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Xu JJ, Zhu XQ, Liu S, Ding LY, Fu BB, Sun CC, Pan YL, Wang W, Zhang L. Sociodemographic, clinical and treatment characteristics of current rapid-cycling bipolar disorder: a multicenter Chinese study. Int J Bipolar Disord 2024; 12:11. [PMID: 38592605 PMCID: PMC11004094 DOI: 10.1186/s40345-024-00332-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/13/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Rapid cycling bipolar disorder (RCBD), characterized by four or more episodes per year, is a complex subtype of bipolar disorder (BD) with poorly understood characteristics. METHOD This multicenter, observational, longitudinal cohort study enrolled 520 BD patients across seven psychiatric institutions in China from January 2013 to January 2014. Participants were divided into RCBD and non-RCBD (NRCBD) groups based on the frequency of mood episodes in the preceding year. Data collection utilized a standardized form, supplemented by a medical record review, focusing on sociodemographic, clinical, and treatment characteristics. Statistical analysis involved independent samples t-tests, Kruskal-Wallis H tests, Chi-square or Fisher's exact tests, with Bonferroni correction applied to account for multiple comparisons, and multivariable logistic regression to identify characteristics associated with RCBD. RESULTS Among the BD cohort, 9.4% were identified as current RCBD. Compared to NRCBD, RCBD patients had a shorter duration from the first psychiatric consultation to the diagnosis of BD, a reduced duration of their longest period of euthymia, a lower proportion of lifetime hospitalization history due to BD, and less use of electroconvulsive therapy (ECT) within the last 12 months. Additionally, they presented higher baseline scores on the Mood Disorder Questionnaire (MDQ) and the Brief 16-item Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR16). However, after applying the Bonferroni correction, these differences were not statistically significant. Multivariable logistic regression analysis identified three factors that were independently associated with RCBD: time from first psychiatric consultation to BD diagnosis (Odds Ratio [OR] = 0.512, P = 0.0416), lifetime hospitalization history due to BD (OR = 0.516, P = 0.0476), and ECT treatment within the past 12 months (OR = 0.293, P = 0.0472). CONCLUSION This study revealed that the duration from first psychiatric consultation to BD diagnosis, lifetime hospitalization history due to BD, and ECT treatment in the past year were associated with RCBD. Recognizing these factors could contribute to enhance the early identification and clinical outcomes of RCBD. Trial Registration Number Registry ClinicalTrials.gov NCT01770704. Date of Registration: First posted on January 18, 2013.
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Affiliation(s)
- Jin-Jie Xu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Xue-Quan Zhu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Shuang Liu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Lu-Yu Ding
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Bing-Bing Fu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Cong-Cong Sun
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Yan-Li Pan
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Wei Wang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China.
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China.
| | - Ling Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China.
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China.
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Palmer EOC, Ker S, Rentería ME, Carmody T, Rush AJ. Psychometric evaluation and linking of the PHQ-9, QIDS-C, and VQIDS-C in a real-world population with major depressive disorder. Neuropsychiatr Dis Treat 2024; 20:671-687. [PMID: 38559772 PMCID: PMC10981376 DOI: 10.2147/ndt.s444223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/28/2024] [Indexed: 04/04/2024] Open
Abstract
Purpose Major depressive disorder (MDD) is a leading cause of disability worldwide. An accurate assessment of depressive symptomology is crucial for clinical management and research. This study assessed the convergent validity, reliability, and total scale score interconversion across the 9-item Patient Health Questionnaire (PHQ-9) self-report, the 16-item Quick Inventory of Depressive Symptomatology-clinician report (QIDS-C) (two widely used clinical ratings) and the 5-item Very Brief Quick Inventory of Depressive Symptoms-clinician report (VQIDS-C), which evaluate the core features of MDD. Patients and Methods This study leveraged electronic health record (EHR)-derived, de-identified data from the NeuroBlu Database (Version 23R1), a longitudinal behavioural health real-world platform. Classical Test Theory (CTT) and Item Response Theory (IRT) analyses were used to evaluate the reliability, validity of, and conversions between the scales. The Test Information Function (TIF) was calculated for each scale, with greater test information reflecting higher precision and reliability in measuring depressive symptomology. IRT was also used to generate conversion tables so that total scores on each scale could be compared to the other. Results The study sample (n = 2,156) had an average age of 36.4 years (standard deviation [SD] = 13.0) and 59.7% were female. The mean depression scores for the PHQ-9, QIDS-C, and VQIDS-C were 12.9 (SD = 6.6), 12.0 (SD = 4.9), and 6.18 (SD = 3.2), respectively. The Cronbach's alpha coefficients for PHQ-9, QIDS-C, and VQIDS-C were 0.9, 0.8, and 0.7, respectively, suggesting acceptable internal consistency. PHQ-9 (TIF = 30.3) demonstrated the best assessment of depressive symptomology, followed by QIDS-C (TIF = 25.8) and VQIDS-C (TIF = 17.7). Conclusion Overall, PHQ-9, QIDS-C, and VQIDS-C appear to be reliable and convertible measures of MDD symptomology within a US-based adult population in a real-world clinical setting.
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Affiliation(s)
| | | | | | - Thomas Carmody
- Peter O’Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - A John Rush
- Duke University School of Medicine, Duke University School of Medicine, Durham, NC, USA
- Clinical sciences, Duke-National University of Singapore, Singapore
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Tao TJ, Yung YYY, Lau AYT, Liu H, Liang L, Bryant FB, Hou WK. Savoring mediates the mental health benefits of positive coping processes: A prospective population-based analysis. Appl Psychol Health Well Being 2024; 16:158-178. [PMID: 37691133 DOI: 10.1111/aphw.12476] [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: 03/06/2023] [Accepted: 07/11/2023] [Indexed: 09/12/2023]
Abstract
Positive coping (e.g., self-efficacy and positive reappraisal) and savoring could bear mental health implications under large-scale disasters such as COVID-19. The integrative affect-regulation framework of psychological resilience proposes that evaluative efforts regulate affect, which then predicts positive short-term consequences and better mental health. This two-wave study was done during the prolonged, intensive COVID-19 control rules in Hong Kong and examined (1) the prospective associations of positive coping processes (i.e., self-efficacy and positive reappraisal) (T1, March-August 2021) with subsequent psychiatric symptoms (T2, September 2021-February 2022) and (2) the mediating effect of T2 savoring in the associations. Path analyses revealed that T1 self-efficacy and positive reappraisal were inversely related to T2 psychiatric symptoms. T2 savoring partially mediated the effect of T1 self-efficacy but fully mediated the effect of T1 positive reappraisal. Self-efficacy could have more sustainable direct positive associations with mental health, whereas the benefit of positive reappraisal might need to be catalyzed by savoring over time. Our study offered concrete illustrations of the conceptual tenets of the affect-regulation framework.
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Affiliation(s)
- Tiffany Junchen Tao
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China
| | - Yoyo Yuk Yu Yung
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China
| | - Abby Yan Tung Lau
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China
| | - Huinan Liu
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China
- Department of Special Education and Counselling, The Education University of Hong Kong, Hong Kong SAR, China
| | - Li Liang
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China
- Department of Psychology, The University of Hong Kong, Hong Kong SAR, China
| | - Fred B Bryant
- Department of Psychology, Loyola University Chicago, Chicago, Illinois, USA
| | - Wai Kai Hou
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China
- Department of Psychology, The Education University of Hong Kong, Hong Kong SAR, China
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Gao X, Liu Z. Analyzing the psychometric properties of the PHQ-9 using item response theory in a Chinese adolescent population. Ann Gen Psychiatry 2024; 23:7. [PMID: 38263122 PMCID: PMC10807143 DOI: 10.1186/s12991-024-00492-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 01/18/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND People are more likely to fall victim to depression during adolescence since it is a period of rapid biopsychosocial transformation. Despite this, most depression research has concentrated on clinical issues, and evaluating depressive symptoms in teenagers is not as widespread. This study used item response theory (IRT) to examine the psychometric properties of the Patient Health Report scale (PHQ-9) in Chinese adolescents. Meanwhile, item function difference tests were used to check whether there were differences in depression symptoms in this group based on education and gender. METHODS In this research, the PHQ-9 was employed as a measurement tool, and 5958 valid data points were obtained from 12 secondary schools in China (Mage = 13.484; SDage = 1.627; range 11-19 years; 52.17% boys). RESULTS IRT shows that all items of the PHQ-9 satisfy monotonicity, unidimensionality and local independence and that they have good psychometric properties. Furthermore, DIF analysis revealed gender and educational disparities in adolescent depressive symptoms. CONCLUSION The study indicates that the PHQ-9 possesses favourable psychometric properties for use in Chinese adolescents. As a result, it serves as a valuable tool for effectively screening depressive symptoms in adolescents. It provides a foundation for prioritizing the development of secondary school students' physical and mental health.
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Affiliation(s)
- Xuliang Gao
- School of Psychology, Guizhou Normal University, Huaxi University Town, Guian New District, Guiyang, 550025, Guizhou, China.
| | - Ziyu Liu
- School of Psychology, Guizhou Normal University, Huaxi University Town, Guian New District, Guiyang, 550025, Guizhou, China
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Teh WL, Liu J, Chandwani N, Lee YW, Tor PC, Subramaniam M, Ho RC. Emotional urgency predicts bipolar symptoms, severity, and suicide attempt better than non-emotional impulsivity: a cross-sectional study. Front Psychol 2023; 14:1277655. [PMID: 38106393 PMCID: PMC10722176 DOI: 10.3389/fpsyg.2023.1277655] [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: 08/15/2023] [Accepted: 10/30/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction Emotional urgency is an emotion-based subdimension of trait impulsivity that is more clinically relevant to psychopathology and disorders of emotion dysfunction than non-emotional subdimensions (i.e., lack of perseverance, sensation seeking, lack of premeditation). However, few studies have examined the relative effects of emotional urgency in bipolar disorder. This cross-sectional study aimed to establish the clinical relevance of emotional urgency in bipolar disorders by (1) explicating clinically relevant correlates of emotional urgency and (2) comparing its effects against non-emotional impulsivity subdimensions. Methods and results A total of 150 individuals with bipolar disorder were recruited between October 2021 and January 2023. Zero-order correlations found that emotional urgency had the greatest effect on bipolar symptoms (r = 0.37 to 0.44). Multiple two-step hierarchical regression models showed that (1) positive urgency predicted past manic symptomology and dysfunction severity (b = 1.94, p < 0.001 and 0.35 p < 0.05, respectively), (2) negative urgency predicted current depression severity, and (3) non-emotional facets of impulsivity had smaller effects on bipolar symptoms and dysfunction by contrast, and were non-significant factors in the final step of all regression models (b < 0.30, ns); Those who had a history of attempted suicide had significantly greater levels of emotional urgency (Cohen's d = -0.63). Discussion Notwithstanding the study's limitations, our findings expand status quo knowledge beyond the perennial relationship between non-emotion-based impulsivity and bipolar disorder and its implications.
