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Kim H. Sex differences in age-varying trends of depressive symptoms, substance use, and their associations among South Korean adults: A Time-Varying Effect Modeling (TVEM) analysis of a nationwide sample. J Affect Disord 2024; 361:596-604. [PMID: 38925308 DOI: 10.1016/j.jad.2024.06.079] [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: 09/16/2023] [Revised: 06/20/2024] [Accepted: 06/22/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND This study investigated sex differences in the age-varying trends of depressive symptoms, substance use, and their relationships throughout the adult lifespan. Using a nationwide sample from South Korea, this study aimed to confirm existing patterns and identify unique characteristics specific to the South Korean context. METHOD Time-Varying Effect Modeling (TVEM) was applied to data from 17,484 participants (9987 women and 7497 men) in the Korea National Health and Nutrition Examination Survey. RESULTS Consistent with global trends, the results revealed a higher prevalence of depressive symptoms among women and a greater prevalence of substance use among men. However, the findings also illuminated unique patterns within the South Korean context. Substance use among South Korean men peaked during their 40s, whereas South Korean women consistently exhibited lower rates of substance use. Additionally, a stronger association between depressive symptoms and substance use was identified in women compared to men. LIMITATIONS The study used cross-sectional data, limiting the analysis of temporal dynamics between depressive symptoms and substance use. Additionally, TVEM cannot distinguish between aging and cohort effects. Furthermore, the assessments of depressive symptoms and substance use were based on self-report. Finally, the study did not include adolescents or sex and gender minorities in its sample. CONCLUSIONS These results emphasize the need for targeted interventions, particularly among women in their 20s and older adulthood, where there is a heightened co-occurrence of depressive symptoms and substance use. These findings also highlight the importance of sex- and culture-sensitive approaches tailored to the South Korean context.
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Affiliation(s)
- Hanjoo Kim
- Department of Psychiatry, University of Michigan, MI, USA.
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2
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Choi NG, Marti CN. Depression in older women who died by suicide: associations with other suicide contributors and suicide methods. J Women Aging 2024; 36:210-224. [PMID: 38090746 PMCID: PMC11062817 DOI: 10.1080/08952841.2023.2292164] [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: 08/29/2023] [Accepted: 12/02/2023] [Indexed: 05/02/2024]
Abstract
Suicides among older women have received little research attention. In this study based on the 2017-2019 National Violent Death Reporting System data, we examined the prevalence of depression in older female suicide decedents (N = 3,061), associations between depression and other suicide precipitants, and the associations between suicide methods and depression. Descriptive statistics and generalized linear models (GLM) for a Poisson distribution with a log link were used to examine the research questions. Of the decedents, 15.0% had depressed mood without a reported diagnosis and 41.8% had a depression diagnosis. Nearly one-half of the decedents with reported depression were receiving mental health/substance use treatment at the time of injury. The likelihood of depression was lower among those who were age 85 and older compared to those were age 65-74, but higher among those who had anxiety disorder (IRR = 1.50, 95% CI = 1.33-1.69), history of suicidal ideation (IRR = 1.22, 95% CI = 1.10-1.35), history of suicide attempt (IRR = 1.27, 95% CI = 1.14-1.41), and bereavement problems (IRR = 1.45, 95% CI = 1.27-1.65). Those who had depression were less likely to have used firearms (IRR = 0.85, 95% CI = 0.75-0.97) but more likely to have used hanging/suffocation (IRR = 1.37, 95% CI = 1.13-1.67). The findings show that gun ownership was likely an important factor for firearm use. The high prevalence of depressed mood and/or depression diagnosis among older female suicide decedents at the time of their fatal injury underscores the importance of assessing depression and providing evidence-based depression treatment as an essential suicide prevention approach.
