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Zhao T, Liu R, Han Q, Han X, Ren J, Mao M, Lu J, Cong L, Wang Y, Tang S, Du Y, Qiu C. Associations of 24-hour movement behaviors with depressive symptoms in rural-dwelling older adults: a compositional data analysis. Aging Clin Exp Res 2024; 36:165. [PMID: 39120630 PMCID: PMC11315720 DOI: 10.1007/s40520-024-02827-2] [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: 05/15/2024] [Accepted: 08/01/2024] [Indexed: 08/10/2024]
Abstract
BACKGROUND We aimed to explore the association of sleep duration with depressive symptoms among rural-dwelling older adults in China, and to estimate the impact of substituting sleep with sedentary behavior (SB) and physical activity (PA) on the association with depressive symptoms. METHODS This population-based cross-sectional study included 2001 rural-dwelling older adults (age ≥ 60 years, 59.2% female). Sleep duration was assessed using the Pittsburgh Sleep Quality Index. We used accelerometers to assess SB and PA, and the 15-item Geriatric Depression Scale to assess depressive symptoms. Data were analyzed using restricted cubic splines, compositional logistic regression, and isotemporal substitution models. RESULTS Restricted cubic spline curves showed a U-shaped association between daily sleep duration and the likelihood of depressive symptoms (P-nonlinear < 0.001). Among older adults with sleep duration < 7 h/day, reallocating 60 min/day spent on SB and PA to sleep were associated with multivariable-adjusted odds ratio (OR) of 0.81 (95% confidence interval [CI] = 0.78-0.84) and 0.79 (0.76-0.82), respectively, for depressive symptoms. Among older adults with sleep duration ≥ 7 h/day, reallocating 60 min/day spent in sleep to SB and PA, and reallocating 60 min/day spent on SB to PA were associated with multivariable-adjusted OR of 0.78 (0.74-0.84), 0.73 (0.69-0.78), and 0.94 (0.92-0.96), respectively, for depressive symptoms. CONCLUSIONS Our study reveals a U-shaped association of sleep duration with depressive symptoms in rural older adults and further shows that replacing SB and PA with sleep or vice versa is associated with reduced likelihoods of depressive symptoms depending on sleep duration.
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Affiliation(s)
- Tong Zhao
- Department of Neurology, Shandong Provincial Hospital, Shandong University, No. 324 Jingwuweiqi Road, Jinan, 250021, Shandong, P.R. China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
| | - Rui Liu
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
| | - Qi Han
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, P.R. China
| | - Xiaolei Han
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, P.R. China
| | - Juan Ren
- Department of Neurology, Shandong Provincial Hospital, Shandong University, No. 324 Jingwuweiqi Road, Jinan, 250021, Shandong, P.R. China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
| | - Ming Mao
- Department of Neurology, Shandong Provincial Hospital, Shandong University, No. 324 Jingwuweiqi Road, Jinan, 250021, Shandong, P.R. China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
| | - Jie Lu
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
| | - Lin Cong
- Department of Neurology, Shandong Provincial Hospital, Shandong University, No. 324 Jingwuweiqi Road, Jinan, 250021, Shandong, P.R. China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, P.R. China
| | - Yongxiang Wang
- Department of Neurology, Shandong Provincial Hospital, Shandong University, No. 324 Jingwuweiqi Road, Jinan, 250021, Shandong, P.R. China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, P.R. China
| | - Shi Tang
- Department of Neurology, Shandong Provincial Hospital, Shandong University, No. 324 Jingwuweiqi Road, Jinan, 250021, Shandong, P.R. China.
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China.
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, P.R. China.
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital, Shandong University, No. 324 Jingwuweiqi Road, Jinan, 250021, Shandong, P.R. China.
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China.
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, P.R. China.
| | - Chengxuan Qiu
- Department of Neurology, Shandong Provincial Hospital, Shandong University, No. 324 Jingwuweiqi Road, Jinan, 250021, Shandong, P.R. China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Aging Research Center, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
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Armstrong N, Fu Z, Woolf K. The Relationship between Lifestyle Behaviors and Mental Illness in Women in College. Nutrients 2024; 16:2211. [PMID: 39064655 PMCID: PMC11280105 DOI: 10.3390/nu16142211] [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: 06/04/2024] [Revised: 06/30/2024] [Accepted: 07/08/2024] [Indexed: 07/28/2024] Open
Abstract
Women, particularly those in college, have the highest prevalence of any mental illness (MI), which negatively impacts social connection, academic performance, and health. Research into alternative treatment methods suggests that lifestyle behaviors are safer and more effective than medication at reducing MI symptoms. This study explores the relationship between lifestyle behaviors and MI in college women through an online survey. The survey included a food frequency questionnaire (Diet History Questionnaire II) and questions about lifestyle behaviors, symptoms of MI, and sociodemographic information. Diet quality was calculated using the Healthy Eating Index (HEI), and MI was assessed using the Depression, Anxiety, and Stress Scale-21. Independent sample t-tests, ANOVA, and chi-square analyses were conducted. A total of 222 women completed the survey. Overall, diet quality was poor, with a mean HEI of 62.6 ± 10.4. No significant differences or associations were found between MI groups for total HEI score, sleep, or tobacco use. However, alcohol use was significantly associated with MI (p = 0.049). Individuals with fewer concurrent unhealthy lifestyle behaviors had less severe symptoms of depression (p = 0.009) and anxiety (p < 0.001) compared to those with more unhealthy lifestyle behaviors. In this study, alcohol use was the only independent lifestyle behavior associated with symptoms of MI. We also found an association between the number of concurrent unhealthy lifestyle behaviors and depression and anxiety symptoms. Future research should explore the benefits of a healthy lifestyle on MI in a more diverse sample of women.
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Affiliation(s)
- Noelle Armstrong
- Department of Nutrition and Food Studies, Steinhart School of Culture, Education, and Human Development, New York University, New York, NY 10003, USA;
| | - Ziyang Fu
- Department of Applied Statistics, Social Science, and Humanities, Steinhart School of Culture, Education, and Human Development, New York University, New York, NY 10003, USA
| | - Kathleen Woolf
- Department of Nutrition and Food Studies, Steinhart School of Culture, Education, and Human Development, New York University, New York, NY 10003, USA;
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Wang F, Li J, Fan Y, Qi X. Construction of a risk prediction model for detecting postintensive care syndrome-mental disorders. Nurs Crit Care 2024; 29:646-660. [PMID: 37699863 DOI: 10.1111/nicc.12978] [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: 10/14/2022] [Revised: 08/03/2023] [Accepted: 08/14/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND Postintensive care syndrome (PICS) has adverse multidimensional effects on nearly half of the patients discharged from ICU. Mental disorders such as anxiety, depression and post-traumatic stress disorder (PTSD) are the most common psychological problems for patients with PICS with harmful complications. However, developing prediction models for mental disorders in post-ICU patients is an understudied problem. AIMS To explore the risk factors of PICS mental disorders, establish the prediction model and verify its prediction efficiency. STUDY DESIGN In this cohort study, data were collected from 393 patients hospitalized in the ICU of a tertiary hospital from April to September 2022. Participants were randomly assigned to modelling and validation groups using a 7:3 ratio. Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis was performed to select the predictors, multiple logistic regression analysis was used to establish the risk prediction model, and a dynamic nomogram was developed. The Hosmer-Lemeshow (HL) test was performed to determine the model's goodness of fit. The area under the receiver operating characteristic (ROC) curve was used to evaluate the model's prediction efficiency. RESULTS The risk factors of mental disorders were Sepsis-related organ failure assessment (SOFA) score, Charlson comorbidity index (CCI), delirium duration, ICU depression score and ICU sleep score. The HL test revealed that p = .249, the area under the ROC curve = 0.860, and the corresponding sensitivity and specificity were 84.8% and 71.0%, respectively. The area under the ROC curve of the verification group was 0.848. A mental disorders dynamic nomogram for post-ICU patients was developed based on the regression model. CONCLUSIONS The prediction model provides a reference for clinically screening patients at high risk of developing post-ICU mental disorders, to enable the implementation of timely preventive management measures. RELEVANCE TO CLINICAL PRACTICE The dynamic nomogram can be used to systematically monitor various factors associated with mental disorders. Furthermore, nurses need to develop and apply accurate nursing interventions that consider all relevant variables.
