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Kawilapat S, Traisathit P, Maneeton N, Prasitwattanaseree S, Kongsuk T, Arunpongpaisal S, Leejongpermpoon J, Sukhawaha S, Maneeton B. Factor Structures in the Depressive Symptoms Domains in the 9Q for Northern Thai Adults and Their Association with Chronic Diseases. Behav Sci (Basel) 2024; 14:577. [PMID: 39062400 PMCID: PMC11274117 DOI: 10.3390/bs14070577] [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: 03/28/2024] [Revised: 06/03/2024] [Accepted: 07/01/2024] [Indexed: 07/28/2024] Open
Abstract
Most of the common models to examine depression are one-factor models; however, previous studies provided several-factor structure models on each depressive symptom using the Patient Health Questionnaire-9 (PHQ-9). The Nine-Questions Depression-Rating Scale (9Q) is an alternative assessment tool that was developed for assessing the severity of depressive symptoms in Thai adults. This study aimed to examine the factor structure of this tool based on the factor structure models for the PHQ-9 provided in previous studies using confirmatory factor analysis (CFA). We also examined the association of chronic diseases and depressive symptoms using the Multiple Indicators Multiple Causes model among 1346 participants aged 19 years old or more without psychiatric disorders. The results show that the two-factor CFA model with six items in the cognitive-affective domain and three items in the somatic domain provided the best fit for depressive symptoms in the study population (RMSEA = 0.077, CFI = 0.953, TLI = 0.936). Dyslipidemia was positively associated with both cognitive-affective symptoms (β = 0.120) and somatic depressive symptoms (β = 0.080). Allergies were associated with a higher level of cognitive-affective depressive symptoms (β = 0.087), while migraine (β = 0.114) and peptic ulcer disease (β = 0.062) were associated with a higher level of somatic symptoms. Increased age was associated with a lower level of somatic symptoms (β = -0.088). Our findings suggested that considering depressive symptoms as two dimensions yields a better fit for depressive symptoms. The co-occurrence of chronic diseases associated with depressive symptoms should be monitored.
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Affiliation(s)
- Suttipong Kawilapat
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand; (S.K.); (P.T.); (S.P.)
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Patrinee Traisathit
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand; (S.K.); (P.T.); (S.P.)
| | - Narong Maneeton
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Sukon Prasitwattanaseree
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand; (S.K.); (P.T.); (S.P.)
| | - Thoranin Kongsuk
- Prasrimahabhodi Psychiatric Hospital, Ubon Ratchathani 34000, Thailand; (T.K.); (J.L.); (S.S.)
- Somdet Chaopraya Institute of Psychiatry, Bangkok 10600, Thailand
| | - Suwanna Arunpongpaisal
- Department of Psychiatry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand;
| | - Jintana Leejongpermpoon
- Prasrimahabhodi Psychiatric Hospital, Ubon Ratchathani 34000, Thailand; (T.K.); (J.L.); (S.S.)
| | - Supattra Sukhawaha
- Prasrimahabhodi Psychiatric Hospital, Ubon Ratchathani 34000, Thailand; (T.K.); (J.L.); (S.S.)
| | - Benchalak Maneeton
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
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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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Soini E, Rosenström T, Määttänen I, Jokela M. Physical activity and specific symptoms of depression: A pooled analysis of six cohort studies. J Affect Disord 2024; 348:44-53. [PMID: 38128736 DOI: 10.1016/j.jad.2023.12.039] [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: 02/14/2023] [Revised: 12/15/2023] [Accepted: 12/17/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The association between physical activity (PA) and depression is well-established, but the details that explain this association remain elusive. We examined whether PA is differentially associated with specific symptoms of depression (e.g., cognitive vs somatic symptoms), and whether these associations follow a dose-response pattern with respect to intensity or frequency of PA. METHODS Cross-sectional analyses were based on 6 samples of the continuous U.S. National Health and Nutrition Examination Surveys (NHANES) carried out between 2007 and 2018 (n = 28,520). Depressive symptoms were assessed with Patient Health Questionnaire 9 (PHQ-9). Information about PA (vigorous, moderate, and daily commuting by foot or bike) and covariates was self-reported. RESULTS After adjusting for education, health behaviors, body-mass index, physical functioning, and all the other depressive symptoms, lower PA was specifically associated with four depressive symptoms: loss of interest/pleasure, feeling down/hopeless, fatigue, and changes in appetite (odds ratios from 0.94 to 0.59). A monotonic dose-response pattern on PA amount was observed only for interest/pleasure and fatigue, and these associations were independent of PA intensity. LIMITATIONS Cross-sectional data did not allow us to assess temporal ordering. Both depressive symptoms and PA were self-reported, which may induce bias. CONCLUSION Low PA may be linked to depressive symptoms particularly through the symptoms of anhedonia and fatigue. Given that their association with PA amount follows a dose-response pattern and is independent of PA intensity, we hypothesize that behavioral activation and exposure to rewarding experiences might help to explain why PA alleviates depression.
