpful by study participants. CONCLUSION If the response to item 9 is positive, the immediate risk of suicide is low. However, PHQ-9 is suitable for identifying patients with non-specific suicidal thoughts. A conspicuous score on the item 9 of the PHQ-9 should be further clarified by a psychotherapist.
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Affiliation(s)
- Annika Sternberg
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck
| | - Matthias Bethge
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck
| | - Jona Ober
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck
| | - Lisa Weier
- Mühlenbergklinik Holsteinische Schweiz, Malente
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Manemann SM, Hade EM, Haller IV, Horne BD, Benziger CP, Lampert BC, Rasmusson KD, Roger VL, Weston SA, Killian JM, Chamberlain AM. The impact of multimorbidity and functional limitation on quality of life in patients with heart failure: A multi-site study. J Am Geriatr Soc 2024; 72:1750-1759. [PMID: 38634747 PMCID: PMC11187645 DOI: 10.1111/jgs.18924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/14/2024] [Accepted: 03/24/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Multimorbidity and functional limitation are associated with poor outcomes in heart failure (HF). However, the individual and combined effect of these on health-related quality of life in patients with HF is not well understood. METHODS Patients aged ≥30 years with two or more HF diagnostic codes and one or more HF-related prescription drugs from four U.S. institutions were mailed a survey to measure patient-centric factors including functional status (activities of daily living [ADLs]) and health-related quality of life (PROMIS-29 Health Profile). Patients with HF from January 1, 2013 to February 1, 2018 were included. Multimorbidity was defined as ≥2 non-cardiovascular comorbidities; functional limitation as any limitation in at least one of eight ADLs. Patients were categorized into four groups by multimorbidity (Yes/No) and functional limitation (Yes/No). We dichotomized the PROMIS-29 sub-scale scores at the median and calculated odd ratios for the four multimorbidity/functional limitation groups. RESULTS A total of 3330 patients with HF returned the survey (response rate 31%); 3020 completed the questions of interest and were retained. Among these patients (45% female; mean age 73 [standard deviation: 12] years), 29% had neither multimorbidity nor functional limitation, 24% had multimorbidity only, 22% had functional limitation only, and 25% had both. After adjustment, having functional limitation only was associated with higher anxiety (odds ratio [OR]: 3.44, 95% confidence interval [CI]: 2.66-4.45), depression (OR: 3.11, 95% CI: 2.39-4.06), and fatigue (OR: 4.19, 95% CI: 3.25-5.40); worse sleep (OR: 2.14, 95% CI: 1.69-2.72) and pain (OR: 6.73, 95% CI: 5.15-8.78); and greater difficulty with social activities (OR: 9.40, 95% CI: 7.19-12.28) compared with having neither. Results were similar for having both multimorbidity and functional limitation. CONCLUSION Patients with only functional limitation have similar poor health-related quality of life scores as those with both multimorbidity and functional limitation, underscoring the important role that physical functioning plays in the well-being of patients with HF.
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Affiliation(s)
| | - Erinn M. Hade
- Department of Population Health, NYU Grossman School of Medicine, New York, NY
| | - Irina V. Haller
- Essentia Institute of Rural Health, Essentia Health, Duluth, MN
| | - Benjamin D. Horne
- Intermountain Medical Center Heart Institute, Salt Lake City, UT
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, CA
| | | | - Brent C. Lampert
- Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, OH
| | | | - Veronique L. Roger
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
- Epidemiology and Community Health Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | - Susan A. Weston
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Jill M. Killian
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Alanna M. Chamberlain
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
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Yu H, Zhang Y, Hu M, Xiang B, Wang S, Wang Q. Inter- and intrapopulation differences in the association between physical multimorbidity and depressive symptoms. J Affect Disord 2024; 354:434-442. [PMID: 38508455 DOI: 10.1016/j.jad.2024.03.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 03/12/2024] [Accepted: 03/15/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND The association between physical multimorbidity and depression differs by populations. However, no direct inter- or intrapopulation comparison of the association has been conducted. Thus, this study aims to estimate the association in China and the United States and reveal inter- and intrapopulation differences in the association. METHODS Middle-aged and older adults from the China Health and Retirement Longitudinal Study and the Health and Retirement Study were included. Physical multimorbidity was defined as the simultaneous presence of two or more chronic physical conditions and depressive symptoms was measured by the Center for Epidemiologic Studies Depression Scale. Generalized estimating equation model and stratification multilevel method were the main statistical models. RESULTS The presence of physical multimorbidity was associated with a higher risk of depression in both China (RR = 1.360 [95 % CI: 1.325-1.395]) and the US (RR = 1.613 [95 % CI: 1.529-1.701]). For individuals at a low risk of multimorbidity, multimorbidity was associated with 47.4 % (95 % CI: 1.377-1.579) and 71.1 % (95 % CI: 1.412-2.074) increases in the likelihood of depression in China and the US. The effect size was smaller for individuals at a moderate or high risk. However, the cross-national differences were greater for those with a high risk of multimorbidity. LIMITATIONS The self-report measures, attribution bias. CONCLUSIONS Compared to Chinese adults, the presence of physical multimorbidity led to an additional increase in depressive symptoms for American counterparts. The association was stronger for individuals at a low risk of multimorbidity, but cross-national differences were observed mostly among individuals at a high risk.
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Affiliation(s)
- Haiyang Yu
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, China; National Institute of Health Data Science of China, Shandong University, Jinan, China
| | - Yike Zhang
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, China; National Institute of Health Data Science of China, Shandong University, Jinan, China
| | - Mengxiao Hu
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, China; National Institute of Health Data Science of China, Shandong University, Jinan, China
| | - Bowen Xiang
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, China; National Institute of Health Data Science of China, Shandong University, Jinan, China
| | - Sijia Wang
- National Institute of Health Data Science of China, Shandong University, Jinan, China; Institute for Global Health, Faculty of Population Health Sciences, University College London, London, United Kingdom
| | - Qing Wang
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, China; National Institute of Health Data Science of China, Shandong University, Jinan, China; Yellow River National Strategic Research Institute, Shandong University, Jinan, Shandong, China.
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32
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Guo D, Wang C, Liu X. Association of chronic diseases with depression in the United States, NHANES 2007-2018. PSYCHOL HEALTH MED 2024; 29:1077-1090. [PMID: 37990352 DOI: 10.1080/13548506.2023.2277153] [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: 04/10/2023] [Accepted: 10/24/2023] [Indexed: 11/23/2023]
Abstract
Depression often coexists with many chronic diseases. However, previous studies mainly focused on the association between a single chronic disease or chronic diseases of the elderly and depression. This study included 26,177 adults aged more than 20 years old from the 2007-2018 National Health and Nutrition Examination Survey. Depression was determined by nine questions which were from the Patient Health Questionnaire. We used propensity score matching to reduce the influence of confounders between the depression and non-depression groups. A multivariate logistic regression model was used to analyze the relationship between various chronic diseases and the number of diseases and depression. The prevalence of depression in participants with chronic diseases was higher than that in participants without chronic diseases, 20.8% of participants with chronic bronchitis had depression. After matching and controlling sleep, insurance and smoking, the highest risk of depression (OR = 1.524; 95% CI: 1.162-2.001) was found in people with stroke, followed by arthritis (OR = 1.464; 95% CI: 1.275-1.681). The percentage of participants with two or more chronic diseases with depression and without depression was 68.9% and 51.9%, respectively. Participants with five or more chronic diseases had the highest risk of depression (OR = 3.653; 95% CI: 3.001-4.446). In conclusion, patients with chronic diseases are at higher risk for depression, especially those with multiple chronic diseases. This study suggested that we should pay more attention to the mental health of people with chronic diseases.