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Affiliation(s)
- Faying Wang
- Clinical Nursing Teaching Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Office of General Affairs, School of Nursing, Harbin Medical University, Harbin, China
| | - Jingshu Li
- Clinical Nursing Teaching Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Office of General Affairs, School of Nursing, Harbin Medical University, Harbin, China
- Hemodialysis Center, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yuying Fan
- Clinical Nursing Teaching Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Office of General Affairs, School of Nursing, Harbin Medical University, Harbin, China
| | - Xiaona Qi
- Clinical Nursing Teaching Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Office of General Affairs, School of Nursing, Harbin Medical University, Harbin, China
- Nursing Department, Tumor Hospital of Harbin Medical University, Harbin, China
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Rantanen AT, Kautiainen H, Ekblad MO, Korhonen PE. Depressive symptoms and smoking: Effect on mortality in a primary care cohort. J Psychosom Res 2024; 182:111690. [PMID: 38704926 DOI: 10.1016/j.jpsychores.2024.111690] [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: 01/15/2024] [Revised: 04/28/2024] [Accepted: 04/28/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVE Depressive symptoms have been suggested to increase mortality risk but causality remains unproven. Depressive symptoms increase likelihood of smoking which is thus a potential factor modifying the effect of depressive symptoms on mortality. This study aims to assess if the association of depressive symptoms and all-cause mortality is affected by smoking. METHODS A prospective cohort study in Finnish primary care setting was conducted among 2557 middle-aged cardiovascular disease (CVD) risk persons identified in a population survey. Baseline depressive symptoms were assessed by Beck's Depression Inventory (BDI) and current smoking by self-report. Data on mortality was obtained from the official statistics. Effect of depressive symptoms and smoking on all-cause mortality after 14-year follow-up was estimated. RESULTS Compared to non-depressive non-smokers, the adjusted hazard ratio (HR) for all-cause mortality was 3.10 (95% CI 2.02 to 4.73) and 1.60 (95% CI 1.15 to 2.22) among smoking subjects with and without depressive symptoms, respectively. Compared to the general population, relative survival was higher among non-depressive non-smokers and lower among depressive smokers. Relative standardized mortality ratio (SMR) for all-cause mortality was 1.78 (95% CI 1.31 to 2.44) and 3.79 (95% CI 2.54 to 6.66) among non-depressive and depressive smokers, respectively, compared to non-depressive non-smokers. The HR for all-cause mortality and relative SMR of depressive non-smokers were not increased compared to non-depressive non-smokers. CONCLUSION Current smoking and increased depressive symptoms seem to additively contribute to excess mortality.
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Affiliation(s)
- Ansa Talvikki Rantanen
- Department of General Practice, University of Turku and Southwest Finland Wellbeing Services County, Turku, Finland.
| | - Hannu Kautiainen
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland; Folkhälsan Research Center, Helsinki, Finland.
| | - Mikael Oskari Ekblad
- Department of General Practice, University of Turku and Southwest Finland Wellbeing Services County, Turku, Finland.
| | - Päivi Elina Korhonen
- Department of General Practice, University of Turku and Southwest Finland Wellbeing Services County, Turku, Finland.
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Zhang P, Huang N, Yang F, Yan W, Zhang B, Liu X, Peng K, Guo J. Determinants of depressive symptoms at individual, school and province levels: a national survey of 398,520 Chinese children and adolescents. Public Health 2024; 229:33-41. [PMID: 38394705 DOI: 10.1016/j.puhe.2024.01.015] [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: 04/25/2023] [Revised: 11/06/2023] [Accepted: 01/18/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVES The aims of this study were to describe the national distribution of depressive symptoms in Chinese children and adolescents, to examine the determinants of depressive symptoms at individual, school and province levels and to assess the gender and age differences in the effect of school factors on depressive symptoms. STUDY DESIGN This was a national cross-sectional study. METHODS A school-based online survey was conducted in mainland China from between December 1, 2021, and January 1, 2022. A total of 398,520 eligible participants were included in the analysis. School-level data were drawn from students, headteachers and Baidu Maps, and province-level data were obtained from the national human development report. The Patient Health Questionnaire-2 was used to measure depressive symptoms. RESULTS Areas with the highest mean scores for depressive symptoms were in the northeastern, inner central and southwestern regions of China. At the individual level, younger age, male sex, being an only child, Han ethnicity, lower body mass index, more days of exercise, less drinking and smoking behaviours, higher subjective family socio-economic status (SES) and popularity in school were related to fewer depressive symptoms; however, objective family SES and maternal education were not related to fewer depressive symptoms. The school-level variables of public status, psychological activities and psychological courses and province-level variable of higher Human Development Index were associated with fewer depressive symptoms. The effect of psychological courses and activities on depressive symptoms was greater in females. CONCLUSIONS The results showed multilevel factors related to depressive symptoms and emphasised the importance of implementing school-based psychological activities to ameliorate depressive symptoms in Chinese children and adolescents across age and gender.
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Affiliation(s)
- P Zhang
- Department of Psychology, Tsinghua University, Beijing 100084, China
| | - N Huang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China
| | - F Yang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China
| | - W Yan
- Department of Psychology, Tsinghua University, Beijing 100084, China.
| | - B Zhang
- Department of Neurology, Boston Children's Hospital, Boston, MA 02215, United States
| | - X Liu
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China
| | - K Peng
- Department of Psychology, Tsinghua University, Beijing 100084, China
| | - J Guo
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China.
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6
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Yoshimaru N, Nanri A, Eguchi M, Kochi T, Kabe I, Mizoue T. Eating behaviors and depressive symptoms among Japanese workers: the Furukawa Nutrition and Health Study. Eur J Clin Nutr 2024; 78:307-313. [PMID: 38135709 DOI: 10.1038/s41430-023-01391-8] [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: 01/04/2023] [Revised: 12/04/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND/OBJECTIVES In addition to the potential effects of nutrients on mood, eating behaviors have been suggested to be associated with depressive symptoms. We investigated the prospective association between the accumulation of unhealthy eating behaviors and depressive symptoms in a Japanese working population. METHODS Participants were 914 workers (aged 19-68 years) who did not have depressive symptoms at baseline (April 2012 and May 2013) and attended a 3-year follow-up survey (April 2015 and May 2016). Unhealthy eating behaviors (skipping breakfast, eating dinner just before bedtime, and snacking after dinner) were assessed at baseline. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) scale at follow-up. Multiple logistic regression was used to estimate the odds ratio of depressive symptoms (CES-D score ≥16) at follow-up according to the number of unhealthy eating behaviors. RESULTS In a model with adjustment of background factors, participants having 2-3 unhealthy eating behaviors at baseline had significantly higher risk of developing depressive symptoms (OR, 2.02; 95% CI, 1.21-3.38) compared with those having no such behaviors. After adjustment for occupational and lifestyle factors, the association was slightly attenuated but remained significant (OR, 1.87; 95% CI, 1.10-3.21). This association was further attenuated and became statistically non-significant after additional adjustment for nutritional factors (OR, 1.67; 95% CI, 0.96-2.90). CONCLUSIONS Our results suggest that the accumulation of unhealthy eating behaviors is associated with an increased risk of depressive symptoms and that this association may be partly ascribed to a lower intake of nutrients with mood-improving effects.