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Affiliation(s)
- Eetu Soini
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Tom Rosenström
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Department of Psychiatry, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
| | - Ilmari Määttänen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Markus Jokela
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Puga T, Liu Y, Xiao P, Dai R, Dai HD. Genetic and environmental influence on alcohol intent and alcohol sips among U.S. children-Effects across sex, race, and ethnicity. PLoS One 2024; 19:e0298456. [PMID: 38359015 PMCID: PMC10868864 DOI: 10.1371/journal.pone.0298456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/23/2024] [Indexed: 02/17/2024] Open
Abstract
INTRODUCTION Alcohol intent (the susceptibility to initiating alcohol use) and alcohol sips (the initiation of alcohol) in youth are a multifactorial puzzle with many components. This research aims to examine the connection between genetic and environmental factors across sex, race and ethnicity. METHODS Data was obtained from the twin hub of the Adolescent Brain Cognitive Development (ABCD) study at baseline (2016-2018). Variance component models were conducted to dissect the additive genetic (A), common (C) and unique environmental (E) effects on alcohol traits. The proportion of the total alcohol phenotypic variation attributable to additive genetic factors is reported as heritability (h2). RESULTS The sample (n = 1,772) included an approximately equal male-female distribution. The 886 same-sex twin pairs were 60.4% dizygotic (DZ), 39.6% monozygotic (MZ), 65.4% non-Hispanic Whites, 13.9% non-Hispanic Blacks, 10.8% of Hispanics with a mean age of 121.2 months. Overall, genetic predisposition was moderate for alcohol intent (h2 = 28%, p = .006) and low for alcohol initiation (h2 = 4%, p = 0.83). Hispanics (h2 = 53%, p < .0001) and Blacks (h2 = 48%, p < .0001) demonstrated higher alcohol intent due to additive genetic factors than Whites (h2 = 34%, p < .0001). Common environmental factors explained more variation in alcohol sips in females (c2 = 63%, p = .001) than in males (c2 = 55%, p = .003). Unique environmental factors largely attributed to alcohol intent, while common environmental factors explained the substantial variation in alcohol initiation. CONCLUSION Sex and racial/ethnic disparities in genetic and environmental risk factors for susceptibility to alcohol initiation can lead to significant health disparities. Certain populations may be at greater risk for alcohol use due to their genetic and ecological factors at an early age.
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Affiliation(s)
- Troy Puga
- College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States of America
- College of Osteopathic Medicine, Kansas City University, Kanas City, MO, United States of America
| | - Yadi Liu
- College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States of America
| | - Peng Xiao
- Dept. of Genetics, Cell Biology & Anatomy, University of Nebraska Medical Center, Omaha, NE, United States of America
| | - Ran Dai
- College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States of America
| | - Hongying Daisy Dai
- College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States of America
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Complementary medicine for fatigue: the importance of basic sciences and clinical studies. ASIAN BIOMED 2023; 17:150-151. [PMID: 37860675 PMCID: PMC10584380 DOI: 10.2478/abm-2023-0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
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Gabarrell-Pascuet A, Domènech-Abella J, Rod NH, Varga TV. Variations in sociodemographic and health-related factors are linked to distinct clusters of individuals with depression based on the PHQ-9 instrument: NHANES 2007-2018. J Affect Disord 2023; 335:95-104. [PMID: 37156277 DOI: 10.1016/j.jad.2023.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 04/26/2023] [Accepted: 05/02/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Depression is a heterogeneous disease. Identification of latent depression subgroups and differential associations across these putative groups and sociodemographic and health-related factors might pave the way toward targeted treatment of individuals. METHODS We used model-based clustering to identify relevant subgroups of 2900 individuals with moderate to severe depression (defined as scores ≥10 on the PHQ-9 instrument) from the NHANES cross-sectional survey. We used ANOVA and chi-squared tests to assess associations between cluster membership and sociodemographics, health-related variables, and prescription medication use. RESULTS We identified six latent clusters of individuals, three based on depression severity and three differentially loaded by somatic and mental components of the PHQ-9. The Severe mental depression cluster had the most individuals with low education and income (P < 0.05). We observed differences in the prevalence of numerous health conditions, with the Severe mental depression cluster showing the worst overall physical health. We observed marked differences between the clusters regarding prescription medication use: the Severe mental depression cluster had the highest use of cardiovascular and metabolic agents, while the Uniform severe depression cluster showed the highest use of central nervous system and psychotherapeutic agents. LIMITATIONS Due to the cross-sectional design we cannot make conclusions about causal relationships. We used self-reported data. We did not have access to a replication cohort. CONCLUSIONS We show that socioeconomic factors, somatic diseases, and prescription medication use are differentially associated with distinct and clinically relevant clusters of individuals with moderate to severe depression.