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Affiliation(s)
- Dingjie Guo
- Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Chunpeng Wang
- School of Mathematics and Statistics, Northeast Normal University, Changchun, Jilin, China
| | - Xin Liu
- Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
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Basu S, Maheshwari V, Sodhi B, Mannan P, Kukreti P. The prevalence of depression, determinants, and linkage with functional disability amongst postmenopausal women in India: Evidence from the Longitudinal Ageing Study in India. Asian J Psychiatr 2024; 96:104030. [PMID: 38598934 DOI: 10.1016/j.ajp.2024.104030] [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: 02/01/2024] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND The study objective was estimating the prevalence and determinants of depression amongst postmenopausal women in India. Additionally, we used panel mediation analysis to model the extent to which multimorbidity was associated with depression after adjusting for the effects of functional disability in the participants. METHODS Data from 28,160 women aged 50 and above from the Longitudinal Aging Study in India (LASI) Wave 1 were analyzed. Depression was assessed using the Composite International Diagnostic Interview-Short Form (CIDI-SF), with multimorbidity and functional disability (ADL and IADL) considered as key predictor variables. Logistic regression and Karlson-Holm-Breen (KHB) mediation analysis were employed. RESULTS The weighted prevalence of depression among women aged ≥ 50 years was 21.76% (95% CI: 20.81, 22.73), significantly higher women aged < 50 years (17.60%, 95% CI: 16.33, 18.94). Factors independently associated with increased odds of depression included being unmarried, rural residence, and multimorbidity, while higher educational status was associated with lower odds of depression. The relationship between multimorbidity and depression was partially mediated by ADL and IADL disabilities. Notable regional (state) variations in the magnitude of depression were observed. CONCLUSIONS Nearly one in five postmenopausal women in India aged 50 years and older have clinical depression. Community screening for reaching the unreached with primary care mental health strengthening need enhanced policy focus.
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Affiliation(s)
- Saurav Basu
- Indian Institute of Public Health - Delhi, Public Health Foundation of India (PHFI), India
| | - Vansh Maheshwari
- Indian Institute of Public Health - Delhi, Public Health Foundation of India (PHFI), India
| | - Baani Sodhi
- Indian Institute of Public Health - Delhi, Public Health Foundation of India (PHFI), India
| | - Pallak Mannan
- Indian Institute of Public Health - Delhi, Public Health Foundation of India (PHFI), India
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Rajovic N, Zagorac S, Cirkovic A, Matejic B, Jeremic D, Tasic R, Cumic J, Masic S, Grupkovic J, Mitrovic V, Milic N, Gluscevic B. Musculoskeletal Diseases as the Most Prevalent Component of Multimorbidity: A Population-Based Study. J Clin Med 2024; 13:3089. [PMID: 38892800 PMCID: PMC11172850 DOI: 10.3390/jcm13113089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/12/2024] [Accepted: 05/16/2024] [Indexed: 06/21/2024] Open
Abstract
Background/Objectives: Due to their high frequency, common risk factors, and similar pathogenic mechanisms, musculoskeletal disorders (MSDs) are more likely to occur with other chronic illnesses, making them a "component disorder" of multimorbidity. Our objective was to assess the prevalence of multimorbidity and to identify the most common clusters of diagnosis within multimorbidity states, with the primary hypothesis that the most common clusters of multimorbidity are MSDs. Methods: The current study employed data from a population-based 2019 European Health Interview Survey (EHIS). Multimorbidity was defined as a ≥2 diagnosis from the list of 17 chronic non-communicable diseases, and to define clusters, the statistical method of hierarchical cluster analysis (HCA) was performed. Results: Out of 13,178 respondents, multimorbidity was present among 4398 (33.4%). The HCA method yielded six multimorbidity clusters representing the most common diagnoses. The primary multimorbidity cluster, which was prevalent among both genders, age groups, incomes per capita, and statistical regions, consisted of three diagnoses: (1) lower spine deformity or other chronic back problem (back pain), (2) cervical deformity or other chronic problem with the cervical spine, and (3) osteoarthritis. Conclusions: Given the influence of musculoskeletal disorders on multimorbidity, it is imperative to implement appropriate measures to assist patients in relieving the physical discomfort and pain they endure. Public health information, programs, and campaigns should be utilized to promote a healthy lifestyle. Policymakers should prioritize the prevention of MSDs by encouraging increased physical activity and a healthy diet, as well as focusing on improving functional abilities.
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Affiliation(s)
- Nina Rajovic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (N.R.); (A.C.)
| | - Slavisa Zagorac
- Clinic for Orthopedic Surgery and Traumatology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (S.Z.); (J.G.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.J.); (J.C.); (B.G.)
| | - Andja Cirkovic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (N.R.); (A.C.)
| | - Bojana Matejic
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Danilo Jeremic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.J.); (J.C.); (B.G.)
- Institute for Orthopedic Surgery “Banjica”, 11000 Belgrade, Serbia
| | - Radica Tasic
- Medical School, College of Vocational Studies, 11000 Belgrade, Serbia;
| | - Jelena Cumic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.J.); (J.C.); (B.G.)
- Department of Anesthesiology, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Srdjan Masic
- Department for Primary Health Care and Public Health, Faculty of Medicine Foca, University of East Sarajevo, 71123 East Sarajevo, Bosnia and Herzegovina;
| | - Jovana Grupkovic
- Clinic for Orthopedic Surgery and Traumatology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (S.Z.); (J.G.)
| | - Vekoslav Mitrovic
- Department for Neurology and Psychiatry, Faculty of Medicine Foca, University of East Sarajevo, 71123 East Sarajevo, Bosnia and Herzegovina
| | - Natasa Milic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (N.R.); (A.C.)
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55902, USA
| | - Boris Gluscevic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.J.); (J.C.); (B.G.)
- Institute for Orthopedic Surgery “Banjica”, 11000 Belgrade, Serbia
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Głowacka M, Przybyła N, Humańska M, Kornatowski M. Depression and anxiety as predictors of performance status and life satisfaction in older adult neurological patients: a cross-sectional cohort study. Front Psychiatry 2024; 15:1412747. [PMID: 38832331 PMCID: PMC11145277 DOI: 10.3389/fpsyt.2024.1412747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 04/30/2024] [Indexed: 06/05/2024] Open
Abstract
Neurological disorders are one of the leading causes of disability globally. Studies emphasise that the course and effectiveness of rehabilitation interventions may be influenced by emotional factors. The aim of the present study was to assess the prevalence of depressive and anxiety symptoms in patients with neurological disorders and examine whether depression and tendency to respond with anxiety are predictors of disability in these patients. The study included 229 individuals with neurological disorders aged over 55. Our findings show that stroke patients are more likely to experience depressive symptoms and are more likely to display trait anxiety as compared with patients with other neurological disorders. Advanced age, female sex, low level of education and the presence of trait anxiety are associated with a higher severity of depressive symptoms. Stroke survivors have significantly poorer ECOG performance scores and are more likely to be incapable for work. Both depression and trait anxiety are significant predictors of neurological patients' performance status, and the presence of depressive symptoms is a determinant of these patients' level of satisfaction with life. An understanding of psychological risk factors for poorer performance status in individuals with neurological disorders will make it possible to plan prophylactic interventions in order to minimise negative health impacts and facilitate access to mental health facilities.
