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Lawrence BJ, Jayakody DMP, Bennett RJ, Eikelboom RH, Gasson N, Friedland PL. Hearing Loss and Depression in Older Adults: A Systematic Review and Meta-analysis. THE GERONTOLOGIST 2019; 60:e137-e154. [DOI: 10.1093/geront/gnz009] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Indexed: 12/31/2022] Open
Abstract
AbstractBackground and ObjectivesStudies reporting an association between hearing loss and depression in older adults are conflicting and warrant a systematic review and meta-analysis of the evidence.Research Design and MethodsA search of academic databases (e.g., MEDLINE) and gray literature (e.g., OpenGrey) identified relevant articles published up to July 17, 2018. Cross-sectional or cohort designs were included. Outcome effects were computed as odds ratios (ORs) and pooled using random-effects meta-analysis (PROSPERO: CRD42018084494).ResultsA total of 147,148 participants from 35 studies met inclusion criteria. Twenty-four studies were cross-sectional and 11 were cohort designs. Overall, hearing loss was associated with statistically significantly greater odds of depression in older adults (OR = 1.47, 95% confidence interval [CI] = 1.31−1.65). When studies were stratified by design, hearing loss was associated with greater odds of depression in cross-sectional studies (OR = 1.54, 95% CI = 1.31−1.80) and cohort studies (OR = 1.39, 95% CI = 1.16 − 1.67), and there was no difference between cross-sectional or cohort effect estimates (Q = 0.64, p = .42). There was no effect of moderator variables (i.e., hearing aid use) on the association between hearing loss and depression, but these findings must be interpreted with caution. There was no presence of publication bias but certainty in the estimation of the overall effect was classified as “low.”Discussion and ImplicationsOlder adults may experience increased odds of depression associated with hearing loss, and this association may not be influenced by study or participant characteristics.
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Affiliation(s)
- Blake J Lawrence
- Ear Science Institute Australia, Subiaco, Western Australia, Crawley, Australia
- Ear Sciences Centre, Faculty of Health and Medical Sciences, The University of Western Australia, Crawley, Australia
| | - Dona M P Jayakody
- Ear Science Institute Australia, Subiaco, Western Australia, Crawley, Australia
- Ear Sciences Centre, Faculty of Health and Medical Sciences, The University of Western Australia, Crawley, Australia
| | - Rebecca J Bennett
- Ear Science Institute Australia, Subiaco, Western Australia, Crawley, Australia
- Ear Sciences Centre, Faculty of Health and Medical Sciences, The University of Western Australia, Crawley, Australia
| | - Robert H Eikelboom
- Ear Science Institute Australia, Subiaco, Western Australia, Crawley, Australia
- Ear Sciences Centre, Faculty of Health and Medical Sciences, The University of Western Australia, Crawley, Australia
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
| | - Natalie Gasson
- School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University, Bentley, Western Australia
| | - Peter L Friedland
- Ear Science Institute Australia, Subiaco, Western Australia, Crawley, Australia
- Ear Sciences Centre, Faculty of Health and Medical Sciences, The University of Western Australia, Crawley, Australia
- Department of Otolaryngology Head Neck Skull Based Surgery, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- School of Medicine, Notre Dame University, Fremantle, Western Australia, Australia
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Iacovino JM, Jackson JJ, Oltmanns TF. The relative impact of socioeconomic status and childhood trauma on Black-White differences in paranoid personality disorder symptoms. JOURNAL OF ABNORMAL PSYCHOLOGY 2015; 123:225-30. [PMID: 24661172 DOI: 10.1037/a0035258] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The current study examines mechanisms of racial differences in symptoms of paranoid personality disorder (PPD) in a sample of adults ages 55-64 from the St. Louis, MO area. Socioeconomic status (SES) and childhood trauma were tested as intervening variables in the association between race and PPD symptoms using structural equation modeling. PPD symptoms were modeled as a latent variable composed of items from the PPD scales of the Multi-Source Assessment of Personality Pathology self and informant reports and the Structured Interview for the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) Personality. Childhood trauma was measured using the Traumatic Life Events Questionnaire, and SES was a composite of parent education, participant education, and annual household income. Blacks exhibited higher levels of PPD symptoms across the 3 personality measures, reported significantly lower SES, and reported greater childhood trauma. The proposed model was a good fit to the data, and the effect of race on PPD symptoms operated mainly through SES. The indirect effect through SES was stronger for males. Findings suggest that racial differences in PPD symptoms are partly explained by problems more commonly experienced by Black individuals.
