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Rogers R, Pan M, Hartigan SE, Chang YT, Donson JE. Workplace Deceptions During the Pandemic: Differences in Conspiracy Beliefs, Psychological Functioning, and Covid-19 Experiences. Psychol Rep 2024; 127:1941-1968. [PMID: 36471643 DOI: 10.1177/00332941221144606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
The global pandemic has disrupted virtually all countries on health, psychological functioning, and economies, to name a few. Accurate information has also fallen victim to the pandemic, which has been rife with misinformation and conspiracy theories. The current study investigated Covid-19 deceptions related to employment. With complete anonymity via MTurk, 389 participants from the United States rated their likelihood of deception regarding hypothetical four workplace scenarios. The first set of analyses examined differences between high and low risk of deceptions for each scenario based on participants' self-appraisals. The largest differences were found for general conspiracy beliefs and affective disorders, specifically major depression and generalized anxiety. The second set of analyses focused across the workplace scenarios on two operationalized groups with Likely-Deceptive (n = 189) vastly outnumbering Likely-Genuine (n = 55). Personal experiences with Covid-19 dramatically increased deceptions. Testing positive for Covid-19 increased the odds of being in the Likely-Deceptive by twelve-fold. Two discriminant models examined cognitive misbeliefs and psychological functioning. When both were combined, depression and Covid-19 misinformation produced the strongest structure coefficients followed closely by general conspiracy beliefs and generalized anxiety. The far-ranging implications of these findings are discussed.
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Affiliation(s)
- Richard Rogers
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Minqi Pan
- Department of Psychology, University of North Texas, Denton, TX, USA
| | | | - Yi-Ting Chang
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Jordan E Donson
- Department of Psychology, University of North Texas, Denton, TX, USA
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Xu X, Qi C, Xu S, Fu X, Li Z, Ren H, Qian Q, Guo S. Association between thiamine intake and depression: A national cross-sectional study. J Affect Disord 2024; 352:259-266. [PMID: 38367708 DOI: 10.1016/j.jad.2024.02.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 02/12/2024] [Accepted: 02/14/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND Recent years have seen increasing attention to improving depressive symptoms through dietary intakes, yet the association between thiamine intake and depression remains unclear. The present study aimed to explore this association using data from an American cross-sectional study. METHODS We explored the association of covariates, exposure, and outcome with logistic regression equations. Multivariable regression models were performed to further exclude confounding factors. To investigate nonlinear relationships, we employed restricted cubic splines. Recursive algorithms were utilized to identify inflection points. Additionally, we conducted stratified analyses by age and sex to uncover differences among subgroups. RESULTS When all covariates were adjusted, the association between thiamine intake and depression was not statistically significant [0.93 (0.82, 1.07)]. In the linear trend test using Q1 as the reference, the ORs (95%CI) for Q2, Q3, and Q4 were 0.87 (0.73, 1.04), 0.83 (0.68, 1.00), and 0.92 (0.73, 1.16), which suggested that the association might be nonlinear. We then confirmed this nonlinear relationship with a restricted cubic spline, and the inflection point of 1.35 mg/day was calculated. Before the inflection point, the effect value of the relationship was 0.68 (0.53, 0.89). After the inflection point, no significant association was found [1.10 (0.92, 1.31)]. Stratified analyses revealed that this nonlinear relationship was consistent among women and individuals aged <60 years. DISCUSSION In this cross-sectional study among American general adults, we found a nonlinear association between thiamine intake and depression and further observed differences by age and sex.
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Affiliation(s)
- Xiying Xu
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Chao Qi
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Shuang Xu
- Affiliated Hospital of Shandong Academy of Traditional Chinese Medicine, Jinan, China
| | - Xinhao Fu
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Zhiyuan Li
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Hong Ren
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Qian Qian
- The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China.
| | - Shanshan Guo
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China.