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Affiliation(s)
- Mariola Głowacka
- Institute of Nursing, Department of Integrated Medical Care, Faculty of Health Sciences, Collegium Medicum, The Mazovian University in Płock, Płock, Poland
| | - Natalia Przybyła
- Department of Applied Neurocognitivistics, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Marzena Humańska
- Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Maciej Kornatowski
- Medical Department, Collegium Medicum, The Mazovian University in Płock, Płock, Poland
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36
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Mehl A, Klaus AK, Reif M, Rodrigues Recchia D, Zerm R, Ostermann T, Brinkhaus B, Kröz M. Validation of the Internal Coherence Scale (ICS) in Healthy Geriatric Individuals and Patients Suffering from Diabetes Mellitus Type 2 and Cancer. Geriatrics (Basel) 2024; 9:63. [PMID: 38804320 PMCID: PMC11130969 DOI: 10.3390/geriatrics9030063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 04/23/2024] [Accepted: 05/01/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND With increased life expectancy, the coexistence of functional impairment and multimorbidity can negatively impact life quality and coherence in geriatric individuals. The self-report 10-item Internal Coherence (ICS) measures how individuals cope with and make sense of disease-specific life challenges. The aim of this study was to validate the ICS in a sample of geriatric individuals. METHODS AND PROCEDURE In a cross-sectional study, geriatric individuals with and without chronic diseases were recruited. A factor analysis with principal component extraction (PCA) and a structural equation model (SEM) was conducted to assess the ICS factor structure in a geriatric sample. To measure convergent validity, the following scales were used: Short Health Survey (SF-12), Karnofsky Performance Index (KPI), Trait autonomic regulation (Trait aR), Sense of Coherence Scale (SOC), and Geriatric Depression Scale (GDS). RESULTS A sample of n = 104 (70-96 years of age) patients with Diabetes Mellitus Type 2 (n = 22), cancer diseases (n = 31) and healthy controls (n = 51) completed the ICS. PCA and SEM yielded the original two-factor solution: 1. Inner resilience and coherence and 2. Thermo coherence. Overall internal consistency for this cohort was satisfying (Cronbach's α with rα = 0.72), and test-retest reliability was moderate (rrt = 0.53). ICS scores were significantly correlated to all convergent criteria ranging between r = 0.22 * and 0.49 ** (p < 0.05 *; p < 0.01 **). CONCLUSION Study results suggest that the ICS appears to be a reliable and valid tool to measure internal coherence in a geriatric cohort (70-96 years). However, moderate test-retest reliability prompts the consideration of potential age-effects that may bias the reliability for this specific cohort.
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Affiliation(s)
- Annette Mehl
- Research Institute Havelhöhe, Kladower Damm 221, 14089 Berlin, Germany; (A.-K.K.); (R.Z.); (M.K.)
| | - Anne-Kathrin Klaus
- Research Institute Havelhöhe, Kladower Damm 221, 14089 Berlin, Germany; (A.-K.K.); (R.Z.); (M.K.)
| | - Marcus Reif
- Society for Clinical Research, Hardenbergstraße 20, 10623 Berlin, Germany;
| | - Daniela Rodrigues Recchia
- Lehrstuhl für Forschungsmethodik und Statistik in der Psychologie, University Witten/Herdecke, 58455 Witten, Germany; (D.R.R.); (T.O.)
| | - Roland Zerm
- Research Institute Havelhöhe, Kladower Damm 221, 14089 Berlin, Germany; (A.-K.K.); (R.Z.); (M.K.)
- Department of Internal Medicine, Havelhöhe Hospital, Kladower Damm 221, 14089 Berlin, Germany
| | - Thomas Ostermann
- Lehrstuhl für Forschungsmethodik und Statistik in der Psychologie, University Witten/Herdecke, 58455 Witten, Germany; (D.R.R.); (T.O.)
- Institute for Integrative Medicine, University Witten/Herdecke, Gerhard Kienle Weg 8, 58313 Herdecke, Germany
| | - Benno Brinkhaus
- Institute for Social Medicine, Epidemiology and Health Economics, Charité, Universitätsmedizin Berlin, Luisenstr. 57, 10117 Berlin, Germany;
| | - Matthias Kröz
- Research Institute Havelhöhe, Kladower Damm 221, 14089 Berlin, Germany; (A.-K.K.); (R.Z.); (M.K.)
- Institute for Integrative Medicine, University Witten/Herdecke, Gerhard Kienle Weg 8, 58313 Herdecke, Germany
- Klinik Arlesheim, Research Department, Pfeffinger Weg 1, 4144 Arlesheim, Switzerland
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Feng AH, Stanhope KK, Jamieson DJ, Boulet SL. Postpartum Psychiatric Outcomes following Severe Maternal Morbidity in an Urban Safety-Net Hospital. Am J Perinatol 2024; 41:e809-e817. [PMID: 36130668 DOI: 10.1055/a-1948-3093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE Severe maternal morbidity (SMM) may be associated with postpartum psychiatric morbidity. However, the direction and strength of this relationship remain unclear. Our goal was to estimate the association between SMM and postpartum inpatient mental health care utilization. STUDY DESIGN We examined all liveborn deliveries at a large, safety-net hospital in Atlanta, Georgia, from 2013 to 2021. SMM at or within 42 days of delivery was identified using International Classification of Disease codes. The primary outcome of interest was hospitalization with a psychiatric diagnosis in the year following the delivery. We used inverse probability of treatment weighting based on propensity scores to adjust for demographics, index delivery characteristics, and medical, psychiatric, and obstetric history. We fit log-binomial models with generalized estimating equations to calculate adjusted risk ratios (aRRs) and 95% confidence intervals (CIs). RESULTS Among 22,233 deliveries, the rates of SMM and postpartum hospitalization with a psychiatric diagnosis, respectively, were 6.8% (n = 1,149) and 0.8% (n = 169). The most common psychiatric diagnosis was nonpsychotic mood disorders (without SMM 0.4%, n = 79; with SMM 1.7% n = 24). After weighting, 2.2% of deliveries with SMM had a postpartum readmission with a psychiatric diagnosis, compared with 0.7% of deliveries without SMM (aRR: 3.2, 95% CI: [2.0, 5.2]). Associations were stronger among individuals without previous psychiatric hospitalization. CONCLUSION Experiencing SMM was associated with an elevated risk of postpartum psychiatric morbidity. These findings support screening and treatment for mild and moderate postpartum psychiatric disorders in the antenatal period. KEY POINTS · Experiencing SMM was associated with three-fold excess risk of postpartum psychiatric admission.. · Experiencing SMM was not associated with an elevated risk of outpatient psychiatric care use.. · Experience SMM was not associated with outpatient psychiatric morbidity diagnoses..
