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Li J, Wang Q, Zhou X. Diversity of purposes of use, time spent online, and depression among older Chinese Internet users. Aging Ment Health 2024:1-9. [PMID: 38436261 DOI: 10.1080/13607863.2024.2323953] [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: 12/11/2022] [Accepted: 02/20/2024] [Indexed: 03/05/2024]
Abstract
Objectives: Previous studies on the associations between Internet use and older people's depression have mostly focused on single types of online activities, especially online social engagement. The current study investigated the diversity of purposes of Internet use and its interaction with the time spent online in shaping older Chinese Internet users' depression. Method: A sample of 974 Internet users aged 60 and above was adopted from the 2020 China Family Panel Studies wave. We adopted a latent class analysis (LCA) to explore the diverse purposes of internet usage. Results: The participants were classified into three distinct types: socializers, basic users, and maximizers. Basic users and maximizers use the Internet for various purposes, despite different intensities; socializers use the Internet only to keep connected with families and friends. Compared with basic users and maximizers, a longer time spent online among socializers was significantly associated with a higher level of depression. Conclusion: This study calls for a closer examination of online profiles among older Internet users; more attention should be paid to the potential harms of excessive Internet use for social reasons only among older adults. Practitioners should enhance older Internet users' digital literacy to maximize the wide-range benefits of Internet use and reduce potential health inequality.
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Affiliation(s)
- Jia Li
- Department of Social Work, Faculty of Social Science, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Qi Wang
- School of Graduate Studies, Lingnan University, Tuen Mun, Hong Kong
| | - Xiaochen Zhou
- Department of Social Work and Social Administration, The University of Hong Kong, Pok Fu Lam, Hong Kong
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Chen J, Yu G, Li W, Yang C, Ye X, Wu D, Wang Y, Du W, Xiao Z, Zeng S, Luo H, Li X, Wu Y, Liu S. A situational analysis of human resource and non-communicable diseases management for community health workers in Chengdu, China: a cross-sectional study. BMC Health Serv Res 2023; 23:1097. [PMID: 37833662 PMCID: PMC10576308 DOI: 10.1186/s12913-023-09880-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 08/07/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Non-communicable diseases (NCDs) pose a major challenge to health economic cost and residents' health status. Community health workers (CHWs) are the gatekeeper of primary health care. OBJECTIVE This study aimed to conduct a situational analysis of current human resource and requirements of NCDs-related training among CHWs in Chengdu with regard to address to understand the suggestions for improvement of challenges and barriers. METHODS A descriptive online cross-sectional survey was conducted among CHWs (doctors and nurses) from 23 districts and counties in Chengdu. Sociodemographic and NCDs-related variables were collected. Univariate analysis and multiple response analysis were used to describe the characteristics of these variables. RESULTS 711 doctors and 637 nurses completely responded. There were significant differences among gender, age, educational levels, professional title, working year, type of institution, urban circle and registration in general practice between doctors and nurses (P < 0.001). 60.6% of doctors were female, compared to 98.0% for nurses. 58.2% of doctors held a bachelor's degree compared with 45.4% of nurses, while 48.3% of nurses held a junior college degree compared with 25.7% of doctors. Higher levels of professional title and registration in general practice were found in doctors compared with nurses. The proportions of NCDs' category, NCDs-related roles and tasks, NCDs-related training contents and forms that CHWs have attend and hoped to gain more were significantly different between doctors and nurses (P < 0.001). In general, the proportions in nurses were much lower than those of doctors (P < 0.05). The top five diseases managed by CHWs were hypertension, diabetes, cerebrovascular disease, chronic respiratory diseases and mental diseases. The five most reported roles performed among doctors included the distribution of health education (91.4%), following up (85.9%), establishing archives (71.3%), medicine adjustment (64.7%) and treatment implementation (52.0%). The top three diseases managed by nurses were same with doctors. The top four and five tasks were contact with patients or health services (39.6%) and referral (16.6%) in nurses. Most CHWs had received primary and common diseases-related trainings, but they had few opportunities to study in a tertiary hospital (40.4% in doctors and 20.9% in nurses, respectively), attend domestic academic conferences (26.9% in doctors vs. 9.7% in nurses), and take part in training courses (44.9% in nurses). CHWs hoped that the above-discussed training contents and forms could be provided more in the future. Besides basic skills related trainings, some specific skills related trainings should be strengthened. CONCLUSION The qualifications in doctors were much better than those of nurses. The roles performed by CHWs in NCDs management are varied form common and frequent disease management to subsequent follow up and supervision. CHWs hope to receive more desired and oriented trainings. There is a need for building capacity of CHWs, optimizing and defining CHWs' role, facilitating postgraduate medical education support and strengthening multidisciplinary collaboration would be effective in NCDs management.