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Affiliation(s)
- Norika Yoshimaru
- Department of Food and Health Sciences, International College of Arts and Sciences, Fukuoka Women's University, Fukuoka, Japan
| | - Akiko Nanri
- Department of Food and Health Sciences, International College of Arts and Sciences, Fukuoka Women's University, Fukuoka, Japan.
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Masafumi Eguchi
- Department of Health Administration, Furukawa Electric Corporation, Tokyo, Japan
| | - Takeshi Kochi
- Department of Health Administration, Furukawa Electric Corporation, Tokyo, Japan
| | | | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
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Wong VWH, Yiu EKL, Ng CH, Sarris J, Ho FYY. Unraveling the associations between unhealthy lifestyle behaviors and mental health in the general adult Chinese population: A cross-sectional study. J Affect Disord 2024; 349:583-595. [PMID: 38176449 DOI: 10.1016/j.jad.2023.12.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 11/24/2023] [Accepted: 12/27/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND This study examined the cumulative risk of unhealthy lifestyle behaviors and the associations between overall lifestyle and common mental disorders (CMDs), insomnia, stress, health-related quality of life (HRQOL), and functional impairment. Additionally, the treatment preferences for managing CMDs and insomnia were examined. METHODS A survey was conducted on 1487 Chinese Hong Kong adults, assessing their lifestyle behaviors (i.e., diet and nutrition, substance use, physical activity, stress management, restorative sleep, social support, and environmental exposures), mental health-related outcomes, and treatment preferences via a vignette. RESULTS The findings revealed significant additive relationships between the number of 'worse' lifestyle domains and the risk of all outcomes. A healthier overall lifestyle was significantly associated with reduced risks of all outcomes (AORs = 0.88 to 0.93). Having healthier practices in diet and nutrition, substance use, stress management, restorative sleep, and social support domains were significantly associated with lower risks of all outcomes (AORs = 0.93 to 0.98), except that substance use was not significantly associated with stress. Physical activity was inversely associated with only depressive symptoms (AOR = 0.98), anxiety symptoms (AOR = 0.99), and stress (AOR = 0.99). Environmental exposures were not significantly associated with functional impairment but with all other outcomes (AORs = 0.98 to 0.99). Besides, lifestyle interventions (55 %) were significantly more preferred for managing CMDs and insomnia relative to psychotherapy (35.4 %) and pharmacotherapy (9.6 %). CONCLUSIONS Our findings underscore the importance of considering lifestyle factors when managing CMDs, insomnia, stress, HRQOL, and functional impairment, with a particular emphasis on adopting a multicomponent treatment approach.
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Affiliation(s)
| | - Eric Kwok-Lun Yiu
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, VIC, Australia
| | - Jerome Sarris
- Western Sydney University, NICM Health Research Institute, Westmead, NSW, Australia; Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Fiona Yan-Yee Ho
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong.
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Liu J, Wu J, Wang J, Chen S, Yin X, Gong Y. Prevalence and associated factors for depressive symptoms among the general population from 31 provinces in China: The utility of social determinants of health theory. J Affect Disord 2024; 347:269-277. [PMID: 37940057 DOI: 10.1016/j.jad.2023.10.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 09/30/2023] [Accepted: 10/21/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Depression is one of the most common types of mental disorders. Guided by the theory of social determinants of health (SDH), the study aimed to assess the prevalence of depressive symptoms and to identify factors related to depressive symptoms in the general population of China. METHODS A cross-sectional, online survey was conducted among 101,392 residents from 31 provinces of mainland China from January to March 2019, and 97,126 survey responses were included in the final analysis. Multilevel linear regression models were used to identify SDH associated with depressive symptoms. RESULTS The prevalence of depressive symptoms (PHQ-9 scores ≥10) in Chinese residents was 15.81 %. The results of the multilevel analysis demonstrated that depressive symptoms were affected by various factors on five levels, including individual characteristics, behavioral lifestyle, community support network, social structural factors, and macro social factors. LIMITATIONS The cross-sectional design of the study makes it difficult to establish causality between variables. CONCLUSIONS The prevalence of depressive symptoms is high among general population in China. According to the theory of SDH, the study shows that the depressive symptoms are complex and involves all areas of social life. Therefore, adopting a multi-level, cross-sectoral intervention approach will be instrumental to improving the mental health of residents in China.
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Affiliation(s)
- Jiaming Liu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Department of Public Health, Shihezi University School of Medicine, Shihezi 832000, Xinjiang, China
| | - Jianxiong Wu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jing Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Silin Chen
- Department of Public Health, Shihezi University School of Medicine, Shihezi 832000, Xinjiang, China
| | - Xiaoxv Yin
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yanhong Gong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Nanri A, Yamamoto S, Suetsugu M, Kochi T, Kabe I, Mizoue T. Isoflavone intake and depressive symptoms among workers. Clin Nutr ESPEN 2023; 58:416-420. [PMID: 38057034 DOI: 10.1016/j.clnesp.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/22/2023] [Accepted: 11/06/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND & AIM High intake of isoflavones has been reported to be associated with decreased prevalence of depressive symptoms. However, no prospective study has examined this association. We prospectively investigated the association between isoflavone intake and depressive symptoms in a Japanese working population. METHODS Participants were 1162 workers (1033 men and 129 women aged 18-68 years) without depressive symptoms at baseline. Dietary intake was assessed using a validated self-administered diet history questionnaire. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) scale. Cox proportional hazards regression for interval-censored data was used to estimate the hazard ratio of depressive symptoms (CES-D ≥16) according to the tertile of isoflavone intake with adjustment for covariates. RESULTS During 5065 person-years of follow-up, 276 (23.8 %) workers were newly identified as having depressive symptoms. Isoflavone intake was not associated with risk of depressive symptoms. After adjustment for lifestyle and dietary factors and baseline CES-D score, the multivariable-adjusted hazard ratios (95 % confidence interval) for the lowest through highest tertile of isoflavone intake were 1.00 (reference), 0.93 (0.66-1.31), and 0.93 (0.62-1.38) (P for trend = 0.70). CONCLUSIONS Our findings suggest that higher isoflavone intake is not associated with decreased risk of depressive symptoms among Japanese.