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Affiliation(s)
- Namkee G. Choi
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX 78712, USA
| | - C. Nathan Marti
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX 78712, USA
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Paul N, Cittadino J, Krampe H, Denke C, Spies CD, Weiss B. Determinants of Subjective Mental and Functional Health of Critical Illness Survivors: Comparing Pre-ICU and Post-ICU Status. Crit Care Med 2024; 52:704-716. [PMID: 38189649 PMCID: PMC11008443 DOI: 10.1097/ccm.0000000000006158] [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] [Indexed: 01/09/2024]
Abstract
OBJECTIVES To compare ICU survivors' subjective mental and functional health before ICU admission and after discharge and to assess determinants of subjective health decline or improvement. DESIGN Secondary analysis of the multicenter cluster-randomized Enhanced Recovery after Intensive Care trial ( ClinicalTrials.gov : NCT03671447). SETTING Ten ICU clusters in Germany. PATIENTS Eight hundred fifty-five patients with 1478 follow-up assessments. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS At two patient follow-ups scheduled 3 and 6 months after ICU discharge, patients rated their subjective mental and functional/physical health on two separate visual analog scales from 0 (worst) to 10 (best) in the previous week and before ICU admission. We compared pre-ICU and post-ICU subjective health and used mixed-effects regression to assess determinants of a health decline or improvement. At the first follow-up, 20% ( n = 165/841) and 30% ( n = 256/849) of patients reported a decline in subjective mental and functional health of at least three points, respectively; 16% ( n = 133/841 and n = 137/849) outlined improvements of mental and functional health. For 65% ( n = 543/841) and 54% ( n = 456/849), mental and functional health did not change three points or more at the first follow-up. Multivariable mixed-effects logistic regressions revealed that the ICU length of stay was a predictor of mental (adjusted odds ratio [OR] per ICU day, 1.04; 95% CI, 1.00-1.09; p = 0.038) and functional health (adjusted OR per ICU day, 1.06; 95% CI, 1.01-1.12; p = 0.026) decline. The odds of a mental health decline decreased with age (adjusted OR per year, 0.98; 95% CI, 0.96-0.99; p = 0.003) and the odds of a functional health decline decreased with time after discharge (adjusted OR per month, 0.86; 95% CI, 0.79-0.94; p = 0.001). CONCLUSIONS The majority of ICU survivors did not experience substantial changes in their subjective health status, but patients with long ICU stays were prone to subjective mental and functional health decline. Hence, post-ICU care in post-ICU clinics could focus on these patients.
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Affiliation(s)
- Nicolas Paul
- All authors: Department of Anesthesiology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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Sergio J, Siedlecki KL. Which variables moderate the relationship between depressive symptoms and global neurocognition across adulthood? NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:145-173. [PMID: 36268987 DOI: 10.1080/13825585.2022.2131714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 09/21/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
The current study examined moderators of the relationship between depressive symptoms and global neurocognition in a large non-clinical community-dwelling sample spanning adulthood. Participants comprised 5,430 individuals between the ages of 18-99 years drawn from the Virginia Cognitive Aging Project. Depressive symptoms were measured via the Center for Epidemiologic Studies-Depression scale and neurocognition was operationalized as a composite variable comprising episodic memory, spatial visualization, processing speed, and reasoning tasks. Moderator variables included physical activity, cognitive activity, education, emotional stability, and openness. Hierarchical regressions were used to examine the influence of depressive symptoms and the moderators on neurocognition. Depressive symptoms significantly predicted neurocognition. Cognitive activity, years of education, and emotional stability moderated the depression-neurocognition relationship by buffering the impact of depressive symptoms on neurocognition. Cognitive activity engagement and level of education may function as a protective influence on those with higher levels of depressive symptoms, while emotional stability may be protective for individuals with lower levels of depressive symptoms. No differences in moderation were found across three age groups representing younger, middle, and older adults. Post-hoc analyses showed years of education and openness as moderators in a subsample excluding individuals with potentially clinically meaningful levels of depressive symptoms.
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Affiliation(s)
- Jordan Sergio
- Department of Psychology, Fordham University, New York, NY, USA
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5
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Altweck L, Freund J, Hahm S, Schmidt S, Tomczyk S. Collective loneliness: The impact of the social network on loneliness and depression during the coronavirus pandemic in older Europeans. Int J Geriatr Psychiatry 2024; 39:e6045. [PMID: 38161288 DOI: 10.1002/gps.6045] [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: 07/20/2023] [Accepted: 12/09/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVES We examined the impact of the social network before the coronavirus pandemic on loneliness and depressed mood during the pandemic in older European individuals, and how these relationships differ between different European countries. METHODS Data of N = 19,999 persons (age: M = 69.18 years; 51% female) from the pan-European longitudinal survey of health, ageing and retirement in Europe, interviewed between October 2019 and March 2020 (Wave 8) and between June and August 2020 (Corona Questionnaire 1), were used. To test the models we employed path analyses, controlling for age, gender, education, and occupational status. Models were also run separately in collectivistic (Romania, Slovenia, Croatia, and Greece) and individualistic (Netherlands, Belgium, Denmark, and France) country groups. RESULTS A larger social network before the pandemic reduced the probability of an increase in loneliness and depression. The negative association between social network size and increase in loneliness was stronger in collectivist countries than in individualist ones. Moreover, an increase in loneliness increased the probability of feeling depressed. CONCLUSIONS It appears that pre-pandemic social networks served as a buffer to negative mental health consequences of the pandemic in older Europeans. In fact, this association was stronger in collectivist than for individualist countries. While this underscores the importance of social connectedness, it also stresses the vulnerability of socially isolated individuals regarding loneliness and depression. Future work should thus focus on supporting social networks in older adults.