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Affiliation(s)
- Jinhua Chen
- Department of General Practice, Chengdu first people's hospital, Chengdu, 610041, China
| | - Guo Yu
- Department of General Practice, Chengdu first people's hospital, Chengdu, 610041, China
| | - Wei Li
- Department of General Practice, Chengdu first people's hospital, Chengdu, 610041, China
| | - Chunyan Yang
- Department of General Practice, Chengdu first people's hospital, Chengdu, 610041, China
| | - Xiaoping Ye
- Department of General Practice, Chengdu first people's hospital, Chengdu, 610041, China
| | - Dan Wu
- Department of General Practice, Chengdu first people's hospital, Chengdu, 610041, China
| | - Yijun Wang
- Department of General Practice, Chengdu first people's hospital, Chengdu, 610041, China
| | - Wen Du
- Department of General Practice, Chengdu first people's hospital, Chengdu, 610041, China
| | - Zhu Xiao
- Department of General Practice, Chengdu first people's hospital, Chengdu, 610041, China
| | - Shuqin Zeng
- Shiyang Community Health Service Center, Chengdu Hi-tech Zone, Chengdu, 610041, China
| | - Honglin Luo
- Zhonghe Community Health Service Center, Chengdu Hi-tech Zone, Chengdu, 610041, China
| | - Xiuhua Li
- Guixi Community Health Service Center, Chengdu Hi-tech Zone, Chengdu, 610041, China
| | - Yuelei Wu
- Department of General Practice, Chengdu first people's hospital, Chengdu, 610041, China.
| | - Shuyi Liu
- Department of General Practice, Chengdu first people's hospital, Chengdu, 610041, China.
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Zhu Z, Qi X, Pei Y, Wang J, Wu B. Longitudinal relationships in the psychopathology of depressive symptoms in middle-aged and older adults in China. Aging Ment Health 2023; 27:1692-1701. [PMID: 36597893 PMCID: PMC10318117 DOI: 10.1080/13607863.2022.2164253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/07/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To develop symptom networks and examine the longitudinal relationships of depressive symptoms among middle-aged and older adults in China. METHOD This study used three-wave data from the China Health and Retirement Longitudinal Study (2013 (T1), 2015 (T2), and 2018 (T3)). Depressive symptoms were measured by the 10-item Center for Epidemiologic Studies Depression Scale (CES-D). A multilevel vector autoregression model (VAR) was used to identify ten depressive symptoms dynamically interacting with each other over time. RESULTS A total of 3,558 participants were included in the final analysis. The strongest direct effects were 'D10: felt fearful' -> 'D6: felt everything I did was an effort' (β = 0.14). 'D10: felt fearful' reported the largest value of out-predictability (r = 0.064) and out-strength (r = 0.635). 'D3: felt depressed' reported the largest value of in-predictability (r = 0.077) and in-strength (r = 0.545). Substantial heterogeneity in the network may stem from an individual's sex and place of residence. CONCLUSIONS 'Felt fearful' was the strongest predictor compared to the other nine depressive symptoms based on node centrality. Our study suggests that, after understanding the causes of fear, strategies to reduce fear should be incorporated into multimodal interventions for middle-aged and older adults with depressive symptoms.