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Affiliation(s)
- Akiko Nanri
- Department of Food and Health Sciences, International College of Arts and Sciences, Fukuoka Women's University, Fukuoka, Japan; Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Shohei Yamamoto
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masana Suetsugu
- Department of Food and Health Sciences, International College of Arts and Sciences, Fukuoka Women's University, Fukuoka, Japan
| | - Takeshi Kochi
- Department of Health Administration, Furukawa Electric Corporation, Tokyo, Japan
| | | | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
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Navarra-Ventura G, Coronado-Simsic V, Riera-Serra P, Castro A, García-Toro M, Roca M, Gili M. Associations between unhealthy lifestyle and depression: Cross-sectional results from the Spanish National Health Survey. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2023:S2950-2853(23)00035-2. [PMID: 38591831 DOI: 10.1016/j.sjpmh.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 05/02/2023] [Accepted: 08/25/2023] [Indexed: 04/10/2024]
Abstract
INTRODUCTION Depression usually worsens lifestyle habits, but previous evidence also suggests that an unhealthy lifestyle (UL) increases the risk of depression. Many studies have analyzed the association between lifestyle and depression in several nationally representative samples, but none have done so in the Spanish adult population. Our aim was to examine the associations between UL habits and depression in Spain. MATERIALS AND METHODS Analysis of cross-sectional data from the latest National Health Survey published in 2018 (N=23,089). Data on depression and 4 lifestyle factors (diet, physical exercise, smoking, and alcohol consumption) were used. These factors were combined into an UL index ranging from 0 (healthiest lifestyle) to 4 (unhealthiest lifestyle). The prevalence of depression at different levels of the UL index, and the association between depression and both the cumulative UL index and the 4 UL factors was analyzed using parametric and non-parametric tests. RESULTS Sedentarism was the most prevalent UL factor, followed by unhealthy diet, smoking and high-risk alcohol consumption. Having ≥1 UL factors was associated with a higher prevalence of depression compared to having 0 UL factors (2.5% vs. ≥5.2%), regardless of the cumulative number UL factors (1, 2, 3 or 4). Being physically inactive (OR=1.6) and a smoker (OR=1.3) increased the likelihood of depression. Being a high-risk wine drinker (OR=0.26) decreased the likelihood of depression. Dietary intake was not significant. CONCLUSIONS The prevalence of depression changes depending on several modifiable lifestyle factors. Policy makers should therefore spare no resources in promoting strategies to encourage healthy lifestyles and prevent the acquisition of UL habits.
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Affiliation(s)
- Guillem Navarra-Ventura
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain
| | - Victoria Coronado-Simsic
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain
| | - Pau Riera-Serra
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain.
| | - Adoración Castro
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain; Department of Psychology, University of the Balearic Islands (UIB), Palma (Mallorca), Spain
| | - Mauro García-Toro
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain; Department of Medicine, University of the Balearic Islands (UIB), Palma (Mallorca), Spain
| | - Miquel Roca
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain; Department of Medicine, University of the Balearic Islands (UIB), Palma (Mallorca), Spain
| | - Margalida Gili
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain; Department of Psychology, University of the Balearic Islands (UIB), Palma (Mallorca), Spain
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11
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Ren Z, Du Y, Lian X, Sun J, Zheng X, Liu J. The dilution effects of healthy lifestyles on the risk of depressive symptoms attributed to life-course disadvantages among Chinese middle-aged and older adults. J Affect Disord 2023:S0165-0327(23)00705-X. [PMID: 37245546 DOI: 10.1016/j.jad.2023.05.064] [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: 10/06/2022] [Revised: 05/15/2023] [Accepted: 05/18/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND Life-course disadvantages and unhealthy lifestyles are well-known to independently induce depressive symptoms, but whether adopting healthy lifestyles can dilute the depressive risks attributed to life-course disadvantages remain unknown in China. METHODS This population-based cross-sectional study included 5724 middle-aged and older people from the China Health and Retirement Longitudinal Study (CHARLS). Depressive symptoms and healthy lifestyles (including regular exercise, reasonable sleep, never smoking, and no heavy alcohol consumption) were collected in 2018 while life-course disadvantages were collected in 2014. RESULTS Multiple healthy lifestyles were associated with decreased depressive risks more significantly as the life-course disadvantages increased, with odds ratios (ORs) and 95 % confidence intervals (CIs) of 0.44 (0.25-0.80) and 0.33 (0.21-0.53) for 4 healthy lifestyles in participants with mild and severe life-course disadvantages, respectively. Life-course disadvantages and unhealthy lifestyles had enormous joint effects on depressive symptoms. Finally, adopting multiple healthy lifestyles can dilute the depressive risks attributed to life-course disadvantages and even mask some risks attributed to childhood disadvantages. LIMITATIONS Given that dietary data were not gathered by the CHARLS, diet was not included in the lifestyles used in this study. In addition, information on life-course disadvantages was primarily self-reported, which may lead to potential recall bias. Finally, the cross-sectional design of this study cannot capture causal associations well. CONCLUSIONS Adopting multiple healthy lifestyles can well-dilute the depressive risks attributed to life-course disadvantages in middle-aged and older Chinese, which is of great importance for reducing the depressive burden and the construction of healthy aging in China.
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Affiliation(s)
- Ziyang Ren
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yushan Du
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Xinyao Lian
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jinfang Sun
- Office of Epidemiology, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaoying Zheng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China.
| | - Jufen Liu
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
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12
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Li H, Song L, Cen M, Fu X, Gao X, Zuo Q, Wu J. Oxidative balance scores and depressive symptoms: Mediating effects of oxidative stress and inflammatory factors. J Affect Disord 2023; 334:205-212. [PMID: 37149058 DOI: 10.1016/j.jad.2023.04.134] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 03/22/2023] [Accepted: 04/29/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Few studies have examined the combined effects of dietary and lifestyle factors on depressive symptoms. This study aimed to evaluate the association between oxidative balance score (OBS) and depressive symptoms and the underlying mechanisms. METHODS A total of 21,283 adults from the 2007 to 2018 National Health and Nutrition Examination Survey (NHANES) were included. Depressive symptoms were defined as a total score of ≥10 on the Patient's Health Questionnaire (PHQ-9). Twenty dietary and lifestyle factors were selected to calculate the OBS. Multivariable logistic regression analyses were used to evaluate the association between OBS and depression risk. Mediation analyses were conducted to explore the roles of oxidative stress and inflammatory markers. RESULTS In multivariate model, a significant negative association was found between OBS and depression risk. Compared with those in OBS tertile 1, participants in tertile 3 had lower odds of developing depressive symptoms (OR:0.50; 95 % CI:0.40-0.62; P < 0.001). Restricted cubic splines showed a linear relationship between OBS and depression risk (P for nonlinearity = 0.67). Moreover, higher OBS was found to be associated with lower depression scores (β = -0.07; 95 % CI:-0.08, -0.05; P < 0.001). GGT concentrations and WBC counts mediated the association between OBS and depression scores by 5.72 % and 5.42 %, respectively (both P < 0.001), with a joint mediated effect of 10.77 % (P < 0.001). LIMITATIONS This study was a cross-sectional design making it difficult to infer a causal association. CONCLUSIONS OBS is negatively associated with depression, which may be mediated in part by oxidative stress and inflammation.
