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Paul R, Muhammad T, Rashmi R, Sharma P, Srivastava S, Zanwar PP. Depression by gender and associated factors among older adults in India: implications for age-friendly policies. Sci Rep 2023; 13:17651. [PMID: 37848598 PMCID: PMC10582097 DOI: 10.1038/s41598-023-44762-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 10/12/2023] [Indexed: 10/19/2023] Open
Abstract
Inspite of implementing policies to control mental health problems, depression remains a severe health concern among older adults in India. We examined self-reported differences in the depression among older men and women in India and examined associated factors for gender differences in depression at the population level. We utilized nationally representative data from the Longitudinal Aging Study in India (LASI) wave I, for years 2017-2019. Our analytical sample comprised of 30,637 older adults ages 60 years and above (14,682 men and 15,655 women). We conducted descriptive statistics and Chi-Square tests followed by binary logistic regression and multivariate decomposition analyses to examine our study objectives. Depression was reported in - 7.4% (95% CI 7.0, 7.8) of older men and 9.5% (CI 9.1, 10.0) of older women. Poor self-rated health, multimorbidity status, physical activity, difficulty in activities of daily living (ADL) and instrumental ADL (IADL) were the significant health-related factors associated with depression among older men and women. Not being satisfied with one's life, not being satisfied with their present living arrangement, receiving any type of ill-treatment, and being widowed were the significant factors associated with depression among older men and women. We found gender disparity in self-reported depression. Marital status contributed-to 36.7% of the gender gap in depression among older adults. Additionally, ADL and IADL difficulties among men and women contributed to 17.6% and 34.0%, gender gap, self-rated health contributed to 18.8% gap, whereas not having equal social participation (4.4%) and not satisfied in present living arrangements (8.1%) were other factors that contributed to gender gap for depression in India. Depression is a critical and persistent public health problem among-older females in India. Our findings provide a broader framework for policymakers and health practitioners to focus on gender-specific strategies to mitigate this highly emergent problem.
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Affiliation(s)
- Ronak Paul
- International Institute for Population Sciences, Mumbai, 400088, India
| | - T Muhammad
- International Institute for Population Sciences, Mumbai, 400088, India
| | - Rashmi Rashmi
- International Institute for Population Sciences, Mumbai, 400088, India
| | - Palak Sharma
- International Institute for Population Sciences, Mumbai, 400088, India
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Werner AM, Ernst M, Brähler E, Tibubos AN, Otten D, Reiner I, Wiltink J, Michal M, Schulz A, Wild PS, Münzel T, König J, Lackner KJ, Pfeiffer N, Beutel ME. The association of depressive symptoms and body weight change in midlife - Results from the Gutenberg Health Study in Germany. J Affect Disord 2023; 332:115-124. [PMID: 36977436 DOI: 10.1016/j.jad.2023.03.078] [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: 03/02/2022] [Revised: 03/20/2023] [Accepted: 03/24/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND The present study aimed to investigate how depressive symptoms affect bodyweight change (gain and loss), and how this association is intertwined with other psychosocial and biomedical factors in the adult general population. METHODS In a population-based, prospective, observational single-center cohort study in the Rhine-Main-Region, Germany (Gutenberg Health Study GHS) with N = 12,220 participants, we analyzed baseline and five year follow-up data with logistic regressions separately for bodyweight gain and loss (vs. stable bodyweight). RESULTS Overall, 19.8 % of participants gained bodyweight of at least 5 %. More female participants were affected than male participants (23.3 % vs. 16.6 %). Regarding weight loss, overall, 12.4 % lost >5 % of bodyweight; participants were more often female than male (13.0 % vs. 11.8 %). Depressive symptoms at baseline were associated with weight gain (OR = 1.03, 95 % CI = 1.02-1.05). In models controlling for psychosocial and biomedical factors, female gender, younger age, lower socioeconomic status and smoking cessation were associated with weight gain. In weight loss, there was no overall significant effect of depressive symptoms (OR = 1.01 [0.99; 1.03]). Weight loss was associated with female gender, diabetes, less physical activity, and higher BMI at baseline. Only in women, smoking and cancer were associated with weight loss. LIMITATIONS Depressive symptoms were assessed via self-report. Voluntary weight loss cannot be determined. CONCLUSIONS Significant weight change frequently occurs in middle to old adulthood resulting from a complex interplay of psychosocial and biomedical factors. Associations with age, gender, somatic illness and health behavior (e.g. smoking cessation) provide important information for the prevention of unfavorable weight change.
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Affiliation(s)
- Antonia M Werner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
| | - Mareike Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Ana N Tibubos
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Daniëlle Otten
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Iris Reiner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jörg Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Matthias Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Andreas Schulz
- Preventive Cardiology and Preventive Medicine - Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Philipp S Wild
- Preventive Cardiology and Preventive Medicine - Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
| | - Jochem König
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
| | - Karl J Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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Acute toxicity and genotoxicity studies on new melatonergic antidepressant GW117. Heliyon 2023; 9:e14026. [PMID: 36915542 PMCID: PMC10006472 DOI: 10.1016/j.heliyon.2023.e14026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 02/08/2023] [Accepted: 02/20/2023] [Indexed: 02/27/2023] Open
Abstract
GW117, a novel derivate compound of agomelatine that acts as both a 5-HT2C receptor antagonist and a MT1/MT2 receptor agonist, likely underlines the potent antidepressant action with less hepatotoxicity than agomelatine. We evaluated the acute toxicity of GW117, and the genotoxicity of GW117 using bacterial reverse mutation test, mammalian chromosomal aberration test in Chinese hamster lung cells (CHL) and mouse bone marrow micronucleus test. The acute toxicity test results showed that maximum tolerated dose (MTD) of GW117 was 2000 mg/kg, under which mean Cmax and AUC0→t was 10,782 ng/mL and 81,046 ng/mL × h, respectively. The result of bacterial reverse mutation test showed that the number of bacterial colonies in each dose group of GW117 did not increase significantly compared with that in the solvent control group with or without S9 metabolic activation system. In vitro chromosome aberration test of CHL cells, the chromosome aberration rate of each dose group of GW117 did not increase with or without S9 metabolic activation system. In mouse micronucleus test, the highest dose was 2000 mg/kg, the micronucleus rate did not increase significantly. Under the conditions of this study, the MTD of a single GW117 administration was 2000 mg/kg, there was no genotoxicity effect of GW117.