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Affiliation(s)
- Zheng Zhu
- Rory Meyers College of Nursing, New York University, New York, NY, USA
- School of Nursing, Fudan University, Shanghai, China
| | - Xiang Qi
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Yaolin Pei
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Jing Wang
- School of Nursing, Fudan University, Shanghai, China
- School of Nursing, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, NY, USA
- NYU Aging Incubator, New York University, New York, NY, USA
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Possidente C, Fanelli G, Serretti A, Fabbri C. Clinical insights into the cross-link between mood disorders and type 2 diabetes: A review of longitudinal studies and Mendelian randomisation analyses. Neurosci Biobehav Rev 2023; 152:105298. [PMID: 37391112 DOI: 10.1016/j.neubiorev.2023.105298] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/15/2023] [Accepted: 06/26/2023] [Indexed: 07/02/2023]
Abstract
Mood disorders and type 2 diabetes mellitus (T2DM) are prevalent conditions that often co-occur. We reviewed the available evidence from longitudinal and Mendelian randomisation (MR) studies on the relationship between major depressive disorder (MDD), bipolar disorder and T2DM. The clinical implications of this comorbidity on the course of either condition and the impact of antidepressants, mood stabilisers, and antidiabetic drugs were examined. Consistent evidence indicates a bidirectional association between mood disorders and T2DM. T2DM leads to more severe depression, whereas depression is associated with more complications and higher mortality in T2DM. MR studies demonstrated a causal effect of MDD on T2DM in Europeans, while a suggestive causal association in the opposite direction was found in East Asians. Antidepressants, but not lithium, were associated with a higher T2DM risk in the long-term, but confounders cannot be excluded. Some oral antidiabetics, such as pioglitazone and liraglutide, may be effective on depressive and cognitive symptoms. Studies in multi-ethnic populations, with a more careful assessment of confounders and appropriate power, would be important.
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Affiliation(s)
- Chiara Possidente
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giuseppe Fanelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
| | - Chiara Fabbri
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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祝 春, 连 至, 崔 一. [Association between depression and chronic diseases among middle-aged and older Chinese adults]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2023; 55:606-611. [PMID: 37534639 PMCID: PMC10398761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Indexed: 08/04/2023]
Abstract
OBJECTIVE To examine the association between depressive symptoms and chronic diseases among middle-aged and older Chinese adults within a national investigation. METHODS Data used in current analysis were obtained from a nationally representative, cross-sectional population-based survey of China health and retirement longitudinal study, which were conducted in 2011 using four-stage probability-proportional-to-size sampling methods. A total of 10 420 participants who were aged 45 years and above from 28 provinces in mainland China were included. Information on demographic characteristics (e.g., age, gender, education level), lifestyle factors (e.g., smoking status and drinking frequency) and chronic diseases (e.g., hypertension, diabetes, and stroke) were collected by well-trained interviewers at the interviewees' homes using a standardized questionnaire. Depressive symptoms were measured using the 10-item version of the center for epidemiological studies depression scale (CESD-10, which was a widely used standard tool in Chinese population, and elevated depressive symptoms were defined by a cut-off ≥10. Multivariate Logistic regression analysis was carried out to assess the association between depressive symptoms and chronic diseases (including hypertension, diabetes, heart disease, dyslipidemia and stroke), adjusting for age, gender, education level, marital status, ethnicity, place of residence, bady mass index (BMI) and other potential confounding factors. RESULTS Among the 10 420 participants, the mean age was (59.2±9.4) years, and 48.2% of them were men. There were 3 900 (37.4%) participants who had a depression rating score of 10 or greater, indicative of elevated depressive symptoms. The results of multivariate Logistic regression analysis demonstrated that diabetes (OR=1.230, 95%CI: 1.080-1.401), hypertension (OR=1.335, 95%CI: 1.205-1.480), heart disease (OR=1.953, 95%CI: 1.711-2.229), and stroke (OR=2.269, 95%CI: 1.704-3.020) were significantly associated with depressive symptoms (P < 0.05), after full adjustment of age, gender, education level, marital status, ethnicity, residency and other potential confounders. While no significant relationship was found between dyslipidemia and depressive symptoms (P>0.05). The prevalence of elevated depressive symptoms increased parallel with the number of chronic diseases (Ptrend < 0.001). CONCLUSION Depressive symptoms were significantly associated with chronic diseases (including diabetes, hypertension, heart disease, and stroke), which suggests that psychological factors, such as depressive symptoms should be taken into consideration in the prevention and control of chronic diseases.
