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de Heer C, Bi S, Finkenauer C, Alink L, Maes M. The Association Between Child Maltreatment and Loneliness Across the Lifespan: A Systematic Review and Multilevel Meta-Analysis. CHILD MALTREATMENT 2024; 29:388-404. [PMID: 35652822 DOI: 10.1177/10775595221103420] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
While there is evidence that child maltreatment is positively associated with loneliness, the strength of this association is not yet clear. It is also unclear whether the magnitude and statistical significance of this association varies across groups of individuals. Therefore, this meta-analysis examines whether there are differences in loneliness between individuals with and without maltreatment histories, and which factors may influence the association between child maltreatment and loneliness. A three-level meta-analysis was conducted on 52 studies reporting 116 effect sizes (N = 1,705,493; Mage = 30.93; 49.6% females). Results showed a medium overall effect (g = 0.45, p < .001, 95% CI [0.36, 0.53]), indicating that individuals with maltreatment histories, on average, feel lonelier than individuals without maltreatment histories. Moderator analyses showed that effect sizes were larger for emotional abuse and emotional neglect as compared to other types of child maltreatment and decreased when participants were older at the time of loneliness assessment. These findings suggest that individuals with maltreatment histories, especially those who have been emotionally abused and/or emotionally neglected, are vulnerable to experiencing loneliness across the lifespan. The results also suggest that feelings of loneliness warrant attention in prevention and intervention programs for individuals with maltreatment histories.
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Affiliation(s)
| | | | | | | | - Marlies Maes
- Utrecht University, the Netherlands
- KU Leuven, Belgium
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2
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van Steen M, Zoet M, Hendriks GJ, Rhebergen D, Lugtenburg A, Lammers M, van den Brink R, Marijnissen R, Voshaar RO, Collard RM, Naarding P. Association Between Personality Traits and Functional Limitations in Older Adults with Affective Disorders: A Cross Sectional Study. Clin Gerontol 2023:1-12. [PMID: 37515583 DOI: 10.1080/07317115.2023.2240317] [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] [Indexed: 07/31/2023]
Abstract
OBJECTIVES Personality traits and affective disorders are both related to functional limitations. It is unknown whether personality traits have an additional effect on functioning in older adults with affective disorders. We studied the association between personality traits and functioning within this group. METHODS We performed a cross-sectional study of 180 older patients referred to outpatient specialized geriatric mental health care centers with a depressive, anxiety and/or somatic symptom disorder according to DSM-criteria. We studied the association between the Big Five personality traits and functional limitations assessed with the WHO-DAS II, adjusting for potential confounders, including the severity of various affective disorders. RESULTS The 180 patients (57.1% female, mean age 69.2 years) had an average WHO-DAS II score of 31.3 (SD 15.1). Lower scores on Conscientiousness were associated with more overall functional limitations (p = .001), particularly limitations in self-care (p = .001) and household activities (p = .001). Lower Extraversion scores were associated with more limitations in getting along with others (p = .001). CONCLUSIONS Personality traits are related to functional limitations independent of the severity of affective disorders in older adults. CLINICAL IMPLICATIONS Personality traits may be used as predictive factors for functioning in older adults with affective disorders.
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Affiliation(s)
- Manon van Steen
- GGNet Old age, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Monique Zoet
- GGNet Mental Health, Division of Old Age Psychiatry, Warnsveld & Apeldoorn, The Netherlands
| | - Gert Jan Hendriks
- Behavioural Science Institute, Radboud University & Pro Persona Institute for Integrated Mental Health Care, Nijmegen, The Netherlands
| | - Didi Rhebergen
- Mental Health Center GGZ Centraal, Ermelo, Netherlands
- The Department of Psychiatry Amsterdam UMC, VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | | | | | - Rob van den Brink
- Rob Giel Research Center (RGOc), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Radboud Marijnissen
- Rob Giel Research Center (RGOc), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Richard Oude Voshaar
- Rob Giel Research Center (RGOc), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Rose M Collard
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Paul Naarding
- GGNet Mental Health, Division of Old Age Psychiatry, Warnsveld & Apeldoorn, The Netherlands
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3
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Coin A, Noale M, Gareri P, Trevisan C, Bellio A, Fini F, Abbatecola AM, Del Signore S, Malara A, Mossello E, Fumagalli S, Volpato S, Monzani F, Bellelli G, Zia G, Incalzi RA. Clinical profile of trazodone users in a multisetting older population: data from the Italian GeroCovid Observational study. Eur Geriatr Med 2023:10.1007/s41999-023-00790-1. [PMID: 37204681 DOI: 10.1007/s41999-023-00790-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 04/19/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND AND OBJECTIVES Depression is highly prevalent in older adults, especially in those with dementia. Trazodone, an antidepressant, has shown to be effective in older patients with moderate anxiolytic and hypnotic activity; and a common off-label use is rising for managing behavioral and psychological symptoms of dementia (BPSD). The aim of the study is to comparatively assess the clinical profiles of older patients treated with trazodone or other antidepressants. METHODS This cross-sectional study involved adults aged ≥ 60 years at risk of or affected with COVID-19 enrolled in the GeroCovid Observational study from acute wards, geriatric and dementia-specific outpatient clinics, as well as long-term care facilities (LTCF). Participants were grouped according to the use of trazodone, other antidepressants, or no antidepressant use. RESULTS Of the 3396 study participants (mean age 80.6 ± 9.1 years; 57.1% females), 10.8% used trazodone and 8.5% others antidepressants. Individuals treated with trazodone were older, more functionally dependent, and had a higher prevalence of dementia and BPSD than those using other antidepressants or no antidepressant use. Logistic regression analyses found that the presence of BPSD was associated with trazodone use (odds ratio (OR) 28.4, 95% confidence interval (CI) 18-44.7 for the outcome trazodone vs no antidepressants use, among participants without depression; OR 2.17, 95% CI 1.05-4.49 for the outcome trazodone vs no antidepressants use, among participants with depression). A cluster analysis of trazodone use identified three clusters: cluster 1 included mainly women, living at home with assistance, multimorbidity, dementia, BPSD, and depression; cluster 2 included mainly institutionalized women, with disabilities, depression, and dementia; cluster 3 included mostly men, often living at home unassisted, with better mobility performance, fewer chronic diseases, dementia, BPSD, and depression. DISCUSSION The use of trazodone was highly prevalent in functionally dependent and comorbid older adults admitted to LTCF or living at home. Clinical conditions associated with its prescription included depression as well as BPSD.
