Occurrence of symptoms and depressive mood among working-aged coronary heart disease patients

Associations between education levels and prevalence of depressive symptoms: NHANES (2005-2018)

PURPOSE

Our study investigated the relationships between the prevalence of depressive symptoms and education levels in those aged ≥20 years.

METHODS

A total of 34,102 participants from the National Health and Nutrition Examination Surveys 2005-2018 were involved in our cross-sectional study. The relations of depressive symptoms (as outcome variable) and education levels (as an independent variable) were analyzed using multivariable logistic regression models in the main analyzes. Sensitivity analyzes, including a multiple sensitivity analysis, were also performed.

RESULT

The education levels were negatively associated with depressive symptoms after adjusting related covariates. Compared with the reference group of individuals with less than 9th grade, people with college graduate or above had an adjusted odds ratio (OR) of 0.464 (95% CI 0.361, 0.595, P < 0.0001). On the other hand, the statistically significant negative association disappeared among Mexican Americans, other races, separated, and high family poverty income ratio group. These results remained stable under a wide range of sensitivity analyzes.

CONCLUSION

Our study indicated the elevated education levels correlated with the decreased prevalence of depressive symptoms, and race, marital status, and family economic factors played a critical role in the relationship. This report reminds us to pay close attention to the further study of factors that affected the association between depressive symptoms and education levels.

LIMITATIONS

The cross-sectional study leaves problems about the direction of causality unclear.

Co-occurring mental health and alcohol misuse: dual disorder symptoms in combat injured veterans

OBJECTIVE

Service members face difficulties during military deployment potentially resulting in morbidities such as posttraumatic stress disorder (PTSD), depression, and alcohol misuse. The co-occurrence of alcohol misuse and mental health disorders is termed dual disorder and has been associated with adverse outcomes.

METHODS

The study included 812 high-risk (i.e., endorsing combat exposure with documented combat injury) male U.S. veterans of Operation Iraqi Freedom, injured between October 2004 and November 2007, identified from the Expeditionary Medical Encounter Database.

RESULTS

PTSD and depression symptoms were significant correlates of alcohol misuse. Veterans with dual disorder symptoms reported a significantly higher mean number of health complaints on the Post-Deployment Health Reassessment compared with those endorsing only mental health symptoms.

CONCLUSIONS

These results highlight how mental health disorders among injured service members increases the odds of problem drinking and those with dual disorder have elevated health complaints.

[Patients' symptoms before a first hospitalization due to Acute Coronary Syndrome]

The objective of this study was to characterize and compare patients regarding their report of experiencing chest pain, dyspnea and limitation of the daily life activities one week before their first hospitalization due to Acute Coronary Syndrome, according to the clinical presentation form, and compare them. This is a cross-sectional, descriptive and correlational study. A clinical evaluation instrument was used to investigate the presence and severity of dyspnea, chest pain and physical restriction due to myocardial ischemia. Regarding the limitation to carry out physical activities, patients diagnosed with unstable angina showed lower capacity the week before hospitalization, and reported experiencing dyspnea and chest pain more frequently than patients who had an infarction in situations ranging from making strong efforts, such as walking uphill or on a flat surface but very quickly, to resting and in situations of little effort.

Quality of life three years after major lower extremity amputation due to peripheral arterial disease

BACKGROUND AND AIMS

The purpose of this study was to assess the quality of life (QoL) of peripheral arterial disease (PAD) amputees.

PATIENTS AND METHODS

Fifty-nine PAD patients (mean age 75.2, SD 10.7, range 39-96, 47% men) who had undergone their first major lower leg amputation (LEA) on average 2.7 years earlier (in 1998-2002) were interviewed, and 118 age- and gender-matched controls completed a postal questionnaire. Outcomes were assessed with 15D Health-Related QoL instrument, Rand-36 Physical Functioning- and General Health subscales, Geriatric Depression Scale, 6-item Brief Social Support Questionnaire, and Self-reported Life Satisfaction score.

RESULTS

The amputees had more diseases than their controls. HRQoL was lower among amputees than among controls. Half the amputees lived in institutional care, 25% had a Mini-Mental Examination score <18, and 22% had unilateral belowknee amputations only. The amputees had a similar self-assessed sense of their general state of health, life satisfaction and perceived social support as controls. Amputees who were institutionalized and those who did not use prostheses had more symptoms of depression than those who lived at home or used prostheses.

CONCLUSION

Home-dwelling amputees had a relatively good QoL, whereas institutionalization was associated with depressive symptoms. In rehabilitation programs, not only physical disability assessment but also QoL should be considered.

Anxiety and depressive disorders in patients presenting with chest pain to the emergency department: a comparison between cardiac and non-cardiac origin

OBJECTIVE

The aim of this study was to determine the prevalence of anxiety and depressive disorders in patients presenting with chest pain to the Emergency Department (ED) and determine if there is a relationship between these and cardiac vs. non-cardiac chest pain.

METHODS

This prospective cross-sectional study was performed in an urban tertiary care hospital between March and October 2005. Consecutive patients presenting with chest pain were enrolled in the study. The prevalence of anxiety and depressive disorders in patients with chest pain were determined by using the Hospital Anxiety and Depression Scale.

RESULTS

A total of 324 patients presented to the ED with chest pain during the study period. The mean age of the patients studied was 50.5 +/- 14 years; 67% were men and 33% were women. Of the 324 study patients, 194 (59.9%) patients were diagnosed with non-cardiac chest pain, 16 (4.9%) with stable angina, 84 (25.9%) with unstable angina, and 30 (9.3%) with acute myocardial infarction. No statistically significant differences were determined between patients with cardiac and non-cardiac chest pain both for anxiety (40% vs. 38.1%, respectively; p = 0.737) and depressive disorders (52.3% vs. 52.1%, respectively; p = 0.965).

CONCLUSION

Anxiety and depressive disorders are common among patients presenting with chest pain to the ED. However, the prevalence of anxiety and depressive disorders is similar between patients with chest pain of cardiac and non-cardiac origin. Chest pain should not be attributed to an anxiety or depressive disorder before organic etiologies are excluded.