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Sharifi V, Bakhshaie J, Hatmi Z, Faghih-Nasiri L, Sadeghianmehr Z, Mirkia S, Darbooy S, Effatpanah M, Mirsharifa SM. Self-reported psychotic symptoms in the general population: correlates in an Iranian urban area. Psychopathology 2012; 45:374-80. [PMID: 22854278 DOI: 10.1159/000337749] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Accepted: 02/25/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND Psychosis exists in the community as a continuum of severity. Here, we examine the correlates of self-reported psychotic symptoms in an urban catchment area of Iran. SAMPLING AND METHODS Two thousand one hundred and fifty-eight participants (age 18-65 years) residing in southern Tehran (the capital city of Iran) were interviewed using the psychoticism and paranoia dimensions of the Symptom Checklist-90-Revised (SCL-90-R) to assess the severity of psychotic symptoms. Other dimensions of the SCL-90-R assessing nonpsychotic symptoms and a sociodemographic questionnaire were also used. Paykel's Interview for Recent Life Events was used to assess stressful life events. RESULTS Independent associations were observed between younger age, female gender, stressful life events and dimensions of depression, anxiety, hostility, obsessive-compulsive symptoms and interpersonal sensitivity and psychoticism. Independent associations were also observed for marital problems, unemployment, stressful life events and dimensions of depression, anxiety, hostility, interpersonal sensitivity and phobic anxiety with paranoid ideation. There was also a trend toward an association between higher educational levels and the severity of psychotic symptoms, particularly paranoid ideation. CONCLUSIONS Most of the previously accepted correlations for psychotic symptoms in the community were replicated. An unexpected association between paranoia and female gender, and a trend toward higher rates of psychotic symptoms in more educated participants, were in contrast with the studies in developed settings. The insufficient coverage of psychosis-relevant questions from the SCL-90-R for the entire psychotic diagnostic spectrum should be considered a limitation.
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Affiliation(s)
- Vandad Sharifi
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Böwing G, Schmidt KUR, Juckel G, Schröder SG. [Psychosis in elderly post-traumatic stress disorder patients]. DER NERVENARZT 2007; 79:73-9. [PMID: 17962915 DOI: 10.1007/s00115-007-2359-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Late-onset post-traumatic stress disorder (PTSD) patients with traumatic experiences from World War II often present psychotic features. METHODS Twelve psychotic elderly PTSD patients were compared with 22 nonpsychotic elderly PTSD patients for age, marital status, age of traumatization, age of onset of psychiatric symptoms, and psychiatric comorbidities. The contents of delusions and hallucinations were registered as well as trauma details. RESULTS The psychotic PTSD patients were significantly older (80 years vs 74), later traumatized (20 years vs 14), more frequently demented (75% vs 27%), and more frequently widowed (83% vs 50%). The contents of their psychotic features often were related to traumatic experiences in early life. CONCLUSIONS Psychoses of traumatized elderly patients should be registered regarding psychotic content to discover a possible relation between traumatic experiences and psychosis. The International Classification of Diseases 11th Edition should include the subtype "PTSD with simultaneous psychotic features."
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Affiliation(s)
- G Böwing
- Klinik für Psychiatrie und Psychotherapie Röbel, MediClin Müritz-Klinikum GmbH, Stadtgarten 15, 17207, Röbel.
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Abstract
Stigmatization in research sustains the spread of the silent epidemic of Alzheimer's disease (AD) in African American populations. Researchers use stereotypes and inappropriate assumptions to select a paradigm to examine the symptoms of AD. This paradigm fails to encompass the symptoms as manifested by African American elders. Yet, stigmatization can be minimized by recognizing the genetic heterogeneity of the symptoms within the general population, especially those manifested by African American elders. Thus, researchers can utilize pioneering genetic analyses to identify other paradigms critical in the assessment and proactive treatment of the symptoms of AD needed for this vulnerable population.
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Kales HC, Valenstein M. Complexity in late-life depression: impact of confounding factors on diagnosis, treatment, and outcomes. J Geriatr Psychiatry Neurol 2003; 15:147-55. [PMID: 12230085 DOI: 10.1177/089198870201500306] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Late-life depression is a heterogeneous syndrome. Although depression in elderly patients is highly treatable, a number of factors or confounds create complexity in its overall management. Patient factors, such as medical illness, neuropsychiatric comorbidity, and race, may interact with provider factors to make management more complex. Outcomes and services research indicate that these factors, particularly medical illness, affect whether late-life depression is appropriately detected, diagnosed, and treated. Attention to such factors must be included in an agenda for mental health services research, with emphasis on the delivery of effective treatment to elderly patients with depression and improved outcomes in clinical settings.
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Affiliation(s)
- Helen C Kales
- Department of Psychiatry, University of Michigan, Ann Arbor Veterans Affairs Medical Center 48105, USA
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