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Affiliation(s)
- Alessandra Coin
- Geriatrics Unit, Azienda Ospedale Università di Padova, Department of Medicine (DIMED), University of Padova, Via N. Giustiniani 2, 35128, Padua, Italy.
| | - Marianna Noale
- Neuroscience Institute, National Research Council (CNR), Aging Branch, Padua, Italy
| | - Pietro Gareri
- Center for Cognitive Disorders and Dementia-Catanzaro Lido, ASP Catanzaro, Catanzaro, Italy
| | - Caterina Trevisan
- Geriatrics Unit, Azienda Ospedale Università di Padova, Department of Medicine (DIMED), University of Padova, Via N. Giustiniani 2, 35128, Padua, Italy
- Department of Medical Science, University of Ferrara, Ferrara, Italy
| | - Andrea Bellio
- Geriatrics Unit, Azienda Ospedale Università di Padova, Department of Medicine (DIMED), University of Padova, Via N. Giustiniani 2, 35128, Padua, Italy
| | - Filippo Fini
- Geriatrics Unit, Azienda Ospedale Università di Padova, Department of Medicine (DIMED), University of Padova, Via N. Giustiniani 2, 35128, Padua, Italy
| | | | | | | | - Enrico Mossello
- Geriatric Intensive Care Unit, Department of Experimental and Clinical Medicine, University of Firenze, Florence, Italy
| | - Stefano Fumagalli
- Geriatric Intensive Care Unit, Department of Experimental and Clinical Medicine, University of Firenze, Florence, Italy
| | - Stefano Volpato
- Department of Medical Science, University of Ferrara, Ferrara, Italy
| | - Fabio Monzani
- Intermediate Care Unit, Nursing Home Misericordia, Navacchio, Pisa, Italy
| | - Giuseppe Bellelli
- Acute Geriatric Unit, IRCCS Foundation San Gerardo Hospital, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | | | - Raffaele Antonelli Incalzi
- Unit of Geriatrics, Department of Medicine, Campus Bio-Medico University and Teaching Hospital, Rome, Italy
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Kashimura M, Ishizu K, Kokubo N, Segal DL. Assessing late-life anxiety in Japanese older adults: psychometric evaluation of the Japanese version of the Geriatric Anxiety Scale. Psychogeriatrics 2023. [PMID: 37095633 DOI: 10.1111/psyg.12971] [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: 02/16/2023] [Revised: 03/31/2023] [Accepted: 04/10/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND This study developed a Japanese version of the Geriatric Anxiety Scale (GAS-J) and its short form (GAS-10-J) to evaluate anxiety in Japanese older adults and assess its psychometric properties using a cross-sectional design. METHODS A total of 331 community-dwelling older adult participants (208 men, 116 women, seven unknowns; mean age = 73.47 ± 5.17 years, range = 60-88 years) recruited from two Silver Human Resources Centres in the Kanto region, Japan, answered a set of self-report questionnaires. Of these respondents, 120 participated in a follow-up survey to evaluate test-retest reliability. RESULTS Confirmatory factor analysis suggested that, as with the original GAS, the GAS-J had a three-factor structure and the GAS-10-J had a unifactor structure with high standardised factor loadings. Test-retest correlations and internal consistency analyses indicated that these scales were reliable. Correlations between the GAS-J/GAS-10-J with the Geriatric Anxiety Inventory, Generalised Anxiety Disorder-7, Geriatric Depression Scale-15, World Health Organization-Five Well-Being Index, and Kihon Checklist were mostly consistent with our hypotheses, thereby supporting the construct validity of the GAS-J/GAS-10-J. CONCLUSIONS The findings indicate that the GAS-J and GAS-10-J have robust psychometric properties for assessing late-life anxiety in Japanese older adults. Further GAS-J studies are required for clinical groups.
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Affiliation(s)
- Masami Kashimura
- Faculty of Human Sciences, Department of Psychology, Tokiwa University, Ibaraki, Japan
| | - Kenichiro Ishizu
- Graduate School of Teacher Training Development, University of Toyama, Toyama, Japan
| | - Naomi Kokubo
- Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institute for Quantum Science and Technology, Chiba, Japan
| | - Daniel L Segal
- Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs, Colorado, USA
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5
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Wang X, Rao W, Chen X, Zhang X, Wang Z, Ma X, Zhang Q. The sociodemographic characteristics and clinical features of the late-life depression patients: results from the Beijing Anding Hospital mental health big data platform. BMC Psychiatry 2022; 22:677. [PMID: 36324116 PMCID: PMC9628045 DOI: 10.1186/s12888-022-04339-7] [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: 07/14/2022] [Accepted: 10/26/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The sociodemographic characteristics and clinical features of the Late-life depression (LLD) patients in psychiatric hospitals have not been thoroughly studied in China. This study aimed to explore the psychiatric outpatient attendance of LLD patients at a psychiatric hospital in China, with a subgroup analysis, such as with or without anxiety, gender differences. METHODS This retrospective study examined outpatients with LLD from January 2013 to August 2019 using data in the Observational Medical Outcomes Partnership Common Data Model (OMOP-CDM) in Beijing Anding Hospital. Age, sex, number of visits, use of drugs and comorbid conditions were extracted from medical records. RESULTS In a sample of 47,334 unipolar depression patients, 31,854 (67.30%) were women, and 15,480 (32.70%) were men. The main comorbidities of LDD are generalized anxiety disorder (GAD) (83.62%) and insomnia (74.52%).Among patients with unipolar depression, of which benzodiazepines accounted for the largest proportion (77.77%), Selective serotonin reuptake inhibitors (SSRIs) accounted for 59.00%, a noradrenergic and specific serotonergic antidepressant (NaSSAs) accounted for 36.20%. The average cost of each visit was approximately 646.27 yuan, and the cost of each visit was primarily attributed to Western medicine (22.97%) and Chinese herbal medicine (19.38%). For the cost of outpatient visits, depression comorbid anxiety group had a higher average cost than the non-anxiety group (p < 0.05). There are gender differences in outpatient costs, men spend more than women, for western medicine, men spend more than women, for Chinese herbal medicine, women spend more than men (all p < 0.05). The utilization rate of SSRIs and benzodiazepines in female patients is significantly higher than that in male patients (p < 0.05). CONCLUSION LLD patients are more commonly women than men and more commonly used SSRIs and NaSSAs. Elderly patients with depression often have comorbid generalized anxiety. LLD patients spend most of their visits on medicines, and while the examination costs are lower.
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Affiliation(s)
- Xiao Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Department of Psychiatry, Capital Medical University& Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, China
| | - Wenwang Rao
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Xueyan Chen
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Department of Psychiatry, Capital Medical University& Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, China
| | - Xinqiao Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Department of Psychiatry, Capital Medical University& Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, China
| | - Zeng Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Department of Psychiatry, Capital Medical University& Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, China
| | - Xianglin Ma
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Department of Psychiatry, Capital Medical University& Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, China
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Department of Psychiatry, Capital Medical University& Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, China.