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Affiliation(s)
- Aina Gabarrell-Pascuet
- Epidemiology of Mental Health Disorders and Ageing Research Group, Sant Joan de Déu Research Institute, Esplugues de Llobregat, Spain; Research, Teaching, and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Joan Domènech-Abella
- Epidemiology of Mental Health Disorders and Ageing Research Group, Sant Joan de Déu Research Institute, Esplugues de Llobregat, Spain; Research, Teaching, and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Naja H Rod
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Tibor V Varga
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
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Malkki VK, Rosenström TH, Jokela MM, Saarni SE. Associations between specific depressive symptoms and psychosocial functioning in psychotherapy. J Affect Disord 2023; 328:29-38. [PMID: 36773764 DOI: 10.1016/j.jad.2023.02.021] [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: 04/28/2022] [Revised: 01/21/2023] [Accepted: 02/04/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Psychotherapy for depression aims to reduce symptoms and to improve psychosocial functioning. We examined whether some symptoms are more important than others in the association between depression and functioning over the course of psychotherapy treatment. METHODS We studied associations between specific symptoms of depression (PHQ-9) and change in social and occupational functioning (SOFAS), both with structural equation models (considering liabilities of depression and each specific symptom) and with logistic regression models (considering the risk for individual patients). The study sample consisted of adult patients (n = 771) from the Finnish Psychotherapy Quality Registry (FPQR) who completed psychotherapy treatment between September 2018 and September 2021. RESULTS Based on our results of logistic regression analyses and SEM models, the baseline measures of depression symptoms were not associated with changes in functioning. Changes in depressed mood or hopelessness, problems with sleep, feeling tired, and feeling little interest or pleasure were associated with improved functioning during psychotherapy. The strongest evidence for symptom-specific effects was found for the symptom of depressed mood or hopelessness. LIMITATIONS Due to our naturalistic study design containing only two measurement points, we were unable to study the causal relationship between symptoms and functioning. CONCLUSIONS Changes in certain symptoms during psychotherapy may affect functioning independently of underlying depression. Knowledge about the dynamics between symptoms and functioning could be used in treatment planning or implementation. Depressed mood or hopelessness appears to have a role in the dynamic relationship between depression and functioning.
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Affiliation(s)
- Veera K Malkki
- Psychiatry, Helsinki University Hospital and University of Helsinki, Finland.
| | - Tom H Rosenström
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Markus M Jokela
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Suoma E Saarni
- Psychiatry, Helsinki University Hospital and University of Helsinki, Finland
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Smith CB, Rosenström T, Hagen EH. Strength is negatively associated with depression and accounts for some of the sex difference. Evol Med Public Health 2022; 10:130-141. [PMID: 35321088 PMCID: PMC8935202 DOI: 10.1093/emph/eoac007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 02/16/2022] [Indexed: 11/25/2022] Open
Abstract
Background Depression occurs about twice as often in women as in men, a disparity that remains poorly understood. In a previous publication, Hagen and Rosenström predicted and found that grip strength, a highly sexually dimorphic index of physical formidability, mediated much of the effect of sex on depression. Striking results like this are more likely to be published than null results, potentially biasing the scientific record. It is therefore critical to replicate and extend them. Methodology Using new data from the 2013–14 cycle of the National Health and Nutrition Examination Survey, a nationally representative sample of US households (n = 3650), we replicated models of the effect of sex and grip strength on depression reported in Hagen and Rosenström, along with additional potential confounds and a new detailed symptom-level exploration. Results Overall, the effects from the original paper were reproduced although with smaller effect sizes. Grip strength mediated 38% of the effect of sex on depression, compared to 63% in Hagen and Rosenström. These results were extended with findings that grip strength had a stronger association with some depression symptoms, like suicidality, low interest and low mood than with other symptoms, like appetite changes. Conclusions Grip strength is negatively associated with depression, especially its cognitive–affective symptoms, controlling for numerous possible confounds. Although many factors influence depression, few of these reliably occur cross-culturally in a sex-stratified manner and so are unlikely to explain the well-established, cross-cultural sex difference in depression. The sex difference in upper body strength occurs in all populations and is therefore a candidate evolutionary explanation for some of the sex difference in depression. Lay summary: Why are women at twice the risk of developing depression as men? Depression typically occurs during social conflicts, such as physical or sexual abuse. Physically strong individuals can often single-handedly resolve conflicts in their favor, whereas physically weaker individuals often need help from others. We argue that depression is a credible cry for help. Because men generally have greater strength than women, we argue that men may be more likely to resolve conflicts using physical formidability and women to signal others for help. We find that higher grip strength is associated with lower depression, particularly symptoms like feeling down or thoughts of suicide and that strength accounts for part of the sex difference in rates of depression.