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Rashmi R, Srivastava S, Muhammad T, Kumar M, Paul R. Indigenous population and major depressive disorder in later life: a study based on the data from Longitudinal Ageing Study in India. BMC Public Health 2022; 22:2258. [PMID: 36463131 PMCID: PMC9719225 DOI: 10.1186/s12889-022-14745-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 11/28/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Existing evidence suggests that the indigenous older population who live with their families and friends might experience lesser depressive symptoms due to better emotional support and well-being. The present study aimed to investigate the differentials in the prevalence of the major depressive disorder among tribal and non-tribal older populations in India and to explore the contribution of socio-demographic, health-related, and household factors in such disparities. METHODS A cross-sectional study was conducted using data from the Longitudinal Aging Study in India (2017-18). The analytical sample included 30,637 older adults, among whom 5,025 and 25,612 belonged to the Scheduled Tribe (ST) and non-Scheduled Tribe (non-ST) social groups, respectively. Major depressive disorder assessed by the Composite International Diagnostic Interview short-form (CIDI-SF) scale was the outcome variable. Descriptive statistics, bivariate and multivariable regression and, decomposition analyses were conducted. RESULTS About 4.8% and 8.9% of older adults from the ST and non-ST social groups had major depression. For both tribal and non-tribal groups, older adults who were unmarried, dissatisfied with living arrangements, and those who faced lifetime discrimination were at increased risk of major depression. Findings from differences due to characteristics (E) revealed that if the regional differences were minimized, it would decrease the ST-non-ST gap in major depression by about 19.6%. Similarly, equal self-rated health status and chronic conditions among ST and non-ST groups would decrease the gap in major depression by almost 9.6% and 7.9%, respectively. Additionally, an equal status of Instrumental Activities of Daily Living (IADL) and Activities of Daily Living (ADL) among older adults would decrease the gap in major depression by about 3.8% and 3% respectively. Also, findings from differences due to coefficients (C) revealed that if older adults from the ST group had the same status of ADL as of older adults from the non-ST group, it would decrease the gap in major depression by about 11.8%. CONCLUSION The findings revealed a greater prevalence of major depression in older adults belonging to the non-ST group than the ST group. For both tribal and non-tribal groups, older adults who were unmarried, dissatisfied with living arrangements, and those who faced lifetime discrimination were at increased risk of major depression and these factors along with health-related variables contributed to significant ST-non-ST gap in depression, advantageous to tribal population; suggesting further research on the coping mechanisms of mental illnesses among indigenous population in India.
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Affiliation(s)
- Rashmi Rashmi
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, 400088 India
| | - Shobhit Srivastava
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, 400088 India
| | - T. Muhammad
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, 400088 India
| | - Manish Kumar
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, 400088 India
| | - Ronak Paul
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, 400088 India
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Hahad O, Beutel M, Gilan DA, Michal M, Schulz A, Pfeiffer N, König J, Lackner K, Wild P, Daiber A, Münzel T. The association of smoking and smoking cessation with prevalent and incident symptoms of depression, anxiety, and sleep disturbance in the general population. J Affect Disord 2022; 313:100-109. [PMID: 35777492 DOI: 10.1016/j.jad.2022.06.083] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 06/01/2022] [Accepted: 06/23/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Smoking is a well-established risk factor for chronic non-communicable diseases. However, the relationship between cigarette smoking and the risk of developing mental health conditions remains largely elusive. This study examined the relationship between cigarette smoking as well as smoking cessation and prevalent and incident symptoms of depression, anxiety, and sleep disturbance in the general population. METHODS In a cohort of 15,010 individuals from the Gutenberg Health Study (aged 35-74 years at enrollment), prevalent (at baseline from 2007 to 2012) and incident symptoms (at follow-up from 2012 to 2017) of depression, anxiety, and sleep disturbance were determined by validated questionnaires and/or medical records. Smoking status, pack-years of smoking in current and former smokers, and years since quitting smoking in former smokers were assessed by a standardized computer-assisted interview. RESULTS In multivariable logistic regression models with comprehensive adjustment for covariates, smoking status was independently associated with prevalent and incident symptoms of depression (Patient Health Questionnaire-9 ≥ 10), whereas this association was weaker for anxiety (Generalized Anxiety Disorder Scale-2 ≥ 3) and sleep disturbance (Patient Health Questionnaire-9 > 1). Among current and former smokers, smoking ≥30 or ≥10 pack-years, respectively, yielded in general the highest effect estimates. Smoking cessation was weakly associated with the prevalence and incidence of all outcomes, here consistent associations were observed for prevalent symptoms of depression. LIMITATIONS The observational nature of the study does not allow for causal inferences. CONCLUSIONS The results of the present study suggest that cigarette smoking is positively and that smoking cessation is negatively associated with symptoms of common mental health conditions, in particular of depression.