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6
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Wiersema C, Oude Voshaar RC, van den Brink RHS, Wouters H, Verhaak P, Comijs HC, Jeuring HW. Determinants and consequences of polypharmacy in patients with a depressive disorder in later life. Acta Psychiatr Scand 2022; 146:85-97. [PMID: 35435249 PMCID: PMC9321061 DOI: 10.1111/acps.13435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 03/27/2022] [Accepted: 04/03/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Polypharmacy and late-life depression often congregate in the geriatric population. The primary objective is to identify determinants of polypharmacy in patients with depression, and second to examine polypharmacy in relation to various clinical phenotypes of depression and its course. METHODS A longitudinal observational study using data of the Netherlands Study of Depression in Older persons (NESDO) including 375 patients with depression ≥ 60 years and 132 non-depressed comparisons. Linear and logistic regression were used to analyze both polypharmacy (dichotomous: ≥5 medications) and number of prescribed drugs (continuous) in relation to depression, various clinical phenotypes, and depression course. RESULTS Polypharmacy was more prevalent among patients with depression (46.9%) versus non-depressed comparisons (19.7%). A lower level of education, lower cognitive functioning, and more chronic diseases were independently associated with polypharmacy. Adjusted for these determinants, polypharmacy was associated with a higher level of motivational problems, anxiety, pain, and an earlier age of onset. A higher number of drugs was associated with a worse course of late-life depression (OR = 1.24 [95% CI: 1.03-1.49], p = 0.022). CONCLUSION Older patients with depression have a huge risk of polypharmacy, in particular among those with an early onset depression. As an independent risk factor for chronic depression, polypharmacy needs to be identified and managed appropriately. Findings suggest that depression moderates polypharmacy through shared risk factors, including motivational problems, anxiety, and pain. The complex interaction with somatic health burden requires physicians to prescribe medications with care.
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Affiliation(s)
- Carlijn Wiersema
- Department: University Center of Psychiatry, University of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Richard C. Oude Voshaar
- Department: University Center of Psychiatry, University of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Rob H. S. van den Brink
- Department: University Center of Psychiatry, University of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Hans Wouters
- Department of General PracticeUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Peter Verhaak
- Department of General PracticeUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands,Research Department, NIVEL, Netherlands Institute for Health Services ResearchUtrechtThe Netherlands
| | - Hannie C. Comijs
- Department Psychiatry, Amsterdam Public Health Research InstituteVU University Medical CenterAmsterdamThe Netherlands
| | - Hans W. Jeuring
- Department: University Center of Psychiatry, University of Groningen, University Medical Center GroningenGroningenThe Netherlands
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An Overview of Anxiety, Trauma-Related and Obsessive-Compulsive Disorders. CURRENT GERIATRICS REPORTS 2021. [DOI: 10.1007/s13670-021-00361-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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8
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Ogunsakin RE, Olugbara OO, Moyo S, Israel C. Meta-analysis of studies on depression prevalence among diabetes mellitus patients in Africa. Heliyon 2021; 7:e07085. [PMID: 34095580 PMCID: PMC8165422 DOI: 10.1016/j.heliyon.2021.e07085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 12/30/2020] [Accepted: 05/13/2021] [Indexed: 12/12/2022] Open
Abstract
Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion or insulin action. It can be caused by the consumption of carbohydrate meals or medication side effects. Depression as a comorbid condition in an individual with diabetes is accountable for increased disability, mortality, and significant health problem in patients. As a continent, Africa does not have an overall estimation of depression prevalence among diabetes mellitus patients at a regional level. Consequently, this study's purpose was to use the meta-analysis method to summarize estimates of extant studies that have reported depression prevalence among patients with diabetes mellitus in Africa. The literature search method was executed to classify studies with reported depression prevalence with evidently designed inclusion and exclusion criteria. In total, 20 studies from sundry screened articles were appropriate for ultimate inclusion in the meta-analysis. Since substantial heterogeneity was expected, a random-effects meta-analysis was carried out using the number of cases with a total sample size to estimate the prevalence of diabetes mellitus at a regional level. The residual amount of heterogeneity was found to be high according to the statistics of τ2 = 0.06; I2 = 99.10%, chi-square = 2184.85, degree of freedom = 19 and P =< 0.001. The pooled depression prevalence was 40% within a 95% confidence interval of 29%–51%. The meta-regression analysis result showed that none of the included moderators contributed to the heterogeneity of studies. The result of effect size estimates against its standard error showed publication bias with a P-value of 0.001. The meta-analysis findings of this study have indicated that depression prevalence in Africa is still high. Reporting on numerous risk factors like socio-demographic characteristics were not possible in this study because of a lack of completeness in the included articles. Consequently, screening diabetes patients for comorbid depression with its associated risk factors is highly recommended.
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Affiliation(s)
- Ropo Ebenezer Ogunsakin
- ICT and Society Research Group, South Africa Luban Workshop, Durban University of Technology, Durban, South Africa
| | - Oludayo O Olugbara
- ICT and Society Research Group, South Africa Luban Workshop, Durban University of Technology, Durban, South Africa
| | - Sibusiso Moyo
- ICT and Society Research Group, South Africa Luban Workshop, Durban University of Technology, Durban, South Africa
| | - Connie Israel
- ICT and Society Research Group, South Africa Luban Workshop, Durban University of Technology, Durban, South Africa
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Badal VD, Nebeker C, Shinkawa K, Yamada Y, Rentscher KE, Kim HC, Lee EE. Do Words Matter? Detecting Social Isolation and Loneliness in Older Adults Using Natural Language Processing. Front Psychiatry 2021; 12:728732. [PMID: 34867518 PMCID: PMC8635064 DOI: 10.3389/fpsyt.2021.728732] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/08/2021] [Indexed: 01/13/2023] Open
Abstract
Introduction: Social isolation and loneliness (SI/L) are growing problems with serious health implications for older adults, especially in light of the COVID-19 pandemic. We examined transcripts from semi-structured interviews with 97 older adults (mean age 83 years) to identify linguistic features of SI/L. Methods: Natural Language Processing (NLP) methods were used to identify relevant interview segments (responses to specific questions), extract the type and number of social contacts and linguistic features such as sentiment, parts-of-speech, and syntactic complexity. We examined: (1) associations of NLP-derived assessments of social relationships and linguistic features with validated self-report assessments of social support and loneliness; and (2) important linguistic features for detecting individuals with higher level of SI/L by using machine learning (ML) models. Results: NLP-derived assessments of social relationships were associated with self-reported assessments of social support and loneliness, though these associations were stronger in women than in men. Usage of first-person plural pronouns was negatively associated with loneliness in women and positively associated with emotional support in men. ML analysis using leave-one-out methodology showed good performance (F1 = 0.73, AUC = 0.75, specificity = 0.76, and sensitivity = 0.69) of the binary classification models in detecting individuals with higher level of SI/L. Comparable performance were also observed when classifying social and emotional support measures. Using ML models, we identified several linguistic features (including use of first-person plural pronouns, sentiment, sentence complexity, and sentence similarity) that most strongly predicted scores on scales for loneliness and social support. Discussion: Linguistic data can provide unique insights into SI/L among older adults beyond scale-based assessments, though there are consistent gender differences. Future research studies that incorporate diverse linguistic features as well as other behavioral data-streams may be better able to capture the complexity of social functioning in older adults and identification of target subpopulations for future interventions. Given the novelty, use of NLP should include prospective consideration of bias, fairness, accountability, and related ethical and social implications.