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Stecher C, Cloonan S, Domino ME. The Economics of Treatment for Depression. Annu Rev Public Health 2024; 45:527-551. [PMID: 38100648 DOI: 10.1146/annurev-publhealth-061022-040533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
The global prevalence of depression has risen over the past three decades across all socioeconomic groups and geographic regions, with a particularly rapid increase in prevalence among adolescents (aged 12-17 years) in the United States. Depression imposes large health, economic, and societal costs, including reduced life span and quality of life, medical costs, and reduced educational attainment and workplace productivity. A wide range of treatment modalities for depression are available, but socioeconomic disparities in treatment access are driven by treatment costs, lack of culturally tailored options, stigma, and provider shortages, among other barriers. This review highlights the need for comparative research to better understand treatments' relative efficacy, cost-effectiveness, scalability, and potential heterogeneity in efficacy across socioeconomic groups and country and cultural contexts. To address the growing burden of depression, mental health policy could consider reducing restrictions on the supply of providers, implementing digital interventions, reducing stigma, and promoting healthy lifestyles.
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Affiliation(s)
- Chad Stecher
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA;
- The Center for Health Information and Research, Arizona State University, Phoenix, Arizona, USA
| | - Sara Cloonan
- Department of Psychology, University of Georgia, Athens, Georgia, USA
| | - Marisa Elena Domino
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA;
- The Center for Health Information and Research, Arizona State University, Phoenix, Arizona, USA
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Zhang J, Fan X, Xu Y, Wang K, Xu T, Han T, Hu C, Li R, Lin X, Jin L. Association between inflammatory biomarkers and mortality in individuals with type 2 diabetes: NHANES 2005-2018. Diabetes Res Clin Pract 2024; 209:111575. [PMID: 38346591 DOI: 10.1016/j.diabres.2024.111575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/25/2024] [Accepted: 02/06/2024] [Indexed: 02/15/2024]
Abstract
PURPOSE This study aimed to examine independent association between inflammatory biomarkers and all-cause mortality as well as cardio-cerebrovascular disease (CCD) mortality among U.S. adults with diabetes. METHODS A cohort of 6412 U.S. adults aged 20 or older was followed from the start until December 31, 2019. Statistical models such as Cox proportional hazards model (Cox) and Kaplan-Meier (K-M) survival curves were employed to investigate the associations between the inflammatory biomarkers and all-cause mortality and CCD mortality. RESULTS After adjusting for confounding factors, the highest quartile of inflammatory biomarkers (NLR HR = 1.99; 95 % CI:1.54-2.57, MLR HR = 1.93; 95 % CI:1.46-2.54, SII HR = 1.49; 95 % CI:1.18-1.87, SIRI HR = 2.32; 95 % CI:1.81-2.96, nLPR HR = 2.05; 95 % CI:1.61-2.60, dNLR HR = 1.94; 95 % CI:1.51-2.49, AISI HR = 1.73; 95 % CI:1.4 1-2.12)) were positively associated with all-cause mortality compared to those in the lowest quartile. K-M survival curves indicated that participants with an inflammatory biomarker above a certain threshold had a higher risk of both all-cause mortality and CCD mortality (Log rank P < 0.05). CONCLUSION Some biomarkers such as NLR, MLR, SII, AISI, SIRI, and dNLR, are significantly associated with all-cause mortality and CCD mortality among U.S. adults with diabetes. The risk of both outcomes increased when the biomarkers surpassed a specific threshold.
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Affiliation(s)
- Jiaqi Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin 130021, China.
| | - Xiaoting Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin 130021, China.
| | - Yan Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin 130021, China.
| | - Kaiyuan Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin 130021, China.
| | - Tong Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin 130021, China.
| | - Tianyang Han
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin 130021, China.
| | - Chengxiang Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin 130021, China.
| | - Runhong Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin 130021, China.
| | - Xinli Lin
- Department of Child and Adolescent Health, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin 130021, China.
| | - Lina Jin
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin 130021, China.