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Affiliation(s)
- Caroline B Smith
- Department of Anthropology, Washington State University, Pullman, WA, USA
| | - Tom Rosenström
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Edward H Hagen
- Department of Anthropology, Washington State University, Pullman, WA, USA
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Dong X, Fang S, Li W, Li X, Zhang S. Deanxit and tandospirone relieved unexplained limb edema in a depressed pituitary adenoma survivor: A case report. Front Psychiatry 2022; 13:965495. [PMID: 36440410 PMCID: PMC9685525 DOI: 10.3389/fpsyt.2022.965495] [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: 06/09/2022] [Accepted: 08/25/2022] [Indexed: 11/11/2022] Open
Abstract
Our case report describes a 45-year-old woman who suffered from limb edema for 2 months. We focused on tumor recurrence and other common potential diseases based on the pituitary adenoma history. However, none of the examinations showed any abnormality. Later, her continuous complaints about the family relationship and depressed mood came into sight, and a psychiatry consultation was arranged. Following that, she was diagnosed with major depressive disorder. After several days of Deanxit and tandospirone treatment, the patient's limb edema dramatically subsided. This is the first case of limb edema associated with depression. This highlights the importance of awareness of mental illness for non-psychiatrists, especially in patients with severe somatic symptoms, but with negative results.
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Affiliation(s)
- Xingyu Dong
- Department of Neurosurgery, The Third People's Hospital of Chengdu, Chengdu, China
| | - Sheng Fang
- Department of Neurosurgery, The Third People's Hospital of Chengdu, Chengdu, China
| | - Wei Li
- Department of Neurology, The Third People's Hospital of Chengdu, Chengdu, China
| | - Xuemei Li
- Department of Neurosurgery, The Third People's Hospital of Chengdu, Chengdu, China
| | - Sunfu Zhang
- Department of Neurosurgery, The Third People's Hospital of Chengdu, Chengdu, China
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Wu X, Zhu Y, Wu Z, Huang J, Cao L, Wang Y, Su Y, Liu H, Fang M, Yao Z, Wang Z, Wang F, Wang Y, Peng D, Chen J, Fang Y. Identifying the Subtypes of Major Depressive Disorder Based on Somatic Symptoms: A Longitudinal Study Using Latent Profile Analysis. Front Psychiatry 2022; 13:759334. [PMID: 35903631 PMCID: PMC9314656 DOI: 10.3389/fpsyt.2022.759334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Two-thirds of major depressive disorder (MDD) patients initially present with somatic symptoms, yet no study has used approaches based on somatic symptoms to subtype MDD. This study aimed to classify MDD via somatic symptoms and tracked the prognosis of each subtype. METHODS Data were obtained from the study of Algorithm Guided Treatment Strategies for Major Depressive Disorder (AGTs-MDD). We recruited 395 subjects who received monotherapy of mirtazapine or escitalopram and conducted 2-, 4-, 6-, 8-, and 12-week follow-up assessments (n = 311, 278, 251, 199, and 178, respectively). Latent profile analysis (LPA) was performed on somatic symptom items of the depression and somatic symptoms scale (DSSS). Generalized linear mixed models (GLMM) were used to study the longitudinal prognosis of the subtypes classed by LPA. Primary outcome measures were the Hamilton Depression Rating Scale (HAMD), HAMD score reduction rate, as well as somatic and depressive items of DSSS. RESULTS Three subtypes of MDD were found, namely, depression with mild somatic symptoms (68.9%), depression with moderate somatic symptoms (19.2%), and depression with severe somatic symptoms (11.9%). Scores of HAMD (F = 3.175, p = 0.001), somatic (F = 23.594, p < 0.001), and depressive (F = 4.163, p < 0.001) DSSS items throughout the 12-week follow-up showed statistical difference among the three subtypes. The moderate group displayed a higher HAMD-17 score and a lower reduction rate at the 6th week, and more severe depressive symptoms both at the 4th and 6th weeks. CONCLUSION The results indicate that somatic symptoms should be emphasized in patients with MDD, and more attention is needed for those with moderate somatic symptoms, which may be relevant to a worse prognosis.