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Affiliation(s)
- Varsha D Badal
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States
| | - Camille Nebeker
- Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, La Jolla, CA, United States
| | | | | | - Kelly E Rentscher
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Ho-Cheol Kim
- AI and Cognitive Software, IBM Research-Almaden, San Jose, CA, United States
| | - Ellen E Lee
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States.,VA San Diego Healthcare System, La Jolla, CA, United States
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10
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Zhang M, Chen B, Zhong X, Zhou H, Wang Q, Mai N, Wu Z, Chen X, Peng Q, Zhang S, Yang M, Lin G, Ning Y. Neuropsychiatric Symptoms Exacerbate the Cognitive Impairments in Patients With Late-Life Depression. Front Psychiatry 2021; 12:757003. [PMID: 34867543 PMCID: PMC8639522 DOI: 10.3389/fpsyt.2021.757003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/21/2021] [Indexed: 12/27/2022] Open
Abstract
Background: Neuropsychiatric symptoms (NPS) and cognitive impairments are both common in patients with late-life depression (LLD). However, the relationship between NPS and cognitive functions in LLD patients remains unclear. The current study aims to explore the effects of NPS on cognitive impairments in LLD patients. Methods: Two hundred and sixty-two LLD patients and 141 normal controls (NC) were recruited. Exploratory factor analysis was used to extract factors from the Neuropsychiatric Inventory (NPI). Correlation, mediation, and moderation analyses were used to explore whether NPS exacerbated the cognitive impairments in LLD and whether NPS exhibited different effects on cognitive impairments in acute-state LLD (aLLD) and recovery-state LLD (rLLD). Results: Three main factors were extracted from the NPI, including emotional, behavioral, and psychotic factors. The patients with LLD exhibited worse cognition and higher NPI scores, and the scores of NPI-total and three extracted factors were negatively associated with cognitive scores. The mediation analyses exhibited that NPI-total and behavioral factor scores increase the difference in cognition scores between LLD and NC groups. The mediation analyses exhibited that behavioral factor score played a greater effect on impairing MMSE in the rLLD group than in the aLLD group. Additionally, behavioral factor score was in a trend to be negatively associated with Mini-Mental State Examination (MMSE) score changes at a one-year follow-up (p = 0.051). Conclusions: NPS, especially behavioral symptoms, exacerbate cognitive impairments in LLD and may contribute to residual cognitive impairment in rLLD patients. Early intervention for behavioral symptoms in LLD patients may be beneficial to their long-term clinical prognosis.
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Affiliation(s)
- Min Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ben Chen
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaomei Zhong
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Huarong Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qiang Wang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Naikeng Mai
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhangying Wu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xinru Chen
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qi Peng
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Si Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Minfeng Yang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Gaohong Lin
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.,The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
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Kidambi N, Lee EE. Insight into Potential Mechanisms Linking Loneliness and Cognitive Decline: Commentary on "Health Factors as Potential Mediator the Longitudinal Effect of Loneliness on General Cognitive Ability". Am J Geriatr Psychiatry 2020; 28:1284-1286. [PMID: 32950365 PMCID: PMC7452903 DOI: 10.1016/j.jagp.2020.08.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 08/25/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Neha Kidambi
- Department of Psychiatry, University of California San Diego, San Diego, CA (NK, EL)
| | - Ellen E Lee
- Department of Psychiatry, University of California San Diego, San Diego, CA (NK, EL); Sam and Rose Stein Institute for Research on Aging, University of California San Diego, San Diego, CA ( EEL); VA San Diego Healthcare System, La Jolla, CA (EEL).
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12
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Suradom C, Wongpakaran N, Wongpakaran T, Lerttrakarnnon P, Jiraniramai S, Taemeeyapradit U, Lertkachatarn S, Arunpongpaisal S, Kuntawong P. Mediation model of comorbid anxiety disorders in late-life depression. Ann Gen Psychiatry 2020; 19:63. [PMID: 33292322 PMCID: PMC7670777 DOI: 10.1186/s12991-020-00313-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 10/25/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND A number of studies have been conducted on risk factors of comorbid anxiety disorders regarding late-life depression (LLD). This study investigated the associated factors and their relationship to comorbid anxiety disorders in LLD. METHODS Participants included 190 elderly Thais (73.2% female, with a mean age of 68.39 ± 6.74 years) with depressive disorders, diagnosed according to DSM-IV Diagnosis Axis I disorders assessed by Mini-International Neuropsychiatric Interview. Demographic data, medical and psychiatric history, family psychiatric history, past depression, family history of depression, Neuroticism Inventory and 7-Item Hamilton Depression Rating Scale (HAMD-7) were analyzed for path analysis using Structural Equation Model framework. The bootstrapping method was used for testing indirect effects. RESULTS Being female was associated with comorbid anxiety disorders with an indirect effect (β = - 0.032, P = 0.018) through neuroticism, depression severity, history and family history of depression. Family history of depression had no effect on comorbidity (P = 0.090). Neuroticism had an indirect effect on comorbid anxiety disorders (β = 0.075, P = 0.019) via depression severity as reflected by HAMD-7 score (β = 0.412, P = < 0.001). Total variance explained from this model was 11%. This model had good-fit index with Chi-square > 0.05, CFI and TLI > 0.95 and RMSEA < 0.06. CONCLUSION Neuroticism mediates the effect of relationship between sex, family history and history of depressive disorders and comorbid anxiety disorders in LLD. Moreover, depression severity is a mediator for neuroticism and comorbid anxiety disorders. Longitudinal studies are warranted to indicate the importance of effective treatment of depression to lower the risk of developing comorbid anxiety disorders among depressed elderly.