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Affiliation(s)
- Huiru Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Lingling Song
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Manqiu Cen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xihang Fu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xinxin Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Qianlin Zuo
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jing Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
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Zheng J, Li J, Pei T, Zhu T, Li X, Wang H. Bidirectional associations and a causal mediation analysis between depressive symptoms and chronic digestive diseases: A longitudinal investigation. J Affect Disord 2023; 333:278-289. [PMID: 37105468 DOI: 10.1016/j.jad.2023.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 03/21/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND Chronic digestive diseases (CDDs) and depression shared major pathogeneses. We aimed to prospectively examine the bidirectional incidence associations between depressive symptoms and CDDs and explore biologically and behaviorally relevant mediators in the bidirectional associations. METHODS Multivariable-adjusted Cox proportional hazard models were used to examine baseline depressive symptoms in relation to incident CDDs among 10,974 adults and the relation of baseline CDDs with new-onset elevated depressive symptoms among 7489 participants in the China Health and Retirement Longitudinal Study of nationally representative middle-aged and older adults. Elevated depressive symptoms were defined as the 10-item Center for Epidemiologic Studies Depression scale (CES-D-10) score at or higher than 10 and CDDs (except for tumor and cancer) were determined by self-reported physician diagnoses. Causal mediation analysis was performed to assess the mediated effects of a priori selected blood biomarkers and lifestyle factors in the bidirectional associations. RESULTS Prevalence of elevated depressive symptoms and nonmalignant CDDs at baseline was 33.05 % and 17.8 % respectively. During a mean of 5.47 years of follow-up, elevated depressive symptoms significantly increased hazard of CDDs by 1.66 folds (95%CI = 1.49-1.84). Having CDDs at baseline was associated with a 27 % (95%CI = 16 %-39 %) increased hazard of developing elevated depressive symptoms. Shorter sleeping duration at night nominally significantly mediated 8.76 % of the association between depressive symptoms and incident CDDs while no significant mediators were identified in the converse association. LIMITATIONS Limited mediator information and inadequately long follow-up may reduce chance of identifying significant mediators. CONCLUSIONS Depressive symptoms and CDDs were mutual independent risk factors. Early screening and management of depressive symptoms and sleep disturbance are suggested in the prevention of CDDs and related comorbidities.
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Affiliation(s)
- Jiali Zheng
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Jingmeng Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Tianduo Pei
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Tianren Zhu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Xiaoguang Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; State Key Laboratory of Oncogenes and Related Genes, Center for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Hui Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; State Key Laboratory of Oncogenes and Related Genes, Center for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
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Hoedjes M, Vrieling A, de Brauwer L, Visser A, Gómez García E, Hoogerbrugge N, Kampman E. Determinants of adherence to recommendations on physical activity, red and processed meat intake, and body weight among lynch syndrome patients. Fam Cancer 2023; 22:155-166. [PMID: 36151358 PMCID: PMC10020312 DOI: 10.1007/s10689-022-00315-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: 02/04/2022] [Accepted: 08/30/2022] [Indexed: 11/26/2022]
Abstract
This study aimed to identify determinants of adherence to lifestyle and body weight recommendations for cancer prevention among Lynch Syndrome (LS) patients. Cross-sectional baseline data of LS patients participating in the Lifestyle & Lynch (LiLy) study was used to assess determinants of adherence to the World Cancer Research Fund cancer prevention recommendations on body weight, physical activity, and red and processed meat intake. Adherence and potential determinants of adherence were assessed using questionnaires. Multivariable logistic regression analyses were conducted to identify determinants of adherence. Of the 211 participants, 50.2% adhered to the body weight recommendation, 78.7% adhered to the physical activity recommendation, and 33.6% adhered to the red and processed meat recommendation. Being younger and having a higher level of education were associated with adherence to the recommendation on body weight. Having knowledge about the recommendation was associated with adherence to the recommendations on physical activity and red and processed meat. Results confirm that knowledge about recommendations for cancer prevention is an important determinant for adherence and suggest that strategies to increase knowledge should be included in lifestyle promotion targeted at LS patients, along with behavior change techniques influencing other modifiable determinants.
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Affiliation(s)
- M Hoedjes
- Center of Research on Psychological and Somatic disorders, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands.
| | - A Vrieling
- Department for Health Evidence, Radboud university medical center, Nijmegen, The Netherlands
| | - L de Brauwer
- Center of Research on Psychological and Somatic disorders, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands
| | - A Visser
- Department for Health Evidence, Radboud university medical center, Nijmegen, The Netherlands
| | - E Gómez García
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - N Hoogerbrugge
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - E Kampman
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
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15
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Garcia A, Yáñez AM, Bennasar-Veny M, Navarro C, Salva J, Ibarra O, Gomez-Juanes R, Serrano-Ripoll MJ, Oliván B, Gili M, Roca M, Riera-Serra P, Aguilar-Latorre A, Montero-Marin J, Garcia-Toro M. Efficacy of an adjuvant non-face-to-face multimodal lifestyle modification program for patients with treatment-resistant major depression: A randomized controlled trial. Psychiatry Res 2023; 319:114975. [PMID: 36442318 DOI: 10.1016/j.psychres.2022.114975] [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: 08/25/2022] [Revised: 11/18/2022] [Accepted: 11/20/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND The high prevalence of depression is partly attributable to the poor response of patients to first-line antidepressants. Multimodal programs that promote a healthy lifestyle are successful in treating depression when used as a complementary therapy, but their medium- and long-term benefits have not been demonstrated for patients with treatment-resistant depression (TRD). The main aim of this study was to compare the effectiveness of a lifestyle modification program (LMP) with mindfulness-based cognitive therapy (MBCT) and a placebo-control (written suggestions for lifestyle changes) in Spanish patients with TRD. METHODS This controlled clinical trial randomized 94 patients with TRD into 3 arms. The primary outcome was the Beck Depression Inventory-II (BDI-II) score at baseline, 2, 6 and 12 months. The secondary outcomes were changes in scores that evaluated quality-of-life, adherence to the Mediterranean diet, physical activity, and social support. RESULTS Relative to the placebo group, the LMP and MBCT groups had significantly better quality of life (p = 0.017; p = 0.027), and the LMP group had significantly better adherence to the Mediterranean diet (p<0.001) and reduced use of antidepressants (p = 0.036). However, the three groups showed no significant differences in BDI-II score. LIMITATIONS Only about half of the planned 180 patients were recruited, in part due to the COVID-19 pandemic. CONCLUSIONS There was no evidence that the LMP treatment significantly reduced symptoms of depression relative to the other groups during the COVID-19 lockdown.