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Zhang A, Huang L, Tang M. Non-linear associations of HOMA2-IR with all-cause mortality in general populations: insights from NHANES 1999-2006. BMC Public Health 2024; 24:574. [PMID: 38388407 PMCID: PMC10885457 DOI: 10.1186/s12889-024-18026-7] [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: 08/15/2023] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The association between homeostatic model assessment (HOMA2-IR) and mortality in obese and non-obese populations has not been clearly explained. METHODS A total of 7,085 individuals aged ≥ 20 years from the 1999-2006 National Health and Nutrition Examination Survey were included in the study. Study endpoints were all-cause and cardiovascular mortality. Multivariate Cox proportional hazards regression models with restricted cubic spline analysis were used for analysis. RESULTS In the study populations, a total of 1666 all-cause deaths and 555 cardiovascular (CV) deaths were recorded during a mean follow-up of 195.53 months. Notably, a significant difference in obesity was observed in the association between HOMA2-IR and mortality. After adjustment for multiple variables, HOMA2-IR was positively associated with all-cause mortality in all participants, in those with normal BMI, and in those with obesity. Conversely, tertile 2 of HOMA2-IR was associated with a lower risk of all-cause mortality in participants with obesity compared with tertile 1 (adjusted hazard ratio, 0.68; 95% confidence interval, 0.52-0.89; P = 0.005). Results from restricted cubic spline analysis showed a J-shaped association between HOMA2-IR and all-cause and CV mortality. In addition, a nonlinear U-shaped correlation with all-cause (P for nonlinear < 0.001) and CV (P for nonlinear = 0.002) mortality was observed in the population with obesity, with inflection points of HOMA2-IR identified at 1.85 and 1.75. Below the inflection point of 1.85, a negative relationship between HOMA2-IR and all-cause mortality was observed. CONCLUSIONS Elevated HOMA2-IR showed a notable correlation with increased risk of all-cause mortality. It was noteworthy that excessively reduced levels of insulin resistance showed a distinct association with increased mortality in individuals with obesity.
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Affiliation(s)
- Aikai Zhang
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Cardiovascular Institute, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, 100037, Beijing, China
| | - Lingchen Huang
- Department of Cardiac Surgery, State Key Laboratory of Cardiovascular Disease, Cardiovascular Institute, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, 100037, Beijing, China
| | - Min Tang
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Cardiovascular Institute, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, 100037, Beijing, China.
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Zhang A, Zhang H, Mi L, Ding L, Jiang Z, Yu F, Tang M. Diabetes: a potential mediator of associations between polycyclic aromatic hydrocarbon exposure and stroke. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024:10.1007/s11356-024-32324-y. [PMID: 38332417 DOI: 10.1007/s11356-024-32324-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 01/30/2024] [Indexed: 02/10/2024]
Abstract
Epidemiological evidence suggests associations between exposure to polycyclic aromatic hydrocarbons (PAHs) and cardiovascular diseases (CVD), while diabetes is a common risk factor for CVD. The present study aims to clarify the effect of high PAH exposure on diabetes and stroke in general population. A total of 7849 individuals aged 20 years or older from the National Health and Nutrition Examination Survey 2007-2016 were included in the study. The logistic regression analysis modeled the association between PAH exposure and diabetes as well as stroke. The analysis yielded odds ratios (ORs) and 95% confidence intervals (CIs). The study also evaluated the potential mediating role of diabetes in the relation between PAH exposure and stroke via mediating effect analyses. Of the 7849 eligible participants, 1424 cases of diabetes and 243 cases of stroke were recorded. After adjusting for covariates including age, gender, smoking status, drinking status, education level, marital status, physical activity, hypertension, low-density lipoprotein cholesterol, and BMI, the ORs for stroke in the highest quartile (Q4) of total urinary PAHs were 1.97 (95% CI 1.11-3.52, P = 0.022) as compared to the lowest quartile (Q1) of total urinary PAHs. The ORs for diabetes in the Q4 of total urinary PAHs were 1.56 (95% CI 1.15-2.12, P = 0.005), while the ORs between Q4 and Q1 for stroke and diabetes concerning exposure to 2-hydroxynaphthalene were 2.23 (95% CI 1.17-4.25, P = 0.016) and 1.40 (95% CI 1.07-1.82, P = 0.015), respectively. The mediation analysis found that diabetes accounted for 5.00% of the associations between urinary PAHs and the prevalence of stroke. Urinary metabolites of PAH have been linked to stroke and diabetes. Increasing the risk of diabetes may play a significant role in mediating the association between exposure to PAHs and increased risk of stroke. Monitoring and improving glucose metabolism in individuals with high exposure to PAHs may aid in reducing the prevalence of stroke.