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Affiliation(s)
- Chawisa Suradom
- Geriatric Psychiatry Unit, Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., Chiang Mai, 50200, Thailand
| | - Nahathai Wongpakaran
- Geriatric Psychiatry Unit, Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., Chiang Mai, 50200, Thailand.
| | - Tinakon Wongpakaran
- Geriatric Psychiatry Unit, Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., Chiang Mai, 50200, Thailand
| | - Peerasak Lerttrakarnnon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Surin Jiraniramai
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | | | - Suwanna Arunpongpaisal
- Department of Psychiatry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Pimolpun Kuntawong
- Geriatric Psychiatry Unit, Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., Chiang Mai, 50200, Thailand
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13
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Weitzner D, Calamia M, Stasik-O'Brien SM, De Vito A, Pugh E. Psychometric properties of the expanded version of the inventory of depression and anxiety symptoms (IDAS-II) in a sample of older adults. Aging Ment Health 2020; 24:1847-1853. [PMID: 31264444 DOI: 10.1080/13607863.2019.1636206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Given the strong relationship often found between self-report measures of anxiety and depression, the Inventory of Depression and Anxiety Symptoms (IDAS) was created and then expanded (IDAS-II) to assess common and unique symptom dimensions of these emotional disorders. Limited research has focused on the use of the IDAS-II with older adults and the purpose of the current study was to provide data on the reliability and validity of the IDAS-II in this population.Method: A sample of 323 participants (age 55-80 years) were recruited online using Amazon's Mechanical Turk (MTurk). They completed the IDAS-II and several other self-report questionnaires of internalizing symptoms, including widely used measures developed specifically for older adults. Internal consistency and validity of the IDAS-II were examined.Results: The IDAS-II demonstrated marginal to excellent internal consistency (α = .68-.91). An exploratory factor analysis indicated three factors: Distress, Positive Mood, and Obsessions. The IDAS-II explained a large amount of variance in the other measures of depression and anxiety (ranging from 52% to 76%) and the IDAS-II Dysphoria scale significantly related to all of the other measures of depression and anxiety (ranging from r = .69 to r = .81).Conclusion: These results support the use of the IDAS-II with older adults as it has good convergent validity with other commonly used measures of depression and anxiety, including those commonly used in the assessment of older adults. Further research can use the IDAS-II with both younger and older adults to examine age-related changes in depression and anxiety symptoms.
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Affiliation(s)
- Daniel Weitzner
- Psychology Department, Louisiana State University, Baton Rouge, LA, USA
| | - Matthew Calamia
- Psychology Department, Louisiana State University, Baton Rouge, LA, USA
| | | | - Alyssa De Vito
- Psychology Department, Louisiana State University, Baton Rouge, LA, USA
| | - Erika Pugh
- Psychology Department, Louisiana State University, Baton Rouge, LA, USA
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14
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Rainer C, Nasrouei S, Tschofen S, Bliem HR, Wilhelm FH, Marksteiner J. Fear acquisition and extinction in elderly patients with depression. J Affect Disord 2020; 276:197-204. [PMID: 32697699 DOI: 10.1016/j.jad.2020.06.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/29/2020] [Accepted: 06/16/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Depression in elderly patients is common and characterized by anxiety symptoms and cognitive impairment. To our knowledge, no studies have yet investigated the process of fear extinction in these patients. We investigated fear extinction with a paradigm consisting of habituation, acquisition and extinction. METHODS We included three age matched (mean age: 75.7 years) groups: Late Life Depression (LLD, n = 33), Mild Cognitive Impairment (MCI, n = 39), healthy controls (HC, n = 39). All participants were diagnosed with a standardized procedure including clinical examination, CERAD cognitive test battery, as well as magnetic resonance imaging. Participants underwent a fear conditioning paradigm consisting of habituation, acquisition, and extinction. During acquisition, a neutral face (conditioned stimulus, CS+) was paired with an electrical unconditioned stimulus, whereas another face (safety stimulus, CS-) was unpaired. Conditioned responses were measured by US-expectancy and valence ratings. RESULTS Compared to HC, both patient groups showed a significantly lower, differential (CS+ vs. CS-) fear acquisition across all measurements. Patients with cognitive impairment showed a significantly slower extinction, which is characterized by higher US-expectancy and reduced positive valence for CS+. Fear extinction was significantly less differential (CS+ vs. CS-) in patients with LLD. LIMITATIONS Due to the cross-sectional design we cannot distinguish whether the observed differences in fear extinction are state or trait markers in the LLD patients. CONCLUSIONS In this study, we demonstrate that fear extinction is impaired in elderly patients with depression. These results can have influence on treatment strategies.
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Affiliation(s)
- Christina Rainer
- Department of Psychiatry and Psychotherapy A, State Hospital Hall, Hall, Austria; Department of Psychology, University of Innsbruck, Innsbruck, Austria.
| | - Sarah Nasrouei
- Department of Psychiatry and Psychotherapy A, State Hospital Hall, Hall, Austria; Division of Clinical Psychology, Psychotherapy, and Health Psychology, Department of Psychology, University of Salzburg, Salzburg, Austria
| | - Simon Tschofen
- Department of Psychiatry and Psychotherapy A, State Hospital Hall, Hall, Austria
| | - Harald R Bliem
- Department of Psychology, University of Innsbruck, Innsbruck, Austria
| | - Frank H Wilhelm
- Division of Clinical Psychology, Psychotherapy, and Health Psychology, Department of Psychology, University of Salzburg, Salzburg, Austria
| | - Josef Marksteiner
- Department of Psychiatry and Psychotherapy A, State Hospital Hall, Hall, Austria
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15
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Baroni C, Lionetti V. The impact of sex and gender on heart-brain axis dysfunction: current concepts and novel perspectives. Can J Physiol Pharmacol 2020; 99:151-160. [PMID: 33002366 DOI: 10.1139/cjpp-2020-0391] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The heart-brain axis (HBA) recapitulates all the circuits that regulate bidirectional flow of communication between heart and brain. Several mechanisms may underlie the interdependent relationship involving heterogeneous tissues at rest and during specific target organ injury such as myocardial infarction, heart failure, arrhythmia, stroke, mood disorders, or dementia. In-depth translational studies of the HBA dysfunction under single-organ injury should include both male and female animals to develop sex- and gender-oriented prevention, diagnosis, and treatment strategies. Indeed, sex and gender are determining factors as females and males exhibit significant differences in terms of susceptibility to risk factors, age of onset, severity of symptoms, and outcome. Despite most studies having focused on the male population, we have conducted a careful appraisal of the literature investigating HBA in females. In particular, we have (i) analyzed sex-related heart and brain illnesses, (ii) recapitulated the most significant studies simultaneously conducted on cardio- and cerebro-vascular systems in female populations, and (iii) hypothesized future perspectives for the development of a gender-based approach to HBA dysfunction. Although sex- and gender-oriented research is at its infancy, the impact of sex on HBA dysfunction is opening unexpected new avenues for managing the health of female subjects exposed to risk of lifestyle multi-organ disease.