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Affiliation(s)
- Xiaohui Wu
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuncheng Zhu
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhiguo Wu
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jia Huang
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lan Cao
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yun Wang
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yousong Su
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongmei Liu
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Zhijian Yao
- Nanjing Medical University Affiliated Brain Hospital, Nanjing, China
| | - Zuowei Wang
- Department of Psychiatry, Hongkou District Mental Health Center of Shanghai, Shanghai, China
| | - Fan Wang
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yong Wang
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Daihui Peng
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Chen
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiru Fang
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai, China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
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Fan J, Qian F, Wang Q, Chen B, Wang L. Efficacy and safety of Qigong Baduanjin exercise in the treatment of depression with insomnia: A randomized controlled study protocol. Medicine (Baltimore) 2021; 100:e27764. [PMID: 34964736 PMCID: PMC8615342 DOI: 10.1097/md.0000000000027764] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 10/28/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Depression is a common mental illness often associated with insomnia. Baduanjin exercise has been found to improve depressive symptoms and has also been found to have good effects on insomnia. However, there are no rigorous clinical studies to evaluate the effects of Baduanjin exercise on depressed patients with insomnia, so this randomized controlled trial will evaluate the efficacy of Qigong Baduanjin exercise in treating depression with insomnia. METHODS This is a prospective randomized controlled trial to investigate the clinical efficacy of Baduanjin exercise in the treatment of depression with insomnia. The included patients will be randomly divided into a treatment group and control group. The treatment group will be treated with Baduanjin exercise and the control group will be treated with oral mirtazapine. After 8 weeks of continuous treatment, they will be followed up for 3 months. Observed indexes included Pittsburgh sleep quality index, Hamilton expression Rating Scale score, and adverse reactions. Finally, the data are statistically analyzed by SPSS 20.0 software. DISCUSSION This study will evaluate the efficacy and safety of Baduanjin exercise in the treatment of depression with insomnia, and the results of this study will provide a clinical basis for the treatment of depression with insomnia.Trial registration: OSF Registration number: DOI 10.17605/OSF.IO/KC48H.
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Affiliation(s)
- Jing Fan
- The Longhua Street Community Health Center, Xuhui, Shanghai, China
| | - Fangmin Qian
- The Shanghai Ruijin Rehabilitation Hospital, Shanghai, China
| | - Qingqing Wang
- The Longhua Street Community Health Center, Xuhui, Shanghai, China
| | - Bihua Chen
- The Longhua Street Community Health Center, Xuhui, Shanghai, China
| | - Linchuang Wang
- The Longhua Street Community Health Center, Xuhui, Shanghai, China
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12
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Jokela M, García-Velázquez R, Komulainen K, Savelieva K, Airaksinen J, Gluschkoff K. Specific symptoms of the General Health Questionnaire (GHQ) in predicting persistence of psychological distress: Data from two prospective cohort studies. J Psychiatr Res 2021; 143:550-555. [PMID: 33243456 DOI: 10.1016/j.jpsychires.2020.11.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 11/05/2020] [Accepted: 11/10/2020] [Indexed: 11/18/2022]
Abstract
Persistent psychological distress is more harmful than transient psychological distress, but little is known about the development of persistent distress. We examined whether some specific symptoms of the 12-item General Health Questionnaire (GHQ-12) were more important than others in predicting the persistence of psychological distress over a 3-year follow-up period among individuals who had at least moderate psychological distress at baseline (GHQ≥3). Participants were from the UK Household Longitudinal Study (UKHLS; n = 6430) and British Household Panel Survey (BHPS; n = 5954). Sense of worthlessness, loss of self-confidence, loss of sleep over worry, and feelings of strain were associated with increasingly persistent distress. General happiness, feelings of unhappiness or depressed mood, and enjoyment of activities showed no such increasing associations. Symptoms of social functioning (capability of making decisions, concentration problems, feelings of usefulness, ability to face problems) showed some but not consistent associations. These results suggest that feelings of worthlessness, loss of self-confidence, loss of sleep over worry, and strain may be particularly important markers for persistent psychological distress.
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Affiliation(s)
- Markus Jokela
- Department of Psychology and Logopedics, University of Helsinki, Finland.