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Affiliation(s)
- Aikai Zhang
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Cardiovascular Institute, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, 100037, China
| | - Hongda Zhang
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Cardiovascular Institute, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, 100037, China
| | - Lijie Mi
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Cardiovascular Institute, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, 100037, China
| | - Lei Ding
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Cardiovascular Institute, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, 100037, China
| | - Zihan Jiang
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Cardiovascular Institute, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, 100037, China
| | - Fengyuan Yu
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Cardiovascular Institute, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, 100037, China
| | - Min Tang
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Cardiovascular Institute, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, 100037, China.
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Shen W, Su Y, Guo T, Ding N, Chai X. The relationship between depression based on patient health questionaire-9 and cardiovascular mortality in patients with hypertension. J Affect Disord 2024; 345:78-84. [PMID: 37852591 DOI: 10.1016/j.jad.2023.10.059] [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: 07/04/2023] [Revised: 09/28/2023] [Accepted: 10/09/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Depression and hypertension are increasingly prevalent in the U.S., with evidence suggesting significant comorbidity. Despite this, the specific relationship within the U.S. hypertensive population is underexplored. Our study investigates this link using data from the 2007-2014 NHANES database and mortality data from the National Death Index. METHODS A total of 8677 participants were included in this cohort study. Depression diagnosis was made based on the Patient Health Questionnaire-9. Hypertension was defined either through a self-reported previous diagnosis, current antihypertensive medication use, or blood pressure exceeding standard thresholds. Cardiovascular disease mortality was determined by mortality recorded with National Death Index on December 31, 2019. The cox proportional hazards regression method was applied to analyze the association of depression with cardiovascular mortality in hypertension. RESULTS During an average follow-up of 8.2 years, 599 deaths were confirmed from cardiovascular disease. The association of depression with cardiovascular mortality in hypertension was significantly positive (HR, 1.0263(95%CI = 1.0033, 1.0498), p = 0.0247). In addition, the risk of cardiovascular mortality increased gradually with the severity of depressive symptoms (p for trend =0.0259). This positive relationship was basically stable in different subgroup analyses and sensitivity analyses. LIMITATIONS The observational design of our study hinders establishment of a causal relationship. Potential bias due to subjective reporting and the absence of depression treatment data represent limitations, although their impact on the conclusions is deemed minimal. CONCLUSIONS Depression is associated with cardiovascular mortality risk in patients with hypertension. The worsening depressive symptoms, the higher risk of cardiovascular mortality.
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Affiliation(s)
- Weijie Shen
- Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China; Emergency Medicine and Difficult Diseases Institute, Central South University, Changsha, Hunan Province, China
| | - Yingjie Su
- Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China; Emergency Medicine and Difficult Diseases Institute, Central South University, Changsha, Hunan Province, China
| | - Tuo Guo
- Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China; Emergency Medicine and Difficult Diseases Institute, Central South University, Changsha, Hunan Province, China
| | - Ning Ding
- Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China; Emergency Medicine and Difficult Diseases Institute, Central South University, Changsha, Hunan Province, China
| | - Xiangping Chai
- Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China; Emergency Medicine and Difficult Diseases Institute, Central South University, Changsha, Hunan Province, China.
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Wang J, Qiu Y, Zhu X. Trends of mental health care utilization among US adults from 1999 to 2018. BMC Psychiatry 2023; 23:665. [PMID: 37700243 PMCID: PMC10496400 DOI: 10.1186/s12888-023-05156-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/30/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Mental health disorders affect millions of US adults, however, the trends and related factors for mental health care utilization in the US remain unknown. AIMS Our study aimed to assess the trend of mental health utilization and related socio-demographic factors in the US. METHODS The study included 55,052 individuals from the National Health and Nutrition Examination Survey (NHANES) in 1999-2018. Temporal trends in the percentages of mental health care utilizers were estimated across survey cycles. Trends and linked factors of mental health care utilization were assessed by a logistic regression model, while the non-linearity was estimated by restricted cubic splines. RESULTS From 1999 to 2018, the percentage of mental health care utilizers in the US adult population increased from 7.0 to 11.3% (P < 0.001); meanwhile, the trends in males and females were consistent. The percentage increased positively with age in individuals aged 20-39 (P < 0.001) or aged 60 and over (P = 0.003). The trends were consistent in three race/ethnicity groups (P < 0.05). The logistic regression analysis revealed that several disparities existed in the subpopulations. Older age, female, lower family poverty-income ratio (PIR), chronic diseases, higher educational level, and smoking were estimated to be associated with a higher percentage of mental health care. CONCLUSIONS The percentage of mental health care utilizers took on an increasing trend in the US adult population from 1999 to 2018. These trends were also observed in the subpopulations, but with disparities. Future research for exploring factors associated with mental health care utilizations is necessary.