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Affiliation(s)
- Omar Hahad
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany; Leibniz Institute for Resilience Research (LIR), Mainz, Germany.
| | - Manfred Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Donya A Gilan
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany; Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Matthias Michal
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Andreas Schulz
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jochem König
- Institute of Medical Biostatistics, Epidemiology & Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Karl Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Philipp Wild
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany; Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Andreas Daiber
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany; Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany; Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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Mann F, Wang J, Pearce E, Ma R, Schlief M, Lloyd-Evans B, Ikhtabi S, Johnson S. Loneliness and the onset of new mental health problems in the general population. Soc Psychiatry Psychiatr Epidemiol 2022; 57:2161-2178. [PMID: 35583561 PMCID: PMC9636084 DOI: 10.1007/s00127-022-02261-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 02/18/2022] [Indexed: 12/27/2022]
Abstract
PURPOSE Loneliness is associated with poor health including premature mortality. There are cross-sectional associations with depression, anxiety, psychosis, and other mental health outcomes. However, it is not known whether loneliness is causally linked with the new onset of mental health problems in the general population. Longitudinal studies are key to understanding this relationship. We synthesized evidence from longitudinal studies investigating the relationship between loneliness and new onset of mental health problems, in the general population. METHOD We systematically searched six electronic databases, unpublished sources, and hand-searched references, up to August 2021. We conducted a meta-analysis of eight independent cohorts and narrative synthesis of the remaining studies. RESULTS We included 32 studies, of which the majority focused on depression. Our narrative synthesis found most studies show loneliness at baseline which is associated with the subsequent new onset of depression. The few studies on anxiety and self-harm also showed a positive association. Our meta-analysis found a pooled adjusted odds ratio of 2.33 (95% CI 1.62-3.34) for risk of new onset depression in adults who were often lonely compared with people who were not often lonely. This should be interpreted with caution given evidence of heterogeneity. CONCLUSION Loneliness is a public mental health issue. There is growing evidence it is associated with the onset of depression and other common mental health problems. Future studies should explore its impact across the age range and in more diverse populations, look beyond depression, and explore the mechanisms involved with a view to better informing appropriate interventions.
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Affiliation(s)
- Farhana Mann
- Division of Psychiatry, University College London, Wing B, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
| | - Jingyi Wang
- School of Public Health Shanghai, Fudan University, Shanghai, China
| | - Eiluned Pearce
- Division of Psychiatry, University College London, Wing B, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Ruimin Ma
- Department of Psychological Medicine, Kings College London, London, UK
| | - Merle Schlief
- Division of Psychiatry, University College London, Wing B, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Brynmor Lloyd-Evans
- Division of Psychiatry, University College London, Wing B, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Sarah Ikhtabi
- Division of Psychiatry, University College London, Wing B, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Sonia Johnson
- Division of Psychiatry, University College London, Wing B, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
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Gairing SJ, Galle PR, Schattenberg JM, Kostev K, Labenz C. Portal Vein Thrombosis Is Associated with an Increased Incidence of Depression and Anxiety Disorders. J Clin Med 2021; 10:5689. [PMID: 34884391 PMCID: PMC8658138 DOI: 10.3390/jcm10235689] [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: 11/09/2021] [Revised: 11/26/2021] [Accepted: 11/30/2021] [Indexed: 11/25/2022] Open
Abstract
Portal vein thrombosis (PVT) is a severe disease that adversely affects patients' well-being. Data on the influence of PVT on the occurrence of depression or anxiety disorders are lacking. This study aimed to explore the impact of PVT on the incidence of depression and anxiety disorders diagnoses in a large German primary care cohort over a ten-year period. Patients with PVT were matched to non-PVT individuals by age, sex, yearly consultation frequency, index year and comorbidities in a 1:5 ratio. The primary outcome of the study was the incidence of depression and anxiety disorders. The relationship between PVT and both depression and anxiety disorders was investigated using Cox regression models. We compared 547 patients with PVT with 2735 matched individuals without PVT. Within 5 years of the index date, 17.4% of patients with PVT and 9.3% of non-PVT individuals were diagnosed with depression (p < 0.001). Anxiety disorders were diagnosed in 5.5% and 3.0% of patients with PVT and non-PVT individuals, respectively (p = 0.002). On regression analyses, PVT was positively associated with incident depression (HR 2.01, 95% CI 1.53-2.64, p < 0.001) as well as anxiety disorders (HR 2.16, 95% CI 1.35-3.46, p = 0.001). Regarding depression, this association remained significant in women as well as in men. There was no association between PVT and the incidence of anxiety disorders in women. In conclusion, PVT is associated with the development of depression and anxiety disorders. However, further prospective studies are needed to confirm our findings before definitive recommendations can be made.
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Affiliation(s)
- Simon Johannes Gairing
- Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, 55131 Mainz, Germany; (S.J.G.); (P.R.G.); (J.M.S.)
- Cirrhosis Center Mainz (CCM), University Medical Center of the Johannes Gutenberg-University, 55131 Mainz, Germany
| | - Peter Robert Galle
- Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, 55131 Mainz, Germany; (S.J.G.); (P.R.G.); (J.M.S.)
- Cirrhosis Center Mainz (CCM), University Medical Center of the Johannes Gutenberg-University, 55131 Mainz, Germany
| | - Jörn M. Schattenberg
- Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, 55131 Mainz, Germany; (S.J.G.); (P.R.G.); (J.M.S.)
- Cirrhosis Center Mainz (CCM), University Medical Center of the Johannes Gutenberg-University, 55131 Mainz, Germany
| | - Karel Kostev
- Epidemiology, IQVIA, 60549 Frankfurt am Main, Germany;
| | - Christian Labenz
- Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, 55131 Mainz, Germany; (S.J.G.); (P.R.G.); (J.M.S.)
- Cirrhosis Center Mainz (CCM), University Medical Center of the Johannes Gutenberg-University, 55131 Mainz, Germany
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Kraav SL, Awoyemi O, Junttila N, Vornanen R, Kauhanen J, Toikko T, Lehto SM, Hantunen S, Tolmunen T. The effects of loneliness and social isolation on all-cause, injury, cancer, and CVD mortality in a cohort of middle-aged Finnish men. A prospective study. Aging Ment Health 2021; 25:2219-2228. [PMID: 33939562 DOI: 10.1080/13607863.2020.1830945] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Loneliness and social isolation both increase mortality and are likely to affect health via several pathways. However, information on the potential pathways remains scarce. We investigated the associations between loneliness, social isolation, and mortality, and possible mechanisms underlying these connections. METHODS The analyzed data comprised a prospective population-based cohort of Finnish men (42-61 years at baseline, n = 2588) who were followed up for an average of 23.2 years. Mortality data were obtained from the national population register in 2012. Cox proportional hazards analysis with adjustments for possible confounding factors was used to examine the associations between loneliness and social isolation at baseline and all-cause, injury, cancer, and cardiovascular disease (CVD) mortality. Mediation analysis was conducted to investigate the mechanisms underlying the associations of loneliness and social isolation with mortality. RESULTS Loneliness predicted all-cause mortality, even after adjustments for all covariates. Loneliness predicted cancer mortality, except after adjustments for lifestyle variables or Human Population Laboratory (HPL) depression scores, and also predicted CVD mortality, except after adjustments for HPL depression scores. Social isolation predicted all-cause mortality and injury mortality. The effect of social isolation on all-cause mortality was mediated by loneliness and HPL depression scores. CONCLUSIONS Our findings suggest that both loneliness and social isolation increase the risk of all-cause mortality, while they have differing effects on different causes of death. Loneliness and depressive symptoms may mediate the effect of social isolation on increased mortality.