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Affiliation(s)
- Wen Lin Teh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute of Mental Health, Singapore, Singapore
| | - Jianlin Liu
- Institute of Mental Health, Singapore, Singapore
| | | | - Yu Wei Lee
- Institute of Mental Health, Singapore, Singapore
| | | | | | - Roger C. Ho
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
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Zhu Y, Wang F, Wang F, Liu H, Guo X, Wang Z, He R, Wu X, Cao L, Wu Z, Peng D, Fang Y. Program of algorithm for pharmacological treatment of major depressive disorder in China: Benefits or not? Heliyon 2023; 9:e20951. [PMID: 37920522 PMCID: PMC10618797 DOI: 10.1016/j.heliyon.2023.e20951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 10/11/2023] [Accepted: 10/11/2023] [Indexed: 11/04/2023] Open
Abstract
Background This research was designed to investigate Algorithm Guided Treatment (AGT) and clinical traits for the prediction of antidepressant treatment outcomes in Chinese patients with major depressive disorder (MDD). Methods This study included 581 patients who had reached treatment response and 406 patients remained non-responded observed after three months of treatment. Sociodemographic factors, clinical traits, and psychiatric rating scales for evaluating therapeutic responses between the two groups were compared. Logistic regression analysis was adopted to determine the risk factors of unresponsive to antidepressant (URA) in MDD. Kaplan-Meier survival analysis was utilized to compare the therapeutic response between AGT and treatment as usual (TAU). Results Compared to the MDD responsive to antidepressant (RA) group, the URA group had significantly lower rates of the following clinical traits: married status, anxious distress, moderate to severe depressive symptoms, and higher rates of comorbidity (p-value < 0.05). Logistic Regression Analysis showed that eight clinical traits from psychiatric rating scales, such as anxious characteristics, were correlated positively with URA, while the other eight symptoms, such as autonomic symptoms, were negatively correlated. Time to symptomatic remission was longer in TAU without statistically significant (p-value = 0.11) by log-rank testing. Conclusions The factors may affect the therapeutic responses and compliance of patients, increasing the non-response risk for antidepressants. Therapeutic responses might be improved by increasing the clarification and elucidation of different symptom clusters of patients. Benefits on treatment response to AGT were not found in our study, indicating a one-size-fits-all approach may not work.Trial Registration: We registered as a clinical trial at the International Clinical Trials Registry Platform (No. NCT01764867) and obtained ethical approval 2012-42 from SMHC.
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Affiliation(s)
- Yuncheng Zhu
- Division of Mood Disorders, Shanghai Hongkou Mental Health Center, Shanghai, 200083, China
- Clinical Research Center, Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
- Clinical Research Center for Mental Health, School of Medicine, Shanghai University, Shanghai, 200083, China
| | - Fang Wang
- Shanghai Yangpu Mental Health Center, Shanghai, 200093, China
| | - Fan Wang
- Clinical Research Center, Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Hongmei Liu
- Clinical Research Center, Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Xiaoyun Guo
- Clinical Research Center, Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Zuowei Wang
- Division of Mood Disorders, Shanghai Hongkou Mental Health Center, Shanghai, 200083, China
- Clinical Research Center for Mental Health, School of Medicine, Shanghai University, Shanghai, 200083, China
| | - Ruoqiao He
- School of Social Work, New York University, New York, 10003, USA
| | - Xiaohui Wu
- Clinical Research Center, Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Lan Cao
- Clinical Research Center, Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Zhiguo Wu
- Shanghai Yangpu Mental Health Center, Shanghai, 200093, China
| | - Daihui Peng
- Clinical Research Center, Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Yiru Fang
- Clinical Research Center, Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
- Clinical Research Center for Mental Health, School of Medicine, Shanghai University, Shanghai, 200083, China
- Department of Psychiatry & Affective Disorders Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai, 200030, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 201108, China
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Tokarek J, Kapuścik A, Kućmierz J, Kowalczyk E, Karbownik MS. Personality traits and health-related behaviors in medical students facing a stressful event. Front Public Health 2023; 11:1256883. [PMID: 37900039 PMCID: PMC10602886 DOI: 10.3389/fpubh.2023.1256883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/21/2023] [Indexed: 10/31/2023] Open
Abstract
Background It is believed that personality traits have an impact on the propensity to change and maintain favorable lifestyle habits. This issue has been raised by multiple studies, however, none of them appeared to focus on population under severe psychological stress. The aim of the present study was to investigate the link between personality traits and health-related behaviors and measures such as dietary intake of specific food products, physical activity, body-mass index and the use of cigarettes in medical students facing a stressful event. Methods The study included a cohort of third-year medical students from the Medical University of Lodz, Poland, facing a stressful subject exam during the first COVID-19-related lockdown. At baseline, personality traits were evaluated with the use of the Polish version of the Big Five Inventory-Short questionnaire. Then, consumption of selected food products was monitored with the use of seven-day electronic dietary record. Also, some other health-related data was collected (body-mass index, physical activity and the use of cigarettes). General Linear Modeling techniques, logistic regression and exploratory factor analysis were applied to analyze the data. Results Four hundred and forty-four students completed the study. A two-factor pattern of food consumption was discovered by the exploratory factor analysis in the study group (34% of the variance explained). Higher conscientiousness, but not the other personality traits, was found to be significantly associated with generally healthier lifestyle manifested by higher consumption of vegetables, wholegrain products, fruits and nuts (adjusted beta 0.16, 95%CI 0.06 to 0.26, pη2 = 2.3%, p = 0.0015) and lower cigarette smoking (adjusted odds ratio 0.84, 95%CI 0.75 to 0.94, p = 0.0020), but insignificantly with physical activity and body-mass index. Conclusion Severely stressed medical students expressing high conscientiousness tend to present healthier behaviors. Therefore, interventions aimed at improving lifestyle habits in students with low conscientiousness might be useful.
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Affiliation(s)
- Julita Tokarek
- Department of Pharmacology and Toxicology, Students Research Club, Medical University of Lodz, Lodz, Poland
| | - Angelika Kapuścik
- Students Research Club “Metoda”, Institute of Sociology, Faculty of Economics and Sociology, University of Lodz, Lodz, Poland
| | - Joanna Kućmierz
- Department of Pharmacology and Toxicology, Students Research Club, Medical University of Lodz, Lodz, Poland
| | - Edward Kowalczyk
- Department of Pharmacology and Toxicology, Medical University of Lodz, Lodz, Poland
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Sun Z, Yang J, Zhou J, Zhou J, Feng L, Feng Y, He Y, Liu M, Li Y, Wang G, Li R. Tissue-Specific Oxysterols as Predictors of Antidepressant (Escitalopram) Treatment Response in Patients With Major Depressive Disorder. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:663-672. [PMID: 37881566 PMCID: PMC10593904 DOI: 10.1016/j.bpsgos.2023.01.004] [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: 07/29/2022] [Revised: 12/22/2022] [Accepted: 01/08/2023] [Indexed: 02/03/2023] Open
Abstract
Background There is growing evidence that disturbances in cholesterol metabolism may be involved in major depressive disorder (MDD). However, it is not known if cholesterol metabolites present in the brain and periphery can be used to diagnose and predict an MDD patient's response to antidepressant treatment. Methods A total of 176 subjects (85 patients with MDD and 91 healthy control subjects) were included in this study. The expression of peripheral and brain-specific oxysterols and related gene polymorphisms were investigated in all subjects. The severity of depression was measured using the 17-item Hamilton Depression Rating Scale, 16-item Quick Inventory of Depressive Symptoms-Self-Report, and Patient Health Questionnaire-9 for all patients with MDD before and after 12 weeks of antidepressant treatment. Results Patients with MDD expressed higher plasma levels of 24(S)-hydroxycholesterol (24OHC) (mainly secreted from the brain) compared with healthy control subjects, and the higher levels of 24OHC were associated with 24OHC synthetase (CYP46A1) gene polymorphisms. In patients with MDD, an improved response to the 12-week antidepressant treatment was associated with a reduction of both 24OHC and 27OHC (mainly secreted from the peripheral system) levels relative to baseline levels. Nonresponders exhibited increased levels of oxysterols at the end of treatment compared with baseline. The superior reduction in oxysterol levels correlated with better outcomes from the antidepressant treatment. Conclusions These data suggest a potential role for oxysterols as diagnostic and treatment response-related indicators for MDD.
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Affiliation(s)
- Zuoli Sun
- National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Jian Yang
- National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Jia Zhou
- National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Jingjing Zhou
- National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Lei Feng
- National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yuan Feng
- National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yi He
- National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Min Liu
- National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yuhong Li
- Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
| | - Gang Wang
- National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Rena Li
- National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
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Stanyte A, Fineberg NA, Podlipskyte A, Gecaite-Stonciene J, Macijauskiene J, Steibliene V, Burkauskas J. Validation of the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder-7 in Lithuanian individuals with anxiety and mood disorders. J Psychiatr Res 2023; 164:221-228. [PMID: 37385000 DOI: 10.1016/j.jpsychires.2023.06.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/02/2023] [Accepted: 06/21/2023] [Indexed: 07/01/2023]
Abstract
The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) are short self-report questionnaires used to screen and assess depression and anxiety severity in medical and community samples. However, little is known about their psychometric properties in individuals with anxiety and mood disorders (AMD) This study evaluated the psychometric properties of the PHQ-9 and GAD-7 in individuals with AMD. Individuals (n = 244, mean age 39.9 ± 12.3 years) with AMD completed the PHQ-9, GAD-7, as well as other measures of depression, anxiety, and a structured diagnostic interview. The PHQ-9 and GAD-7 demonstrated good internal consistency (Cronbach's alpha 0.87 and 0.84, respectively). The PHQ-9 and GAD-7 showed a weak correlation with clinician-rated scales HAM-D and HAM-A (r = 0.316, p < 0.01, r = 0.307, p < 0.01, respectively). For the PHQ-9, a cut score of ≥11 resulted in 72% sensitivity and 72% specificity at recognizing depression symptoms. For the GAD-7, a cut score ≥7 resulted in 73% sensitivity and 54% specificity at recognizing any anxiety disorders. The confirmatory factor analysis suggested a two-factor structure ("cognitive/affectional", "somatic") for both the PHQ-9 and GAD-7. In conclusion, the PHQ-9 and GAD-7 have adequate formal psychometric properties as severity measures for symptoms of anxiety and depression in individuals with AMD. The PHQ-9 performs well as a screener using a cut score of ≥11. However, the clinical utility of the GAD-7 as a diagnostic tool for recognition of anxiety disorders is limited.