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Affiliation(s)
- Carlotta Baroni
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Vincenzo Lionetti
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy.,UOS Anesthesiology and Intensive Care Medicine, Fondazione Toscana G. Monasterio, Pisa, Italy
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16
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Prevalence, comorbidity and predictors of anxiety disorders among children and adolescents. Asian J Psychiatr 2020; 53:102059. [PMID: 32512529 DOI: 10.1016/j.ajp.2020.102059] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 03/28/2020] [Accepted: 03/29/2020] [Indexed: 11/22/2022]
Abstract
Childhood anxiety may lead to serious health consequences in later life. The present study provides the prevalence, comorbidity, and predictors of anxiety disorders among children and adolescents. This was a cross-sectional national project that was implemented on 28,698 children and adolescents in Iran. Participants entered the study by multistage cluster sampling with an equal number of each gender and three age groups (6-9, 10-14, and 15-18 years) within each cluster. The tools used in this research were the demographic questionnaire and K-SADS-PL. To analyze the data logistic regression and chi-square tests were used in SPSS (ver. 16). The prevalence of anxiety disorder in children and adolescents was 13.2 in boys and 15.1 in girls. Furthermore, gender, age, place of residence and history of psychiatric hospitalization of parents could predict anxiety disorders. Anxiety disorders had comorbidity with behavioral disorders, neurodevelopmental disorders, mood disorders, psychotic disorders, substance abuse disorders, and elimination disorders. According to our findings in this study, anxiety disorders affect the performance, health and life of children and adolescents, identifying the childhood anxiety, as well as finding diseases that are associated with anxiety disorders, can help in the prevention of the disorder.
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17
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The Prevalence of Depression and Anxiety and Their Lifestyle Determinants in a Large Sample of Iranian Adults: Results from a Population Based Cross-Sectional Study. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2020. [DOI: 10.2478/sjecr-2018-0079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Abstract
Association of lifestyle-related factors and mental health has been less studied in Middle Eastern countries. This study aimed to examine the prevalence of two common mental health problems, i.e., depression and anxiety, and their lifestyle determinants in a large sample of Iranian population.
This study was conducted within the framework of SEPAHAN population based cross-sectional study (N=4763(. The General Practice Physical Activity Questionnaire (GPPAQ) was used to assess physical activity and the Iranian-validated version of Hospital Anxiety and Depression Scale (HADS) was applied to screen for anxiety and depression. Logistic regression was used as the main statistical method for data analysis by SPSS version 16.0. A P-value <0.05 was considered to be statistically significant.
The risk of anxiety and depression was 2.5 (OR=2.56,95% CI: 1.97-3.33) and 2.21(1.83-2.67) times higher in women than men, respectively. With every one-year increase in the age, the risk of anxiety decreased by 2% (OR=0.98,95% CI:0.97-0.99). Individuals with higher education had 56% lower risk of anxiety (OR=0.44,95% CI: 0.36-0.55) and 46% depression (OR=0.54,95% CI: 0.46-0.64) than the undergraduate group, and the risk of depression in the inactive (less than one hour of activity per week) group was 27% higher than the active group (OR=1.27,95% CI: 1.06-1.51). The risk of anxiety in the non-smoker group was 65% (OR=0.35,95% CI: 0.20-0.59) and depression was 64% lower than among smokers (OR=0.34,95% CI:0.22-0.53). In the ex-smoker group, the risk of anxiety was 60% (OR=0.40,95% CI:0.19-0.85) and depression was 59% lower than for the smoker group (OR=0.41,95% CI: 0.24-0.73).
This current study’s results demonstrated significant associations between unhealthy lifestyle factors and increased risk of anxiety and depression. Hence, special attention must be paid to preventive intervention programmes aiming to enhance healthy lifestyle among at-risk populations.
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Braund TA, Palmer DM, Williams LM, Harris AW. Characterising anxiety in major depressive disorder and its use in predicting antidepressant treatment outcome: An iSPOT-D report. Aust N Z J Psychiatry 2019; 53:782-793. [PMID: 30880405 DOI: 10.1177/0004867419835933] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Major depressive disorder commonly co-occurs with one or more anxiety disorders or with clinically significant levels of anxiety symptoms. Although evidence suggests that anxious forms of depression are prognostic of poorer antidepressant outcomes, there is no clear definition of anxious depression, and inferences about clinical outcomes are thus limited. Our objective was to compare and evaluate definitions of anxious depression and anxiety-related scales according to clinical and antidepressant outcome criteria. METHOD A total of 1008 adults with a current diagnosis of single-episode or recurrent, nonpsychotic, major depressive disorder were assessed at baseline on clinical features. Participants were then randomised to one of three antidepressants and reassessed at 8 weeks regarding remission and response of the 17-item Hamilton Rating Scale Depression (HRSD17) and the 16-item Quick Inventory of Depressive Symptomatology (QIDS-SR16). Anxious depression was defined as major depressive disorder with one or more anxiety disorders or major depressive disorder with a HRSD17 anxiety/somatisation factor score ⩾7. Anxiety-related scales included the HRSD17 anxiety/somatisation factor and the 42-item Depression Anxiety Stress Scales (DASS42) anxiety and stress subscales. RESULTS Anxious depression definitions showed poor agreement (κ = 0.15) and the HRSD17 anxiety/somatisation factor was weakly correlated with both DASS42 anxiety (r = 0.24) and stress subscales (r = 0.20). Anxious depression definitions were also associated with few impairments on clinical features and did not predict poorer antidepressant treatment outcome. However, higher DASS42 anxiety predicted poorer HRSD17 and QIDS-SR16 remission, and item-level analysis found higher scores on items 9 (situational anxiety) and 23 (somatic anxiety) of the DASS42 predicted poorer treatment outcome, even after adjusting for covariates and multiple comparisons. CONCLUSION Common definitions of anxious depression show poor agreement and do not predict poorer treatment outcome. Anxiety symptoms may be better characterised dimensionally using DASS42 when predicting treatment outcome.