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Affiliation(s)
- Siiri-Liisi Kraav
- Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland.,Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
| | - Olutosin Awoyemi
- Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland.,Coventry and Warwickshire Partnership NHS Trust, Coventry, United Kingdom.,Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
| | - Niina Junttila
- Department for Teacher Education, Centre for Education and Research on Social and Health Services, University of Turku, Turku, Finland
| | - Riitta Vornanen
- Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Timo Toikko
- Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
| | - Soili M Lehto
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,R&D Department, Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway.,Department of Psychiatry, University of Helsinki, Helsinki, Finland
| | - Sari Hantunen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Tommi Tolmunen
- Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland.,Department of Adolescent Psychiatry, Kuopio University Hospital, Kuopio, Finland
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Smoking and Neuropsychiatric Disease-Associations and Underlying Mechanisms. Int J Mol Sci 2021; 22:ijms22147272. [PMID: 34298890 PMCID: PMC8304236 DOI: 10.3390/ijms22147272] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/28/2021] [Accepted: 07/03/2021] [Indexed: 01/02/2023] Open
Abstract
Despite extensive efforts to combat cigarette smoking/tobacco use, it still remains a leading cause of global morbidity and mortality, killing more than eight million people each year. While tobacco smoking is a major risk factor for non-communicable diseases related to the four main groups—cardiovascular disease, cancer, chronic lung disease, and diabetes—its impact on neuropsychiatric risk is rather elusive. The aim of this review article is to emphasize the importance of smoking as a potential risk factor for neuropsychiatric disease and to identify central pathophysiological mechanisms that may contribute to this relationship. There is strong evidence from epidemiological and experimental studies indicating that smoking may increase the risk of various neuropsychiatric diseases, such as dementia/cognitive decline, schizophrenia/psychosis, depression, anxiety disorder, and suicidal behavior induced by structural and functional alterations of the central nervous system, mainly centered on inflammatory and oxidative stress pathways. From a public health perspective, preventive measures and policies designed to counteract the global epidemic of smoking should necessarily include warnings and actions that address the risk of neuropsychiatric disease.
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Bastiaanssen TFS, Cussotto S, Claesson MJ, Clarke G, Dinan TG, Cryan JF. Gutted! Unraveling the Role of the Microbiome in Major Depressive Disorder. Harv Rev Psychiatry 2021; 28:26-39. [PMID: 31913980 PMCID: PMC7012351 DOI: 10.1097/hrp.0000000000000243] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Microorganisms can be found in virtually any environment. In humans, the largest collection of microorganisms is found in the gut ecosystem. The adult gut microbiome consists of more genes than its human host and typically spans more than 60 genera from across the taxonomic tree. In addition, the gut contains the largest number of neurons in the body, after the brain. In recent years, it has become clear that the gut microbiome is in communication with the brain, through the gut-brain axis. A growing body of literature shows that the gut microbiome plays a shaping role in a variety of psychiatric disorders, including major depressive disorder (MDD). In this review, the interplay between the microbiome and MDD is discussed in three facets. First, we discuss factors that affect the onset/development of MDD that also greatly impinge on the composition of the gut microbiota-especially diet and stressful life events. We then examine the interplay between the microbiota and MDD. We examine evidence suggesting that the microbiota is altered in MDD, and we discuss why the microbiota should be considered during MDD treatment. Finally, we look toward the future and examine how the microbiota might become a therapeutic target for MDD. This review is intended to introduce those familiar with the neurological and psychiatric aspects of MDD to the microbiome and its potential role in the disorder. Although research is in its very early days, with much yet to be the understood, the microbiome is offering new avenues for developing potentially novel strategies for managing MDD.
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11
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Kraav SL, Lehto SM, Kauhanen J, Hantunen S, Tolmunen T. Loneliness and social isolation increase cancer incidence in a cohort of Finnish middle-aged men. A longitudinal study. Psychiatry Res 2021; 299:113868. [PMID: 33774371 DOI: 10.1016/j.psychres.2021.113868] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 03/11/2021] [Indexed: 10/21/2022]
Abstract
Globally, cancer is the second leading cause of death. Loneliness has been suggested as a risk factor for cancer mortality. However, connections between loneliness, social isolation, and cancer are poorly understood. In our longitudinal study (mean follow-up: 20.44 years) of 2570 middle-aged men, loneliness, social isolation, and health-related factors were measured at baseline. Cox proportional hazards analysis was used to examine the association between cancer incidence, loneliness, and social isolation. The effect of relationship status on cancer mortality among cancer patients was tested with the Kaplan-Meier method. Loneliness was associated with total cancer incidence after adjustments for tested lifestyle and health-related covariates. Social Isolation was associated with total cancer incidence, except when adjusted for lifestyle, diet, or Human Population Laboratory (HPL) Depression Scale scores. Loneliness was associated with lung cancer incidence, except when adjusted for HPL Depression Scale scores. There was no significant association between social isolation and lung cancer. Neither loneliness nor social isolation were connected with prostate or colorectal cancer. Being single at baseline was associated with worse survival outcomes for cancer patients. Our findings suggest that regardless of the social network size, loneliness among middle-aged men is associated with an increased likelihood of cancer.