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Affiliation(s)
- Aurora Garcia
- Health Research Institute of the Balearic Islands (IdISBa), Spain; University Institute of Health Science Research (IUNICS), University of the Balearic Islands (UIB), Spain
| | - Aina M Yáñez
- Health Research Institute of the Balearic Islands (IdISBa), Spain; Department of Nursing and Physiotherapy and Research Group on Global Health and Human Development, UIB
| | - Miquel Bennasar-Veny
- Health Research Institute of the Balearic Islands (IdISBa), Spain; Department of Nursing and Physiotherapy and Research Group on Global Health and Human Development, UIB; CIBER de Epidemiologíública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | - Capilla Navarro
- Health Research Institute of the Balearic Islands (IdISBa), Spain; University Institute of Health Science Research (IUNICS), University of the Balearic Islands (UIB), Spain
| | - Joan Salva
- Health Research Institute of the Balearic Islands (IdISBa), Spain; University Institute of Health Science Research (IUNICS), University of the Balearic Islands (UIB), Spain; Department of Medicine, University of the Balearic Islands, E-07122 Palma, Spain
| | - Olga Ibarra
- Health Research Institute of the Balearic Islands (IdISBa), Spain; University Institute of Health Science Research (IUNICS), University of the Balearic Islands (UIB), Spain
| | - Rocío Gomez-Juanes
- Health Research Institute of the Balearic Islands (IdISBa), Spain; University Institute of Health Science Research (IUNICS), University of the Balearic Islands (UIB), Spain; Department of Medicine, University of the Balearic Islands, E-07122 Palma, Spain
| | - María J Serrano-Ripoll
- Primary Care Research Unit of Majorca, Balearic Islands Health Services and Department of Psychology, UIB
| | - Bárbara Oliván
- Department of Psychology and Sociology, University of Zaragoza. Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
| | - Margalida Gili
- Health Research Institute of the Balearic Islands (IdISBa), Spain; University Institute of Health Science Research (IUNICS), University of the Balearic Islands (UIB), Spain
| | - Miquel Roca
- Health Research Institute of the Balearic Islands (IdISBa), Spain; University Institute of Health Science Research (IUNICS), University of the Balearic Islands (UIB), Spain; Department of Medicine, University of the Balearic Islands, E-07122 Palma, Spain
| | - Pau Riera-Serra
- Health Research Institute of the Balearic Islands (IdISBa), Spain; University Institute of Health Science Research (IUNICS), University of the Balearic Islands (UIB), Spain
| | | | - Jesús Montero-Marin
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK; Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Mauro Garcia-Toro
- Health Research Institute of the Balearic Islands (IdISBa), Spain; University Institute of Health Science Research (IUNICS), University of the Balearic Islands (UIB), Spain; Department of Medicine, University of the Balearic Islands, E-07122 Palma, Spain
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He F, Li Y, Hu Z, Zhang H. Association of domain-specific physical activity with depressive symptoms: A population-based study. Eur Psychiatry 2022; 66:e5. [PMID: 36503700 PMCID: PMC9879900 DOI: 10.1192/j.eurpsy.2022.2350] [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] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND It remains unclear whether all physical activity (PA) domains (e.g., occupation-related PA [OPA], transportation-related PA [TPA], and leisure-time PA [LTPA]) have equivalent beneficial relationships. We aimed to investigate the associations of OPA, TPA, and LTPA with depressive symptoms in adults. METHODS We included and analyzed 31,221 participants (aged ≥18 years) from the cross-sectional 2007-2018 U.S. National Health and Nutrition Examination Survey (NHANES). The PA domains were assessed by a self-report questionnaire and categorized based on the PA guidelines. Depressive symptoms were measured by the nine-item Patient Health Questionnaire. RESULTS Participants achieving PA guidelines (≥150 min/week) were 26% (odds ratio [OR] 0.74, 95% confidence interval [CI] 0.68-0.80) and 43% (OR 0.57, 95% CI 0.51-0.62) less likely to have depressive symptoms depending on total PA and LTPA, respectively, while OPA or TPA did not demonstrate lower risks of depressive symptoms. LTPA at levels of 1-149, 150-299, and ≥300 min/week was associated with 31% (OR 0.69, 95% CI 0.60-0.78), 43% (OR 0.57, 95% CI 0.49-0.67), and 51% (OR 0.49, 95% CI 0.43-0.55) lower odds of depressive symptoms, respectively. CONCLUSION LTPA, but not OPA or TPA, was associated with a lower risk of depressive symptoms at any amount, suggesting that significant mental health would benefit from increased PA, even at levels below the recommendation.
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Affiliation(s)
- Fan He
- Human Phenome Institute, Zhangjiang Fudan International Innovation Centre, Fudan University, Shanghai, China
| | - Yi Li
- Human Phenome Institute, Zhangjiang Fudan International Innovation Centre, Fudan University, Shanghai, China
| | - Zixin Hu
- Human Phenome Institute, Zhangjiang Fudan International Innovation Centre, Fudan University, Shanghai, China.,Artificial Intelligence Innovation and Incubation Institute, Fudan University, Shanghai, China
| | - Hui Zhang
- Human Phenome Institute, Zhangjiang Fudan International Innovation Centre, Fudan University, Shanghai, China.,National Clinical Research Centre for Ageing and Medicine, Huashan Hospital, Fudan University, Shanghai, China
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Wang X, Memon AA, Palmér K, Hedelius A, Sundquist J, Sundquist K. Role of multiple risk factors in mental disorders diagnosed in middle-aged women: A population-based follow-up study. J Psychiatr Res 2022; 156:414-421. [PMID: 36323144 DOI: 10.1016/j.jpsychires.2022.10.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/15/2022] [Accepted: 10/17/2022] [Indexed: 11/05/2022]
Abstract
The aims of the study were 1). to investigate the association between the potential risk factors including socio-demographic, lifestyle and DNA methylation and mental disorders in middle-aged women from a large population-based follow-up study, and 2). to estimate the risk score by combining the potential risk factors to examine the mental disorder's incidence. A total of 6461 women, aged 50-65 years, were included in the study. After a median follow-up of 17 years, 2026 (31%) women were diagnosed with mental disorders. The association between these factors and the risk of mental disorders was analyzed using Cox regression models. Harrell's concordance index (C-index) was used to quantify models' predictive performance for future mental disorders. Blood-based global DNA methylation was assessed by an enzyme-linked immunosorbent assay. We found that smoking (HR = 1.38, 95% CI: 1.24-1.54), less physical activity (HR = 1.33, 95% CI: 1.10-1.60), being single (HR = 1.16, 95% CI: 1.04-1.29) and unemployment (HR = 1.50, 95% CI: 1.33-1.70) were independently associated with an increased risk of overall mental disorders. Risk score models combining all these observed factors showed an increased risk, but the prediction ability was low, except for the risk of alcohol use disorders (AUD) and drug use disorders (DUD) (C-index = 0.8). Finally, women who developed MDD/anxiety during follow-up had significantly higher global DNA methylation at baseline than women who did not develop MDD/anxiety (p = 0.005). In conclusion, our results indicate that the studied risk factors were associated with mental disorders in a type-specific manner. The predictive model showed that smoking, alcohol consumption, education and physical activity may predict future AUD/DUD. Global DNA methylation may be a potential risk factor for MDD/anxiety incidence.
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Affiliation(s)
- Xiao Wang
- Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, 20502, Sweden.