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Affiliation(s)
- Junzhe Wang
- Nanjing Medical University, Nanjing, 211166, China
| | - Yang Qiu
- Jiangsu Provincial Academy of Environmental Science, Nanjing, 210036, China
- Jiangsu Key Lab of Environmental Engineering, Nanjing, 210036, China
| | - Xiaozhou Zhu
- Department of Medical Insurance, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China.
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Liang Y, Liu F, Yin H, Shi X, Chen Y, Wang H, Wang Y, Bai B, Liu Y, Liu Q, Wu C, Yu X, Ma H, Geng Q. Trends in unhealthy lifestyle factors in US NHANES respondents with cardiovascular disease for the period between 1999 and 2018. Front Cardiovasc Med 2023; 10:1169036. [PMID: 37273875 PMCID: PMC10235541 DOI: 10.3389/fcvm.2023.1169036] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 04/24/2023] [Indexed: 06/06/2023] Open
Abstract
Objectives To examine national trends in unhealthy lifestyle factors among adults with cardiovascular disease (CVD) in the United States (US) between 1999 and 2018. Methods We analyzed data from National Health and Nutrition Examination Survey (NHANES), a nationally representative survey of participants with CVD who were aged ≥20 years, which was conducted between 1999 and 2000 and 2017-2018. CVD was defined as a self-report of congestive heart failure, coronary heart disease, angina, heart attack, or stroke. The prevalence rate of each unhealthy lifestyle factor was calculated among adults with CVD for each of the 2-year cycle surveys. Regression analyses were used to assess the impact of sociodemographic characteristics (age, sex, race/ethnicity, family income, education level, marital status, and employment status). Results The final sample included 5610 NHANES respondents with CVD. The prevalence rate of their current smoking status remained stable among respondents with CVD between 1999 and 2000 and 2017-2018. During the same period, there was a decreasing trend in the age-adjusted prevalence rate of poor diet [primary American Heart Association (AHA) score <20; 47.5% (37.9%-57.0%) to 37.5% (25.7%-49.3%), p < 0.01]. Physical inactivity marginally increased before decreasing, with no statistical significance. The prevalence rate of sedentary behavior increased from 2007 to 2014 but subsequently returned to its original level in 2018 with no statistical significance. The age-adjusted prevalence rate of obesity increased from 32% (27.2%-36.8%) in 1999-2000 to 47.9% (39.9%-55.8%) in 2017-2018 (p < 0.001). The age-adjusted prevalence rate of depression increased from 7% (4.2%-9.9%) in 1999-2000 to 13.9% (10.2%-17.6%) in 2017-2018 (p = 0.056). Trends in mean for each unhealthy lifestyle factor were similar after adjustment for age. We found that respondents who had low education and income levels were at a higher risk of being exposed to unhealthy lifestyle factors (i.e., smoking, poor diet, and physical inactivity) than those who had high education and income levels. Conclusions There is a significant reduction in the prevalence rate of poor diet among US adults with CVD between 1999 and 2018, while the prevalence rate of obesity showed increasing trends over this period. The prevalence rate of current smoking status, sedentary behavior, and depression was either stable or showed an insignificant increase. These findings suggest that there is an urgent need for health policy interventions targeting unhealthy lifestyles among adults with CVD.