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Affiliation(s)
- Taylor A Braund
- 1 Brain Dynamics Centre, The Westmead Institute for Medical Research, Sydney, NSW, Australia.,2 Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,3 The Brain Resource Company, Sydney, NSW, Australia
| | - Donna M Palmer
- 1 Brain Dynamics Centre, The Westmead Institute for Medical Research, Sydney, NSW, Australia.,3 The Brain Resource Company, Sydney, NSW, Australia
| | - Leanne M Williams
- 4 Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA.,5 Sierra-Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Anthony Wf Harris
- 1 Brain Dynamics Centre, The Westmead Institute for Medical Research, Sydney, NSW, Australia.,2 Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
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19
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The psychometrics of the Hospital Anxiety and Depression Scale supports a shorter -12 item- version. Psychiatry Res 2019; 274:372-376. [PMID: 30852430 DOI: 10.1016/j.psychres.2019.02.074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 02/27/2019] [Accepted: 02/28/2019] [Indexed: 11/20/2022]
Abstract
The diagnosis of patients suffering from both anxiety and depression is complex due to mixed effects of the two disorders. This complexity has hardened the task to find an adapted treatment for these patients. Consequently, several instruments, known as depression anxiety scales, have been developed and are now used internationally by physicians to determine the diagnosis of anxiety and depression and treat the patients accordingly. This study aims at testing the consistency and reliability of one of the main anxiety and depression scale which is composed of 14 items, the Hospital Anxiety and Depression Scale (HADS). We have used explanatory factor analysis (EFA) and factor extraction by principal component analysis (PCA) with orthogonal varimax (Kaiser Normalization) rotation on a cohort of 9706 French depressed patients. The relevance of the 14 items included in the HADS was also scrutinized by measuring the internal consistency and reliability of the global HADS removing each item one by one. Our conclusion is that the HADS could potentially gain in consistency in the detection of anxiety, notably through the revision of two of the anxiety items.
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20
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Chireh B, Li M, D'Arcy C. Diabetes increases the risk of depression: A systematic review, meta-analysis and estimates of population attributable fractions based on prospective studies. Prev Med Rep 2019; 14:100822. [PMID: 30815337 PMCID: PMC6378921 DOI: 10.1016/j.pmedr.2019.100822] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 01/25/2019] [Accepted: 02/06/2019] [Indexed: 12/27/2022] Open
Abstract
We aim to examine the relationship between diabetes and depression risk in longitudinal cohort studies and by how much the incidence of depression in a population would be reduced if diabetes was reduced. Medline/PubMed, EMBASE, PsycINFO, and Cochrane Library databases were searched for English-language published literature from January 1990 to December 2017. Longitudinal studies with criteria for depression and self-report doctors' diagnoses or diagnostic blood test measurement of diabetes were assessed. Systematic review with meta-analysis synthesized the results. Study quality, heterogeneity, and publication bias were examined. Pooled odds ratios were calculated using random effects models. Population attributable fractions (PAFs) were used to estimate potential preventive impact. Twenty high-quality articles met inclusion criteria and were analyzed. The pooled odds ratio (OR) between diabetes and depression was 1.33 (95% CI, 1.18–1.51). For the various study types the ORs were as follows: prospective studies (OR 1.34, 95% CI 1.14–1.57); retrospective studies (OR 1.30, 95% CI 1.05–1.62); self-reported diagnosis of diabetes (OR 1.37, 95% CI 1.17–1.60); and diagnostic diabetes blood test (OR 1.25, 95% CI 1.04–1.52). PAFs suggest that over 9.5 million of global depression cases are potentially attributable to diabetes. A 10–25% reduction in diabetes could potentially prevent 930,000 to 2.34 million depression cases worldwide. Our systematic review provides fairly robust evidence to support the hypothesis that diabetes is an independent risk factor for depression while also acknowledging the impact of risk factor reduction, study design and diagnostic measurement of exposure which may inform preventive interventions. Depression risk is 1.33 times higher in people with diabetes. Prospective studies likely to report depression incidence Self-reported diabetes diagnoses likely to report depression A 10–25% diabetes reduction could prevent 930,000–2.34 million depression.
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Affiliation(s)
- Batholomew Chireh
- University of Saskatchewan School of Public Health, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Muzi Li
- The Douglas Hospital Research Centre, 6875 boulevard LaSalle, Montreal H4H 1R3, Canada
| | - Carl D'Arcy
- University of Saskatchewan, Department of Psychiatry and, School of Public Health, 103 Hospital drive, Ellis Hall, Room 107, Saskatoon, SK S7N 0W8, Canada
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21
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Suradom C, Wongpakaran N, Wongpakaran T, Lerttrakarnnon P, Jiraniramai S, Taemeeyapradit U, Lertkachatarn S, Arunpongpaisal S. Prevalence and associated factors of comorbid anxiety disorders in late-life depression: findings from geriatric tertiary outpatient settings. Neuropsychiatr Dis Treat 2019; 15:199-204. [PMID: 30662265 PMCID: PMC6328289 DOI: 10.2147/ndt.s184585] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The study evaluated the prevalence of comorbid anxiety disorders in late-life depression (LLD) and identified their associated factors. PATIENTS AND METHODS This study involved 190 elderly Thais with depressive disorders diagnosed according to the Mini-International Neuropsychiatric Interview (MINI). Anxiety disorders were also diagnosed by the MINI. The 7-item Hamilton Depression Rating Scale (HAMD-7), Montreal Cognitive Assessment, Geriatric Depression Scale (GDS), Core Symptoms Index, Neuroticism Inventory, Perceived Stress Scale and Multidimensional Scale for Perceived Social Support were completed. Descriptive statistics and ORs were used for analysis. RESULTS Participants included 139 females (73.2%) with a mean age of 68.39±6.74 years. The prevalence of anxiety disorders was 7.4% for generalized anxiety disorder (GAD), 4.7% for panic disorder, 5.3% for agoraphobia, 1.1% for social phobia, 2.1% for obsessive-compulsive disorder and 3.7% for post-traumatic stress disorder, with an overall prevalence of 16.84%. The comorbidity of anxiety disorders was associated with gender (P=0.045), history of depressive disorder (P=0.040), family history of depressive disorder (P=0.004), GDS (P=0.037), HAMD-7 (P=0.001), suicidality (P=0.002) and neuroticism (P=0.003). History of alcohol use was not associated. CONCLUSION The prevalence of anxiety in LLD was comparable to other studies, with GAD and agoraphobia being the most prevalent. This study confirmed the role of depression severity and neuroticism in developing comorbid anxiety disorders.
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Affiliation(s)
- Chawisa Suradom
- Geriatric Psychiatry Unit, Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand,
| | - Nahathai Wongpakaran
- Geriatric Psychiatry Unit, Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand,
| | - Tinakon Wongpakaran
- Geriatric Psychiatry Unit, Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand,
| | - Peerasak Lerttrakarnnon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Surin Jiraniramai
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | | | - Suwanna Arunpongpaisal
- Department of Psychiatry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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22
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Blanchard D, Meyza K. Risk assessment and serotonin: Animal models and human psychopathologies. Behav Brain Res 2019; 357-358:9-17. [DOI: 10.1016/j.bbr.2017.07.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 05/19/2017] [Accepted: 07/07/2017] [Indexed: 02/08/2023]
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Wang W, Wu Q, Yang X, He X, An X. Migrant elders in Hainan, China, report better health and lower depression than local-born elderly residents. Ann Hum Biol 2017; 44:622-627. [PMID: 28952360 DOI: 10.1080/03014460.2017.1377289] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND The number of migrant elders is increasing due to ageing of the global population and increasing life expectancy. There is accumulating evidence of the impact of internal or international migration on health. AIM To compare the health and depression of local and migrant elders in Hainan province. SUBJECTS AND METHODS Health and depression were assessed by the Self-Rated Health Measurement Scale Version 1.0 (SRHMS V1.0) and the Geriatric Depression Scale (GDS), respectively. The relationship between health and depression was investigated, along with the three sub-scales of SRHMS and the potential independent variables. RESULTS In total, 564 valid questionnaires were returned. Migrant elders were younger, had higher education levels and monthly income, and lower prevalence rates of chronic diseases than the local elders. The SRHMS scores were significantly higher, while the GDS scores were statistically lower in the migrant elders than the locals. Depression was negatively correlated with health (r = -0.674, p = 0.0000). Moreover, the three sub-scales of SRHMS were correlated with age, birth place, marital status, chronic diseases, GDS and/or educational level. CONCLUSION Migrant elders self-reported better health and lower depression compared to the local elders. Differences in age, education, monthly income and chronic diseases might be influencing factors.