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Affiliation(s)
- Laura Altweck
- Department Health and Prevention, Institute of Psychology, University of Greifswald, Greifswald, Germany
| | - Justus Freund
- Department Health and Prevention, Institute of Psychology, University of Greifswald, Greifswald, Germany
| | - Stefanie Hahm
- Department Health and Prevention, Institute of Psychology, University of Greifswald, Greifswald, Germany
| | - Silke Schmidt
- Department Health and Prevention, Institute of Psychology, University of Greifswald, Greifswald, Germany
| | - Samuel Tomczyk
- Department Health and Prevention, Institute of Psychology, University of Greifswald, Greifswald, Germany
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Levasseur M, Naud D, Menec V, Dubois MF, Wolfson C, Griffith LE, Trottier L, McMillan J, Généreux M, Roy M, Couturier Y, Raina P. Effect of Age-Friendly Communities Action Plan on Trajectories of Older Canadians' Depressive Symptoms Between 2018 and 2020: Multilevel Results From the Canadian Longitudinal Study on Aging. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580231225918. [PMID: 38361415 PMCID: PMC10874163 DOI: 10.1177/00469580231225918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 11/28/2023] [Accepted: 12/17/2023] [Indexed: 02/17/2024]
Abstract
As the COVID-19 pandemic impacted mental health, this longitudinal study examined the effect of age-friendly communities (AFC) action plan on older adults' depressive symptoms. Using the CLSA, the CLSA COVID-19 Questionnaire study, survey of Canadian municipalities, and the census, the depressive symptoms trajectories were modeled with multilevel multinomial regressions. Most respondents (66.1%) had non-depressed trajectories, 28.1% experienced a moderate increase in depressive symptoms, and 5.8% had a depressed trajectory. AFC action plans did not have a protective effect on these trajectories. Being a female, greater loneliness, lower income, ≥2 chronic conditions, inferior social participation, weaker sense of belonging, COVID-19 infection, and pandemic stressors predicted a depressed trajectory. Neighborhood's deprivation had a weak protective effect on the declining trajectory. Although AFC action plans provided no benefits during the pandemic, volunteers facilitating resource access and social interactions could limit any increase in depressive symptoms.