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Affiliation(s)
- Alayna H Feng
- Department of Epidemiology, Rollins School of Public Health, Atlanta, Georgia
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia
| | - Kaitlyn K Stanhope
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia
| | - Denise J Jamieson
- Department of Epidemiology, Rollins School of Public Health, Atlanta, Georgia
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia
| | - Sheree L Boulet
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia
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Stecher C, Cloonan S, Domino ME. The Economics of Treatment for Depression. Annu Rev Public Health 2024; 45:527-551. [PMID: 38100648 DOI: 10.1146/annurev-publhealth-061022-040533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
The global prevalence of depression has risen over the past three decades across all socioeconomic groups and geographic regions, with a particularly rapid increase in prevalence among adolescents (aged 12-17 years) in the United States. Depression imposes large health, economic, and societal costs, including reduced life span and quality of life, medical costs, and reduced educational attainment and workplace productivity. A wide range of treatment modalities for depression are available, but socioeconomic disparities in treatment access are driven by treatment costs, lack of culturally tailored options, stigma, and provider shortages, among other barriers. This review highlights the need for comparative research to better understand treatments' relative efficacy, cost-effectiveness, scalability, and potential heterogeneity in efficacy across socioeconomic groups and country and cultural contexts. To address the growing burden of depression, mental health policy could consider reducing restrictions on the supply of providers, implementing digital interventions, reducing stigma, and promoting healthy lifestyles.
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Affiliation(s)
- Chad Stecher
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA;
- The Center for Health Information and Research, Arizona State University, Phoenix, Arizona, USA
| | - Sara Cloonan
- Department of Psychology, University of Georgia, Athens, Georgia, USA
| | - Marisa Elena Domino
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA;
- The Center for Health Information and Research, Arizona State University, Phoenix, Arizona, USA
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Varga A, Czeglédi E, Tóth MD, Purebl G. Effectiveness of iFightDepression ® online guided self-help tool in depression: A pilot study. J Telemed Telecare 2024; 30:696-705. [PMID: 35300546 DOI: 10.1177/1357633x221084584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Depression is one of the leading causes of human misery and disability worldwide. For those fortunate enough to have access to the rapidly expanding World Wide Web, online self-help tools can guide those suffering from depression, with or without professional intervention, to better manage their symptoms and maintain some measure of self-actualization. This study assesses the efficacy of the widely used, online self-help tool, iFightDepression®. METHODS A six-week, observational study was conducted with 143 participants (29.4% men, mean age: 37.8; standard deviation [SD] = 12.05, range = 18-70, years) in three intervention groups, as follows: 1) Treatment As Usual (TAU), 2) TAU combined with access to the iFightDepression® tool (TAU + iFD®), 3) TAU combined with iFightDepression® and weekly phone support (TAU + iFD® + phone). Depression symptoms were measured pre- and post- by Patient Health Questionnaire-9. RESULTS There was a significantly greater decrease of depressive symptoms in both iFD® groups compared to the TAU group (time × group interaction: F(2) = 34.657, p < 0.001, partial η2 = 0.331). The reliable change index calculation identified one participant (0.7%) as having experienced a statistically reliable deterioration in depression. A total of 102 participants (71.3%) showed no reliable change, while 40 participants (28.0%) showed a statistically reliable improvement. Multiple binary logistic regression analysis found odds of reliable improvement to be significantly higher in both iFD® groups compared to the TAU group (TAU + iFD®: OR = 18.52, p = 0.015, TAU + iFD® + Phone: OR = 126.72, p < 0.001). Participants living in Budapest were found to have significantly higher odds for a reliable improvement compared to those living in the countryside (odds ratio [OR] = 4.04, p = 0.023). Finally, higher levels of depressive symptoms at baseline (pretest) were also associated with increased odds for post-intervention improvement (OR = 1.58, p < 0.001). The variance explained by the model is 62.0%. With regards to the iFD® self-help program, the mean of completed modules was 4.8 (SD = 1.73, range = 1-6). Participants in the group supported by weekly phone calls completed significantly more modules (n = 50, M = 5.7, SD = 0.76) than participants without weekly telephone support (n = 52, M = 3.9, SD = 1.94, Z = 5.253, p < 0.001). However, there was no significant difference in the number of completed modules between respondents with a reliable improvement in depression (n = 39, M = 4.9, SD = 1.57) and those without a reliable change (n = 63, M = 4.7, SD = 1.83, Z = 0.343, p = 0.731). CONCLUSION Our results confirm previous findings regarding the efficacy of web-based interventions with the low-intensity guidance of mental health professional. Findings suggest that a relatively short additional weekly call may result in a significant decrease in depressive symptoms and higher number of completed iFD® modules. The study confirms that the IFD® tool, both alone and with additional phone support, is a possible and effective way to help patients with mild to moderate and, in some cases, even severe depression. Providing mental and primary health care systems with the availability of online self-help tools may contribute to the efficacious treatment of depression and prevention of the increase in depressive symptoms.
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Affiliation(s)
- Anna Varga
- Semmelweis University, Budapest, Hungary
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40
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Xiao W, Liu Y, Huang J, Huang LA, Bian Y, Zou G. Analysis of factors associated with depressive symptoms in stroke patients based on a national cross-sectional study. Sci Rep 2024; 14:9268. [PMID: 38649386 PMCID: PMC11035548 DOI: 10.1038/s41598-024-59837-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 04/16/2024] [Indexed: 04/25/2024] Open
Abstract
Post-stroke depression is commonly experienced by stroke survivors and has a significant negative impact on the physical, cognitive, and social functioning of those affected. This study aims to investigate the prevalence of depressive symptoms and their associated factors in Chinese stroke patients. Research samples were selected from the China Health and Retirement Longitudinal Study 2018 survey. Depression was evaluated using the 10-item Center for Epidemiological Studies Depression Scale, with a score ≥ 10 defined as depression. Univariate and multivariable analyses were performed to examine the associations of depressive symptoms with demographics, family relationships, health status, and lifestyle. A total of 963 stroke patients were included and 57.8% of them had depressive symptoms. Depressive symptoms were significantly associated with female sex (OR 1.762, 95% CI 1.235-2.514), lower education level (non-formal education: OR 2.148, 95% CI 1.235-3.737, primary to secondary school education: OR 1.964, 95% CI 1.272-3.033), dissatisfaction with spouse (OR 1.912, 95% CI 1.075-3.401), dissatisfaction with life (OR 1.779, 95% CI 1.080-2.931), dissatisfaction with health (OR 1.592, 95% CI 1.138-2.226), pain (OR 1.392, 95% CI 1.005-1.928) and abnormal sleep (OR 1.557, 95% CI 1.126-2.152). The findings suggest the need for regular depression screening and evaluation after a stroke, and that a well-functioning support system, effective health management, and lifestyle modifications could potentially improve the mental state of stroke patients.
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Affiliation(s)
- Wenhui Xiao
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macau SAR, China
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Taipa, Macau SAR, China
- School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ying Liu
- School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jinglin Huang
- School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, China
- School of Public Health, Zhejiang University, Hangzhou, China
| | - Li-An Huang
- The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Ying Bian
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macau SAR, China.
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Taipa, Macau SAR, China.
| | - Guanyang Zou
- School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, China.