| | | | - Kaisla Komulainen
- Department of Psychology and Logopedics, University of Helsinki, Finland
| | - Kateryna Savelieva
- Department of Psychology and Logopedics, University of Helsinki, Finland
| | - Jaakko Airaksinen
- Institute of Criminology and Legal Policy, University of Helsinki, Finland
| | - Kia Gluschkoff
- Department of Psychology and Logopedics, University of Helsinki, Finland; Finnish Institute for Health and Welfare, Helsinki, Finland
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13
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Thompson KN, Hübel C, Cheesman R, Adey BN, Armour C, Davies MR, Hotopf M, Jones IR, Kalsi G, McIntosh AM, Monssen D, Peel AJ, Rogers HC, Skelton M, Smith DJ, Walters JTR, Breen G, Eley TC. Age and sex-related variability in the presentation of generalized anxiety and depression symptoms. Depress Anxiety 2021; 38:1054-1065. [PMID: 34496112 DOI: 10.1002/da.23213] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 07/07/2021] [Accepted: 08/20/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Generalized anxiety and depression are extremely prevalent and debilitating. There is evidence for age and sex variability in symptoms of depression, but despite comorbidity it is unclear whether this extends to anxiety symptomatology. Studies using questionnaire sum scores typically fail to address this phenotypic complexity. METHOD We conducted exploratory and confirmatory factor analyses on Generalized Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9) items to identify latent factors of anxiety and depression in participants from the Genetic Links to Anxiety and Depression Study (N = 35,637; 16-93 years). We assessed age- and sex-related variability in latent factors and individual symptoms using multiple logistic regression. RESULTS Four factors of mood, worry, motor, and somatic symptoms were identified (comparative fit index [CFI] = 0.99, Tucker-Lewis Index [TLI] = 0.99, root mean square error of approximation [RMSEA] = 0.07, standardized root mean square residuals [SRMR] = 0.04). Symptoms of irritability (odds ratio [OR] = 0.81) were most strongly associated with younger age, and sleep change (OR = 1.14) with older age. Males were more likely to report mood and motor symptoms (p < .001) and females to report somatic symptoms (p < .001). CONCLUSION Significant age and sex variability suggest that classic diagnostic criteria reflect the presentation most commonly seen in younger males. This study provides avenues for diagnostic adaptation and factor-specific interventions.
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Affiliation(s)
- Katherine N Thompson
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK
| | - Christopher Hübel
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK
- UK National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health, South London and Maudsley Hospital, London, UK
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Rosa Cheesman
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Brett N Adey
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK
| | - Chérie Armour
- Stress, Trauma & Related Conditions (STARC) Research Lab, School of Psychology, Queen's University Belfast, Belfast, UK
| | - Molly R Davies
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK
- UK National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health, South London and Maudsley Hospital, London, UK
| | - Matthew Hotopf
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK
- UK National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health, South London and Maudsley Hospital, London, UK
- South London and Maudsley NHS Foundation Trust, Denmark Hill, Camberwell, London, UK
| | - Ian R Jones
- National Centre for Mental Health, Division of Psychiatry and Clinical Neuroscience, Cardiff University, Cardiff, UK
| | - Gursharan Kalsi
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK
- UK National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health, South London and Maudsley Hospital, London, UK
| | - Andrew M McIntosh
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Dina Monssen
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK
- UK National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health, South London and Maudsley Hospital, London, UK
| | - Alicia J Peel
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK
| | - Henry C Rogers
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK
- UK National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health, South London and Maudsley Hospital, London, UK
| | - Megan Skelton
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK
- UK National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health, South London and Maudsley Hospital, London, UK
| | - Daniel J Smith
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - James T R Walters
- National Centre for Mental Health, Division of Psychiatry and Clinical Neuroscience, Cardiff University, Cardiff, UK
| | - Gerome Breen
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK
- UK National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health, South London and Maudsley Hospital, London, UK
| | - Thalia C Eley
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK
- UK National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health, South London and Maudsley Hospital, London, UK
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14
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Subclinical hypothyroidism and symptoms of depression: Evidence from the National Health and Nutrition Examination Surveys (NHANES). Compr Psychiatry 2021; 109:152253. [PMID: 34147730 DOI: 10.1016/j.comppsych.2021.152253] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 05/07/2021] [Accepted: 06/03/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Subclinical hypothyroidism has been associated with increased risk for depression, yet the findings remain controversial. It is possible that subclinical hypothyroidism is associated with some, but not all symptoms of depression. We examined symptom-specific associations between depression and subclinical hypothyroidism. METHODS Participants (N = 7683 adults) were from the National Health and Nutrition Examination Surveys of 2007-2008, 2009-2010, and 2011-2012 We included participants who had data on their thyroid profile and depressive symptoms (measured using Patient Health Questionnaire), and excluded those with overt hypothyroidism or hyperthyroidism, and those on thyroid hormone replacement therapy. Logistic regression with sampling weights was used to examine the association between subclinical hypothyroidism and depression symptoms. We also ran sensitivity analysis using different cut-off points for defining subclinical hypothyroidism. RESULTS Of all the participants, 208 (2.7%) had subclinical hypothyroidism and of them only six had depression. Subclinical hypothyroidism was not associated with depression (OR = 0.61, 95% CI 0.20-1.87) nor with the specific depression symptoms. Using lower criteria for subclinical hypothyroidism diagnosis resulted in similar findings. CONCLUSIONS In a nationally representative sample of US adults, we observed no association between subclinical hypothyroidism and overall depression risk or any of the individual symptoms of depression.