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Affiliation(s)
- Siiri-Liisi Kraav
- Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland; Department of Social Sciences, University of Eastern Finland, Kuopio, Finland.
| | - Soili M Lehto
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; R&D department, Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway; Department of Psychiatry, University of Helsinki, Helsinki, Finland
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Sari Hantunen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Tommi Tolmunen
- Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland; Department of Adolescent Psychiatry, Kuopio University Hospital, Kuopio, Finland
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12
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Sachs-Ericsson N, Carr D, Sheffler J, Preston TJ, Kiosses D, Hajcak G. Cognitive reappraisal and the association between depressive symptoms and perceived social support among older adults. Aging Ment Health 2021; 25:453-461. [PMID: 31876170 DOI: 10.1080/13607863.2019.1698516] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVES There is an association between depression and diminished social support; indeed, interpersonal dysfunction is often a central feature of depression. The purpose of this study is to examine the role that an emotion regulation (ER) strategy, cognitive reappraisal, plays in influencing the association between depressive symptoms and perceived social support in older adults. METHOD Data for this cross-sectional study come from a community-based survey of older adults (60+, N = 910). We examined the effects of depressive symptoms and cognitive reappraisal on perceived social support. We then examined the potential moderating role of cognitive reappraisal on the association between depressive symptoms and perceived social support. RESULTS Depressive symptoms were associated with lower levels of perceived social support. Cognitive reappraisal was associated with higher levels of perceived social support. Cognitive reappraisal moderated the negative consequences of depressive symptoms on perceived social support. Whereas depressive symptoms had a negative effect on perceived social support, the negative effect was greater for those with lower levels of cognitive reappraisal compared to those with higher levels of cognitive reappraisal. DISCUSSION ER strategies may play a role in attenuating the negative consequences of depressive symptoms on social support in older age. It may be possible to help individuals maintain social support in later life, even in the face of mental health challenges, if they cultivate ER skills.
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Affiliation(s)
| | - Dawn Carr
- Department of Sociology, Florida State University, Tallahassee, FL, USA
| | - Julia Sheffler
- Center for Translational Behavioral Science, Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, USA
| | - Thomas J Preston
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Dimitris Kiosses
- Department of Clinical Psychiatry, Weill Cornell Medicine, New York, NY, USA
| | - Greg Hajcak
- Department of Psychology, Florida State University, Tallahassee, FL, USA
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13
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Otten D, Tibubos AN, Schomerus G, Brähler E, Binder H, Kruse J, Ladwig KH, Wild PS, Grabe HJ, Beutel ME. Similarities and Differences of Mental Health in Women and Men: A Systematic Review of Findings in Three Large German Cohorts. Front Public Health 2021; 9:553071. [PMID: 33614574 PMCID: PMC7892592 DOI: 10.3389/fpubh.2021.553071] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 01/11/2021] [Indexed: 12/18/2022] Open
Abstract
In Germany, large, population-based cohort studies have been implemented in order to identify risk and protective factors for maintaining health across the life span. The purpose of this systematic review is to analyse findings from three large ongoing cohorts and to identify sex-specific prevalence rates, risk and protective factors for mental health. Published studies from the Cooperative Health Research in the Region Augsburg (KORA), the Study of Health in Pomerania (SHIP) and the Gutenberg Health Study (GHS)), representing the southern, north-eastern and middle parts of Germany, were identified through searches of the databases PubMed and Web of Science. A total of 52 articles was identified from the start of each cohort until June 2019. Articles reporting prevalence rates of mental health [N = 22], explanatory factors for mental health [N = 25], or both [N = 5] were identified. Consistent across cohorts, higher prevalence rates of internalizing disorders were found for women and more externalizing disorders for men. Risk and protective factors for mental health included social factors, lifestyle, physical health, body mass index (BMI), diabetes, genetic and biological factors. In all areas, differences and similarities were found between women and men. The most evident were the sex-specific risk profiles for depression with mostly external risk factors for men and internal risk factors for women. Gender was not assessed directly, therefore we examined whether socioeconomic and family-related factors reflecting gender roles or institutionalized gender could be used as a proxy for gender. Overall, this systematic review shows differences and similarities in prevalence rates and determinants of mental health indicators between women and men. They underline the importance of focussing on sex specific approaches in mental health research and in the development of prevention measures. Current research on mental health still lacks focus on gender aspects. Therefore, an increased focus on sex and gender in mental health research is of great importance.
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Affiliation(s)
- Daniëlle Otten
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Ana N. Tibubos
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Georg Schomerus
- Department of Psychiatry and Psychotherapy, University Medicine Leipzig, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Harald Binder
- Faculty of Medicine and Medical Center, Institute of Medical Biometry and Statistics, University of Freiburg, Freiburg, Germany
- Faculty of Mathematics and Physics, Freiburg Center of Data Analysis and Modelling, Mathematical Institute, University of Freiburg, Freiburg, Germany
| | - Johannes Kruse
- Clinic for Psychosomatic Medicine and Psychotherapy, University Giessen and Marburg, Giessen, Germany
| | - Karl-Heinz Ladwig
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Philipp S. Wild
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Rhine-Main, Mainz, Germany
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Manfred E. Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
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14
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Ernst M, Brähler E, Otten D, Werner AM, Tibubos AN, Reiner I, Wicke F, Wiltink J, Michal M, Nagler M, Münzel T, Wild PS, König J, Pfeiffer N, Borta A, Lackner KJ, Beutel ME. Inflammation predicts new onset of depression in men, but not in women within a prospective, representative community cohort. Sci Rep 2021; 11:2271. [PMID: 33500534 PMCID: PMC7838404 DOI: 10.1038/s41598-021-81927-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 01/14/2021] [Indexed: 12/28/2022] Open
Abstract
Depression has been associated with increased inflammation. However, only few large-scale, prospective studies have evaluated whether inflammation leads to new cases of depression and whether this association can be found in men and women. Longitudinal data of N = 10,357 adult participants with no evidence of depression at baseline (based on Patient Health Questionnaire (PHQ-9), lifetime diagnoses, and current antidepressant medication) were evaluated for depression 5 years later. Multivariate logistic regression models were used to predict the onset of depression based on C-reactive protein (CRP) and white blood cell count (WBC). We used interaction terms and separate analyses in men and women to investigate gender-dependent associations. Based on both markers, inflammation was predictive of new cases of depression 5 years later, even when adjusting for sociodemographic, physical health, health behavior variables, and baseline depression symptoms. As established by interaction terms and separate analyses, inflammatory markers were predictive of depression in men, but not in women. Additional predictors of new onset of depression were younger age, loneliness, smoking (only in men), cancer and less alcohol consumption (only in women). The study indicates gender differences in the etiology of depressive disorders within the community, with a greater role of physical factors in men.