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Affiliation(s)
- Agne Stanyte
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga-Kaunas, Lithuania.
| | - Naomi A Fineberg
- University of Hertfordshire, Hatfield, UK; Hertfordshire Partnership University NHS Foundation Trust, Hatfield, UK; University of Cambridge Clinical Medical School, Cambridge, UK
| | - Aurelija Podlipskyte
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga-Kaunas, Lithuania
| | - Julija Gecaite-Stonciene
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga-Kaunas, Lithuania
| | - Jurate Macijauskiene
- Department of Geriatrics, Faculty of Nursing, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vesta Steibliene
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga-Kaunas, Lithuania
| | - Julius Burkauskas
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga-Kaunas, Lithuania
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Tao TJ, Liang L, Liu H, Hobfoll SE, Hou WK, Bonanno GA. The interrelations between psychological outcome trajectories and resource changes amid large-scale disasters: A growth mixture modeling analysis. Transl Psychiatry 2023; 13:57. [PMID: 36792591 PMCID: PMC9930711 DOI: 10.1038/s41398-023-02350-4] [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: 09/30/2022] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 02/17/2023] Open
Abstract
Currently little is known about the interrelations between changes in psychiatric symptoms and changes in resources (personal, social, financial) amid large-scale disasters. This study investigated trajectories of psychiatric symptoms and their relationships with different patterns of changes in personal, social, and financial resources between 2020 and 2022 amid the COVID-19 pandemic. A population-representative sample (N = 1333) was recruited to complete self-report instruments at the pandemic's acute phase (February-July 2020, T1), and again at 1-year (March-August 2021, T2) and 1.5-year (September 2021-February 2022, T3) follow-ups. Respondents reported depressive and anxiety symptoms, self-efficacy, perceived social support, and financial capacity. Growth mixture modeling (GMM) identified four trajectories of depressive and anxiety symptoms: resilience (72.39-74.19%), recovery (8.40-11.93%), delayed distress (7.20-7.35%), and chronic distress (8.33-10.20%). Four patterns were demonstrated in resource changes: persistent high resources (40.89-47.64%), resource gain (12.08-15.60%), resource loss (6.30-10.43%), and persistent low resources (28.73-36.61%). Loss and gain in financial resources characterized chronic distress and resilience, respectively. Loss in personal resources characterized delayed distress, whereas loss or no gain in social resources was related to chronic/delayed distress. Respondents in resilience were also more likely to have persistent high resources while those with delayed/chronic distress were more likely to have persistent low resources. These results provide an initial evidence base for advancing current understanding on trajectories of resilience and psychopathology in the context of resource changes during and after large-scale disasters.
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Affiliation(s)
- Tiffany Junchen Tao
- grid.419993.f0000 0004 1799 6254Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China
| | - Li Liang
- grid.419993.f0000 0004 1799 6254Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China ,grid.194645.b0000000121742757Department of Psychology, The University of Hong Kong, Hong Kong SAR, China
| | - Huinan Liu
- grid.419993.f0000 0004 1799 6254Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China ,grid.419993.f0000 0004 1799 6254Department of Psychology, The Education University of Hong Kong, Hong Kong SAR, China
| | - Stevan E. Hobfoll
- STAR Consultants-STress, Anxiety and Resilience, Salt Lake City, UT USA
| | - Wai Kai Hou
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China. .,Department of Psychology, The Education University of Hong Kong, Hong Kong SAR, China.
| | - George A. Bonanno
- grid.21729.3f0000000419368729Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY 10027 USA
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11
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Alavi N, Moghimi E, Stephenson C, Gutierrez G, Jagayat J, Kumar A, Shao Y, Miller S, Yee CS, Stefatos A, Gholamzadehmir M, Abbaspour Z, Shirazi A, Gizzarelli T, Khan F, Patel C, Patel A, Yang M, Omrani M. Comparison of online and in-person cognitive behavioral therapy in individuals diagnosed with major depressive disorder: a non-randomized controlled trial. Front Psychiatry 2023; 14:1113956. [PMID: 37187863 PMCID: PMC10175610 DOI: 10.3389/fpsyt.2023.1113956] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 04/10/2023] [Indexed: 05/17/2023] Open
Abstract
Objective The increased prevalence of major depressive disorder (MDD) amid the COVID-19 pandemic has resulted in substantial growth in online mental health care delivery. Compared to its in-person counterpart, online cognitive behavioral therapy (e-CBT) is a time-flexible and cost-effective method of improving MDD symptoms. However, how its efficacy compares to in-person CBT is yet to be explored. Therefore, the current study compared the efficacy of a therapist-supported, electronically delivered e-CBT program to in-person therapy in individuals diagnosed with MDD. Methods Participants (n = 108) diagnosed with MDD selected either a 12 week in-person CBT or an asynchronous therapist-supported e-CBT program. E-CBT participants (n = 55) completed weekly interactive online modules delivered through a secure cloud-based online platform (Online Psychotherapy Tool; OPTT). These modules were followed by homework in which participants received personalized feedback from a trained therapist. Participants in the in-person CBT group (n = 53) discussed sessions and homework with their therapists during one-hour weekly meetings. Program efficacy was evaluated using clinically validated symptomatology and quality of life questionnaires. Results Both treatments yielded significant improvements in depressive symptoms and quality of life from baseline to post-treatment. Participants who opted for in-person therapy presented significantly higher baseline symptomatology scores than the e-CBT group. However, both treatments demonstrated comparable significant improvements in depressive symptoms and quality of life from baseline to post-treatment. e-CBT seems to afford higher participant compliance as dropouts in the e-CBT group completed more sessions on average than those in the in-person CBT group. Conclusion The findings support e-CBT with therapist guidance as a suitable option to treat MDD. Future studies should investigate how treatment accessibility is related to program completion rates in the e-CBT vs. in-person group. Clinical Trial Registration ClinicalTrials.Gov Protocol Registration and Results System (NCT04478058); clinicaltrials.gov/ct2/show/NCT04478058.
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Affiliation(s)
- Nazanin Alavi
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
- Centre for Neuroscience Studies, Queen’s University, Kingston, ON, Canada
- OPTT Inc., Toronto, ON, Canada
- *Correspondence: Nazanin Alavi,
| | - Elnaz Moghimi
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | | | - Gilmar Gutierrez
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Jasleen Jagayat
- Centre for Neuroscience Studies, Queen’s University, Kingston, ON, Canada
| | - Anchan Kumar
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Yijia Shao
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Shadé Miller
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Caitlin S. Yee
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Anthi Stefatos
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | | | - Zara Abbaspour
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | | | - Tessa Gizzarelli
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Ferwa Khan
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Charmy Patel
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Archana Patel
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Megan Yang
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Mohsen Omrani
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
- OPTT Inc., Toronto, ON, Canada
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12
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Low assets predict persistent depression through living difficulties amid large-scale disasters: A cohort study. J Affect Disord 2022; 315:282-290. [PMID: 35872246 PMCID: PMC9304334 DOI: 10.1016/j.jad.2022.07.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/18/2022] [Accepted: 07/18/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND In face of large-scale disasters, persons with fewer assets are at greater risk of persistent poorer mental health than persons with more assets. Everyday daily routine disruptions and financial hardship could mediate this association. METHODS This prospective population-representative study in Hong Kong aimed to investigate the relation between assets during the acute phase of COVID-19 (February-August 2020, T1) and persistent probable depression from T1 to March-August 2021 (T2), as well as the mediating effects of daily routine disruptions and financial hardship on the assets-depression association. RESULTS Low assets at T1 prospectively related to persistent probable depression from T1 to T2. Primary routine disruptions (i.e., healthy eating and sleep) at T1 and financial hardship at T2 were found to fully mediate the association between T1 assets and persistent probable depression. LIMITATIONS Persistent probable depression reported on the PHQ-9 should be further verified with clinical diagnoses/interviews. CONCLUSIONS The COVID-19 pandemic was accompanied by a global economic downturn. Persons who have fewer assets could be at greater risk of depression during this period. Our findings suggest a need to provide behavioral and financial assistance to persons with fewer assets in the short run and a need to ensure that everyone has adequate assets to mitigate the mental health consequences of the COVID-19 pandemic in the long run.
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13
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Ma Z, Mao Y, Wang Y, Duan Z, Qu D, Li C, Chen R, Liu Z. Suicidal ideation and attempted suicide among cancer patients during the COVID-19 pandemic. J Med Virol 2022; 94:5827-5835. [PMID: 35982024 PMCID: PMC9538100 DOI: 10.1002/jmv.28076] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/04/2022] [Accepted: 08/17/2022] [Indexed: 01/06/2023]
Abstract
This study aimed to understand the suicidal ideation and suicidal attempts among cancer patients during the COVID-19 pandemic. The data were collected from patients diagnosed with cancer while attending the largest cancer center in the south of China. A structured questionnaire was used to investigate patients' demographic data, suicidal behavior, and factors related to COVID-19. Mental health conditions were measured by the Generalized Anxiety Disorder-7, the Patient Health Questionnaire-9, and the Brief Symptom Inventory. Comorbidities and medical conditions of cancer patients were extracted from the electronic healthcare records. Among the 5670 cancer patients, 755 (13.3%) reported suicidal ideation, and 266 (4.7%) reported suicidal attempts during the COVID-19 pandemic. The age group with the highest risk of suicidal ideation was 20-24 years (23.9%). Lifetime history of suffering from mental disorders, longer time since cancer diagnosis, regional and distant tumor stage, depression, anxiety, hostility, having a higher frequency of worrying about cancer management due to COVID-19, higher frequency feeling of overwhelming psychological pressure due to COVID-19, having a higher level of barriers to manage cancer due to COVID-19, and higher barriers to continue treatment of cancer due to inconveniences caused by COVID-19, were all significantly associated with increased risk of suicidal ideation. We also identified the risk factors of suicide attempts. This is the first study investigating the prevalence and risk factors associated with suicidal ideation and suicidal attempts in Chinese cancer patients during the COVID-19 pandemic. Our findings suggest that it is essential to monitor the mental health conditions of this vulnerable population, especially for cancer patients who have comorbidity with a history of mental disorders. Also, government policymakers should take action to protect cancer patients to avoid any interruption of their continued treatment. Further efforts are urgently required to develop specific psychological interventions to reduce the risk factors among cancer patients during the COVID-19 pandemic.