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Affiliation(s)
- 春素 祝
- 北京大学第一医院药学部,北京 100034Department of Pharmacy, Peking University First Hospital, Beijing 100034, China
- 北京大学药学院药事管理与临床药学系,北京 100191Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
| | - 至炜 连
- 福建医科大学附属肿瘤医院,福建省肿瘤医院,福州 350014Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou 350014, China
| | - 一民 崔
- 北京大学第一医院药学部,北京 100034Department of Pharmacy, Peking University First Hospital, Beijing 100034, China
- 北京大学药学院药事管理与临床药学系,北京 100191Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
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Wang Z, Yang H, Sun C, Hong S. Estimating causal effects of physical disability and number of comorbid chronic diseases on risk of depressive symptoms in an elderly Chinese population: a machine learning analysis of cross-sectional baseline data from the China longitudinal ageing social survey. BMJ Open 2023; 13:e069298. [PMID: 37407052 DOI: 10.1136/bmjopen-2022-069298] [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: 07/07/2023] Open
Abstract
OBJECTIVE This study aimed to explore the causal effects of physical disability and number of comorbid chronic diseases on depressive symptoms in an elderly Chinese population. DESIGN, SETTING AND ANALYSIS Cross-sectional, baseline data were obtained from the China Longitudinal Ageing Social Survey, a stratified, multistage, probabilistic sampling survey conducted in 2014 that covers 28 of 31 provincial areas in China. The causal effects of physical disability and number of comorbid chronic diseases on depressive symptoms were analysed using the conditional average treatment effect method of machine learning. The causal effects model's adjustment was made for age, gender, residence, marital status, educational level, ethnicity, wealth quantile and other factors. OUTCOME Assessment of the causal effects of physical disability and number of comorbid chronic diseases on depressive symptoms. PARTICIPANTS 7496 subjects who were 60 years of age or older and who answered the questions on depressive symptoms and other independent variables of interest in a survey conducted in 2014 were included in this study. RESULTS Physical disability and number of comorbid chronic diseases had causal effects on depressive symptoms. Among the subjects who had one or more functional limitations, the probability of depressive symptoms increased by 22% (95% CI 19% to 24%). For the subjects who had one chronic disease and those who had two or more chronic diseases, the possibility of depressive symptoms increased by 13% (95% CI 10% to 15%) and 20% (95% CI 18% to 22%), respectively. CONCLUSION This study provides evidence that the presence of one or more functional limitations affects the occurrence of depressive symptoms among elderly people. The findings of our study are of value in developing programmes that are designed to identify elderly individuals who have physical disabilities or comorbid chronic diseases to provide early intervention.
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Affiliation(s)
- Zhenjie Wang
- Institute of Population Research, Peking University, Beijing, People's Republic of China
| | - Hanmo Yang
- T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Chenxi Sun
- School of Intelligence Science and Technology and the Key Laboratory of Machine Perception (Ministry of Education), Peking University, Beijing, People's Republic of China
| | - Shenda Hong
- National Institute of Health Data Science, Peking University, Beijing, People's Republic of China
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Xie Y, Ma M, Wang W. Trajectories of depressive symptoms and their predictors in Chinese older population: Growth Mixture model. BMC Geriatr 2023; 23:372. [PMID: 37328803 PMCID: PMC10276362 DOI: 10.1186/s12877-023-04048-0] [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: 08/29/2022] [Accepted: 05/17/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Given the rapidly rising proportion of the older population in China and the relatively high prevalence of depressive symptoms among this population, this study aimed to identify the trajectories of depressive symptoms and the factors associated with the trajectory class to gain a better understanding of the long-term course of depressive symptoms in this population. METHODS Data were obtained from four wave's survey of the China Health and Retirement Longitudinal Study (CHARLS). A total of 3646 participants who aged 60 years or older during baseline survey, and completed all follow-ups were retained in this study. Depressive symptoms were measured using the 10-item version of the Center for Epidemiologic Studies Depression Scale (CES-D-10). Growth mixture modelling (GMM) was adopted to identify the trajectory classes of depressive symptoms, and both linear and quadratic functions were considered. A multivariate logistic regression model was used to calculate the adjusted odds ratios (ORs) of the associated factors to predict the trajectory class of participants. RESULTS A four-class quadratic function model was the best-fitting model for the trajectories of depressive symptoms in the older Chinese population. The four trajectories were labelled as increasing (16.70%), decreasing (12.31%), high and stable (7.30%), and low and stable (63.69%), according to their trends. Except for the low and stable trajectory, the other trajectories were almost above the threshold for depressive symptoms. The multivariate logistic regression model suggested that the trajectories of chronic depressive symptoms could be predicted by being female, living in a village (rural area), having a lower educational level, and having chronic diseases. CONCLUSIONS This study identified four depressive symptom trajectories in the older Chinese population and analysed the factors associated with the trajectory class. These findings can provide references for prevention and intervention to reduce the chronic course of depressive symptoms in the older Chinese population.