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Affiliation(s)
- Mélanie Levasseur
- Eastern Townships Integrated University Health and Social Services Centre – Sherbrooke University Hospital Centre (CIUSSS de l’Estrie – CHUS), Sherbrooke, QC, Canada
- Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Daniel Naud
- Eastern Townships Integrated University Health and Social Services Centre – Sherbrooke University Hospital Centre (CIUSSS de l’Estrie – CHUS), Sherbrooke, QC, Canada
- Université de Sherbrooke, Sherbrooke, QC, Canada
| | | | - Marie-France Dubois
- Eastern Townships Integrated University Health and Social Services Centre – Sherbrooke University Hospital Centre (CIUSSS de l’Estrie – CHUS), Sherbrooke, QC, Canada
- Université de Sherbrooke, Sherbrooke, QC, Canada
| | | | | | - Lise Trottier
- Eastern Townships Integrated University Health and Social Services Centre – Sherbrooke University Hospital Centre (CIUSSS de l’Estrie – CHUS), Sherbrooke, QC, Canada
| | | | | | - Mathieu Roy
- Université de Sherbrooke, Sherbrooke, QC, Canada
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Hopper S, Grady A, Best JR, Stinchcombe A. Bidirectional associations between memory and depression moderated by sex and age: Findings from the CLSA. Arch Gerontol Geriatr 2024; 116:105154. [PMID: 37604014 DOI: 10.1016/j.archger.2023.105154] [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: 06/30/2023] [Revised: 07/26/2023] [Accepted: 08/03/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Research has struggled to understand the temporal relationship between cognition and depression. Some literature suggests that depression may be a risk factor for memory decline, while other work indicates that memory decline may precede depression symptoms. The purpose of this study was to clarify the temporal relationship between memory and depression, examining the moderating role of sex and age. METHODS Data were drawn from two time points in the Canadian Longitudinal Study on Aging (CLSA). Memory was measured using a composite of immediate and delayed verbal recall scores, and depressive symptoms were measured using the Center for Epidemiologic Studies Short Depression Scale (CESD-10). Separate cross-lagged panel models (CLPMs) were run based on age (i.e., ages 45-64; ages 65+) and sex (n = 51,338). RESULTS Results indicated bidirectional associations between depressive symptoms and memory such that depressive symptoms at baseline predicted memory at follow-up (β= 0.029-0.068, with all p-values <0.01) and memory at baseline predicted depressive symptoms at follow-up (β= 0.025-0.033, with all p-values <0.05). The only exception was in the older female group, where memory did not predict depressive symptoms (β= -0.006, p = 0.543). Depressive symptoms at baseline were a stronger predictor of memory at follow-up than memory at baseline was for depressive symptoms at follow-up in all groups except for older males. FINDINGS The findings suggest small but consistent bidirectional associations between depression and memory in almost all sex/age groupings. Depressive symptoms tended to be a stronger predictor of memory than memory was for future depressive symptoms.
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Affiliation(s)
- Shawna Hopper
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
| | - Alexandra Grady
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - John R Best
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada; Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada; Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Arne Stinchcombe
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Bruyère Research Institute, Ottawa, Ontario, Canada.
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8
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Antwi-Amoabeng D, Neelam V, Ulanja MB, Beutler BD, Gbadebo TD, Sugathan P. Association between Psychiatric Disorders and the Incidence of Heart Failure in Women. J Cardiovasc Dev Dis 2023; 10:491. [PMID: 38132659 PMCID: PMC10743548 DOI: 10.3390/jcdd10120491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/18/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Depression and anxiety occur more frequently in women and are associated with an increased risk of cardiovascular disease. OBJECTIVES Data on the association between these psychiatric conditions and the incidence of acute heart failure (HF) and how they influence heart failure outcomes in women are lacking. We investigated this potential relationship using data from the National Inpatient Sample. METHODS We used ICD-10 codes to extract encounters for acute heart failure and/or the acute exacerbation of chronic heart failure, anxiety, and depression from the discharge data of the NIS from 2019 to 2020. We compared baseline characteristics and length of stay (LOS), cost of care (COC) and acute HF by depression/anxiety status for males and females and employed regression models to assess the influence of these psychiatric conditions on the outcomes. RESULTS There were 6,394,136 encounters involving females, which represented 56.6% of the sample. The prevalence of depression and anxiety were 15.7% and 16.8%, respectively. Among females, the occurrence of acute CHF did not differ by depression or anxiety status. However, Takostubo cardiomyopathy was more prevalent in those with depression (0.3% vs. 0.2%, p = 0.003) and anxiety (0.3% vs. 0.2%, p = 0.03) compared to those without these conditions. Among those with depression, LOS was significantly longer (3 days IQR: 2-6, vs. 3 days IQR:2-5 days, p < 0.001). The COC was USD 1481 more in patients with depression. On the contrary, LOS and COC were significantly lower in those without anxiety. CONCLUSIONS Depression was associated with an increased LOS among both men and women and an increased cost of care among women. Anxiety was associated with a decreased LOS and cost of care among women, which may be related to an increased rate of against medical advice (AMA) discharges among this population. Further research is necessary to identify optimal management strategies for depression and anxiety among patients hospitalized with HF.