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Affiliation(s)
- Zikun Ma
- Department of Urology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer MedicineSun Yat‐sen University Cancer CenterGuangzhouChina
| | - Yize Mao
- Department of Pancreatobiliary Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer MedicineSun Yat‐sen University Cancer CenterGuangzhouChina
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education SciencesMinistry of EducationChina,School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive ScienceSouth China Normal UniversityChina
| | - Zhizhou Duan
- Preventive health service, Jiangxi provincial people's HospitalThe First Affiliated Hospital of Nanchang Medical CollegeNanchangJiangxiChina
| | - Diyang Qu
- Vanke School of Public HealthTsinghua UniversityBeijingChina,Department of Social and Behavioural SciencesCity University of Hong KongHong KongChina
| | - Chaofeng Li
- Department of Information Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer MedicineSun Yat‐sen University Cancer CenterGuangzhouChina
| | - Runsen Chen
- Vanke School of Public HealthTsinghua UniversityBeijingChina,Institute for Healthy ChinaTsinghua UniversityBeijingChina
| | - Zhuowei Liu
- Department of Urology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer MedicineSun Yat‐sen University Cancer CenterGuangzhouChina
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14
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Karbownik MS, Mokros Ł, Kowalczyk E. Who Benefits from Fermented Food Consumption? A Comparative Analysis between Psychiatrically Ill and Psychiatrically Healthy Medical Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3861. [PMID: 35409544 PMCID: PMC8997937 DOI: 10.3390/ijerph19073861] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/19/2022] [Accepted: 03/21/2022] [Indexed: 12/18/2022]
Abstract
Probiotic therapies and fermented food diets hold promise for improving mental health. Although in this regard psychiatric patients appear to benefit more than healthy individuals, no research has been performed to directly evaluate this hypothesis. The present study examined a cohort of medical students facing a stressful event, and some of the students reported suffering from chronic psychiatric diseases. The amount of fermented food consumption was calculated with the use of seven-day dietary records, while depressive and anxiety symptoms were assessed with the use of the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7, respectively. In psychiatrically healthy medical students under psychological stress (n = 372), higher fermented food consumption was associated with more depressive and anxiety symptoms. In contrast, psychiatrically ill medical students (n = 25, 6.3% of all the participants) were found to present a negative association between the amount of fermented food consumed and the severity of depressive symptoms (adjusted β -0.52, 95% CI -0.85 to -0.19, p = 0.0042); however, this relationship was insignificant for anxiety symptoms (adjusted β -0.22, 95% CI -0.59 to 0.15, p = 0.22). A significant interaction was found between the consumption of fermented food and psychiatric diagnosis in predicting depressive symptoms (p = 0.0001), and a borderline significant interaction for anxiety symptoms (p = 0.053). In conclusion, psychiatrically ill people, but not healthy ones, may benefit from fermented food consumption in terms of alleviation of depressive symptoms. Our findings require cautious interpretation and further investigation.
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Affiliation(s)
- Michał Seweryn Karbownik
- Department of Pharmacology and Toxicology, Medical University of Lodz, Żeligowskiego 7/9, 90-752 Lodz, Poland;
| | - Łukasz Mokros
- Department of Clinical Pharmacology, Medical University of Lodz, Kopcińskiego 22, 90-153 Lodz, Poland;
| | - Edward Kowalczyk
- Department of Pharmacology and Toxicology, Medical University of Lodz, Żeligowskiego 7/9, 90-752 Lodz, Poland;
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15
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Xiang YT, Cai H, Sun HL, Su Z, Cheung T, Ng CH. Prevalence of mental disorders in China. Lancet Psychiatry 2022; 9:13-14. [PMID: 34921786 DOI: 10.1016/s2215-0366(21)00430-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 10/06/2021] [Accepted: 10/13/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao Special Administrative Region, 999078, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao Special Administrative Region, 999078, China; Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao Special Administrative Region, 999078, China.
| | - Hong Cai
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao Special Administrative Region, 999078, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao Special Administrative Region, 999078, China; Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao Special Administrative Region, 999078, China
| | - He-Li Sun
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao Special Administrative Region, 999078, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao Special Administrative Region, 999078, China; Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao Special Administrative Region, 999078, China
| | - Zhaohui Su
- Center on Smart and Connected Health Technologies, Mays Cancer Center, School of Nursing, UT Health San Antonio, San Antonio, TX, USA
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, VIC, Australia
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16
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Lu J, Xu X, Huang Y, Li T, Ma C, Xu G, Yin H, Xu X, Ma Y, Wang L, Huang Z, Yan Y, Wang B, Xiao S, Zhou L, Li L, Zhang Y, Chen H, Zhang T, Yan J, Ding H, Yu Y, Kou C, Shen Z, Jiang L, Wang Z, Sun X, Xu Y, He Y, Guo W, Jiang L, Li S, Pan W, Wu Y, Li G, Jia F, Shi J, Shen Z, Zhang N. Prevalence of depressive disorders and treatment in China: a cross-sectional epidemiological study. Lancet Psychiatry 2021; 8:981-990. [PMID: 34559991 DOI: 10.1016/s2215-0366(21)00251-0] [Citation(s) in RCA: 280] [Impact Index Per Article: 93.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/21/2021] [Accepted: 06/30/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND In China, depressive disorders have been estimated to be the second leading cause of years lived with disability. However, nationally representative epidemiological data for depressive disorders, in particular use of mental health services by adults with these disorders, are unavailable in China. The present study, part of the China Mental Health Survey, 2012-15, aims to describe the socioeconomic characteristics and the use of mental health services in people with depressive disorders in China. METHODS The China Mental Health Survey was a cross-sectional epidemiological survey of mental disorders in a multistage clustered-area probability sample of adults of Chinese nationality (≥18 years) from 157 nationwide representative population-based disease surveillance points in 31 provinces across China. Trained investigators interviewed the participants with the Composite International Diagnostic Interview 3.0 to ascertain the presence of lifetime and 12-month depressive disorders according to DSM-IV criteria, including major depressive disorder, dysthymic disorder, and depressive disorder not otherwise specified. Participants with 12-month depressive disorders were asked whether they received any treatment for their emotional problems during the past 12 months and, if so, the specific types of treatment providers. The Sheehan Disability Scale (SDS) was used to assess impairments associated with 12-month depressive symptoms. Data-quality control procedures included logic check by computers, sequential recording check, and phone-call check by the quality controllers, and reinterview check by the psychiatrists. Data were weighted according to the age-sex-residence distribution data from China's 2010 census population survey to adjust for differential probabilities of selection and differential response, as well as to post-stratify the sample to match the population distribution. FINDINGS 28 140 respondents (12 537 [44·6%] men and 15 603 [55·4%] women) completed the survey between July 22, 2013, and March 5, 2015. Ethnicity data (Han or non-Han) were collected for only a subsample. Prevalence of any depressive disorders was higher in women than men (lifetime prevalence odds ratio [OR] 1·44 [95% CI 1·20-1·72] and 12-month prevalence OR 1·41 [1·12-1·78]), in unemployed people than employed people (lifetime OR 2·38 [95% CI 1·68-3·38] and 12-month OR 2·80 [95% CI 1·88-4·18]), and in people who were separated, widowed, or divorced compared with those who were married or cohabiting (lifetime OR 1·87 [95% CI 1·39-2·51] and 12-month OR 1·85 [95% CI 1·40-2·46]). Overall, 574 (weighted % 75·9%) of 744 people with 12-month depressive disorders had role impairment of any SDS domain: 439 (83·6%) of 534 respondents with major depressive disorder, 207 (79·8%) of 254 respondents with dysthymic disorder, and 122 (59·9%) of 189 respondents with depressive disorder not otherwise specified. Only an estimated 84 (weighted % 9·5%) of 1007 participants with 12-month depressive disorders were treated in any treatment sector: 38 (3·6%) in speciality mental health, 20 (1·5%) in general medical, two (0·3%) in human services, and 21 (2·7%) in complementary and alternative medicine. Only 12 (0·5%) of 1007 participants with depressive disorders were treated adequately. INTERPRETATION Depressive disorders in China were more prevalent in women than men, unemployed people than employed, and those who were separated, widowed, or divorced than people who were married or cohabiting. Most people with depressive disorders reported social impairment. Treatment rates were very low, and few people received adequate treatment. National programmes are needed to remove barriers to availability, accessibility, and acceptability of care for depression in China. FUNDING National Health Commission and Ministry of Science and Technology of People's Republic of China. TRANSLATION For the Chinese translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Jin Lu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xiufeng Xu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China; The Fourth People's Hospital in Urumqi, Urumqi, China
| | - Yueqin Huang
- Institute of Mental Health, Peking University Sixth Hospital, National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China.
| | - Tao Li
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Chao Ma
- Institute of Mental Health, Peking University Sixth Hospital, National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | | | | | - Xiangdong Xu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China; The Fourth People's Hospital in Urumqi, Urumqi, China
| | - Yanjuan Ma
- The Fourth People's Hospital in Urumqi, Urumqi, China
| | - Limin Wang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhengjing Huang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yongping Yan
- Department of Epidemiology, the Fourth Military Medical University, Xi'an, China
| | - Bo Wang
- Department of Epidemiology, the Fourth Military Medical University, Xi'an, China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha, China
| | - Liang Zhou
- Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha, China
| | - Lingjiang Li
- Mental Health Institute, the Second Xiangya Hospital, Central South University, Changsha, China
| | - Yan Zhang
- Mental Health Institute, the Second Xiangya Hospital, Central South University, Changsha, China
| | - Hongguang Chen
- Institute of Mental Health, Peking University Sixth Hospital, National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - TingTing Zhang
- Institute of Mental Health, Peking University Sixth Hospital, National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Jie Yan
- Institute of Social Science Survey, Peking University, Beijing, China
| | - Hua Ding
- Institute of Social Science Survey, Peking University, Beijing, China
| | - Yaqin Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Changgui Kou
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Zonglin Shen
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Linling Jiang
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China; Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Zhizhong Wang
- Department of Epidemiology and Statistics, School of Public Health, Ningxia Medical University, Yinchuan, China
| | - Xian Sun
- Department of Epidemiology and Statistics, School of Public Health, Ningxia Medical University, Yinchuan, China
| | - Yifeng Xu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanling He
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wanjun Guo
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Lijun Jiang
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China; Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Shengyan Li
- The Third People's Hospital of Qinghai Province, Xining, Qinghai, China
| | - Wen Pan
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Yue Wu
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, Jiangsu, China
| | - Guohua Li
- Chifeng Anding Hospital, Chifeng, Inner Mongolia, China
| | - Fujun Jia
- Guangdong Mental Health Center, Guangzhou, Guangdong, China
| | - Jianfei Shi
- Department of Psychiatry, Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
| | - Zhongxia Shen
- The Third People's Hospital of Huzhou, Huzhou, Zhejiang, China
| | - Ning Zhang
- Nanjing Brain Hospital, affiliated to Nanjing Medical University, Nanjing, Jiangsu, China
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Yan T, Zheng W, Wang D, Zhang W. Cultural adaptation and validation of the Survivor Unmet Needs Survey Short-Form among cancer patients in China. Nurs Open 2021; 8:1098-1107. [PMID: 34482653 PMCID: PMC8046061 DOI: 10.1002/nop2.720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 10/29/2020] [Accepted: 11/05/2020] [Indexed: 12/24/2022] Open
Abstract
AIM Cancer patients have long been found to have multiple types of unmet needs during their survivorship. Composite psychological instruments are essential for measuring the unmet needs of cancer patients. The objective of this study was to evaluate the psychometric properties of the Short-Form Survivor Unmet Needs Survey (SF-SUNS)-Chinese version. DESIGN A cross-sectional survey. METHODS The Chinese version was developed using the standard Functional Assessment of Chronic Illness Therapy (FACIT) translation methodology and 428 Chinese cancer patients participated in the survey between 2016-2017. Inter-rater reliability, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were calculated. RESULTS Confirmatory factor analysis supported the four-factor structure with good model fit. Cronbach's alpha of 0.894 for the overall scale and intra-class correlation coefficients (0.869-0.884) indicated that reliability was satisfactory. The EFA extracted four factors with eigenvalues greater than 1 and these factors explained 50.68% of the total variance. The Chinese version of SF-SUNS was confirmed to have the potential to become a useful and valid instrument. It could contribute to the assessment of unmet needs among Chinese cancer patients with accuracy and with respect to Chinese culture and context. This measurement of unmet needs may help promote cancer management and nursing quality. Clinical nurses and researchers could use the simple assessment tool to target the individual needs of Chinese cancer patients and then provide more personalized care efficiently.