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Affiliation(s)
- Mareike Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany.
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany
| | - Daniëlle Otten
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany
| | - Antonia M Werner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany
| | - Ana N Tibubos
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany
| | - Iris Reiner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany
| | - Felix Wicke
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany
| | - Jörg Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany
| | - Matthias Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany
| | - Markus Nagler
- Preventive Cardiology and Preventive Medicine - Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Philipp S Wild
- Preventive Cardiology and Preventive Medicine - Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Jochem König
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Andreas Borta
- Boehringer Ingelheim Pharma GmbH Co KG, Ingelheim am Rhein, Germany
| | - Karl J Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany
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15
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Lee SL, Pearce E, Ajnakina O, Johnson S, Lewis G, Mann F, Pitman A, Solmi F, Sommerlad A, Steptoe A, Tymoszuk U, Lewis G. The association between loneliness and depressive symptoms among adults aged 50 years and older: a 12-year population-based cohort study. Lancet Psychiatry 2021; 8:48-57. [PMID: 33181096 PMCID: PMC8009277 DOI: 10.1016/s2215-0366(20)30383-7] [Citation(s) in RCA: 165] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/05/2020] [Accepted: 08/07/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Loneliness is experienced by a third of older adults in the UK and is a modifiable potential risk factor for depressive symptoms. It is unclear how the association between loneliness and depressive symptoms persists over time, and whether it is independent of related social constructs and genetic confounders. We aimed to investigate the association between loneliness and depressive symptoms, assessed on multiple occasions during 12 years of follow-up, in a large, nationally representative cohort of adults aged 50 years and older in England. METHODS We did a longitudinal study using seven waves of data that were collected once every 2 years between 2004 and 2017, from adults aged 50 years and older in the English Longitudinal Study of Ageing (ELSA). The exposure was loneliness at baseline (wave two), measured with the short 1980 revision of the University of California, Los Angeles Loneliness Scale (R-UCLA). The primary outcome was a score indicating severity of depression measured at six subsequent timepoints (waves three to eight), using the eight-item version of the Centre for Epidemiologic Studies Depression Scale (CES-D). Analyses were linear multilevel regressions, before and after adjusting for social isolation, social support, polygenic risk scores, and other sociodemographic and health-related confounders. The secondary outcome was depression diagnosis, measured using a binary version of the CES-D. FINDINGS 4211 (46%) of 9171 eligible participants had complete data on exposure, outcome, and confounders, and were included in our complete case sample. After all adjustments, a 1-point increase in loneliness score was associated with a 0·16 (95% CI 0·13-0·19) increase in depressive symptom severity score (averaged across all follow-ups). We estimated a population attributable fraction for depression associated with loneliness of 18% (95% CI 12-24) at 1 year of follow-up and 11% (3-19) at the final follow-up (wave eight), suggesting that 11-18% of cases of depression could potentially be prevented if loneliness were eliminated. Associations between loneliness and depressive symptoms remained after 12 years of follow-up, although effect sizes were smaller with longer follow-up. INTERPRETATION Irrespective of other social experiences, higher loneliness scores at baseline were associated with higher depression symptom severity scores during 12 years of follow-up among adults aged 50 years and older. Interventions that reduce loneliness could prevent or reduce depression in older adults, which presents a growing public health problem worldwide. FUNDING National Institute on Aging and a consortium of UK Government departments coordinated by the National Institute for Health Research.
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Affiliation(s)
- Siu Long Lee
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Eiluned Pearce
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Olesya Ajnakina
- Department of Behavioural Science and Health, University College London, London, UK; Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Sonia Johnson
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK; Camden and Islington National Health Service Foundation Trust, London, UK
| | - Glyn Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK; Camden and Islington National Health Service Foundation Trust, London, UK
| | - Farhana Mann
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK; Camden and Islington National Health Service Foundation Trust, London, UK
| | - Alexandra Pitman
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK; Camden and Islington National Health Service Foundation Trust, London, UK
| | - Francesca Solmi
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Andrew Sommerlad
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK; Camden and Islington National Health Service Foundation Trust, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| | - Urszula Tymoszuk
- Centre for Performance Science, Royal College of Music, Imperial College London, London, UK
| | - Gemma Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK.
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16
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Raykh OI, Sumin AN, Kokov АN, Indukaeva EV, Artamonova GV. Association of type D personality and level of coronary artery calcification. J Psychosom Res 2020; 139:110265. [PMID: 33038817 DOI: 10.1016/j.jpsychores.2020.110265] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 09/23/2020] [Accepted: 10/02/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate the association of the type D personality and the level of coronary arteries calcification in population-based sample. METHODS 1595 residents aged 25 to 64 years were recruited in a observational cross-sectional study in the period from 2012 to 2013. In addition to the ESSE-RF study protocol, we assessed the presence of a Type D personality and quantified coronary artery calcium (CAC) using multispiral computed tomography. The obtained data was analyzed by the Agatston method. The patients were divided into two groups: patients with type D personality (n = 231) and without type D (n = 1379). RESULTS CAC score differed significantly between the groups: 689.3 ± 53.7 in patients with type D and 546.5 ± 47 without type D (p = 0.04). The greatest differences of calcium score were found in the left coronary artery system, namely left anterior descending artery (p = 0.01) and circumflex artery (p = 0.03). Patients with type D had higher levels of clinically significant anxiety (p = 0.04) and depression (p = 0.02). Type D personality is associated with high levels of CAC score independently from age, sex, diabetes mellitus status, smoking, alcohol consumption, body mass index, arterial hypertension status, cholesterol level, history of brain stroke, myocardial infarction, coronary artery disease, HADS-A and HADS-D scores. CONCLUSIONS Type D personality is associated with higher average values of the CAC score, and type D may represent a potentially modifiable risk factor CAD. But it is unclear whether type D can affect the progression of CAC score.