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Affiliation(s)
- Yaofei Xie
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei, China
- Department of Psychiatry, Wuhan Hospital for Psychotherapy, Wuhan, Hubei, China
| | - Mengdi Ma
- Wuhan Blood Center, Wuhan, Hubei, China.
| | - Wei Wang
- School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Center for Medical Statistics and Data Analysis, Xuzhou Medical University, Xuzhou, Jiangsu, China
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Chen S, Sun X, Zhu Q, Zhao Y, Tang J, Song H. Factors Influencing the Level of Depression and Anxiety of Community-Dwelling Patients with Schizophrenia in China during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4376. [PMID: 36901386 PMCID: PMC10001627 DOI: 10.3390/ijerph20054376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/18/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
UNLABELLED The coronavirus disease 2019 (COVID-19) poses a huge challenge to global public health. People with schizophrenia living in communities urgently need effective interventions to help them adjust to life and work, but they have not received enough attention. This study aims to assess the prevalence of anxiety and depression symptoms in community-dwelling patients with schizophrenia in China during the epidemic and to explore the possible influencing factors. METHODS Using a cross-sectional survey, we collected 15,165 questionnaires. Assessments included demographic information, concern about COVID-19-related information, sleep status, anxiety and depressive symptoms, and accompanying illnesses. The 7-item Generalized Anxiety Disorder (GAD-7) and the 9-item Patient Health Questionnaire (PHQ-9) were used to evaluate depression and anxiety levels. Group comparison was conducted by t-test, ANOVA, or chi-square test wherever suitable, with Bonferroni pairwise correction. Multivariate logistic regression was performed to identify predictors for anxiety and depression. RESULTS 16.9% of patients had at least moderate anxiety, and 34.9% had at least moderate depression. T-test showed that females scored higher on GAD-7 and PHQ-9 than males, and patients without accompanying long-standing diseases, who were not concerned about COVID-19, had lower GAD-7 and PHQ-9 scores. ANOVA showed that participants aged from 30 to 39, with higher education scored higher on GAD-7, and patients with better sleep, and having less concern about COVID-19, had lower GAD-7 and PHQ-9 scores. Regression analysis indicated that participant ages of 30-39 and 40-49 positively predicted anxiety, whereas patient ages of 30-39 years positively predicted depression. Patients with poor sleep, accompanying diseases, and concern about the COVID-19 pandemic were more likely to experience anxiety and depression. CONCLUSION During the pandemic, Chinese community-dwelling patients with schizophrenia had high rates of anxiety and depression. These patients deserve clinical attention and psychological intervention, especially those with risk factors.