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Affiliation(s)
- Tingting Yan
- The Nethersole School of NursingThe Chinese University of Hong KongHong KongChina
| | - Wei Zheng
- The Second Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Dandan Wang
- The Second Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Wei Zhang
- The Second Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
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Ma S, Yang J, Yang B, Kang L, Wang P, Zhang N, Wang W, Zong X, Wang Y, Bai H, Guo Q, Yao L, Fang L, Liu Z. The Patient Health Questionnaire-9 vs. the Hamilton Rating Scale for Depression in Assessing Major Depressive Disorder. Front Psychiatry 2021; 12:747139. [PMID: 34803766 PMCID: PMC8599822 DOI: 10.3389/fpsyt.2021.747139] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 10/14/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The Hamilton Rating Scale for Depression (HAMD-17) has been used for several decades to assess the severity of depression. Multiple studies have documented defects in this scale and deemed it unsuitable for clinical evaluation. The HAMD-6, which is the abbreviated version of HAMD-17, has been shown to be effective in assessing the core symptoms of depression with greater sensitivity than HAMD-17. And the Patient Health Questionnaire-9 (PHQ-9) is suggested as an effective alternative to the HAMD-17 because of its simplicity and ease-of-use. Methods: Research was completed involving 1,741 participants having major depressive disorder. Cronbach's alpha, intraclass correlation coefficient (ICC) and weighted Kappa analysis was used to determine the reliability of the scales. Pearson correlation analysis and factor analysis were used to analyze validity. Item response theory (IRT) was used to analyze psychological characteristics of items in both the HAMD-17 and PHQ-9. Results: Reliability analysis showed that the Cronbach's alpha of the HAMD-17, HAMD-6 and PHQ-9 were 0.829, 0.764, and 0.893 respectively, and the ICC of the three scales ranged from 0.606 to 0.744. The Kappa score of the consistency of depression severity assessment was 0.248. Validity analysis showed that the PHQ-9 was a single factor structure, and the total score of the scale was strongly correlated with the HAMD-17 (r = 0.724, P < 0.001). The IRT analysis showed that the discrimination parameters of the PHQ-9 were higher than that of the HAMD-17 in all dimensions. The HAMD-6 had the lowest measurement accuracy in distinguishing the severity of depression, while the PHQ-9 had the highest measurement accuracy. Conclusion: Results showed that the PHQ-9 was satisfactory in terms of reliability, validity and distinguishing the severity of depression. It is a simple, rapid, effective and reliable tool which can be used as an alternative to the HAMD-17 to assess the severity of depression.
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Affiliation(s)
- Simeng Ma
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jun Yang
- School of Information Engineering, Wuhan University of Technology, Wuhan, China
| | - Bingxiang Yang
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Lijun Kang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Peilin Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Nan Zhang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Wei Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xiaofen Zong
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ying Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Hanping Bai
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Qingshan Guo
- Department of Psychiatry, Jingmen No. 2 People's Hospital, Jingmen, China
| | - Lihua Yao
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Li Fang
- Department of Psychiatry, Jingmen No. 2 People's Hospital, Jingmen, China
| | - Zhongchun Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
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19
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Tjelle K, Opstad HB, Solem S, Launes G, Hansen B, Kvale G, Hagen K. Treatment Adherence as Predictor of Outcome in Concentrated Exposure Treatment for Obsessive-Compulsive Disorder. Front Psychiatry 2021; 12:667167. [PMID: 34248703 PMCID: PMC8264255 DOI: 10.3389/fpsyt.2021.667167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 05/28/2021] [Indexed: 12/04/2022] Open
Abstract
Background: The treatment of choice for obsessive-compulsive disorder (OCD) is exposure and response prevention (EX/RP). Previous studies have demonstrated that treatment adherence predicts treatment outcome for patients with OCD, but there is little knowledge on its role in concentrated exposure treatment for OCD. Method: In the present study, 42 patients received EX/RP treatment using the Bergen 4-day format. Adherence was measured with the Exposure and Response Prevention Adherence Scale (PEAS, rated both by patients and therapists) after the second and third day. Treatment outcome (symptoms of OCD, depression, anxiety, work- and social functioning, and well-being) was assessed at 3-month follow-up. Results: At follow-up, 71.4% were in remission. High adherence was reported (mean score of 6 on a 1-7 scale). The combination of patient- and therapist rated adherence was significantly associated with treatment outcome whilst controlling for age, sex, and pre-treatment scores. Patients with higher degree of adherence reported less symptoms, higher functioning, and more well-being at follow-up. Conclusions: The results of the present study indicated that adherence in concentrated exposure treatment is significantly associated with a wide range of treatment outcomes for OCD.
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Affiliation(s)
- Kristian Tjelle
- Department of Psychiatry, Møre og Romsdal Hospital Trust, Molde Hospital, Molde, Norway.,Bergen Center for Brain Plasticity, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Håvard Berg Opstad
- Department of Psychiatry, Møre og Romsdal Hospital Trust, Molde Hospital, Molde, Norway.,Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Stian Solem
- Bergen Center for Brain Plasticity, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gunvor Launes
- Division of Psychiatry, Sørlandet Hospital, Kristiansand, Norway.,Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Bjarne Hansen
- Bergen Center for Brain Plasticity, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Psychosocial Sciences, University of Bergen, Bergen, Norway
| | - Gerd Kvale
- Bergen Center for Brain Plasticity, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Kristen Hagen
- Department of Psychiatry, Møre og Romsdal Hospital Trust, Molde Hospital, Molde, Norway.,Bergen Center for Brain Plasticity, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
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20
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Hu Y, Yang Z, Li Y, Xu Y, Tian M, Jiang N, Guo N. Prevalence and Associated Factors of Depressive Symptoms Among Patients With Chronic Low Back Pain: A Cross-Sectional Study. Front Psychiatry 2021; 12:820782. [PMID: 35095623 PMCID: PMC8793741 DOI: 10.3389/fpsyt.2021.820782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 12/20/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Few studies have focused on depressive symptoms among patients with chronic low back pain in China. The aim of this cross-sectional study was to assess the prevalence and associated factors of depressive symptoms in patients with chronic low back pain. Methods: From May to August 2021, 1,172 patients with chronic low back pain were recruited in China. Depressive symptoms were assessed through the Patient Health Questionnaire. Associations of demographic characteristics, clinical characters and social-psychological factors with depressive symptoms were investigated among patients with chronic low back pain. Results: The prevalence of depressive symptoms was 25.00%. Logistic regression analysis found that duration of pain in 1-5 years (1-3 years: OR = 2.91, 95%CI: 1.65-5.14, 3-5 years: OR = 3.09, 95%CI: 1.55-6.15) and more severe pain (OR = 1.13, 95%CI: 1.10-1.17) were associated with higher risks of depressive symptoms. Better family function (good family function: OR = 0.25, 95%CI: 0.15-0.41, moderate family dysfunction: OR = 0.47, 95%CI: 0.29-0.77) and higher pain self-efficacy (OR = 0.94, 95%CI: 0.93-0.95) were associated with lower risks of depressive symptoms. Conclusion: Patients with chronic low back pain have a high prevalence of depressive symptoms in China. Duration of pain, pain severity, family function and pain self-efficacy were predictors of depressive symptoms among chronic low back pain patients in China. Early identification of the associated factors may be helpful for the timely management of depressive symptoms.
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Affiliation(s)
- Yueming Hu
- Department of Orthopedics, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China.,Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China
| | - Zechuan Yang
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yong Li
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yong Xu
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengge Tian
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Nan Jiang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ningfeng Guo
- Department of Orthopedics, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China.,Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China
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21
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Liu R, Wang F, Liu S, Zhang Q, Feng Y, Sim K, Cui X, Lin JX, Ungvari GS, Xiang YT. Reliability and Validity of the Quick Inventory of Depressive Symptomatology-Self-Report Scale in Older Adults With Depressive Symptoms. Front Psychiatry 2021; 12:686711. [PMID: 34744812 PMCID: PMC8564063 DOI: 10.3389/fpsyt.2021.686711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 09/13/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Depressive symptoms are common in older adults. Developing rapid self-report tools is essential to measure the presence and severity of depressive symptoms in older adults. This study evaluated the psychometric properties of the Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR) scale for use in depressed older adults. Methods: A total of 238 depressed older adults were included in the study. The Montgomery-Asberg Depression Rating Scale (MADRS) and the QIDS-SR were administered to assess the severity of depressive symptoms. Cronbach's alpha coefficient, Spearman rank correlations, and principal component analysis were performed to estimate the internal consistency, convergent validity, and factorial structure of the QIDS-SR, respectively. Results: The Cronbach's alpha for the QIDS-SR was acceptable (α = 0.64). Item-total correlation analyses showed that the items of concentration/decision-making, involvement, energy level, and agitation/retardation had high correlation with the QIDS-SR total score (all correlation coefficients ≥0.60). The QIDS-SR total score was significantly correlated with the MADRS total score (r = 0.53, p < 0.001), demonstrating acceptable convergent validity. Factor analysis revealed the unidimensional structure of the QIDS-SR. Conclusions: The QIDS-SR appears to be a reliable and valid self-report scale for estimating the severity of depressive symptoms in depressed older adults.