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Affiliation(s)
- Yanting Liang
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Department of Cardiology, Shenzhen People's Hospital, Jinan University, Shenzhen, China
| | - Fengyao Liu
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- School of Medicine South China University of Technology, Guangzhou, China
| | - Han Yin
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Department of Cardiology, Shenzhen People's Hospital, Jinan University, Shenzhen, China
| | - Xiaohe Shi
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Yilin Chen
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- School of Medicine South China University of Technology, Guangzhou, China
| | - Haochen Wang
- Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Yu Wang
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Bingqing Bai
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- School of Biomedical Sciences and Engineering, South China University of Technology, Guangzhou, China
| | - Yuting Liu
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Quanjun Liu
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- School of Medicine South China University of Technology, Guangzhou, China
| | - Chao Wu
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Xueju Yu
- Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Huan Ma
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Qingshan Geng
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Department of Cardiology, Shenzhen People's Hospital, Jinan University, Shenzhen, China
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Zhao M, He Y, Tang Q, Wang N, Zheng H, Feng Z. Risk factors and prediction model for mental health in Chinese soldiers. Front Psychiatry 2023; 14:1125411. [PMID: 37215678 PMCID: PMC10196266 DOI: 10.3389/fpsyt.2023.1125411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 03/27/2023] [Indexed: 05/24/2023] Open
Abstract
Introduction This study aimed to explore potential risk factors for mental health concerns, and the prediction model for mental health concerns in Chinese soldiers was constructed through combined eligible risk factors. Methods This cross-sectional study was performed on soldiers under direct command from Gansu, Sichuan, and Chongqing in China, and the soldiers were selected by cluster convenient sampling from 16 October 2018 to 10 December 2018. The Symptom Checklist-90 (SCL-90) and three questionnaires (Military Mental Health Status Questionnaire, Military Mental Health Ability Questionnaire, and Mental Quality Questionnaire for Army Men) were administered, including demographics, military careers, and 18 factors. Results Of 1,430 Chinese soldiers, 162 soldiers presented mental disorders, with a prevalence of 11.33%. A total of five risk factors were identified, including serving place (Sichuan vs. Gansu: OR, 1.846, 95% CI: 1.028-3.315, P = 0.038; Chongqing vs. Gansu: OR, 3.129, 95% CI, 1.669-5.869, P = 0.003), psychosis (OR, 1.491, 95% CI, 1.152-1.928, P = 0.002), depression (OR, 1.482, 95% CI, 1.349-1.629, P < 0.001), sleep problems (OR, 1.235, 95% CI, 1.162-1.311, P < 0.001), and frustration (OR, 1.050, 95% CI, 1.015-1.087, P = 0.005). The area under the ROC curve by combining these factors was 0.930 (95% CI: 0.907-0.952) for predicting mental disorders in Chinese soldiers. Conclusion The findings of this study demonstrate that mental disorders and onset in Chinese soldiers can be predicted on the basis of these three questionnaires, and the predictive value of the combined model was high.
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Affiliation(s)
- Mengxue Zhao
- Department of Military Psychology, Faculty of Medical Psychology, Army Medical University (Third Military Medical University), Chongqing, China
| | - Ying He
- Department of Psychiatry, Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Quan Tang
- Medical Psychology Department, No. 984 Hospital of PLA, Beijing, China
| | - Ni Wang
- General Hospital of Xinjiang Military Region, Wulumuqi, China
| | - Haoxin Zheng
- The 33rd Company of the 11th Battalion, College of Command and Control Engineering, Army Engineering University of PLA, Nanjing, China
| | - Zhengzhi Feng
- Faculty of Medical Psychology, Army Medical University (Third Military Medical University), Chongqing, China
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11
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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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Li HR, Fu XH, Song LL, Cen MQ, Wu J. Association between pyrethroid exposure and risk of depressive symptoms in the general US adults. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:685-698. [PMID: 35904735 DOI: 10.1007/s11356-022-22203-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 07/20/2022] [Indexed: 06/15/2023]
Abstract
This study aimed to investigate the association between pyrethroid exposure and the risk of depressive symptoms in adults in the USA. Data of participants aged ≥20 years (n = 6455) from the National Health and Nutrition Examination Survey (NHANES, 2007-2014) were included. 3-Phenoxybenzoic acid (3-PBA), an adequately detected pyrethroid metabolite, was used as a biomarker to assess pyrethroid exposure. Depressive symptoms were defined as the Patient's Health Questionnaire (PHQ-9) total score ≥10 or use of antidepressant. Multivariable logistic regression analyses were performed to examine the association between urinary 3-PBA levels and the risk of depressive symptoms. In this study, 1150 participants (weighted frequency, 18.45%) developed depressive symptoms. Participants in the highest tertile have a higher risk of depressive symptoms than those in the lowest tertile of urinary 3-PBA and weighted OR of 1.28 (95% CI, 1.00-1.63, P=0.019). There was a nonlinear association between urinary 3-PBA and depressive symptoms (P for nonlinearity = 0.034). Mediation analysis showed the mediating effect of trouble sleeping on the association of urinary 3-PBA with depressive symptoms was 28.8% (P = 0.006). Our findings indicate that pyrethroid exposure is associated with the increased risk of depressive symptoms, and trouble sleeping may mediated this association. Further studies should be conducted to validate our findings and elucidate their underlying mechanisms.