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Affiliation(s)
- Shanshan Chen
- Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310000, China
| | - Xiaohua Sun
- Affiliated Mental Health Center, School of Medicine, Zhejiang University, Hangzhou Seventh People′s Hospital, The 4th Clinical College of Zhejiang Chinese Medical University, Hangzhou 310000, China
| | - Qisha Zhu
- Affiliated Mental Health Center, School of Medicine, Zhejiang University, Hangzhou Seventh People′s Hospital, The 4th Clinical College of Zhejiang Chinese Medical University, Hangzhou 310000, China
| | - Yuan Zhao
- Affiliated Mental Health Center, School of Medicine, Zhejiang University, Hangzhou Seventh People′s Hospital, The 4th Clinical College of Zhejiang Chinese Medical University, Hangzhou 310000, China
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310000, China
| | - Haidong Song
- Affiliated Mental Health Center, School of Medicine, Zhejiang University, Hangzhou Seventh People′s Hospital, The 4th Clinical College of Zhejiang Chinese Medical University, Hangzhou 310000, China
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Ji R, Chen WC, Ding MJ. The contribution of the smartphone use to reducing depressive symptoms of Chinese older adults: The mediating effect of social participation. Front Aging Neurosci 2023; 15:1132871. [PMID: 37091518 PMCID: PMC10117680 DOI: 10.3389/fnagi.2023.1132871] [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: 12/28/2022] [Accepted: 03/13/2023] [Indexed: 04/25/2023] Open
Abstract
Background Depression is a prevalent mental health disorder. Although Internet use has been associated with depression, there is limited data on the association between smartphone use and depressive symptoms. The present study aimed to investigate the relationship between smartphone use and depressive symptoms among older individuals in China. Methods 5,244 Chinese older individuals over the age of 60 were selected as the sample from the China Longitudinal Aging Social Survey (CLASS) 2018 dataset. The dependent variable "depression symptoms" was measured using the 9-item Center for Epidemiologic Studies-Depression (CES-D) scale. The study employed multiple linear regression to investigate the relationship between smartphone use (independent variable) and depressive symptoms in older people. Thorough analyses of robustness, sensitivity, and heterogeneity were conducted to ensure the robustness and sensitivity of the findings. Additionally, mediating effect analysis was performed to elucidate the mechanism through which the dependent and independent variables were related. Results Empirical study indicated that smartphone use had a negative impact on depressive symptoms among older adults, specifically leading to a reduction in such symptoms. The above-mentioned result was verified through endogenous and robustness tests. The heterogeneity analysis revealed that older individuals aged 70 years and above, male, and residing in urban areas exhibited a stronger association between smartphone use and depressive symptoms. Furthermore, the mediating effect model indicated that political participation, voluntary participation, and active leisure participation mediated the relationship between smartphone use and lower levels of depression symptoms among the older adults. However, passive leisure participation had a suppressing effect on the relationship between smartphone use and reduced depressive symptoms among the older adults. Limitations The causal relationship between variables required further investigation with a longitudinal design. Conclusion These findings suggested that smartphone use may be considered an intervention to reduce depression symptoms among older people by increasing levels of political participation, voluntary participation, and active leisure participation.
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Affiliation(s)
- Rong Ji
- School of Journalism and Communication, Hunan Normal University, Changsha, China
- School of Literature and Journalism, Xiangtan University, Xiangtan, China
| | - Wei-chao Chen
- School of Journalism and Communication, Hunan Normal University, Changsha, China
- *Correspondence: Wei-chao Chen,
| | - Meng-jun Ding
- School of Journalism and Communication, Hunan Normal University, Changsha, China
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Jiang MM, Wang DW, Wu ZY, Gao K, Guo PP, Kong Y. The influence of internet use frequency, family atmosphere, and academic performance on adolescent depression: Based on the chain mediating effect of self-adjustment and campus deviant behavior. Front Psychol 2022; 13:992053. [PMID: 36544450 PMCID: PMC9762425 DOI: 10.3389/fpsyg.2022.992053] [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: 07/12/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Depression has become a prominent psychological problem among young people. The purpose of this study was to investigate the potential relationship between the frequency of Internet use, family atmosphere, academic performance, self-adjustment, campus deviant behavior, and depressive symptoms among adolescents. Methods Based on the survey data of the fifth wave (2017~2018) and the sixth wave (2019~2020) of the China Family Panel Studies (CFPS), this study used LISREL8.8 software to analyze 1,577 10~15 data on adolescents. Results In this study, the mean score of self-adjustment was 42.40 (SD = 6.79), the mean score of campus deviant behavior was 12.59 (SD = 4.00), the mean score of depressive symptoms in 2018 was 11.88 (SD = 3.04), and the mean score of depressive symptoms in 2020 was 7.64 (SD = 2.20). Secondly, the frequency of Internet use had no direct effect on the depressive symptoms of adolescents, family atmosphere was negatively correlated with depressive symptoms (p < 0.005), and academic performance was positively correlated with depressive symptoms (p < 0.005). Depressive symptoms in 2020 had a direct effect (β = 0.37, p < 0.001), and also had a negative effect on depressive symptoms in 2020, with a total effect of-0.07 (p < 0.001); self-adjustment had no direct effect on depressive symptoms in adolescents in 2018, However, the total effect was -0.14 (p < 0.001), which had a significant positive effect on 2020 depressive symptoms, and the total effect was 0.18 (p < 0.001), and self-adjustment had a significant negative effect on adolescent campus deviant behavior (β = -0.38, p < 0.001); in addition, the frequency of Internet use, family atmosphere, and academic performance all had indirect effects on adolescents' 2020 depressive symptoms, with total effects of -0.60, 0.01, and 0.02 (p < 0.001), respectively. This study also found depressive symptoms in adolescents have a certain persistence in time. Discussion Based on this study, it is necessary to pay more attention to the depression of adolescents, strengthen the training of self-adjustment, improve the anti-frustration ability and psychological resilience, and reduce the campus deviant behavior of adolescents. It is recommended to try to start from emotional self-adjustment to promote the personality health of adolescents.