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Affiliation(s)
- Daniel Antwi-Amoabeng
- Christus Ochsner St. Patrick Hospital, Lake Charles, LA 70602, USA; (V.N.); (M.B.U.); (P.S.)
| | - Vijay Neelam
- Christus Ochsner St. Patrick Hospital, Lake Charles, LA 70602, USA; (V.N.); (M.B.U.); (P.S.)
| | - Mark Bilinyi Ulanja
- Christus Ochsner St. Patrick Hospital, Lake Charles, LA 70602, USA; (V.N.); (M.B.U.); (P.S.)
| | - Bryce David Beutler
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA;
| | | | - Prasanna Sugathan
- Christus Ochsner St. Patrick Hospital, Lake Charles, LA 70602, USA; (V.N.); (M.B.U.); (P.S.)
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Boreham ID, Schutte NS. The relationship between purpose in life and depression and anxiety: A meta-analysis. J Clin Psychol 2023; 79:2736-2767. [PMID: 37572371 DOI: 10.1002/jclp.23576] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/05/2023] [Accepted: 07/19/2023] [Indexed: 08/14/2023]
Abstract
Purpose in life consists of having a sense of meaning and purpose regarding one's activities as well as an overall sense that life is meaningful. This study reports a comprehensive assessment of the relationship of purpose in life with depression and anxiety. A meta-analysis (total n = 66,468, total k = 99) investigated the association of purpose in life with depression and anxiety. Across samples, greater purpose in life was significantly associated with lower levels of depression and anxiety. The mean weighted effect size between purpose in life and depression was r = -0.49, [95% confidence intervals, CIs: -0.52, -0.45], p < 0.001. For the purpose in life and anxiety the mean weighted effect size was r = -0.36, [95% CIs: -0.40, -0.32], p < 0.001. The association of purpose in life with mental health was stronger for clinical populations, especially with regard to the relationship with anxiety. Both approach deficits and avoidance motivation are argued to play a role in the relationship between purpose and psychopathology, with greater purpose potentially limiting avoidance tendencies and reducing the effects of depression and anxiety. Understanding the role that purpose in life may play in depression and anxiety could help to inform current conceptualizations of these disorders and improve treatment outcomes.
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Affiliation(s)
- Ian D Boreham
- Department of Psychology, University of New England, Armidale, Australia
| | - Nicola S Schutte
- Department of Psychology, University of New England, Armidale, Australia
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Ali FZ, Parsey RV, Lin S, Schwartz J, DeLorenzo C. Circadian rhythm biomarker from wearable device data is related to concurrent antidepressant treatment response. NPJ Digit Med 2023; 6:81. [PMID: 37120493 PMCID: PMC10148831 DOI: 10.1038/s41746-023-00827-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 04/11/2023] [Indexed: 05/01/2023] Open
Abstract
Major depressive disorder (MDD) is associated with circadian rhythm disruption. Yet, no circadian rhythm biomarkers have been clinically validated for assessing antidepressant response. In this study, 40 participants with MDD provided actigraphy data using wearable devices for one week after initiating antidepressant treatment in a randomized, double-blind, placebo-controlled trial. Their depression severity was calculated pretreatment, after one week and eight weeks of treatment. This study assesses the relationship between parametric and nonparametric measures of circadian rhythm and change in depression. Results show significant association between a lower circadian quotient (reflecting less robust rhythmicity) and improvement in depression from baseline following first week of treatment (estimate = 0.11, F = 7.01, P = 0.01). There is insufficient evidence of an association between circadian rhythm measures acquired during the first week of treatment and outcomes after eight weeks of treatment. Despite this lack of association with future treatment outcome, this scalable, cost-effective biomarker may be useful for timely mental health care through remote monitoring of real-time changes in current depression.
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Affiliation(s)
- Farzana Z Ali
- Department of Biomedical Engineering, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA.