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Affiliation(s)
- Wei Wang
- a Department of Nursing , Haikou People's Hospital & Central South University, Xiangya School of Medicine Affiliated Haikou Hospital , Haikou , PR China
| | - Qingxia Wu
- a Department of Nursing , Haikou People's Hospital & Central South University, Xiangya School of Medicine Affiliated Haikou Hospital , Haikou , PR China
| | - Xiaoyang Yang
- b Department of Hematology , Haikou People's Hospital, Central South University, Xiangya School of Medicine Affiliated Haikou Hospital , Haikou , PR China
| | - Xin He
- c Department of Nursing , Qionghai People's Hospital , Qionghai , PR China
| | - Xuefang An
- d Department of Neurology , Haikou People's Hospital & Central South University, Xiangya School of Medicine Affiliated Haikou Hospital , Haikou , PR China
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Maeng LY, Milad MR. Sex differences in anxiety disorders: Interactions between fear, stress, and gonadal hormones. Horm Behav 2015; 76:106-17. [PMID: 25888456 PMCID: PMC4823998 DOI: 10.1016/j.yhbeh.2015.04.002] [Citation(s) in RCA: 228] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Revised: 03/26/2015] [Accepted: 04/06/2015] [Indexed: 12/22/2022]
Abstract
This article is part of a Special Issue "SBN 2014". Women are more vulnerable to stress- and fear-based disorders, such as anxiety and post-traumatic stress disorder. Despite the growing literature on this topic, the neural basis of these sex differences remains unclear, and the findings appear inconsistent. The neurobiological mechanisms of fear and stress in learning and memory processes have been extensively studied, and the crosstalk between these systems is beginning to explain the disproportionate incidence and differences in symptomatology and remission within these psychopathologies. In this review, we discuss the intersect between stress and fear mechanisms and their modulation by gonadal hormones and discuss the relevance of this information to sex differences in anxiety and fear-based disorders. Understanding these converging influences is imperative to the development of more effective, individualized treatments that take sex and hormones into account.
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Affiliation(s)
- Lisa Y Maeng
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Charlestown, MA 02129, USA.
| | - Mohammed R Milad
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Charlestown, MA 02129, USA.
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Abstract
Anxiety is an adaptive human experience that may occur at all ages and serves to help draw attention to, avoid or cope with immanent threat and danger. Given its evolutionary importance, it has strong genetic and biological underpinnings, and when it serves that adaptive function for the organism, anxiety may be viewed as useful. However, complex adaptive systems, such as our adaptation to threat or stress, by definition provide many and often interrelated points of breakdown or dysregulation, which, if sustained, may lead to psychopathology. Anxiety has been described as a common currency for psychopathology, indicating that it is a first line and universal way for us to respond to stress and threat. It is more or less prominent in patients diagnosed with practically all psychiatric or neurodegenerative disorders. This has lead to the inclusion of anxiety as a cross-cutting symptom measure in the development of DSM-5 (APA, 2013). Given that they are rooted in a complex adaptive system that has many potential points of impact to develop pathology, it is not surprising that anxiety disorders are extremely heterogeneous. This heterogeneity of anxiety disorders pertains to symptomatology, etiology and outcomes, and poses great challenges to both research and clinical practice.
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Smulevich AB, Briko NI, Andryushchenko AV, Romanov DV, Shuliak YA, Brazhnikov АY, Gerasimov AN, Melik-Pashaian AE, Mironova EV, Pushkarev DF. [Comorbidity of depression and nonaffective - schizophrenia spectrum disorders: the clinical-epidemiological study EDIP]. Zh Nevrol Psikhiatr Im S S Korsakova 2015; 115:6-19. [PMID: 26978259 DOI: 10.17116/jnevro20151151126-19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
AIM To explore the association between depression and heterogenic nonaffective symptom complexes in the study EDIP (Epidemiology of Depression and nonaffective Psychiatric disorders). MATERIAL AND METHODS The study consisted of two stages. The first stage (91 patients) aimed to resolve organizational and methodological issues, the second stage was performed in the epidemiological sample of 705 patients. RESULTS AND CONCLUSION The heterogeneity (inequivalence and bidirectionality) of associations between depression and heteronomous nonaffective disorders have been identified. The associations are distinguished in three types: 1) affinity (agonism); 2) repulsion (antagonism); 3) lack of selective interaction (inertness) between depression and nonaffective disorders. The results obtained are discussed in a context of two conceptually polar psychopathological models of comorbidity between depression and nonaffective disorders: 1) based on a nosological dichotomy «affective disease - schizophrenia» and 2) denying the abovementioned dichotomy. The first model places depression among disorders of a mild psychiatric register. The second model supposes the integration of depression with syndromes typical for schizophrenia in a common "affect-symptoms" space and considers the increase of depression frequency proportionally to duration and severity of schizophrenia. Our own results have shown that depression is observed not only among disorders of mild psychiatric registers, but also in schizophrenia, though with a significantly lower frequency (as a nonobligatory compound of a syndrome). Thus, depression influence in comorbid delusional, schizophrenic and other severe nonaffective disorders is greatly diminished.
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Affiliation(s)
- A B Smulevich
- Sechenov First Moscow State Medical University, Moscow; Mental Health Research Centre, Moscow
| | - N I Briko
- Sechenov First Moscow State Medical University, Moscow
| | | | - D V Romanov
- Sechenov First Moscow State Medical University, Moscow; Mental Health Research Centre, Moscow
| | | | | | - A N Gerasimov
- Sechenov First Moscow State Medical University, Moscow
| | | | - E V Mironova
- Heratsi Yerevan State Medical University, Yerevan, Armenia
| | - D F Pushkarev
- Sechenov First Moscow State Medical University, Moscow
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