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Affiliation(s)
- Mao-min Jiang
- School of Public Affairs, Xiamen University, Xiamen, China
| | - De-wen Wang
- School of Public Affairs, Xiamen University, Xiamen, China
| | - Zheng-yu Wu
- School of Public Affairs, Xiamen University, Xiamen, China
| | - Kai Gao
- School of Management, Shanghai University of Engineering Sciences, Shanghai, China
| | - Pei-pei Guo
- School of Management, Shanghai University of Engineering Sciences, Shanghai, China
| | - Yang Kong
- School of Public Health and Management, Binzhou Medical University, Yantai, China,*Correspondence: Yang Kong,
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11
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Jiang Y, Yang F. Association between internet use and successful aging of older Chinese women: a cross-sectional study. BMC Geriatr 2022; 22:536. [PMID: 35764930 PMCID: PMC9241215 DOI: 10.1186/s12877-022-03199-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 06/08/2022] [Indexed: 12/16/2022] Open
Abstract
Background The internet has become ubiquitous in contemporary human life. However, little is known about the association between internet use and older people’s aging process, especially that of older women. Methods Using the nationally representative dataset of the China Longitudinal Aging Social Survey 2016, we examined the relationship between internet usage and the successful aging of older Chinese women. The sample in this study consisted of 2713 respondents with an average age of 69.963 years. Successful aging was defined as no major diseases, no disability, high cognitive functioning, high physical functioning, and active engagement with life. Older women’s internet use behavior was represented by internet use frequency. Probit and instrumental variable models were employed to test the association between internet use frequency and successful aging of older women. The Karlson/Holm/Breen (KHB) mediation analysis was used to estimate the mediating effect of social capital on the relationship between internet use frequency and older women’s successful aging. Results Using a probit model (coefficient = 0.030, p < 0.001) and an instrumental variable probit model (coefficient = 0.287, p < 0.001), it was found that a successful aging status was significantly correlated with an increase in internet use frequency. The functional mechanism analysis suggested that social capital partially mediated the overall association between internet use frequency and successful aging. Conclusions This study suggests that the more frequently older Chinese women use the internet, the greater the possibility of successful aging. Our findings provide new evidence from China about the determinants of older women’s aging process and aid in formulating targeted aging policies for older women in developing countries and regions.
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Affiliation(s)
- Yao Jiang
- Zhou Enlai School of Government, Nankai University, Tianjin, 300350, China
| | - Fan Yang
- Department of Labor and Social Security, School of Public Administration, Sichuan University, Chengdu, 610065, China.