| | - Ramin V Parsey
- Department of Biomedical Engineering, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
- Department of Psychology, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
- Department of Radiology, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
| | - Shan Lin
- Department of Electrical and Computer Engineering, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
| | - Joseph Schwartz
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
| | - Christine DeLorenzo
- Department of Biomedical Engineering, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY, 10032, USA
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11
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Best JR, Cosco TD. An analysis of dynamic, bidirectional associations between memory and verbal fluency with depressive symptoms in middle- and older-aged adults: A cohort study. J Affect Disord 2022; 318:400-408. [PMID: 36113688 DOI: 10.1016/j.jad.2022.09.019] [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: 04/11/2022] [Revised: 08/22/2022] [Accepted: 09/09/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVES This study compared two approaches to analyzing bidirectional associations between aspects of cognition-specifically, verbal memory and fluency-and depression using multi-wave longitudinal data. The cross-lagged panel model (CLPM) does not distinguish between- versus within-person variation, whereas the random-intercepts CLPM (RI-CLPM) partitions variation into a stable, trait-like component that varies across individuals and a wave-specific deviation that varies within individuals. METHODS Observational study of 47,719 adults ages 45 to 95 from the Survey of Health, Ageing, and Retirement in Europe (mean age = 63 years, SD = 9 years at first assessment; 57 % female). Participants completed at least four of 8 biennial waves of data collection from 2004 and 2020. Depressive symptoms were assessed by the EURO-D. Cognition was assessed by animal fluency, and immediate and delayed word recall. Multi-group CLPMs and RI-CLPMs were fit on middle-aged (45-65 year) and older (65+ years) males and females. RESULTS The estimates from the CLPMs indicated bidirectionality in the associations between cognition and depression, whereas the RI-CLPMs provided clearer evidence that changes in depression may produce subsequent changes in cognition, rather than vice versa. Prospective associations were small and consistent across age, sex and cognitive measure. LIMITATIONS Measures of executive function-a domain of cognition affected by aging and related to mood-were not available. CONCLUSIONS CLPMs and RI-CLPMs address conceptually distinct questions about how verbal memory and fluency may be dynamically related to depression, and therefore, produce different inferences from the same data about how these aspects of cognition and depression are related.
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Affiliation(s)
- John R Best
- Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada; Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada; Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Theodore D Cosco
- Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada; Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada; Oxford Institute of Population Ageing, University of Oxford, Oxford, United Kingdom
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12
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Kravitz HM, Colvin AB, Avis NE, Joffe H, Chen Y, Bromberger JT. Risk of high depressive symptoms after the final menstrual period: the Study of Women's Health Across the Nation (SWAN). Menopause 2022; 29:805-815. [PMID: 35796553 PMCID: PMC9268212 DOI: 10.1097/gme.0000000000001988] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To examine depressive symptoms during postmenopause and the contribution of depressive symptom trajectories before the final menstrual period (FMP) and psychosocial/health factors to postmenopause depressive symptoms. METHODS Longitudinal analysis of depressive symptoms (Center for Epidemiologic Studies-Depression scale) collected every 1 to 2 years from 1996 to 2017 from 1,551 midlife women in the Study of Women's Health Across the Nation for a median follow-up of 19.0 years. Latent class growth analysis identified depression trajectories from baseline to FMP. Multivariable random effects (woman as random effect) linear or logistic regression models were conducted. RESULTS Women had higher odds of reporting high depressive symptom score (≥16) during postmenopause than when they were premenopausal (OR = 1.49, 95% CI, 1.09-2.04), but not when perimenopausal. Three pre-FMP trajectories were identified: Group 1 (47.7%), consistently low scores, Group 2 (39.9%), moderate scores below the high depressive symptom threshold, and Group 3 (12.4%), consistently high scores. Both the moderate (OR = 2.62, 95% CI, 1.89-3.66) and high score (OR = 6.88, 95% CI, 4.72-10.02) groups, compared with the consistently low group, had significantly higher postmenopausal depressive symptom scores. Other pre-FMP variables associated with high postmenopausal depressive symptoms were: higher odds of childhood trauma/maltreatment, poor role physical, high anxiety symptoms, sleep problems, high vasomotor symptoms, and lower odds for chronological aging and lower social support. CONCLUSIONS Compared with premenopause, postmenopause remains a period of increased risk for higher depressive symptoms, especially for women with pre-FMP depressive symptoms. Pre-FMP depressive symptom trajectories are highly predictive of postmenopause depressive symptoms independent of health and psychosocial factors.