| | - Ashfaque A Memon
- Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, 20502, Sweden
| | - Karolina Palmér
- Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, 20502, Sweden
| | - Anna Hedelius
- Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, 20502, Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, 20502, Sweden; Department of Family Medicine and Community Health, Department of Population Health Science and Policy Icahn School of Medicine at Mount Sinai, New York, USA; Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Japan
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, 20502, Sweden; Department of Family Medicine and Community Health, Department of Population Health Science and Policy Icahn School of Medicine at Mount Sinai, New York, USA; Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Japan
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Wagner J, Bermúdez-Millán A, Berthold SM, Buckley T, Buxton OM, Feinn R, Kong S, Kuoch T, Master L, Scully M, Seng K. Psychological distress and health behaviours among Cambodian Americans at risk for developing diabetes. Stress Health 2022; 39:372-383. [PMID: 35986929 DOI: 10.1002/smi.3189] [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: 11/26/2021] [Revised: 06/25/2022] [Accepted: 08/10/2022] [Indexed: 11/07/2022]
Abstract
This paper reports secondary data analysis of associations between psychological distress and health behaviours among Cambodian Americans. Data are from baseline assessments from a diabetes prevention trial. All participants met stucriteria for depression and were free of diabetes. Participants (n = 191) completed surveys, a food frequency assessment, and wore sleep and physical activity actigraphy devices for 7 days. A factor analysis of symptoms of post-traumatic stress, baksbat (a Cambodian culture-bound syndrome), depression, and anxiety yielded a single factor named 'psychological distress'. Multivariate models controlling for psychotropic medications were run for the following outcomes: sleep actigraphy, self-reported sleep, physical activity actigraphy, self-reported physical activity, nutrition, and substance use. For actigraphy, higher distress was associated with lower moderate/vigorous physical activity and higher mean variability of 24 h total sleep time. Higher distress was also associated with worse self-reported sleep quality as indicated by standard, and culturally-specific, sleep indicators. Higher distress was also associated with lower use of food labels, lower carbohydrate consumption, and higher alcohol consumption as a coping mechanism. Interventions to mitigate diabetes risk in high-distress populations may benefit from strategies to decrease psychological distress. The sequelae of complex trauma may transcend discrete psychiatric diagnoses.
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Affiliation(s)
- Julie Wagner
- UConn Schools of Medicine and Dental Medicine, Farmington, Connecticut, USA
| | | | | | | | - Orfeu M Buxton
- Pennsylvania State University, University Park, Pennsylvania, USA
| | | | - Sengly Kong
- Khmer Health Advocates, West Hartford, Connecticut, USA
| | - Theanvy Kuoch
- Khmer Health Advocates, West Hartford, Connecticut, USA
| | - Lindsay Master
- Pennsylvania State University, University Park, Pennsylvania, USA
| | - Mary Scully
- Khmer Health Advocates, West Hartford, Connecticut, USA
| | - Kagnica Seng
- Central Connecticut State University, New Britain, Connecticut, USA
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19
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Aguilar-Latorre A, Pérez Algorta G, Navarro-Guzmán C, Serrano-Ripoll MJ, Oliván-Blázquez B. Effectiveness of a lifestyle modification programme in the treatment of depression symptoms in primary care. Front Med (Lausanne) 2022; 9:954644. [PMID: 35957845 PMCID: PMC9361711 DOI: 10.3389/fmed.2022.954644] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/07/2022] [Indexed: 11/19/2022] Open
Abstract
Background Depression symptoms are prevalent in the general population, and their onset and continuation may be related to biological and psychosocial factors, many of which are related to lifestyle aspects. Health promotion and lifestyle modification programmes (LMPs) may be effective on reducing the symptoms. The objective of this study was to analyse the clinical effectiveness of a LMP and a LMP plus Information and Communication Technologies, when compared to Treatment as Usual (TAU) over 6 months. The interventions were offered as an adjuvant treatment delivered in Primary Healthcare Centers (PHCs) for people with depression symptoms. Methods We conducted an open-label, multicentre, pragmatic, randomized clinical trial. Participants were recruited from several PHCs. Those participants visiting general practitioner for any reason, who also met the inclusion criteria (scoring 10 to 30 points on the Beck II Self-Applied Depression Inventory) were invited to take part in the study. TAU+LMP consisted of six weekly 90-min group sessions focused on improving lifestyle. TAU+LMP + ICTs replicated the TAU+LMP format, plus the addition of a wearable smartwatch to measure daily minutes walked and sleep patterns. A total of 188 participants consented to participate in the study and were randomized. We used linear mixed models, with a random intercept and an unstructured covariance to evaluate the impact of the interventions compared to TAU. Results Both interventions showed a statistically significant reduction on depressive symptoms compared to TAU (TAU+LMP vs. TAU slope difference, b = −3.38, 95% CI= [−5.286, −1.474] p = 0.001 and TAU+LMP+ICTs vs. TAU slope difference, b = −4.05, 95% CI = [−5.919, −2.197], p < 0.001). These reductions imply a moderate effect size. In the TAU+LMP+ICTs there was a significant increase regarding minutes walking per week (b = 99.77) and adherence to Mediterranean diet (b = 0.702). In the TAU+LMP there was a significant decrease regarding bad sleep quality (b = −1.24). Conclusion TAU+LMPs administered in PHCs to people experiencing depression symptoms were effective on reducing these symptoms compared to TAU. They also have a positive impact on changing several lifestyle factors. These findings indicate that these interventions can be promising strategies for PHCs.
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Affiliation(s)
- Alejandra Aguilar-Latorre
- Primary Healthcare Center Arrabal, Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
| | - Guillermo Pérez Algorta
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
| | | | - María J. Serrano-Ripoll
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Spain
- Research in Preventive Activities and Promotion and in Cancer Illes Balears (GRAPP-CAIB), Balearic Islands Health Research Institute (IdISBa), Palma, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
- *Correspondence: María J. Serrano-Ripoll
| | - Bárbara Oliván-Blázquez
- Primary Healthcare Center Arrabal, Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
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20
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Stewart V, McMillan SS, Wheeler AJ. The development of a taxonomy to support goal setting between mental health consumers and community pharmacists. Res Social Adm Pharm 2022; 18:4003-4008. [PMID: 35717529 DOI: 10.1016/j.sapharm.2022.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 05/10/2022] [Accepted: 06/09/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Goal setting is widely used in mental healthcare, yet there is limited information about goal development between community pharmacists and people experiencing mental health conditions. OBJECTIVES i) To review goals developed in partnership between Australian community pharmacists and people experiencing depression/anxiety, and ii) categorize goals and develop a taxonomy. METHODS Community pharmacists (n = 142) who had completed a mental health training program provided an individualized medication support service and documented goal planning for 350 people experiencing anxiety and/or depression. Goals were reviewed using a general inductive content analysis to develop themes which were then grouped, categorized, and coded. This involved three researchers in different phases of the coding, repeated review and redrafting of the taxonomy, and inter-rater reliability consistency checks. RESULTS The goals (n = 749) represented a diverse range of health behaviors and outcomes (e.g., medication adherence, relationships, leisure activities). The resulting taxonomy involved five overarching domains: improved health; satisfaction with life; manage physical illnesses; manage mental health; and use of medicines. CONCLUSIONS Pharmacists have a role in providing person-centered care and addressing social determinants of health by considering factors that contribute to a person's overall wellbeing. While further testing is necessary, the taxonomy is valuable for pharmacists unfamiliar with supporting goal development with people experiencing anxiety and/or depression.