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15
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Määttänen I, Gluschkoff K, Komulainen K, Airaksinen J, Savelieva K, García-Velázquez R, Jokela M. Testosterone and specific symptoms of depression: Evidence from NHANES 2011–2016. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2021; 6:100044. [PMID: 35757365 PMCID: PMC9216439 DOI: 10.1016/j.cpnec.2021.100044] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 12/17/2020] [Accepted: 02/27/2021] [Indexed: 12/02/2022] Open
Abstract
Testosterone is one possible biomarker for depression risk among men and women. Both high and low levels of testosterone have been associated with depression, at least among men. Testosterone may be associated only with specific symptoms of depression, which might help to explain inconsistencies in previous results. We examined the cross-sectional associations between total testosterone and the specific symptoms of depression using pooled data across three cycles of NHANES (2011–2012, 2013–2014, and 2015–2016). The sample included 4253 men and 5102 women. Testosterone was modelled as 1) a dichotomous (low testosterone cut-off <300 ng/dL for men and 15 ng/dL for women) and 2) a continuous variable using cubic splines. In men, very low testosterone was weakly associated with problems with appetite, whereas very high testosterone was associated with sleep problems and weakly associated with tiredness. There were no consistent symptom-specific associations among women. These findings provide only suggestive evidence for symptom-specific associations between testosterone and depression, mainly related to somatic complaints. Further data are needed to assess the reliability of these associations. Testosterone and depression have been associated in some past studies. To find a possible explanation for the inconsistencies of some of the previous studies, we studied the association between testosterone and depression in men and women. Very high testosterone was associated with sleep problems and weakly associated with tiredness among men. Very low testosterone was weakly associated with appetite problems among men. There was some evidence that very low testosterone may be associated with appetite problems among women.
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Affiliation(s)
- Ilmari Määttänen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Corresponding author. University of Helsinki, P.O. Box 63, FIN-00014, Helsinki, Finland.
| | - Kia Gluschkoff
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Social and Health Systems Research, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Kaisla Komulainen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jaakko Airaksinen
- Institute of Criminology and Legal Policy, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Kateryna Savelieva
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Regina García-Velázquez
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Markus Jokela
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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16
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Komulainen K, Gluschkoff K, García Velázquez R, Airaksinen J, Szmulewicz A, Jokela M. Association of depressive symptoms with health care utilization in older adults: Longitudinal evidence from the Survey of Health, Aging, and Retirement in Europe. Int J Geriatr Psychiatry 2021; 36:521-529. [PMID: 33045767 DOI: 10.1002/gps.5447] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 10/02/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Many older adults with depression do not receive adequate treatment. Differences in treatment utilization may reflect the heterogeneous nature of depression, encompassing multiple distinct symptoms. We assessed whether depressive symptoms are differentially associated with subsequent health care utilization with respect to three outcomes as follows: (1) contact with a medical doctor (MD), (2) depression-specific treatment, and (3) inpatient psychiatric admission. METHODS/DESIGN Longitudinal analyses were based on data from three follow-up cycles conducted between 2004 and 2013 among 53,139 participants from the Survey of Health, Aging, and Retirement in Europe. Depressive symptoms were self-reported at baseline of each follow-up cycle using the 12-item EURO-D scale. Health care utilization was self-reported at the end of each follow-up cycle. RESULTS After adjustment for sex, age, country of interview, follow-up time, educational attainment, presence of a partner in household, body-mass index, the number of chronic diseases, disability, average/prior frequency of contact with an MD, and all other depressive symptoms, people with more frequent contact with an MD had most often reported sleep problems (IRR = 1.10) and fatigue (IRR = 1.10), followed by sad/depressed mood, tearfulness, concentration problems, guilt, irritability, and changes in appetite. Those treated for depression had most often reported sad/depressed mood (OR = 2.18) and suicidal ideation (OR = 1.72), but also sleep problems, changes in appetite, fatigue, concentration problems, hopelessness, and irritability. Sad/depressed mood (OR = 2.87) was also associated with psychiatric inpatient admission. Similarly to other outcomes, appetite change, fatigue, and sleep problems were associated with inpatient admission. CONCLUSIONS Specific symptoms of depression may determine utilization of different types of health care among elderly.