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Chen L, Ashton-James CE, Shi B, Radojčić MR, Anderson DB, Chen Y, Preen DB, Hopper JL, Li S, Bui M, Beckenkamp PR, Arden NK, Ferreira PH, Zhou H, Feng S, Ferreira ML. Variability in the prevalence of depression among adults with chronic pain: UK Biobank analysis through clinical prediction models. BMC Med 2024; 22:167. [PMID: 38637815 PMCID: PMC11027372 DOI: 10.1186/s12916-024-03388-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 04/11/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND The prevalence of depression among people with chronic pain remains unclear due to the heterogeneity of study samples and definitions of depression. We aimed to identify sources of variation in the prevalence of depression among people with chronic pain and generate clinical prediction models to estimate the probability of depression among individuals with chronic pain. METHODS Participants were from the UK Biobank. The primary outcome was a "lifetime" history of depression. The model's performance was evaluated using discrimination (optimism-corrected C statistic) and calibration (calibration plot). RESULTS Analyses included 24,405 patients with chronic pain (mean age 64.1 years). Among participants with chronic widespread pain, the prevalence of having a "lifetime" history of depression was 45.7% and varied (25.0-66.7%) depending on patient characteristics. The final clinical prediction model (optimism-corrected C statistic: 0.66; good calibration on the calibration plot) included age, BMI, smoking status, physical activity, socioeconomic status, gender, history of asthma, history of heart failure, and history of peripheral artery disease. Among participants with chronic regional pain, the prevalence of having a "lifetime" history of depression was 30.2% and varied (21.4-70.6%) depending on patient characteristics. The final clinical prediction model (optimism-corrected C statistic: 0.65; good calibration on the calibration plot) included age, gender, nature of pain, smoking status, regular opioid use, history of asthma, pain location that bothers you most, and BMI. CONCLUSIONS There was substantial variability in the prevalence of depression among patients with chronic pain. Clinically relevant factors were selected to develop prediction models. Clinicians can use these models to assess patients' treatment needs. These predictors are convenient to collect during daily practice, making it easy for busy clinicians to use them.
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Affiliation(s)
- Lingxiao Chen
- Department of Orthopaedics, Qilu Hospital of Shandong University, Shandong University Centre for Orthopaedics, Advanced Medical Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, People's Republic of China
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, People's Republic of China
- Sydney Musculoskeletal Health, The Kolling Institute, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Claire E Ashton-James
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Baoyi Shi
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, USA
| | - Maja R Radojčić
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - David B Anderson
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Yujie Chen
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - David B Preen
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - John L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Shuai Li
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Minh Bui
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Paula R Beckenkamp
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Nigel K Arden
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Paulo H Ferreira
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Hengxing Zhou
- Department of Orthopaedics, Qilu Hospital of Shandong University, Shandong University Centre for Orthopaedics, Advanced Medical Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, People's Republic of China.
- The Second Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250033, People's Republic of China.
| | - Shiqing Feng
- Department of Orthopaedics, Qilu Hospital of Shandong University, Shandong University Centre for Orthopaedics, Advanced Medical Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, People's Republic of China.
- The Second Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250033, People's Republic of China.
| | - Manuela L Ferreira
- Sydney Musculoskeletal Health, The Kolling Institute, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Leon-Zamora S, Villarreal-Zegarra D, Bellido-Boza L. Association between abdominal obesity and depressive symptoms in Peruvian women aged 18-49 years: a sub-analysis of the Demographic and Family Health Survey 2018-2019. Public Health Nutr 2024; 27:e114. [PMID: 38605643 PMCID: PMC11036433 DOI: 10.1017/s1368980024000867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 02/22/2024] [Accepted: 04/02/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVE Abdominal obesity (AO) is characterised by excess adipose tissue. It is a metabolic risk that affects the physical and mental health, particularly in women since they are more prone to mental health problems like depression. This study investigated the association between AO and depressive symptoms in Peruvian women of reproductive age (18-49 years). DESIGN This is a cross-sectional observational study. SETTING Peruvian women population of reproductive age. PARTICIPANTS We used data from the Peruvian Demographic and Family Health Survey (DHS) for 2018 and 2019 to assess 17 067 women for the presence of depressive symptoms (using the Patient Health Questionnaire (PHQ-9): cut-off score ≥ 10) and AO (measured by abdominal circumference; cut-off score ≥88 cm). RESULTS We observed a 64·55 % prevalence of AO and 7·61 % of depressive symptoms in the study sample. Furthermore, 8·23 % of women with AO had depressive symptoms (P < 0·05). Initially, women with AO appeared to have a 26 % higher risk of depressive symptoms compared with women without AO (P = 0·028); however, after adjustment for covariates, no statistically significant association was observed. CONCLUSIONS Therefore, although both conditions are common in women of this age group, no significant association was found between AO and depressive symptoms.
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Affiliation(s)
- Sharon Leon-Zamora
- Facultad de Ciencias de la Salud, Universidad Peruana de
Ciencias Aplicadas, Lima, Peru
| | - David Villarreal-Zegarra
- Instituto Peruano de Orientación Psicológica, Lima,
Peru
- Escuela de Psicología, Universidad Continental,
Lima, Peru
| | - Luciana Bellido-Boza
- Facultad de Ciencias de la Salud, Universidad Peruana de
Ciencias Aplicadas, Lima, Peru
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Zhang Y, Yu G, Bai W, Wu S, Geng X, Zhang W, Liu Y, Meng Y, Gao J, Li W, Kou C. Association of depression and sleep quality with frailty: a cross-sectional study in China. Front Public Health 2024; 12:1361745. [PMID: 38645453 PMCID: PMC11026860 DOI: 10.3389/fpubh.2024.1361745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 03/21/2024] [Indexed: 04/23/2024] Open
Abstract
Background With the rapid growth of global aging, frailty has become a serious public health burden, affecting the life quality of older adults. Depressive symptoms (depression hereafter) and sleep quality are associated with frailty, but the pathways in which sleep quality and depression affect frailty remain unclear. Method This cross-sectional study included 1866 community-dwelling older adults. Demographic characteristics and health-related data of them was collected, and we also assessed frailty, depression, and sleep quality. Descriptive statistics were carried out and ordinal logistic regression analysis was used to identify the factors correlated with frailty. Spearman correlation analysis and mediation analysis were employed to assess associations between sleep quality, depression and frailty. Two-sided p < 0.05 was considered as significant. Results The results showed that 4.1% older adults were frail and 31.0% were pre-frail. Ordinal logistic regression showed that age, consumptions of vegetables, exercise, sleep quality, depression, number of chronic diseases, chronic pain, and self-rated health were correlated with frailty. Spearman correlation analysis revealed that frailty was associated with depression and sleep quality. There was a mediation effect that sleep quality was a significant and positive predictor of frailty (total effect = 0.0545, 95% boot CI = 0.0449-0.0641), and depression was a mediator between sleep quality and frailty (mediation effect = 60.4%). Conclusion Depression and poor sleep quality may be early indicators of frailty in older adults. Improving the sleep quality and psychological state of older adults can improve frailty, which is beneficial for healthy aging.