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Affiliation(s)
- Hui-Ru 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, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xi-Hang 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, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ling-Ling 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, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Man-Qiu 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, and 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, and 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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Antibiotic use and the development of depression: A systematic review. J Psychosom Res 2023; 164:111113. [PMID: 36502554 DOI: 10.1016/j.jpsychores.2022.111113] [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: 12/21/2021] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Increasingly, disruption of the gastrointestinal ecosystem is thought to be involved in the pathogenesis of several medical conditions, including depression. Antibiotics can induce substantial changes in the gastrointestinal microbiota and several lines of evidence suggest that antibiotics exposure may increase the risk of developing depression. This systematic review examined this potential association. METHODS PubMed, Ovid EMBASE, CINAHL, and PsychINFO databases, as well as unpublished resources, were searched for studies in humans published from 2000 onwards. The studies needed to consider the connection between antibiotic exposure (either alone or in combination with other antibiotics and medications) and the development of depressive symptoms and/or disorders (in isolation to other psychological conditions). RESULTS Nine studies met the eligibility criteria. All were observational in nature. The studies were conducted in different age groups with various indications for receiving antibiotics. Together, these relatively low-quality studies suggest a potential association between antibiotic exposure and subsequent development of depression symptoms. Specifically, studies from the United Kingdom and Sweden indicate that the risk of depression is increased by at least 20%, with the former (over 1 million participants) reporting an increased risk with the number of courses and agents used, that persists with a slow decline over the ten years following exposure. CONCLUSIONS The inherent limitations associated with the studies' methodologies make a reliable conclusion difficult. While the risk of antimicrobial resistance may prohibit large randomised clinical trials in healthy individuals, future placebo-controlled trials with antibiotics-based protocols (e.g. for acne) should explore their effect on mental health.
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14
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Zhao L, Zhang K, Gao Y, Jia Z, Han S. The relationship between gender, marital status and depression among Chinese middle-aged and older people: Mediation by subjective well-being and moderation by degree of digitization. Front Psychol 2022; 13:923597. [PMID: 36324779 PMCID: PMC9621090 DOI: 10.3389/fpsyg.2022.923597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 09/15/2022] [Indexed: 11/18/2022] Open
Abstract
The purposes of this study were to investigate the effects of gender and marital status on depression among middle-aged and older people in China, and to explore the mediating effect of subjective well-being and the moderating effect of degree of digitization in the relationship between subjective well-being and depression. A total of 15,586 Chinese middle-aged and older people (≥ 45 years old) were included in the study using data from the 2018 China Health and Retirement Longitudinal Survey (CHARLS). T-test, ANOVA, hierarchical regression and Bootstrap methods were adopted to test the mediating role of subjective well-being and the moderating role of degree of digitization. The results showed that middle-aged and older women were more likely to suffer from depression than men, and married middle-aged and older people were less likely to be depressed than those who were separated or divorced, widowed and never married. Subjective well-being partially mediated the relationship between gender and depression, and masked the relationship between marital status and depression, and all five dimensions it contains also played a mediating role. Degree of digitization moderated the effect of subjective well-being on depression. Simple slope tests indicated that the effect of subjective well-being on depression increased as degree of digitization increased. In conclusion, to address the mental health problems of middle-aged and older people brought about by the ageing and digital society, we should start by improving their subjective well-being and promoting their integration into the digital society.