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Affiliation(s)
- Kaisla Komulainen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Kia Gluschkoff
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Social and Health Systems Research Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Regina García Velázquez
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jaakko Airaksinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Criminology and Legal Policy, University of Helsinki, Helsinki, Finland
| | - Alejandro Szmulewicz
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Markus Jokela
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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17
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Effect of Sacubitril-Valsartan in reducing depression in patients with advanced heart failure. J Affect Disord 2020; 272:132-137. [PMID: 32379604 DOI: 10.1016/j.jad.2020.03.158] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/18/2020] [Accepted: 03/29/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Depression is highly prevalent in Heart Failure (HF). Treatment with sacubitril/valsartan improved quality of life and survival in HF patients. Aim of the study was to investigate prospectively the effect of sacubitril/valsartan on depression in advanced HF patients in waiting list for heart transplant (HT). METHODS 37 consecutive patients with advanced HF in waiting list for HT were treated with sacubitril/valsartan. We analyzed data derived from the assessment performed the year before the beginning of sacubitril/valsartan, at study entry, and at one year of follow-up. Depression was assessed with Beck Depression Inventory II (BDI) scale. Cognitive function were assessed with Mini-Mental State Examination (MMSE). Functioning was evaluated measuring meters at 6 Minute Walking Test (6MWT) and maximum rate of oxygen consumption (VO2 max). RESULTS At baseline, 64.9% of HF patients were in NYHA III and 35.1% NYHA IIIB, BDI was 15.2 ± 5.2 with 59.5% of patients with a score > 13. MMSE was 27.8 ± 2.6. After one year of follow-up NYHA class improved significantly, with 56.8% in NYHA II, 40.5% in NYHA III and 2.7% NYHA in IIIB (p < 0.001). VO2 max and 6MWT increased. Notably, BDI was 9.5 ± 3.9 with 21.6% of patients with a score > 13. MMSE remain stable (28.2 ± 2.1) (p = 0.104). No statistical differences are observed between data collected in the evaluation 1-year before and soon before treatment with sacubitril/valsartan. Multivariate regression analysis demonstrate a relationship between reduction in BDI-II score and improvement in six-minute walking test independently by the effect of sex, age, selective serotonin reuptake inhibitors, VO2 max, NT-proBNP, PAPs, NYHA class differences evaluated at follow-up versus baseline. CONCLUSIONS Our study showed a reduction in depressive symptomatology in heart transplant waiting list patients treated with sacubitril/valsartan. The improvement in depressive symptomatology was paralleled by 6MWT increase in the follow-up.
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18
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Lommel L, Hu X, Sun M, Chen JL. Frequency of depressive symptoms among female migrant workers in China: associations with acculturation, discrimination, and reproductive health. Public Health 2020; 181:151-157. [PMID: 32036172 DOI: 10.1016/j.puhe.2019.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 11/18/2019] [Accepted: 12/05/2019] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Depression has been associated with numerous adverse health conditions. This study sought to determine the frequency of significant depressive symptoms and whether or not acculturative stress, discrimination, and reproductive health conditions were risk factors for significant depressive symptoms in migrant working women in China. STUDY DESIGN The design of this study is cross-sectional. METHODS Data were derived from a survey of female migrant workers at three employment sites in Changsha, China. The associations between acculturative stress, discrimination, reproductive health, and risk for significant depressive symptoms were obtained using F-tests for mean differences, correlations, ordinary least squares regression, and logistic regression analysis. RESULTS Between March and June 2017, 232 eligible female participants completed the survey among whom the median age was 34.36 years (standard error 0.43) and 25.58% reported significant depressive symptoms. Significant depressive symptoms were associated with higher education (F-test, P = .006), all four acculturative stress factors (r = 0.15 to r = 0.29), both institutional and interpersonal discrimination (r = 0.29, r = 0.35), age (r = - 0.13), and self-rated health (r = - 0.19). In multivariate regression analysis of depression scale scores, interpersonal discrimination was the strongest predictor (beta = 0.238, P = .002) among the nine factors identified in bivariate analysis. None of the other predictors (age, self-rated health, education, acculturative stress, and institutional discrimination) showed significant associations with the depression scale. Similar results were obtained for a multivariate logistic regression analysis of a clinically important threshold for depression (<10 versus ≥ 10 on the depression scale). Only interpersonal discrimination significantly distinguished between clinical depression categories (odds ratio = 2.607 per unit change in the index, P = .001). CONCLUSIONS Migrant women workers in China appear to be at risk for significant depressive symptoms, and interpersonal discrimination appears to be an important risk factor in this setting. Acculturative stress and institutional discrimination may also be relevant risk factors, as suggested in our bivariate analysis, but in our sample, the correlations between the stress and discrimination factors are high enough to compromise identification of unique associations between acculturation stress and depression. Government, community and workplace education, and psychosocial services for migrant women are recommended.
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Affiliation(s)
- L Lommel
- Department of Family Health Care Nursing, School of Nursing, 2 Koret Way, Box 0606, University of California, San Francisco, San Francisco, CA, USA, 94143-0606.
| | - X Hu
- Xianga Nursing School, Central South University, No. 172 Tongzipo Road, Yuelu District, Changsha, Hunan Province, China.
| | - M Sun
- Xianga Nursing School, Central South University, No. 172 Tongzipo Road, Yuelu District, Changsha, Hunan Province, China.
| | - J-L Chen
- Department of Family Health Care Nursing, School of Nursing, 2 Koret Way, Box 0606, University of California, San Francisco, San Francisco, CA, USA, 94143-0606.
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