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Affiliation(s)
- Victoria Stewart
- School of Health Sciences and Social Work, Griffith University, Australia; Menzies Health Institute Queensland, Griffith University, Australia; School of Pharmacy and Medical Sciences, Griffith University, Australia.
| | - Sara S McMillan
- Menzies Health Institute Queensland, Griffith University, Australia; School of Pharmacy and Medical Sciences, Griffith University, Australia
| | - Amanda J Wheeler
- Menzies Health Institute Queensland, Griffith University, Australia; School of Pharmacy and Medical Sciences, Griffith University, Australia; Faculty of Health and Behavioural Sciences, University of Auckland, New Zealand
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21
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Ceolin G, Breda V, Koning E, Meyyappan AC, Gomes FA, Moreira JD, Gerchman F, Brietzke E. A Possible Antidepressive Effect of Dietary Interventions: Emergent Findings and Research Challenges. CURRENT TREATMENT OPTIONS IN PSYCHIATRY 2022; 9:151-162. [PMID: 35496470 PMCID: PMC9034261 DOI: 10.1007/s40501-022-00259-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 04/01/2022] [Indexed: 02/07/2023]
Abstract
Purpose Despite recent advancements in the treatment of depression, the prevalence of affected individuals continues to grow. The development of new strategies has been required and emerging evidence has linked a possible antidepressant effect with dietary interventions. In this review, we discuss recent findings about the possible antidepressant effect of dietary interventions with an emphasis on the results of randomized controlled trials. Recent findings A high consumption of refined sugars and saturated fat and a low dietary content of fruits and vegetables has been associated with the development of depression. There is evidence supporting a small to moderate beneficial effect of a Mediterranean-type diet in depression. In addition, new dietary protocols are being studied for their use as possible interventions, such as the ketogenic diet, Nordic diet, and plant-based diet. Summary Lifestyle interventions surrounding diet and nutrition are a relatively affordable way to enhance response to treatment and to be employed as an adjunct in mental health care. Most studies, however, are limited by the difficulty in controlling for the placebo effect. Mediterranean-style diets seem to be the most promising as an adjunctive treatment for mood disorders. Larger randomized controlled trials that could assess predictors of response to dietary interventions are needed to establish a clear positive effect of diet and guide clinical care and nutritional recommendations concerning mental health care.
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Affiliation(s)
- Gilciane Ceolin
- Centre for Neuroscience Studies (CNS), Queen's University, Kingston, 752 King Street West, Kingston, ON K7L 7X3 Canada.,Postgraduate Program in Nutrition, Universidade Federal de Santa Catarina, Florianópolis, SC Brazil
| | - Vitor Breda
- Centre for Neuroscience Studies (CNS), Queen's University, Kingston, 752 King Street West, Kingston, ON K7L 7X3 Canada.,Department of Psychiatry, Queen's University School of Medicine, Kingston, ON Canada
| | - Elena Koning
- Centre for Neuroscience Studies (CNS), Queen's University, Kingston, 752 King Street West, Kingston, ON K7L 7X3 Canada
| | - Arun Chinna Meyyappan
- Centre for Neuroscience Studies (CNS), Queen's University, Kingston, 752 King Street West, Kingston, ON K7L 7X3 Canada
| | - Fabiano A Gomes
- Centre for Neuroscience Studies (CNS), Queen's University, Kingston, 752 King Street West, Kingston, ON K7L 7X3 Canada.,Department of Psychiatry, Queen's University School of Medicine, Kingston, ON Canada
| | - Júlia Dubois Moreira
- Department of Nutrition, Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC Brazil
| | - Fernando Gerchman
- Endocrinology and Metabolism, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS Brazil.,Postgraduate Program in Medical Sciences: Endocrinology, Department of Internal Medicine, Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS Brazil
| | - Elisa Brietzke
- Centre for Neuroscience Studies (CNS), Queen's University, Kingston, 752 King Street West, Kingston, ON K7L 7X3 Canada.,Department of Psychiatry, Queen's University School of Medicine, Kingston, ON Canada
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22
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Castro A, Roca M, Ricci-Cabello I, García-Toro M, Riera-Serra P, Coronado-Simsic V, Pérez-Ara MÁ, Gili M. Adherence to Lifestyle Interventions for Treatment of Adults with Depression: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413268. [PMID: 34948874 PMCID: PMC8702100 DOI: 10.3390/ijerph182413268] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/07/2021] [Accepted: 12/13/2021] [Indexed: 11/18/2022]
Abstract
The aim of this systematic review was to determine the adherence to lifestyle interventions for adults with depression and to estimate the dropout rates in trials examining the impact of these interventions. A bibliographic search was conducted in PubMed, Embase, PsycINFO, the Cochrane library, and several sources of grey literature. We included randomised controlled trials examining the impact of multiple lifestyle interventions on depressive symptomatology in adults when compared to control or other active treatments. Two reviewers independently screened citations, extracted the relevant data, and assessed the risk of bias using Cochrane tools. A random effects meta-analysis of proportions was used to summarise the proportion of participants who completed the intervention and to determine the proportion of dropouts at post-treatment assessment. Multiple subgroup analyses were also carried out. We identified six trials. The meta-analysis of proportions showed that 53% (95%CI 49% to 58%) of the participants assigned to the intervention group fully adhered to the intervention program. The weighted mean proportion of completed intervention sessions was 66%. The pooled trial dropout rate was 22% (95%CI 20% to 24%). Around half of adults with depression adhere to lifestyle interventions. Future research is needed to develop interventions to support adherence to lifestyle interventions in depressive patients.
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Affiliation(s)
- Adoración Castro
- Health Research Institute of the Balearic Islands (IdiSBa), Hospital Universitario Son Espases, Edificio S, 07120 Palma de Mallorca, Spain; (M.R.); (I.R.-C.); (M.G.-T.); (P.R.-S.); (M.Á.P.-A.); (M.G.)
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07122 Palma de Mallorca, Spain;
- Correspondence: ; Tel.: +34-971259888
| | - Miquel Roca
- Health Research Institute of the Balearic Islands (IdiSBa), Hospital Universitario Son Espases, Edificio S, 07120 Palma de Mallorca, Spain; (M.R.); (I.R.-C.); (M.G.-T.); (P.R.-S.); (M.Á.P.-A.); (M.G.)
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07122 Palma de Mallorca, Spain;
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), 28029 Madrid, Spain
| | - Ignacio Ricci-Cabello
- Health Research Institute of the Balearic Islands (IdiSBa), Hospital Universitario Son Espases, Edificio S, 07120 Palma de Mallorca, Spain; (M.R.); (I.R.-C.); (M.G.-T.); (P.R.-S.); (M.Á.P.-A.); (M.G.)
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, 07002 Palma, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Mauro García-Toro
- Health Research Institute of the Balearic Islands (IdiSBa), Hospital Universitario Son Espases, Edificio S, 07120 Palma de Mallorca, Spain; (M.R.); (I.R.-C.); (M.G.-T.); (P.R.-S.); (M.Á.P.-A.); (M.G.)
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07122 Palma de Mallorca, Spain;
| | - Pau Riera-Serra
- Health Research Institute of the Balearic Islands (IdiSBa), Hospital Universitario Son Espases, Edificio S, 07120 Palma de Mallorca, Spain; (M.R.); (I.R.-C.); (M.G.-T.); (P.R.-S.); (M.Á.P.-A.); (M.G.)
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07122 Palma de Mallorca, Spain;
| | - Victoria Coronado-Simsic
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07122 Palma de Mallorca, Spain;
| | - María Ángeles Pérez-Ara
- Health Research Institute of the Balearic Islands (IdiSBa), Hospital Universitario Son Espases, Edificio S, 07120 Palma de Mallorca, Spain; (M.R.); (I.R.-C.); (M.G.-T.); (P.R.-S.); (M.Á.P.-A.); (M.G.)
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07122 Palma de Mallorca, Spain;
| | - Margalida Gili
- Health Research Institute of the Balearic Islands (IdiSBa), Hospital Universitario Son Espases, Edificio S, 07120 Palma de Mallorca, Spain; (M.R.); (I.R.-C.); (M.G.-T.); (P.R.-S.); (M.Á.P.-A.); (M.G.)
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07122 Palma de Mallorca, Spain;
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), 28029 Madrid, Spain
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