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15
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Rutherford ER, Vandelanotte C, Chapman J, To QG. Associations between depression, domain-specific physical activity, and BMI among US adults: NHANES 2011-2014 cross-sectional data. BMC Public Health 2022; 22:1618. [PMID: 36008859 PMCID: PMC9413906 DOI: 10.1186/s12889-022-14037-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 08/19/2022] [Indexed: 11/29/2022] Open
Abstract
Background Physical activity is associated with depression. However, benefits of physical activity on depression may differ for specific domains of physical activity (i.e., leisure-time, work, and travel). Moreover, the relationship between physical activity and depression could also differ for people in different Body Mass Index (BMI) categories. This study investigated the relationship between domain-specific physical activity and BMI with depression, and the moderation effects of BMI on the relationship between domain physical activity and depression. Methods Complex survey data from the NHANES 2011-2014 was used (N=10,047). Depression was measured using the Patient Health Questionnaire (PHQ-9). Participants reported physical activity minutes in each domain using the Global Physical Activity Questionnaire. Demographic characteristics were self-reported. Weight and height were objectively measured and used for calculating BMI. Survey procedures were used to account for complex survey design. As two survey cycles were used, sampling weights were re-calculated and used for analyses. Taylor series linearisation was chosen as a variance estimation method. Results Participants who engaged in ≥150 minutes/week of total moderate-vigorous physical activity (MVPA) (adjusted B = 0.83, 95% CI [0.50, 1.16]) and leisure-time MVPA (adjusted B = 0.84, 95% CI [0.57, 1.11]) experienced lower levels of depression compared to those engaging in <150 MVPA minutes/week. Work and travel-related physical activity were not associated with depression. Overweight (adjusted B = -0.40, 95% CI [-0.76, -0.04]) and underweight/normal weight participants (adjusted B = -0.60, 95%CI [-0.96, -0.25]) experienced less depressive symptoms compared to obese participants. BMI did not moderate the relationship between domain-specific physical activity and depression. Conclusions Interventions that focus on leisure-time physical activity appear to be best suited to improve depression, however, this needs to be confirmed in purposefully designed intervention studies. Future studies may also examine ways to improve the effectiveness of work and travel physical activity for reducing depression. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14037-4.
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Affiliation(s)
- Emily R Rutherford
- Central Queensland University, School of Health, Medical and Applied Sciences, Appleton Institute, Rockhampton, Australia
| | - Corneel Vandelanotte
- Central Queensland University, School of Health, Medical and Applied Sciences, Appleton Institute, Rockhampton, Australia
| | - Janine Chapman
- Central Queensland University, School of Health, Medical and Applied Sciences, Appleton Institute, Rockhampton, Australia
| | - Quyen G To
- Central Queensland University, School of Health, Medical and Applied Sciences, Appleton Institute, Rockhampton, Australia.
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Fan H, Nie X, Wilson S. Mental Health, Material Possessions, and Social Capital During COVID-19: A Study of the United States Urban Working-Age Population. APPLIED RESEARCH IN QUALITY OF LIFE 2022; 18:561-599. [PMID: 35991286 PMCID: PMC9382014 DOI: 10.1007/s11482-022-10093-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 07/26/2022] [Indexed: 06/15/2023]
Abstract
This study evaluates the associations between the urban working-age population's mental health, material possession, and social capital during the COVID-19 pandemic. The specific stressors examined in this empirical analysis are income level, food insecurity, and virtual psychological support. This paper further examines the differences across the employed and unemployed population groups. We obtained data from the COVID-19 Household Impact Survey and constructed four measures of mental health conditions: Nervous, Depressed, Lonely, and Hopeless. Our empirical analyses use an ordinal regression model that takes both time and regional factors into consideration to control for potential time effects and time-invariant confounders that only vary between regions. For the employed group, the main results suggest that lower income and food insecurity is correlated with a higher frequency of mental health symptoms, while virtual psychological support predicts a better mental health status. For the unemployed group, food insecurity is negatively associated with mental health, and virtual psychological might help alleviate nervousness and depression.
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Affiliation(s)
- Haobin Fan
- Shanghai Academy of Social Sciences, Fudan University, The Development Research Center of Shanghai Municipal People’s Government, Shanghai, China
| | - Xuanyi Nie
- Harvard T.H. Chan School of Public Health, Department of Architecture, National University of Singapore, Cambridge, MA USA
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