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Affiliation(s)
- Yue Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Ge Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Wei Bai
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Songyu Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xiaohan Geng
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Wangyi Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Yihang Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Yujiao Meng
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Junling Gao
- School of Public Health, Fudan University, Shanghai, China
| | - Wenjun Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Changgui Kou
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
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Nkoka O, Munthali-Mkandawire S, Mwandira K, Nindi P, Dube A, Nyanjagha I, Mainjeni A, Malava J, Amoah AS, McLean E, Stewart RC, Crampin AC, Price AJ. Association between physical multimorbidity and common mental health disorders in rural and urban Malawian settings: Preliminary findings from Healthy Lives Malawi long-term conditions survey. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002955. [PMID: 38574079 PMCID: PMC10994288 DOI: 10.1371/journal.pgph.0002955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/03/2024] [Indexed: 04/06/2024]
Abstract
In low-income Africa, the epidemiology of physical multimorbidity and associated mental health conditions is not well described. We investigated the multimorbidity burden, disease combinations, and relationship between physical multimorbidity and common mental health disorders in rural and urban Malawi using early data from 9,849 adults recruited to an on-going large cross-sectional study on long-term conditions, initiated in 2021. Multimorbidity was defined as having two or more measured (diabetes, hypertension) or self-reported (diabetes, hypertension, disability, chronic pain, HIV, asthma, stroke, heart disease, and epilepsy) conditions. Depression and anxiety symptoms were measured using the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item General Anxiety Disorder scale (GAD-7) and defined by the total score (range 0-27 and 0-21, respectively). We determined age-standardized multimorbidity prevalence and condition combinations. Additionally, we used multiple linear regression models to examine the association between physical multimorbidity and depression and anxiety symptom scores. Of participants, 81% were rural dwelling, 56% were female, and the median age was 30 years (Inter Quartile Range 21-43). The age-standardized urban and rural prevalence of multimorbidity was 14.1% (95% CI, 12.5-15.8%) and 12.2% (95% CI, 11.6-12.9%), respectively. In adults with two conditions, hypertension, and disability co-occurred most frequently (18%), and in those with three conditions, hypertension, disability, and chronic pain were the most common combination (23%). Compared to adults without physical conditions, having one (B-Coefficient (B) 0.79; 95% C1 0.63-0.94%), two- (B 1.36; 95% CI 1.14-1.58%), and three- or more- physical conditions (B 2.23; 95% CI 1.86-2.59%) were associated with increasing depression score, p-trend <0.001. A comparable 'dose-response' relationship was observed between physical multimorbidity and anxiety symptom scores. While the direction of observed associations cannot be determined with these cross-sectional data, our findings highlight the burden of multimorbidity and the need to integrate mental and physical health service delivery in Malawi.
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Affiliation(s)
- Owen Nkoka
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | | | - Kondwani Mwandira
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | - Providence Nindi
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | - Albert Dube
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | | | - Angella Mainjeni
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | - Jullita Malava
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | - Abena S. Amoah
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Parasitology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Estelle McLean
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Robert C. Stewart
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
- Division of Psychiatry, Centre for Clinical Brain Sciences, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Amelia C. Crampin
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Alison J. Price
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Li J, Zelmat Y, Storck W, Laforgue EJ, Yrondi A, Balcerac A, Sommet A, Montastruc F. Drug-induced depressive symptoms: An update through the WHO pharmacovigilance database. J Affect Disord 2024; 350:452-467. [PMID: 38244800 DOI: 10.1016/j.jad.2024.01.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 01/04/2024] [Accepted: 01/09/2024] [Indexed: 01/22/2024]
Abstract
BACKGROUND Depression is a highly incident condition and some drugs have been described as inducing or worsening depression. However, literature on this topic is rare and possibly outdated. METHODS We performed disproportionality analyses using VigiBase®, the largest pharmacovigilance database worldwide to identify drugs associated with depression. Then we excluded drugs already known as depressogenic according to American Summary of Product Characteristics (SPC). We then reviewed drug mechanism of action, scientific literature and European SPC for each drug identified to assess a level of plausibility. We measured Reporting Odds Ratio (ROR) statistically significant and superior to 1, suggesting a significant association between a drug and the reporting of depressive symptoms. RESULTS Out of the 5237 drugs extracted on VigiBase®, we have retained 89 new drugs associated with depression. More than half of drugs of interest are from nervous system. Opicapone (ROR: 20.66 95 %CI: 15.62-27.33), and gadoversetamide (ROR 18.62, 95 %CI 9.63-35.95) were the drugs with the highest ROR. Among the 89 drugs, 38 were considered already described such as suvorexant or ivacaftor, 20 likely associated such as anti-migraines drugs or new antipsychotic drugs and 31 potentially associated. LIMITATIONS Pharmacovigilance studies have many inherent limitations, such as under-reporting bias, notoriety effect and protopathic bias. These results are not intended to establish a causal link, only a statistical association. CONCLUSION We found a strong statistical signal and pharmacological plausibility for 58 new depressogenic drugs. This update list of suspected drugs may prove useful for doctors faced with potential cases of drug-induced depression or to stay aware in case. Other studies are needed to confirm the list.
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Affiliation(s)
- Julien Li
- Department of Medical and Clinical Pharmacology, Centre of PharmacoVigilance and Pharmacoepidemiology, Toulouse University Hospital (CHU), Faculty of Medicine, Toulouse, France
| | - Yoann Zelmat
- Department of Medical and Clinical Pharmacology, Centre of PharmacoVigilance and Pharmacoepidemiology, Toulouse University Hospital (CHU), Faculty of Medicine, Toulouse, France
| | - Wilhelm Storck
- Department of Medical and Clinical Pharmacology, Centre of PharmacoVigilance and Pharmacoepidemiology, Toulouse University Hospital (CHU), Faculty of Medicine, Toulouse, France
| | - Edouard-Jules Laforgue
- Nantes Université, CHU Nantes, Service de Pharmacologie Clinique-Centre d'Évaluation et d'Information sur la Pharmacovigilance-Addictovigilance, F-44000 Nantes, France; Nantes Université, Univ Tours, CHU Nantes, CHU Tours, INSide EffectsRM, MethodS in Patients-Centered Outcomes and HEalth Research, SPHERE, F-44000 Nantes, France
| | - Antoine Yrondi
- Department of Psychiatry, Toulouse University Hospital (CHU), Treatment Resistant Depression Expert Center, FondaMental Toulouse, France
| | - Alexander Balcerac
- Neurology Department, Sorbonne University, Public assistance of Paris Hospitals, Pitié-Salpêtrière Hospital, Paris, France
| | - Agnès Sommet
- Department of Medical and Clinical Pharmacology, Centre of PharmacoVigilance and Pharmacoepidemiology, Toulouse University Hospital (CHU), Faculty of Medicine, Toulouse, France; CIC 1436, Team PEPSS (Pharmacologie En Population cohorteS et biobanqueS), Toulouse University Hospital, Toulouse, France
| | - François Montastruc
- Department of Medical and Clinical Pharmacology, Centre of PharmacoVigilance and Pharmacoepidemiology, Toulouse University Hospital (CHU), Faculty of Medicine, Toulouse, France; CIC 1436, Team PEPSS (Pharmacologie En Population cohorteS et biobanqueS), Toulouse University Hospital, Toulouse, France.
