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Shim EJ, Park SJ, Im GH, Hackett RA, Zaninotto P, Steptoe A. Trajectories of depressive symptoms in Korean adults with diabetes: Individual differences and associations with life satisfaction and mortality. Br J Health Psychol 2024. [PMID: 39048530 DOI: 10.1111/bjhp.12742] [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: 09/07/2023] [Accepted: 07/09/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVE We examined trajectories of depressive symptoms and their predictors in adults with diabetes. We assessed whether these trajectories were related to life satisfaction and mortality. DESIGN Longitudinal, prospective observational study. METHODS We analysed data from 1217 adults with diabetes (aged ≥45 years) in the Korean Longitudinal Study of Aging (2006-2018). RESULTS Three trajectories of depressive symptomology were identified in growth mixture models: low/stable (i.e., low and stable levels of symptoms; 85.56%), high/decreasing (i.e., high levels of symptoms with a decreasing trajectory; 7.47%), and moderate/increasing (i.e., moderate levels of symptoms with an increasing trajectory; 6.98%). Participants with poor perceived health status at baseline were more likely to be in the moderate/increasing or high/decreasing classes than in the low/stable class. The moderate/increasing class had the lowest satisfaction with quality of life, followed by the high/decreasing and low/stable classes. The moderate/increasing and the high/decreasing classes had lower satisfaction with relationships with spouse and children than the low/stable class. The high/decreasing class had a higher mortality risk than the low/stable class. CONCLUSIONS Long-term monitoring of depressive symptoms in adults with diabetes is warranted given their potential adverse impact on life satisfaction and mortality.
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Affiliation(s)
- Eun-Jung Shim
- Department of Psychology, Pusan National University, Busan, Korea
| | - Sang Jin Park
- Department of Psychology, Pusan National University, Busan, Korea
| | - Gyu Hyeong Im
- Department of Psychology, Pusan National University, Busan, Korea
| | - Ruth A Hackett
- Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Paola Zaninotto
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
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Herhaus B, Kruse J, Hinz A, Brähler E, Petrowski K. Depression, anxiety, and health-related quality of life in normal weight, overweight and obese individuals with diabetes: a representative study in Germany. Acta Diabetol 2024; 61:725-734. [PMID: 38430257 PMCID: PMC11101582 DOI: 10.1007/s00592-024-02248-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/29/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVE Diabetes in the course of lifetime is related to a higher risk for mental disorders. The present study addresses the comparison of individuals with diabetes and non-diabetic individuals in depressive symptoms, generalized anxiety symptoms, and health-related quality of life. Furthermore, mediator effect of BMI and health-related quality of life (HRQOL) on the association between diabetes, depression, and generalized anxiety was analyzed. METHODS In this cross-sectional study, the three questionnaires PHQ-9, GAD-7, EQ-5D-5L were measured in a representative sample of the German population (N = 2386). In addition, the presence of diabetes and BMI were assessed via self-report. RESULTS There were higher values in depressive and anxiety symptoms as well as lower score in HRQOL in individuals with diabetes compared to non-diabetic individuals. Obese individuals with diabetes showed the highest rates in depressive symptoms and generalized anxiety as well as lowest score in HRQOL. With regard to the mediator analyses, association between diabetes, depressive symptoms, and anxiety symptoms is partially mediated by the BMI and fully mediated by the HRQOL. CONCLUSIONS In conclusion, individuals with diabetes have an increased risk in the development of depressive and anxiety symptoms as well as lower health-related quality of life. Future research and strategies in the public health policies among individuals with diabetes should take into account that the association between diabetes, depression, and anxiety is mediated by BMI and HRQOL.
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Affiliation(s)
- Benedict Herhaus
- Medical Psychology and Medical Sociology, University Medical Center Mainz, Johannes Gutenberg University of Mainz, Duesbergweg 6, 55128, Mainz, Germany.