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Affiliation(s)
- Rui Liu
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, The Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Fei Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Shou Liu
- Department of Public Health, Medical College, Qinghai University, Xining, China
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, The Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yuan Feng
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, The Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Kang Sim
- West Region, Institute of Mental Health, Singapore, Singapore
| | - Xiling Cui
- Department of Business Administration, Hong Kong Shue Yan University, Hong Kong, Hong Kong, SAR China
| | - Jing-Xia Lin
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, Hong Kong, SAR China
| | - Gabor S Ungvari
- Department of Psychiatry, University of Notre Dame Australia, Fremantle, WA, Australia.,Division of Psychiatry, School of Medicine, University of Western Australia/Graylands Hospital, Perth, WA, Australia
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau, Macao, SAR China.,Centre for Cognitive and Brain Sciences, University of Macau, Macau, Macao, SAR China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macau, Macao, SAR China
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22
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Hall BJ, Patel A, Lao L, Liem A, Mayawati EH, Tjipto S. Structural validation of The Patient Health Questionnaire-9 (PHQ-9) among Filipina and Indonesian female migrant domestic workers in Macao: STRUCTURAL VALIDATION OF PHQ-9. Psychiatry Res 2021; 295:113575. [PMID: 33248710 DOI: 10.1016/j.psychres.2020.113575] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 11/14/2020] [Indexed: 01/15/2023]
Abstract
Within diverse global populations, validated tools are needed to assess common mental disorders. The Patient Health Questionnaire-9 (PHQ-9) is one of the most commonly used depression screeners. However, the PHQ-9 has not been structurally validated among female migrant domestic workers (MDWs). Female MDWs constitute a population numbering 11.5 million, and commonly report depression. This study aimed to structurally validate the PHQ-9 among Filipina and Indonesian female MDWs in Macao Special Administrative Region of China. Participants were recruited using respondent driven sampling. Participants were adult female MDWs from The Philippines (N=1375) or Indonesia (N=367) and legally working in Macao. We used confirmatory factor analysis (CFA) to test five structural models of depression using all PHQ-9 items with the Filipina and Indonesian samples. We applied multi-group CFA to test measurement invariance across samples. A two-factor (cognitive/affective, somatic) model yielded the best fit within both samples, and the multi-group CFA demonstrated invariance across samples. The two-factor model best represents the factor structure of the PHQ-9 among Filipina and Indonesian female MDWs.
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Affiliation(s)
- Brian J Hall
- Global and Community Mental Health Research Group, New York University (Shanghai), Shanghai, China; Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, USA.
| | - Anushka Patel
- Department of Psychiatry, University of California San Francisco, USA.
| | - Lorris Lao
- Global and Community Mental Health Research Group, New York University (Shanghai), Shanghai, China; Faculty of Social Sciences, University of Macau, Macao (SAR), China.
| | - Andrian Liem
- Global and Community Mental Health Research Group, New York University (Shanghai), Shanghai, China; Centre for Macau Studies, University of Macau, Macao (SAR), China; Faculty of Social Sciences, University of Macau, Macao (SAR), China.
| | - Elisabeth H Mayawati
- Global and Community Mental Health Research Group, New York University (Shanghai), Shanghai, China.
| | - Susana Tjipto
- Faculty of Psychology, Sanata Dharma University, Yogyakarta, Indonesia.
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23
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Sun Y, Fu Z, Bo Q, Mao Z, Ma X, Wang C. The reliability and validity of PHQ-9 in patients with major depressive disorder in psychiatric hospital. BMC Psychiatry 2020; 20:474. [PMID: 32993604 PMCID: PMC7525967 DOI: 10.1186/s12888-020-02885-6] [Citation(s) in RCA: 116] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 09/21/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To assess the reliability and validity of Patient Health Questionnaire-9 (PHQ-9) for patients with major depressive disorder (MDD) and to assess the feasibility of its use in psychiatric hospitals in China. METHODS One hundred nine outpatients or inpatients with MDD who qualified the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria completed PHQ-9 and Hamilton Depression Scale (HAMD-17). Two weeks after the initial evaluation, 54 randomly selected patients underwent repeat assessment using PHQ-9. For validity analysis, the construct validity and criterion validity were assessed. The internal concordance coefficient and the test-retest correlation coefficients were used for reliability analysis. The correlation between total score and scores for each item and the correlation between scores for various items were evaluated using Pearson correlation coefficient. RESULTS Principal components factor analysis showed good construct validity of the PHQ-9. PHQ-9 total score showed a positive correlation with HAMD-17 total score (r = 0.610, P < 0.001). With HAMD as the standard, PHQ-9 depression scores of 7, 15, and 21 points were used as cut-offs for mild, moderate, and severe depression, respectively. Consistency assessment was conducted between the depression severity as assessed by PHQ-9 and HAMD (Kappa = 0.229, P < 0.001). Intraclass correlation coefficient between PHQ-9 total score and HAMD total score was 0.594 (95% confidence interval, 0.456-0.704, P < 0.001). The Cronbach's α coefficient of PHQ-9 was 0.892. Correlation coefficients between each item score and the total score ranged from 0.567-0.789 (P < 0.01); the correlation coefficient between various item scores ranged from 0.233-0.747. The test-retest correlation coefficient for total score was 0.737. CONCLUSIONS PHQ-9 showed good reliability and validity, and high adaptability for patients with MDD in psychiatric hospital. It is a simple, rapid, effective, and reliable tool for screening and evaluation of the severity of depression.
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Affiliation(s)
- Yue Sun
- grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, No.5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088 China ,grid.24696.3f0000 0004 0369 153XAdvanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069 China
| | - Zhaoyan Fu
- grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, No.5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088 China ,grid.24696.3f0000 0004 0369 153XAdvanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069 China
| | - Qijing Bo
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, No.5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China. .,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China.
| | - Zhen Mao
- grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, No.5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088 China ,grid.24696.3f0000 0004 0369 153XAdvanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069 China
| | - Xin Ma
- grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, No.5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088 China ,grid.24696.3f0000 0004 0369 153XAdvanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069 China
| | - Chuanyue Wang
- grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, No.5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088 China ,grid.24696.3f0000 0004 0369 153XAdvanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069 China
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24
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Zhang WY, Zhao YJ, Zhang Y, He F, Pan HQ, Cheung T, Ungvari GS, Li SY, Xiang YT. Psychometric Properties of the Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR) in Depressed Adolescents. Front Psychiatry 2020; 11:598609. [PMID: 33362608 PMCID: PMC7755996 DOI: 10.3389/fpsyt.2020.598609] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 11/05/2020] [Indexed: 11/29/2022] Open
Abstract
Background: Accurate and reliable self-report measurement tools examining depressive symptoms are scant in child psychiatry. This study assessed the psychometric properties of the Chinese Version of the Quick Inventory of Depressive Symptomatology-Self-Report (C-QIDS-SR) in depressed adolescents in China. Methods: Adolescents with major depressive episodes or bipolar depressive episodes were assessed using the C-QIDS-SR. The structure validity of the C-QIDS-SR was estimated using principal component analysis with varimax rotation. Results: A total of 246 depressed adolescents were included in the study. Cronbach's alpha was 0.77. The correlation coefficient between the baseline and endpoint assessments was 0.49 (p < 0.001), whereas, the correlation coefficient between the C-QIDS-SR and the Hamilton Rating Scale for Depression-17 items (HAMD-17) was 0.63 (p < 0.001). Principal component analysis with varimax rotation demonstrated the unidimensional structure of the C-QIDS-SR. Conclusion: The C-QIDS-SR is a reliable and valid instrument with acceptable psychometric properties to measure depressive symptoms in adolescents.
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Affiliation(s)
- Wu-Yang Zhang
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yan-Jie Zhao
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, China.,Center for Cognition and Brain Sciences, University of Macau, Macao, China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao, China
| | - Yao Zhang
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Fan He
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital, The Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
| | - Hong-Qing Pan
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | - Gabor S Ungvari
- Division of Psychiatry, School of Medicine, University of Western Australia/Graylands Hospital, Perth, WA, Australia.,Department of Psychiatry, University of Notre Dame Australia, Fremantle, WA, Australia
| | - Shu-Ying Li
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, China.,Center for Cognition and Brain Sciences, University of Macau, Macao, China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao, China
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25
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Cui L, Wang C, Wu Z, Peng D, Huang J, Zhang C, Huang J, Hong W, Wang Y, Chen J, Liu T, Rong H, Yang H, Fang Y. Symptomatology differences of major depression in psychiatric versus general hospitals: A machine learning approach. J Affect Disord 2020; 260:349-360. [PMID: 31521873 DOI: 10.1016/j.jad.2019.09.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 08/18/2019] [Accepted: 09/03/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Symptomatology differences of major depressive disorder (MDD) in psychiatric and general hospitals in China leads to possible misdiagnosis. Looking at the symptomatology of first-visit patients with MDD in different mental health services, and identifying predictors of health-seeking behavior using machine learning may help to improve diagnostic accuracy. METHODS 1500 patients first diagnosed with MDD were recruited from 16 psychiatric hospitals and 16 general hospitals across China. Socio-demographic characteristics, causal attribution, symptoms of depression within and outside Diagnostic and Statistical Manual of Mental Disorders (DSM) framework were collected using a self-made questionnaire. A predictive model of 62 variables was established using Random forest, symptom frequencies of patients in general hospitals and psychiatric hospitals were compared. RESULTS The machine learning approach revealed that symptoms were strong predictors of health-seeking behavior among patients with MDD. General hospitals patients had higher frequencies of suicidal ideation (χ2=15.230, p<0.001), psychosis (χ2=14.264, p<0.001), weight change (all p<0.001), hypersomnia (χ2=25.940, p<0.001), and a tendency of denying emotional/cognitive symptoms compared with psychiatric hospitals patients. LIMITATIONS Stigma and preference bias were not measured. Severity of current depressive episodes was not assessed. Data of previous episode(s) was not presented. CONCLUSIONS Symptom evaluation targeting specific patient population in different hospitals is crucial for diagnostic accuracy. Suicide prevention reliant on collaboration between general hospitals and psychiatric hospitals is required in the future construction of Chinese mental health system.
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Affiliation(s)
- Lvchun Cui
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chenglei Wang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhiguo Wu
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Daihui Peng
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingjing Huang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chen Zhang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Jia Huang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wu Hong
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yong Wang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Chen
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Tiebang Liu
- Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China
| | - Han Rong
- Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China
| | - Haichen Yang
- Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China
| | - Yiru Fang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China; CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai, China.