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Liu Y, Chen J, Wu T, He J, Wang B, Li P, Ning N, Chen H. Effects of nurses-led multidisciplinary-based psychological management in spinal surgery: a retrospective, propensity-score-matching comparative study. BMC Nurs 2024; 23:217. [PMID: 38549159 PMCID: PMC10979556 DOI: 10.1186/s12912-024-01842-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 03/03/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Patients in spine surgery often have emotional disorders which is caused by multi-factors. Therefore, a multidisciplinary and multimodal intervention program is required to improve emotional disorders during the perioperative period. However, related studies were rare. This study aimed to confirm that the multidisciplinary-based psychological management leading by nurses was effective in treating emotional disorders and show the assignments of the members of the multidisciplinary team with the orientations of nurses. DESIGN A retrospective, comparative study. METHOD This study was a retrospective cohort research and compared the results between the intervention group and control group using the Huaxi Emotional Distress Index (HEI) which was used to evaluate emotional disorders. The intervention group consisted of patients who underwent surgery between January 2018 and December 2020 after psychological management was implemented. The control group consisted of patients with regular care who underwent surgery between January 2015 and December 2017. To improve comparability between the two groups, baseline data from the recruited patients were analyzed using propensity-score-matching (PSM) based on age, sex, marital status, education, and disease region. RESULTS A total of 539 (11.5%) people developed emotional disorders, of which 319 (6.8%), 151 (3.2%) and 69 (1.5%) had mild, moderate mood and severe emotional disorders, respectively. 2107 pairs of patients were matched after PSM. Scores of HEI in the intervention group were heightened compared with those in the control group (P<0.001) after matching. Moreover, the incidence of emotional disorders in patients decreased after implementing psychological management (P = 0.001). The severity of emotional disorders was alleviated with statistical significance as well (P = 0.010). CONCLUSIONS Nurses-led Multidisciplinary-Based psychological management was able to reduce the incidence of emotional disorders and improve the severity of these in spine surgery patients.
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Affiliation(s)
- Ying Liu
- Department of Orthopedic Surgery, West China Hospital, Sichuan University/School of Nursing, Sichuan University, No. 37 Guoxue Xiang, Chengdu, Sichuan, 610041, P.R. China
- Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Jiali Chen
- Department of Orthopedic Surgery, West China Hospital, Sichuan University/School of Nursing, Sichuan University, No. 37 Guoxue Xiang, Chengdu, Sichuan, 610041, P.R. China
| | - Tingkui Wu
- Department of Orthopedic Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, Sichuan, 610041, P.R. China
| | - Junbo He
- Department of Orthopedic Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, Sichuan, 610041, P.R. China
| | - Beiyu Wang
- Department of Orthopedic Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, Sichuan, 610041, P.R. China
| | - Peifang Li
- Department of Orthopedic Surgery, West China Hospital, Sichuan University/School of Nursing, Sichuan University, No. 37 Guoxue Xiang, Chengdu, Sichuan, 610041, P.R. China
| | - Ning Ning
- Department of Orthopedic Surgery, West China Hospital, Sichuan University/School of Nursing, Sichuan University, No. 37 Guoxue Xiang, Chengdu, Sichuan, 610041, P.R. China.
| | - Hong Chen
- West China School of Nursing, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, Sichuan, 610041, P.R. China.
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47
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Boris P, Kovács KE, Nagy BE. The comparative study of chronically ill and healthy children and adolescents in the light of their general mental health. Sci Rep 2024; 14:6754. [PMID: 38514800 PMCID: PMC10957949 DOI: 10.1038/s41598-024-57442-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/18/2024] [Indexed: 03/23/2024] Open
Abstract
Children's hospitalisation is difficult for the family and the immediate environment. In these cases, the provision of psychological support is particularly important. Chronically ill children who are regularly hospitalised are in a particularly difficult situation, often feeling vulnerable. Our research aims to explore and analyse in detail the psychological state, attitudes and mental health of chronically ill children and to compare patient groups (children receiving care in pulmonology, gastroenterology, onco-haematology and rehabilitation) to understand the interacting factors, which may be of great importance for quality patient care and for measures to improve patient care in the future. We studied chronically ill children (N = 107) aged 10 to 18 years (M = 14.3; SD = 2.0), cared for by the Department of Paediatric Rehabilitation, Paediatric Psychiatry and Psychosomatics of the University of Debrecen Clinical Centre, the second largest paediatric institution in Hungary. In our survey, sociodemographic questions, the Connor-Davidson Resilience Scale, the Satisfaction With Life Scale, the Cantril Ladder, the Non-Productive Thoughts Questionnaire, the Problematic Internet Use Questionnaire, the Drawing version of Pictorial Representation of Illness Self-Measure (PRISM-D), the Beck Depression Inventory-Shortened Scale, the Illness Intrusiveness Ratings Scale, the Spielberger State-Trait Anxiety Questionnaire-Child Version and the Strength and Difficulty Questionnaire were applied. One-way analysis of variance (ANOVA) was used to examine differences between groups, and Pearson rank correlation analysis was used to measure the relationships between individual variables. The results show significant differences between patient groups in terms of resilience, depression, nonproductive thoughts, problematic internet use, anxiety and coping, but no consistent pattern in the development of scores. In addition, for some psychological correlates, the role of sociodemographic background also showed significant results. The practical utility of our study is that using questionnaire methods to map patient satisfaction, compliance, and patient attitudes will provide regarding the factors that influence the mental health status of children living with chronic illnesses. In the light of this, additional methods and tools can be included to improve the quality of healthcare and to develop a set of procedures that will serve the intended purpose.
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Affiliation(s)
- Péter Boris
- Laki Kálmán Doctoral School, University of Debrecen, Debrecen, 4032, Hungary
| | - Karolina Eszter Kovács
- Faculty of Arts, Institute of Psychology, University of Debrecen, Debrecen, 4032, Hungary.
| | - Beáta Erika Nagy
- Pediatric Rehabilitation, Pediatric Psychology and Psychosomatic Unit, Faculty of Medicine, Institute of Pediatrics, University of Debrecen, Debrecen, 4032, Hungary
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48
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Mehdi SMA, Costa AP, Svob C, Pan L, Dartora WJ, Talati A, Gameroff MJ, Wickramaratne PJ, Weissman MM, McIntire LBJ. Depression and cognition are associated with lipid dysregulation in both a multigenerational study of depression and the National Health and Nutrition Examination Survey. Transl Psychiatry 2024; 14:142. [PMID: 38467624 PMCID: PMC10928164 DOI: 10.1038/s41398-024-02847-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 02/15/2024] [Accepted: 02/21/2024] [Indexed: 03/13/2024] Open
Abstract
Chronic dysregulation of peripheral lipids has been found to be associated with depression and cognition, but their interaction has not been investigated. Growing evidence has highlighted the association between peripheral lipoprotein levels with depression and cognition with inconsistent results. We assessed the association between peripheral lipids, depression, and cognition while evaluating their potential interactions using robust clinically relevant predictors such as lipoprotein levels and chronic medical disorders that dysregulate lipoproteins. We report an association between peripheral lipids, depression, and cognition, suggesting a common underlying biological mechanism driven by lipid dysregulation in two independent studies. Analysis of a longitudinal study of a cohort at high or low familial risk for major depressive disorder (MDD) (n = 526) found metabolic diseases, including diabetes, hypertension, and other cardiovascular diseases, were associated with MDD and cognitive outcomes. Investigating a cross-sectional population survey of adults in the National Health and Nutrition Examination Survey 2011-2014 (NHANES) (n = 2377), depression was found to be associated with high density lipoprotein (HDL) and cognitive assessments. In the familial risk study, medical conditions were found to be associated with chronic lipid dysregulation and were significantly associated with MDD using the structural equation model. A positive association between chronic lipid dysregulation and cognitive scores was found in an exploratory analysis of the familial risk study. In a complementary study, analysis of NHANES revealed a positive association of HDL levels with cognition. Further analysis of the NHANES cohort indicated that depression status mediated the interaction between HDL levels and cognitive tests. Importantly, the protective effect of HDL on cognition was absent in those with depressive symptoms, which may ultimately result in worse outcomes leading to cognitive decline. These findings highlight the potential for the early predictive value of medical conditions with chronic lipid dyshomeostasis for the risk of depression and cognitive decline.