| | - Johannes Kruse
- Department of Psychosomatic Medicine and Psychotherapy, Philipps University Marburg, Marburg, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Giessen, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Elmar Brähler
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Unit, Department of Psychosomatic Medicine and Psychotherapy, Leipzig University Medical Center, Leipzig, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Katja Petrowski
- Medical Psychology and Medical Sociology, University Medical Center Mainz, Johannes Gutenberg University of Mainz, Duesbergweg 6, 55128, Mainz, Germany
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Feng W, Wu H, Ma H, Tao Z, Xu M, Zhang X, Lu S, Wan C, Liu Y. Applying contrastive pre-training for depression and anxiety risk prediction in type 2 diabetes patients based on heterogeneous electronic health records: a primary healthcare case study. J Am Med Inform Assoc 2024; 31:445-455. [PMID: 38062850 PMCID: PMC10797279 DOI: 10.1093/jamia/ocad228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/13/2023] [Accepted: 11/21/2023] [Indexed: 01/22/2024] Open
Abstract
OBJECTIVE Due to heterogeneity and limited medical data in primary healthcare services (PHS), assessing the psychological risk of type 2 diabetes mellitus (T2DM) patients in PHS is difficult. Using unsupervised contrastive pre-training, we proposed a deep learning framework named depression and anxiety prediction (DAP) to predict depression and anxiety in T2DM patients. MATERIALS AND METHODS The DAP model consists of two sub-models. Firstly, the pre-trained model of DAP used unlabeled discharge records of 85 085 T2DM patients from the First Affiliated Hospital of Nanjing Medical University for unsupervised contrastive learning on heterogeneous electronic health records (EHRs). Secondly, the fine-tuned model of DAP used case-control cohorts (17 491 patients) selected from 149 596 T2DM patients' EHRs in the Nanjing Health Information Platform (NHIP). The DAP model was validated in 1028 patients from PHS in NHIP. Evaluation included receiver operating characteristic area under the curve (ROC-AUC) and precision-recall area under the curve (PR-AUC), and decision curve analysis (DCA). RESULTS The pre-training step allowed the DAP model to converge at a faster rate. The fine-tuned DAP model significantly outperformed the baseline models (logistic regression, extreme gradient boosting, and random forest) with ROC-AUC of 0.91±0.028 and PR-AUC of 0.80±0.067 in 10-fold internal validation, and with ROC-AUC of 0.75 ± 0.045 and PR-AUC of 0.47 ± 0.081 in external validation. The DCA indicate the clinical potential of the DAP model. CONCLUSION The DAP model effectively predicted post-discharge depression and anxiety in T2DM patients from PHS, reducing data fragmentation and limitations. This study highlights the DAP model's potential for early detection and intervention in depression and anxiety, improving outcomes for diabetes patients.
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Affiliation(s)
- Wei Feng
- Department of Medical Informatics, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, 210009, China
| | - Honghan Wu
- Institute of Health Informatics, University College London, London, WC1E 6BT, United Kingdom
- The Alan Turing Institute, London, NW1 2DB, United Kingdom
| | - Hui Ma
- Department of Medical Psychology, Nanjing Brain Hospital affiliated with Nanjing Medical University, Nanjing, Jiangsu, 210024, China
| | - Zhenhuan Tao
- Department of Planning, Nanjing Health Information Center, Nanjing, Jiangsu, 210003, China
| | - Mengdie Xu
- Department of Medical Informatics, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, 210009, China
| | - Xin Zhang
- Department of Medical Informatics, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, 210009, China
- Department of Information, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - Shan Lu
- Department of Medical Informatics, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, 210009, China
- Department of Information, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - Cheng Wan
- Department of Medical Informatics, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, 210009, China
| | - Yun Liu
- Department of Medical Informatics, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, 210009, China
- Department of Information, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210029, China
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Han J, Li H, Lin H, Wu P, Wang S, Tu J, Lu J. Depression prediction based on LassoNet-RNN model: A longitudinal study. Heliyon 2023; 9:e20684. [PMID: 37842633 PMCID: PMC10570602 DOI: 10.1016/j.heliyon.2023.e20684] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/21/2023] [Accepted: 10/04/2023] [Indexed: 10/17/2023] Open
Abstract
Depression has become a widespread health concern today. Understanding the influencing factors can promote human mental health as well as provide a basis for exploring preventive measures. Combining LassoNet with recurrent neural network (RNN), this study constructed a screening model ,LassoNet-RNN, for identifying influencing factors of individual depression. Based on multi-wave surveys of China Health and Retirement Longitudinal Study (CHARLS) dataset (11,661 observations), we analyzed the multivariate time series data and recognized 27 characteristic variables selected from four perspectives: demographics, health-related risk factors, household economic status, and living environment. Additionally, the importance rankings of the characteristic variables were obtained. These results offered insightful recommendations for theoretical developments and practical decision making in public health.
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Affiliation(s)
- Jiatong Han
- School of Computer Science, Nanjing Audit University, China
| | - Hao Li
- School of Computer Science, Nanjing Audit University, China
| | - Han Lin
- Jiangsu Key Laboratory of Public Project Audit, School of Engineering Audit, Nanjing Audit University, China
| | - Pingping Wu
- Jiangsu Key Laboratory of Public Project Audit, School of Engineering Audit, Nanjing Audit University, China
| | - Shidan Wang
- School of Computer Science, Nanjing Audit University, China
| | - Juan Tu
- Key Laboratory of Modern Acoustics (MOE), School of Physics, Nanjing University, China
| | - Jing Lu
- Key Laboratory of Modern Acoustics (MOE), School of Physics, Nanjing University, China
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