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Affiliation(s)
| | - Alicia B Colvin
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Nancy E Avis
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC
| | | | - Yuqing Chen
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
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13
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Depressive history as a major predictor of postmenopausal depressive symptoms. Menopause 2022; 29:763-764. [PMID: 35728014 DOI: 10.1097/gme.0000000000002027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Chae WR, Schienkiewitz A, Du Y, Hapke U, Otte C, Michalski N. Comorbid depression and obesity among adults in Germany: Effects of age, sex, and socioeconomic status. J Affect Disord 2022; 299:383-392. [PMID: 34910960 DOI: 10.1016/j.jad.2021.12.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/03/2021] [Accepted: 12/10/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Depression and obesity are common health problems with major public health implications. These conditions frequently co-occur, adversely affecting the course of the other. The sociodemographic and socioeconomic risk factors for comorbid depression and obesity in the German adult population have not yet been reported. METHODS We analyzed the prevalence and sociodemographic and socioeconomic correlates of comorbid depression and obesity using cross-sectional data from the national German health interview and examination survey for adults (DEGS1; n = 7987) and its mental health module (DEGS1-MH; n = 4493). The Composite International Diagnostic Interview was used to diagnose major depressive disorder (CIDI-MDD). Sensitivity was analyzed using the self-reported depression measure and current depressive symptoms measured by Patient Health Questionnaire-9 (PHQ-9). Obesity was defined by body mass index calculated from measured data. RESULTS Prevalence of comorbid depression and obesity was 1.3% (95% CI 0.8-2.0) in men and 2.0% (95% CI 1.3-3.0) in women. We found significant sex differences in results from the self-reported depression measure and the PHQ-9, but not from the CIDI-MDD. Low socioeconomic status and poor social support were linked to a higher prevalence of comorbid depression and obesity among women. LIMITATIONS Severe depression may have been underreported. CONCLUSIONS Depression is statistically more prevalent in women than in men, which accounts for many of the sex differences in the prevalence of comorbid depression and obesity in our models. Targeted public health strategies need to be developed to prevent and treat comorbid depression and obesity in women with a low socioeconomic position.
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Affiliation(s)
- Woo Ri Chae
- Charité - Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Berlin, Germany.
| | - Anja Schienkiewitz
- Department of Epidemiology and Health Monitoring, Division of Health Behaviour, Robert Koch Institute, Berlin, Germany
| | - Yong Du
- Department of Epidemiology and Health Monitoring, Physical Health Unit, Robert Koch Institute, Berlin, Germany
| | - Ulfert Hapke
- Department of Epidemiology and Health Monitoring, Mental Health Unit, Robert Koch Institute, Berlin, Germany
| | - Christian Otte
- Charité - Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Berlin, Germany
| | - Niels Michalski
- Department of Epidemiology and Health Monitoring, Unit of Social Determinants of Health, Robert Koch Institute, Berlin, Germany
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15
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Gan DRY, Best JR. Prior Social Contact and Mental Health Trajectories during COVID-19: Neighborhood Friendship Protects Vulnerable Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9999. [PMID: 34639300 PMCID: PMC8507683 DOI: 10.3390/ijerph18199999] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/15/2021] [Accepted: 09/20/2021] [Indexed: 11/16/2022]
Abstract
Social networking protects mental health during a crisis. Prior contact with social organizations, friends, and non-friend neighbors may be associated with better trajectories of loneliness, depression and subjective memory during COVID-19. Regression analysis was conducted using longitudinal data from a representative sample of n = 3105 US adults aged ≥55 in April-October 2020. Latent profile analysis was also conducted. Prior contact with friends (B = -0.075, p < 0.001), neighbors (B = -0.048, p = 0.007), and social organizations (B = -0.073, p < 0.001) predicted for better mental health during COVID-19. Three profiles were identified: Profile 1 had the best outcomes, with prior contact with social organizations (B = -0.052, p = 0.044) predicting decreasing loneliness. For Profile 2, prior 'meeting' contact with friends predicted decreasing loneliness (B = -0.075, p < 0.001) and better subjective memory (B = -0.130, p = 0.011). Conversely, prior contact with neighbors (B = -0.165, p = 0.010) predicted worsening loneliness among Profile 3. The COVID-19 pandemic has had a differential impact on the mental health trajectories of aging adults with social ties of different strengths. Stronger neighborhood networks are important to mitigate poor mental health outcomes among vulnerable older adults during a crisis. Older adults who are living alone and had relied on non-friend neighbors for social connectedness require additional community supports. Policy interventions are required to mitigate the mental health impact of future pandemics.
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Affiliation(s)
- Daniel R. Y. Gan
- Gerontology Research Centre, Simon Fraser University, Vancouver, BC V6N 5K3, Canada;
| | - John R. Best
- Gerontology Research Centre, Simon Fraser University, Vancouver, BC V6N 5K3, Canada;
- Department of Psychiatry, University of British Columbia, Vancouver, BC V6T 2A1, Canada
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