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Affiliation(s)
- Olga Igorevna Raykh
- Federal State Budgetary Scientific Institution "Research Institute for Complex Issues of Cardiovascular Diseases", 6, Sosnoviy blvd, Kemerovo 650002, Russian Federation
| | - Alexei Nikolayevich Sumin
- Federal State Budgetary Scientific Institution "Research Institute for Complex Issues of Cardiovascular Diseases", 6, Sosnoviy blvd, Kemerovo 650002, Russian Federation.
| | - Аlexander Nikolayevich Kokov
- Federal State Budgetary Scientific Institution "Research Institute for Complex Issues of Cardiovascular Diseases", 6, Sosnoviy blvd, Kemerovo 650002, Russian Federation
| | - Elena Vladimirovna Indukaeva
- Federal State Budgetary Scientific Institution "Research Institute for Complex Issues of Cardiovascular Diseases", 6, Sosnoviy blvd, Kemerovo 650002, Russian Federation
| | - Galina Vladimirovna Artamonova
- Federal State Budgetary Scientific Institution "Research Institute for Complex Issues of Cardiovascular Diseases", 6, Sosnoviy blvd, Kemerovo 650002, Russian Federation
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17
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Rezapour J, Schuster AK, Nickels S, Korb CA, Elbaz H, Peto T, Michal M, Münzel T, Wild PS, König J, Lackner K, Schulz A, Pfeiffer N, Beutel ME. Prevalence and new onset of depression and anxiety among participants with AMD in a European cohort. Sci Rep 2020; 10:4816. [PMID: 32179798 PMCID: PMC7075932 DOI: 10.1038/s41598-020-61706-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 02/27/2020] [Indexed: 12/20/2022] Open
Abstract
To investigate the prevalence and new onset of depression and anxiety among subjects with age-related macular degeneration (AMD) and its association with AMD in a large European cohort with relatively good visual acuity. 11,834 participants enrolled in the German population-based Gutenberg Health Study were studied. AMD was diagnosed by grading of fundus photographs. Depression and anxiety were assessed with the Patient Health Questionnaire and the Generalized Anxiety Disorder-2 Scale, respectively. Logistic regression analyses were performed and adjusted for several parameters. 1,089 (9.2%) participants were diagnosed having AMD. Prevalence of depression in AMD and non-AMD participants was 7.2% and 8.0%, respectively and prevalence of anxiety was 4.2% and 7.0%, respectively. New onset of depression and anxiety at 5-year follow-up in AMD subjects was 2.6% and 3.6%, respectively. AMD was not associated with depression (OR 0.93; CI 95% 0.70–1.20; p = 0.62). AMD was associated with less anxiety (OR 0.67; CI 95% 0.47–0.93; p = 0.02). This is the first study analyzing both prevalence and new onset of depression and anxiety in AMD subjects. AMD- and non-AMD participants had a similar prevalence and new onset of depression in our population-based sample. Participants without AMD had a higher prevalence of anxiety. AMD was not associated with depression.
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Affiliation(s)
- Jasmin Rezapour
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, 55131, Germany. .,Hamilton Glaucoma Center, Shiley Eye Institute, Department of Ophthalmology, UC San Diego, La Jolla, CA, 92037, United States.
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, 55131, Germany
| | - Stefan Nickels
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, 55131, Germany
| | - Christina A Korb
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, 55131, Germany
| | - Hisham Elbaz
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, 55131, Germany.,Department of Ophthalmology, Otto-von-Guericke University, Magdeburg, 39106, Germany
| | - Tunde Peto
- NIHR Biomedical Research Center at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, EC1V 9EL, United Kingdom.,Queen's University Belfast, Centre for Public Health, Belfast, BT7 1NN, Northern Ireland, United Kingdom
| | - Matthias Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, 55131, Germany
| | - Thomas Münzel
- Center for Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, 55131, Germany
| | - Philipp S Wild
- Preventive Cardiology and Preventive Medicine/Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, 55131, Germany.,Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, 55131, Germany.,German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, 55131, Germany
| | - Jochem König
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, 55131, Germany
| | - Karl Lackner
- Institute for Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, 55131, Germany
| | - Andreas Schulz
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, 55131, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, 55131, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, 55131, Germany
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18
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Ghaemi Kerahrodi J, Brähler E, Wiltink J, Michal M, Schulz A, Wild PS, Münzel T, Toenges G, Lackner KJ, Pfeiffer N, Beutel ME. Association between medicated obstructive pulmonary disease, depression and subjective health: results from the population-based Gutenberg Health Study. Sci Rep 2019; 9:20252. [PMID: 31882715 PMCID: PMC6934802 DOI: 10.1038/s41598-019-56440-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 12/03/2019] [Indexed: 12/19/2022] Open
Abstract
Medicated obstructive pulmonary disease (asthma or COPD) has been associated with depression. Yet, there is little knowledge of the interplay of contributing social, biological, behavioral and psychological factors in the community. The study was conducted: (1) To determine the prevalence of depression in participants with medicated COPD or asthma from the general population, (2) to identify underlying social, biological, behavioral and psychological factors and (3) to determine the contribution of obstructive pulmonary disease and depression to subjective health. The population-based sample of 15.010 study participants (35–74 years) from the Gutenberg Health Study (GHS) was queried according to a medical diagnosis of obstructive pulmonary disease, defined as medicated COPD or asthma, and comorbid disorders. Demographic, behavioral and psychological factors were assessed by self-report; lung function (FEV1; FCV) was measured by spirometry. 307 men (4.3%) and 396 women (5.6%) reported a medical diagnosis of COPD or asthma. The prevalence of depression (PHQ-9 > = 10) was twice as high (16.2% vs. 7.5%) compared to participants without obstructive pulmonary disease. Participants with obstructive pulmonary disease were older, had a lower SES, more comorbid diseases and cardiovascular risk factors, higher distress and took more psychotropic medication. In multivariable logistic regression analyses, obstructive pulmonary disease was associated with a 71% increase of depression (OR = 1.71; 95% CI = 1.30 to 2.24). Additional contributors were FEV1 (1.18; 95% CI = 1.05 to 1.32) and dyspnea (NYHA > = 1) (2.19; 1.82 to 2.64), sex (women) (OR = 1.73; 95% CI 1.41 to 2.12), lower SES (OR = 0.98; 95%CI = 0.96 to 0.99). Lack of active sports OR = 0.79; 95% CI 0.68 to 0.92), obesity (OR 1.27; 95% CI 1.07 to 1.50), smoking (OR = 1.26; 95% CI 1.06 to 1.49) and dyslipidemia (OR = 1.35; 95% CI 1.15 to 1.57) also increased the risk of depression. Additional psychological risks were social phobia, type D, low social support, loneliness and life events in the past 12 months. In multivariable linear regression analyses, obstructive pulmonary disease and depression independently contributed to reduced subjective health in addition to sedentary behavior, smoking and comorbid somatic and mental disorders. These findings provide evidence that COPD and asthma are associated with depression in the community. Complex underlying demographic, medical and psychosocial variables have been identified which may justify an integrative treatment approach. Promoting health behavior (smoking cessation, exercising, weight reduction) and social integration may not only improve the somatic course of the disease, but also mental health. Mental health treatment may also improve health behavior and subjective health.