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26
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Zhen L, Wang G, Xu G, Xiao L, Feng L, Chen X, Liu M, Zhu X. Evaluation of the Paper and Smartphone Versions of the Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR16) and the Patient Health Questionnaire-9 (PHQ-9) in Depressed Patients in China. Neuropsychiatr Dis Treat 2020; 16:993-1001. [PMID: 32368061 PMCID: PMC7173799 DOI: 10.2147/ndt.s241766] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 03/24/2020] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Smartphone-based questionnaires have advantages compared with their paper versions, but there is a lack of consistent research on depressive disorder questionnaires. This study aimed to assess the equivalence between the paper and smartphone versions of the Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR16) and Patient Health Questionnaire-9 (PHQ-9) for patients with depressive disorders in psychiatric hospitals in China. PATIENTS AND METHODS This was a randomized crossover study of 110 depressed patients recruited from the outpatient department of Beijing Anding Hospital from March 2016 to September 2018. Group 1 completed both the QIDS-SR16 and PHQ-9 in paper format and then completed the smartphone version 1-2 h later. Group 2 completed the scales in the reverse order. Reliability was evaluated using intraclass correlation coefficients (ICCs) with 95% confidence intervals (CI). The expected ICC was 0.9 (α=0.05). RESULTS The overall ICC score of the QIDS-SR16 paper and smartphone versions was 0.904 (95% CI: 0.861-0.934), and the ICCs of each item ranged from 0.769 to 0.923. The overall ICC score of the PHQ-9 paper and smartphone versions was 0.951 (95% CI: 0.929-0.967), and the ICCs of each item ranged from 0.779 to 0.914. CONCLUSION This study demonstrated the equivalence of the paper and smartphone versions of the PHQ-9 and QIDS-SR16 in depressed patients in China.
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Affiliation(s)
- Long Zhen
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders and Beijing Anding Hospital, Capital Medical University, Beijing 100088, People's Republic of China.,Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin 300222, People's Republic of China
| | - Gang Wang
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders and Beijing Anding Hospital, Capital Medical University, Beijing 100088, People's Republic of China
| | - Gailing Xu
- Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin 300222, People's Republic of China
| | - Le Xiao
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders and Beijing Anding Hospital, Capital Medical University, Beijing 100088, People's Republic of China
| | - Lei Feng
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders and Beijing Anding Hospital, Capital Medical University, Beijing 100088, People's Republic of China
| | - Xu Chen
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders and Beijing Anding Hospital, Capital Medical University, Beijing 100088, People's Republic of China
| | - Man Liu
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders and Beijing Anding Hospital, Capital Medical University, Beijing 100088, People's Republic of China
| | - Xuequan Zhu
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders and Beijing Anding Hospital, Capital Medical University, Beijing 100088, People's Republic of China
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Bai CF, Sun JW, Li J, Jing WH, Zhang XK, Zhang X, Ma LL, Yue R, Cao FL. Gender differences in factors associated with depression in infertility patients. J Adv Nurs 2019; 75:3515-3524. [PMID: 31410867 DOI: 10.1111/jan.14171] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 06/09/2019] [Accepted: 08/06/2019] [Indexed: 12/25/2022]
Abstract
AIMS To clarify gender differences in the demographic variables and infertility problems associated with depression among men and women undergoing infertility treatment. DESIGN A cross-sectional study. METHODS We surveyed 380 women and 360 men undergoing infertility treatment at the reproductive medicine center of a hospital in China's Ningxia Province from March - September 2016. RESULTS For women, ethnicity, the number of clinic visits, social concern, and sexual concern were factors linked with depression symptoms. For men, treatment cost pressure and social concern were significantly associated with depression symptoms. CONCLUSION Psychological counseling and intervention programs should be integrated into in-vitro fertilization treatments and interventions should be targeted based on gender differences. IMPACT The provision of treatment-related sexual knowledge by nurses is indispensable for infertile participants. Mental health policies should be developed to facilitate the implementation of psychological services. Psychological counseling and intervention programs should be integrated into in vitro fertilization treatment to help men and women with infertility cope with psychological distress.
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Affiliation(s)
- Cai-Feng Bai
- School of Nursing, Shandong University, Jinan, P.R. China.,School of Nursing, Ningxia Medical University, Yinchuan, China
| | - Ji-Wei Sun
- School of Nursing, Shandong University, Jinan, P.R. China
| | - Jie Li
- School of Nursing, Shandong University, Jinan, P.R. China
| | - Wan-Hong Jing
- Reproductive Medicine Center, General Hospital of Ningxia Medical University, Yinchuan, P.R. China
| | - Xue-Kun Zhang
- School of Nursing, Soochow University, Suzhou, P.R. China
| | - Xuan Zhang
- School of Nursing, Shandong University, Jinan, P.R. China
| | - Li-Li Ma
- Reproductive Medicine Center, General Hospital of Ningxia Medical University, Yinchuan, P.R. China
| | - Rong Yue
- Reproductive Medicine Center, General Hospital of Ningxia Medical University, Yinchuan, P.R. China
| | - Feng-Lin Cao
- School of Nursing, Shandong University, Jinan, P.R. China
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Bai CF, Cui NX, Xu X, Mi GL, Sun JW, Shao D, Li J, Jiang YZ, Yang QQ, Zhang X, Cao FL. Effectiveness of two guided self-administered interventions for psychological distress among women with infertility: a three-armed, randomized controlled trial. Hum Reprod 2019; 34:1235-1248. [PMID: 31242506 DOI: 10.1093/humrep/dez066] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 04/03/2019] [Indexed: 12/19/2022] Open
Abstract
Abstract
STUDY QUESTION
What is the effect of two guided self-administered interventions on psychological distress in women undergoing IVF or ICSI?
SUMMARY ANSWER
A brief mindfulness intervention significantly reduced depression and improved sleep quality, while the gratitude journal intervention showed no significant effect on any outcome variables.
WHAT IS KNOWN ALREADY
Mindfulness and gratitude journal interventions have been found to be beneficial in reducing negative affect and improving well-being. However, there are very few mental health professionals who implement such interventions in low- and middle-income countries. Therefore, two guided self-administered interventions for women with infertility were designed to help them cope with their psychological distress.
STUDY DESIGN, SIZE, DURATION
A three-armed, randomized controlled trial was designed to evaluate the mindfulness and gratitude journal interventions for women undergoing IVF/ICSI. Between May 2016 and November 2017, at the reproductive center in a public hospital, 234 women were randomly assigned to the brief mindfulness group (BMG, n = 78), gratitude journal group (GJG, n = 78) or control group (CG, n = 78). The inclusion criteria were being a woman undergoing her first cycle of IVF, having at least junior middle school education and having no biological or adopted children.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Female infertility patients (n = 346) were approached, and 112 did not meet the inclusion criteria. All three randomized groups completed questionnaires on the day of down-regulation (T1), the day before embryo(s) transfer (T2), and 3 days before the pregnancy test (T3). The BMG completed four sessions and listened to a 20-minute audio daily, including guided mindfulness breathing and body scan. The GJG completed four sessions and wrote three gratitude journals daily. The CG received routine care. A generalized estimating equation was used in an intention-to-treat analysis. The primary outcome was depression. Secondary outcomes were anxiety, sleep quality, infertility-related stress, mindfulness and gratitude.
MAIN RESULTS AND THE ROLE OF CHANCE
Participants of the BMG showed decreased depression (mean difference (MD) = −1.69, [−3.01, −0.37], d = 0.44) and improved sleep quality (MD = −1.24, [−1.95, −0.39], d = 0.43) compared to the CG, but the effect was not significant for anxiety, Fertility Problem Inventory totals, mindfulness, gratitude scores or pregnancy rates. The BMG showed a significant reduction in depression and improvement in sleep quality between T1 and T2, a continuous significant reduction between T1 and T3 and no reduction between T2 and T3. There were no significant effects on any of the variables for the GJG.
LIMITATIONS, REASONS FOR CAUTION
The inclusion criteria may result in bias because some participants with low education were excluded and only women with infertility were included. A low compliance rate occurred in the gratitude journals group. Moreover, men were not included in this study. Further research should consider including spouses of the target population.
WIDER IMPLICATIONS OF THE FINDINGS
The brief mindfulness intervention was beneficial in decreasing depression and improving sleep quality. Implementation of guided self-administered mindfulness could make the psychological counseling service more accessible for patients with infertility in resource-poor settings. The efficiency and feasibility of the gratitude journal intervention needs to be investigated further.
STUDY FUNDING/COMPETING INTEREST(S)
This study was funded by the National Social Science Foundation (17BSH054). The authors have no conflicts of interest.
TRIAL REGISTRATION NUMBER
ChiCTR-IOR-16008452.
TRIAL REGISTRATION DATE
9 May 2016
DATE OF FIRST PATIENT’S ENROLMENT
15 May 2016.
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Affiliation(s)
- Cai-Feng Bai
- School of Nursing, Shandong University, No. 44 Wenhua Xi Road, Jinan 250012, China
- School of Nursing, Ningxia Medical University, 1160 Sheng Li Street, Yinchuan 750004, China
| | - Nai-Xue Cui
- School of Nursing, Shandong University, No. 44 Wenhua Xi Road, Jinan 250012, China
| | - Xian Xu
- Reproductive Medicine Center, General Hospital of Ningxia Medical University, 804 Sheng Li Street, Yinchuan 750004, China
| | - Guang-li Mi
- Nursing Department, General Hospital of Ningxia Medical University, 804 Sheng Li Street, Yinchuan 750004, China
| | - Ji-Wei Sun
- School of Nursing, Shandong University, No. 44 Wenhua Xi Road, Jinan 250012, China
| | - Di Shao
- School of Health Care Management, Shandong University, No. 44 Wenhua Xi Road, Jinan 250012, China
| | - Jie Li
- School of Nursing, Shandong University, No. 44 Wenhua Xi Road, Jinan 250012, China
| | - Yin-Zhi Jiang
- Reproductive Medicine Center, General Hospital of Ningxia Medical University, 804 Sheng Li Street, Yinchuan 750004, China
| | - Qian-Qian Yang
- School of Nursing, Shandong University, No. 44 Wenhua Xi Road, Jinan 250012, China
| | - Xuan Zhang
- School of Nursing, Shandong University, No. 44 Wenhua Xi Road, Jinan 250012, China
| | - Feng-Lin Cao
- School of Nursing, Shandong University, No. 44 Wenhua Xi Road, Jinan 250012, China
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Zhao D, Wu Z, Zhang H, Mellor D, Ding L, Wu H, Wu C, Huang J, Hong W, Peng D, Fang Y. Somatic symptoms vary in major depressive disorder in China. Compr Psychiatry 2018; 87:32-37. [PMID: 30195098 DOI: 10.1016/j.comppsych.2018.08.013] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 07/30/2018] [Accepted: 08/20/2018] [Indexed: 10/28/2022] Open
Abstract
PURPOSE This study aimed to investigate the clinical characteristics of somatic symptoms of patients in China who suffer from major depressive disorder (MDD). METHOD 3273 patients who met the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) MDD were recruited from 16 general hospitals and 16 mental health centers in China. Physicians and patients completed complementary customized depression disorder symptomatology questionnaires assessing the clinical characteristics of patients with MDD. RESULT 1. In this study we analyzed physician-recorded data. The major somatic symptoms in patients with MDD in China were insomnia (64.6%), pre-verbal physical complaints (46.9%), weight loss (38.5%), low appetite (37.6%), circulatory system complaints (31.3%), headache (31.3%), hyposexuality (31.0%), gastrointestinal symptom complaints (29.6%), and respiratory system complaints (29.6%). 2. Compared with MDD patients who sought medical help from mental health centers, MDD patients who sought medical help from general hospitals were more likely to suffer from urinary system complaints, headache, sensory system complaints, trunk pain, and nervous system complaints. A lower prevalence rate of insomnia and hyposexuality was also observed among MDD patients who visited general hospitals (p < .05). 3. Patients aged from 40 to 54 had the highest probability of pre-verbal physical complaints, respiratory system complaints, trunk pain, hyposexuality, limb pain and other pain conditions, while patients over 55 years of age had the lowest prevalence respiratory system complaints, hyposexuality, and other pain conditions, and they also had the highest rate of low appetite and insomnia. 4. Female patients appeared to exhibit higher rates of pre-verbal physical complaints, low appetite, and insomnia than male patients, but had fewer urinary systems complaints than male patients (p < .05). CONCLUSION The major somatic symptoms in patients with MDD in China are insomnia, pre-verbal physical complaints, weight loss, low appetite, circulatory system complaints, headache, hyposexuality, gastrointestinal system complaints, and respiratory system complaints. These symptoms vary by the type of medical setting to which patients present, and well as by age, and gender.