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Affiliation(s)
- S M A Mehdi
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - A P Costa
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
- Brain Health Imaging Institute, New York, NY, USA
| | - C Svob
- Division of Translational Epidemiology and Mental Health Equity, New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - L Pan
- Division of Translational Epidemiology and Mental Health Equity, New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - W J Dartora
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
- Brain Health Imaging Institute, New York, NY, USA
| | - A Talati
- Division of Translational Epidemiology and Mental Health Equity, New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - M J Gameroff
- Division of Translational Epidemiology and Mental Health Equity, New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - P J Wickramaratne
- Division of Translational Epidemiology and Mental Health Equity, New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - M M Weissman
- Mailman School of Public Health, Columbia University, New York, NY, USA.
- Division of Translational Epidemiology and Mental Health Equity, New York State Psychiatric Institute, New York, NY, USA.
- Department of Psychiatry, Columbia University, New York, NY, USA.
| | - L B J McIntire
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA.
- Brain Health Imaging Institute, New York, NY, USA.
- Department of Pathology and Cell Biology, Columbia University, New York, NY, USA.
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49
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Kvestad CA, Holte IR, Reitan SK, Chiappa CS, Helle GK, Skjervold AE, Rosenlund AMA, Watne Ø, Brattland H, Helle J, Follestad T, Hara KW, Holgersen KH. Measuring the Effect of the Early assessment Team (MEET) for patients referred to outpatient mental health care: a study protocol for a randomised controlled trial. Trials 2024; 25:179. [PMID: 38468321 DOI: 10.1186/s13063-024-08028-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 03/01/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Referrals to specialised mental health care (such as community mental health centres; CMHC) have increased over the last two decades. Patients often have multifaceted problems, which cannot only be solved by such care. Resources are limited, and triaging is challenging. A novel method which approaches patients early and individually upon referral to a CMHC-possibly with a brief intervention-is an Early assessment Team (EaT). In an EaT, two therapists meet the patient early in the process and seek to solve the present problem, often involving community services, primary health care, etc.; attention is paid to symptoms and functional strife, rather than diagnoses. This is in contrast to treatment as usual (TAU), where the patient (after being on a waiting list) meets one therapist, who focuses on history and situation to assign a diagnosis and eventually start a longitudinal treatment. The aim of this study is to describe and compare EaT and TAU regarding such outcomes as work and social adjustment, mental health, quality of life, use of health services, and patient satisfaction. The primary outcome is a change in perceived function from baseline to 12-month follow-up, measured by the Work and Social Adjustment Scale. METHOD Patients (18 years and above; n = 588) referred to outpatient health care at a CMHC are randomised to EaT or TAU. Measures (patient self-reports and clinician reports, patients' records, and register data) are collected at baseline, after the first and last meeting, and at 2, 4, 8, 12, and 24 months after inclusion. Some participants will be invited to participate in qualitative interviews. TRIAL DESIGN The study is a single-centre, non-blinded, RCT with two conditions involving a longitudinal and mixed design (quantitative and qualitative data). DISCUSSION This study will examine an intervention designed to determine early on which patients will benefit from parallel or other measures than assessment and treatment in CMHC and whether these will facilitate their recovery. Findings may potentially contribute to the development of the organisation of mental health services. TRIAL REGISTRATION ClinicalTrials.gov NCT05087446. Registered on 21 October 2021.
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Affiliation(s)
- Camilla Angelsen Kvestad
- Nidelv Community Mental Health Center, Clinic of Mental Health, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway.
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Ingvild Rønneberg Holte
- Nidelv Community Mental Health Center, Clinic of Mental Health, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Solveig Klæbo Reitan
- Nidelv Community Mental Health Center, Clinic of Mental Health, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Charlotte S Chiappa
- Nidelv Community Mental Health Center, Clinic of Mental Health, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Gunn Karin Helle
- Nidelv Community Mental Health Center, Clinic of Mental Health, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Anne E Skjervold
- Nidelv Community Mental Health Center, Clinic of Mental Health, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Anne Marit A Rosenlund
- Nidelv Community Mental Health Center, Clinic of Mental Health, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Øyvind Watne
- Nidelv Community Mental Health Center, Clinic of Mental Health, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Heidi Brattland
- Nidelv Community Mental Health Center, Clinic of Mental Health, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jon Helle
- Nidelv Community Mental Health Center, Clinic of Mental Health, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Turid Follestad
- Clinical Research Unit Central Norway, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Karen Walseth Hara
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Trondheim, Norway
- Norwegian Labour and Welfare Administration Trøndelag, Trondheim, Norway
| | - Katrine Høyer Holgersen
- Nidelv Community Mental Health Center, Clinic of Mental Health, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
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50
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Mindlis I, Revenson TA. Above and Beyond Number of Illnesses: A Two-Sample Replication of Current Approaches to Depressive Symptoms in Multimorbidity. Clin Gerontol 2024:1-10. [PMID: 38431827 PMCID: PMC11369122 DOI: 10.1080/07317115.2024.2324323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
OBJECTIVES To expand current models of depressive symptoms in older adults with multimorbidity (MM) beyond the number of illnesses as a predictor of worsened mental health. METHODS Two-sample replication study of adults ≥62 years old with ≥ two chronic illnesses, who completed validated questionnaires assessing depressive symptoms, and disease- and treatment-related stressors. Data were analyzed using hierarchical linear regression. RESULTS The model of cumulative number of illnesses was worse at explaining variance in depressive symptoms (Sample 1 R2 = .035; Sample 2 R2 = .029), compared to models including disease- and treatment-related stressors (Sample 1 R2 = .37; Sample 2 R2 = .47). Disease-related stressors were the strongest factor associated with depressive symptoms, specifically, poor subjective cognitive function (Sample 1: b = -.202, p = .013; Sample 2: b = -.288, p < .001) and greater somatic symptoms (b = .455, p < .001; Sample 2: b = .355, p < .001). CONCLUSIONS Using the number of illnesses to understand depressive symptoms in MM is a limited approach. Models that move beyond descriptive relationships between MM and depressive symptoms are needed. CLINICAL IMPLICATIONS Providers should consider the role of somatic symptom management in patients with MM and depressive symptoms.
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Affiliation(s)
- Irina Mindlis
- Weill Cornell Medicine, Division of Geriatrics and Palliative Medicine, New York, NY
| | - Tracey A. Revenson
- Psychology, Hunter College and The Graduate Center, City University of New York, NY
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