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Affiliation(s)
- Jasmin Ghaemi Kerahrodi
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jörg Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Matthias Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Andreas Schulz
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Phillip S Wild
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,DZHK (German Center for Cardiovascular Research), partner site RhineMain, Mainz, Germany
| | - Thomas Münzel
- Center for Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.,DZHK (German Center for Cardiovascular Research), partner site RhineMain, Mainz, Germany
| | - Gerrit Toenges
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Karl J Lackner
- DZHK (German Center for Cardiovascular Research), partner site RhineMain, Mainz, Germany.,Institute for Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Course of depressive symptoms in men and women: differential effects of social, psychological, behavioral and somatic predictors. Sci Rep 2019; 9:18929. [PMID: 31831794 PMCID: PMC6908702 DOI: 10.1038/s41598-019-55342-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 11/27/2019] [Indexed: 11/08/2022] Open
Abstract
In this study, we aimed to identify the most important and sex-specific social, psychological, behavioral and somatic predictors of recurrent depressive symptoms. Data was obtained at two measurement points within five years by the Gutenberg Health Study (GHS). Out of N = 12,061 individuals, a sample of 877 (age 52.3 ± 9.9) who reported clinically relevant depressive symptoms at baseline was analyzed. Univariate analyses and multiple logistic regression analyses were conducted. Almost half of participants depressed at baseline also reported depressive symptoms five years later. Sex-stratified multivariate analyses revealed that solely social support remained a significant protective predictor against recurrence of depression in men (OR = 0.93; CI95% = 0.87-0.99), whereas in women smoking (OR = 1.97; CI95% = 1.23-3.22), and Type D personality (OR = 1.65; CI95% = 1.10-2.49) were significant risk factors. However, when analyzing the entire sample, no interaction effect between sex and each predictor turned out to be significant. Only social support was retained as an overall predictive factor. As depressive symptoms recur, depressive vulnerability is established involving personality, health behavior and social factors. Although no significant sex-specific interactions were observed, sex-stratified analyses point out different patterns for relevant predictors of recurrent depressive symptoms in men and women.
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20
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Beutel ME, Brähler E, Wiltink J, Kerahrodi JG, Burghardt J, Michal M, Schulz A, Wild PS, Münzel T, Schmidtmann I, Lackner KJ, Pfeiffer N, Borta A, Tibubos AN. New onset of depression in aging women and men: contributions of social, psychological, behavioral, and somatic predictors in the community - CORRIGENDUM. Psychol Med 2019; 49:175. [PMID: 30207259 DOI: 10.1017/s0033291718002787] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy,University Medical Center of the Johannes Gutenberg-University Mainz,Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy,University Medical Center of the Johannes Gutenberg-University Mainz,Germany
| | - Joerg Wiltink
- Department of Psychosomatic Medicine and Psychotherapy,University Medical Center of the Johannes Gutenberg-University Mainz,Germany
| | - Jasmin Ghaemi Kerahrodi
- Department of Psychosomatic Medicine and Psychotherapy,University Medical Center of the Johannes Gutenberg-University Mainz,Germany
| | - Juliane Burghardt
- Department of Psychosomatic Medicine and Psychotherapy,University Medical Center of the Johannes Gutenberg-University Mainz,Germany
| | - Matthias Michal
- Department of Psychosomatic Medicine and Psychotherapy,University Medical Center of the Johannes Gutenberg-University Mainz,Germany
| | - Andreas Schulz
- Preventive Cardiology and Preventive Medicine,Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz,Germany
| | - Phillipp S Wild
- Preventive Cardiology and Preventive Medicine,Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz,Germany
| | - Thomas Münzel
- Center for Translational Vascular Biology (CTVB), University Medical Center of the Johannes Gutenberg-University Mainz,Germany
| | - Irene Schmidtmann
- Institute for Medical Biostatistics,Epidemiology and Informatics,University Medical Center Mainz,Germany
| | - Karl J Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz,Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology,University Medical Center of the Johannes Gutenberg-University Mainz,Germany
| | - Andreas Borta
- Boehringer Ingelheim Pharma GmbH Co KG,Ingelheim am Rhein,Germany
| | - Ana N Tibubos
- Department of Psychosomatic Medicine and Psychotherapy,University Medical Center of the Johannes Gutenberg-University Mainz,Germany
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