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Affiliation(s)
- Dongmei Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, No.600, South Wanping Road, Xuhui District, 200030 Shanghai, PR China; Shanghai Changning Mental Health Center, No 229, Xiehe Road, Changning District, Shanghai 200042, PR China
| | - Zhiguo Wu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, No.600, South Wanping Road, Xuhui District, 200030 Shanghai, PR China
| | - Huifeng Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, No.600, South Wanping Road, Xuhui District, 200030 Shanghai, PR China
| | - David Mellor
- School of Psychology, Deakin University, Melbourne, Australia
| | - Lei Ding
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, No.600, South Wanping Road, Xuhui District, 200030 Shanghai, PR China
| | - Haiyan Wu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, No.600, South Wanping Road, Xuhui District, 200030 Shanghai, PR China
| | - Chuangxin Wu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, No.600, South Wanping Road, Xuhui District, 200030 Shanghai, PR China
| | - Jia Huang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, No.600, South Wanping Road, Xuhui District, 200030 Shanghai, PR China
| | - Wu Hong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, No.600, South Wanping Road, Xuhui District, 200030 Shanghai, PR China
| | - Daihui Peng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, No.600, South Wanping Road, Xuhui District, 200030 Shanghai, PR China.
| | - Yiru Fang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, No.600, South Wanping Road, Xuhui District, 200030 Shanghai, PR China; Shanghai Key Laboratory of Psychotic Disorders, PR China; CAS Center for Excellence in Brain Science and Intelligence Technology, PR China.
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30
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Hansen B, Hagen K, Öst LG, Solem S, Kvale G. The Bergen 4-Day OCD Treatment Delivered in a Group Setting: 12-Month Follow-Up. Front Psychol 2018; 9:639. [PMID: 29774005 PMCID: PMC5943612 DOI: 10.3389/fpsyg.2018.00639] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 04/16/2018] [Indexed: 01/18/2023] Open
Abstract
The Bergen 4-day concentrated exposure treatment (cET) for obsessive-compulsive disorder (OCD) has proven highly acceptable; with practically no drop-out and a 6 month remission rate of nearly 70%. The aim of the present study was to evaluate long term gains of the approach, and to compare the results to findings from our recent meta-analysis. Sixty-nine of 95 patients consecutively referred to an outpatient clinic in the specialist health care, were offered the Bergen 4-day treatment. Among the 65 who initiated treatment, 60.0% were classified with "severe" to "extreme" OCD. None of the patients dropped-out during treatment. Independent Yale-Brown Obsessive-Compulsive Scale interviews were conducted post-treatment, and at 3- and 12-month follow-up. Using the international consensus criteria, 83.1% responded to treatment at 12-month follow-up, and 67.7% of patients were classified as recovered. Significant changes were also seen in depression, as measured by Patient Health Questionnaire-9, and in generalized anxiety, as measured by Generalized Anxiety Disorder-7 scale. A total of 89% of the patients rated the treatment as very good and 100% would recommend the treatment to a friend. Compared to results in a recent meta-analysis, the Bergen 4-day treatment is favorable in respect to attrition, response and 12-month recovery. In sum the Bergen 4-day treatment is a feasible way to deliver treatment for OCD, and the effects are stable at 12-month follow-up. Implications for dissemination are discussed.
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Affiliation(s)
- Bjarne Hansen
- OCD-Team, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Kristen Hagen
- OCD-Team, Haukeland University Hospital, Bergen, Norway.,OCD-Team, Molde Hospital, Molde, Norway
| | - Lars-Göran Öst
- OCD-Team, Haukeland University Hospital, Bergen, Norway.,Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Stian Solem
- OCD-Team, Haukeland University Hospital, Bergen, Norway.,Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gerd Kvale
- OCD-Team, Haukeland University Hospital, Bergen, Norway
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31
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Lashley M. The impact of length of stay on recovery measures in faith-based addiction treatment. Public Health Nurs 2018; 35:396-403. [PMID: 29600517 DOI: 10.1111/phn.12401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 01/23/2018] [Accepted: 02/09/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine the impact of length of stay among homeless men in faith-based residential addictions recovery on physical activity, depression, self-esteem, and nicotine dependence. DESIGN AND SAMPLE A time series design was utilized to measure changes in the four quality measures at program entry and at 3, 6, and 9 months following admission. The sample consisted of 175 homeless residents enrolled in a faith-based residential recovery program. MEASURES Paired t tests were used to determine the change in average instrument response from admission to each follow-up period. Analysis of variance (ANOVA) and Tukey posthoc tests were used to assess for differences in length of stay between demographic variables. RESULTS Statistically significant improvements were noted in self-esteem and depressive symptomatology at 3 and 6 months following admission and in physical activity levels at 3 months following admission. Nicotine dependence scores declined at 3 and 6 months but were not statistically significant. CONCLUSION Time spent in this faith-based spiritual recovery program had a significant impact on depression, self-esteem, and physical activity. Recommendations for future study include conducting research to analyze the relationship between distinct program elements and quality indicators and comparing faith-based programs to other similar programs and to publicly funded secular recovery programs.
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Affiliation(s)
- Mary Lashley
- Community Health Nursing, Towson University, Fallston, MD, USA
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32
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Depression promotes prostate cancer invasion and metastasis via a sympathetic-cAMP-FAK signaling pathway. Oncogene 2018. [PMID: 29515233 DOI: 10.1038/s41388-018-0177-4] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Depression drives cancer progression and induces poor clinical outcome. However, the mechanisms underlying depression and cancer outcomes are unclear. In this work, we investigated 98 prostate cancer patients and found that patients with high score of psychological depression were correlated with tumor invasion and metastasis. We found focal adhesion kinase (FAK) was increased in cancer patients with metastatic features and high score of depression. FAK knockdown completely blocked depression-promoted tumor invasion in orthotopic transplantation tumors. In Hi-myc mice and a murine model of depression, sympathetic activation was detected in the prostate tissue. Further we showed that FAK activation was dependent on a cAMP-PKA signaling pathway. Our results demonstrated that the activation of a sympathetic-FAK signaling pathway in prostate cancer patients with high degrees of depression facilitates tumor invasion. We suggest that blocking β2AR with propranolol or inhibiting FAK activation with PF562 271 may be novel strategies for depressed patients with invasive prostate cancer.
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Wang Q, Dong L, Jian Z, Tang X. Effectiveness of a PRECEDE-based education intervention on quality of life in elderly patients with chronic heart failure. BMC Cardiovasc Disord 2017; 17:262. [PMID: 29037148 PMCID: PMC5644077 DOI: 10.1186/s12872-017-0698-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Accepted: 10/10/2017] [Indexed: 12/12/2022] Open
Abstract
Background One of the most important challenges in public health is to improve the quality of life in patients with chronic heart failure (CHF). Depression, self-care capacity, and quality of life interact each other in these patients. It’s difficult to treat with general education programs and conventional therapy. PRECEDE model is a comprehensive and exclusive theory-based education programs. Its effectiveness for reducing depression and increasing quality of life has been demonstrated in patients with coronary artery bypass grafting, type 2 diabetes, and the elderly. It has not been used in elderly patients with CHF. Thus, this study aims to investigate the effects of this model on self-care behaviors, depression, and quality of life in these patients. Methods Patients who met the inclusion criteria were randomly assigned to the intervention or control group. All the patients received conventional medical care. The patients in the intervention group also received 9 sessions of education intervention based on the PRECEDE model and then followed up for 3 months after the intervention. Data were collected before and 3 months after the intervention using 4 questionnaires, namely a PRECEDE-based questionnaire to evaluate predisposing, reinforcing, and enabling factors; the 9-item European Heart Failure Self-care Behavior Scale (EHFScBS-9); the 9-item Personal Health Questionnaire (PHQ-9); and the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Results No significant differences were found in the mean scores for the predisposing, enabling, and reinforcing factors, and the mean total scores in EHFScBS-9, PHQ-9, and MLHFQ before the intervention between the intervention and control groups. After the intervention, the scores for the predisposing, reinforcing, and enabling factors increased significantly, and the mean total scores in EHFScBS-9, PHQ-9, and MLHFQ decreased significantly in the intervention group. In addition, these scores significantly differed from those of the control group. Furthermore, the MLHFQ score significantly correlated with the EHFScBS-9 and PHQ-9 scores. Conclusion This study demonstrates a trend that PRECEDE model of health education promotion is effective in relieving depression symptoms, enhancing self-monitoring, and improving the quality of life of elderly patients with CHF. Trial registration Trial registration number: ChiCTR-IOR-17012779; Trial registry: Chinese Clinical Trial Registry; Date registered: 22 Sep 2017; Retrospectively registered.
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Affiliation(s)
- Qiong Wang
- Department of Geriatrics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Lini Dong
- Department of Geriatrics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Zaijin Jian
- Department of Geriatrics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Xianghua Tang
- Department of Geriatrics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China.
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