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12
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Yao H, Zhang Q, Song Q, Liu M, Tang G. Characteristics of Oral Mucosal Lesions and Their Association With Socioeconomic Status and Systemic Health: A Cross-Sectional Study of Consecutively Collected Oral Medicine Clinic Data in a Remote Rural Area of China. Front Public Health 2022; 10:897814. [PMID: 35677771 PMCID: PMC9168324 DOI: 10.3389/fpubh.2022.897814] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 04/26/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives Epidemiological data of oral mucosal lesions (OMLs) are required to develop practical oral care policies. However, limited data are available for rural areas in China. We aimed to estimate the spectrum and frequency of OMLs and to identify their associated socioeconomic status (SES) and systemic health in a remote rural area in Yunnan, China. Methods We screened patients for OMLs in an oral medicine clinic in rural Yunnan, China, from August 2020 to February 2021. OMLs were documented. SES, including the highest education level achieved and the previous month's household income, as well as the patient's systemic health, including a history of smoking, alcohol use, and chronic disease, were obtained from the Medical History/Health Questionnaire Form and patient medical records. Results A total of 146 patients were found to have OMLs. The most frequent OML was aphthous ulcer (n = 41, 28.1%), followed by burning mouth syndrome (BMS) (n = 16, 11.0%), viral ulcer (n = 14, 9.6%), and oral lichen planus (OLP) (n = 9, 6.2%). In these patients, the most common chronic diseases were sleep apnea (n = 35, 24.0%), hypertension (n = 23, 15.8%), bronchitis (n = 16, 11.0%), reflux (including gastroesophageal reflux disease) (n = 12, 8.2%), and arthritis (n = 11, 7.5%). On adjusted regression, the patients without chronic diseases had a lower risk of BMS than those with chronic diseases [odds ratio (OR), 0.2; 95% confidence interval (CI), 0.03–0.9]. Age was an independent protective factor for viral ulcers (OR, 1.0; 95% CI, 0.9–1.0). Patients with low-income levels had a lower risk of OLP than those with high-income levels (OR, 0.2; 95% CI, 0.05–0.9). Conclusions Our oral medicine clinic data in remote Yunnan, China, showed the most frequent OML was aphthous ulcer, which was followed by BMS, viral ulcer, and OLP. Oral care policies should be prioritized among patients with aphthous ulcer. Preventive strategy of BMS should be targeted to people with chronic disease for health equalities. Therefore, an individualized strategy for interventions of OMLs might be optimal, based on the specific epidemiologic characteristics in rural settings.
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Affiliation(s)
- Hui Yao
- Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Qiongyue Zhang
- Department of Stomatology, The People's Hospital of Xiangyun Affiliated With Dali University, Yunnan, China
| | - Qianqian Song
- Department of Stomatology, The People's Hospital of Xiangyun Affiliated With Dali University, Yunnan, China
| | - Mingshan Liu
- Department of Stomatology, The People's Hospital of Xiangyun Affiliated With Dali University, Yunnan, China
- *Correspondence: Mingshan Liu
| | - Guoyao Tang
- Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Guoyao Tang
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13
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Li L, Sun W, Luo J, Huang H. Associations between education levels and prevalence of depressive symptoms: NHANES (2005-2018). J Affect Disord 2022; 301:360-367. [PMID: 34990632 DOI: 10.1016/j.jad.2022.01.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 11/21/2021] [Accepted: 01/02/2022] [Indexed: 12/19/2022]
Abstract
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.
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Affiliation(s)
- Lingli Li
- School of Education Science and Technology, Guangdong Polytechnic Normal University, Guangzhou, China
| | - Wang Sun
- School of Information Technology Education, South China Normal University, Guangzhou, China
| | - Jinglan Luo
- Department of Internal Medicine, the First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Hao Huang
- Department of Pain Management, the First Affiliated Hospital of Jinan University, 601 Huangpu Avenue West, Tianhe District, Guangzhou, China.
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14
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Motsamai TB, Mhaka-Mutepfa M. Depression: Determinants That Influence the Mental Health of Older People (60 Years +) in Botswana. Gerontol Geriatr Med 2022; 8:23337214211053121. [PMID: 35237710 PMCID: PMC8883394 DOI: 10.1177/23337214211053121] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/06/2021] [Accepted: 09/26/2021] [Indexed: 11/16/2022] Open
Abstract
Correlates of depression in older people were explored in this study. The prevalence of depression was also calculated. Data were collected using a cross-sectional study stratified by district in urban and rural Botswana using the Patient Health Questionnaire. A snowballing technique was utilized to recruit older participants (N = 378; age = 71.8; SD = 9.1) with low to high incomes. Univariate and multivariate analyses were used to investigate the associations among demographics, individual, social, and environmental factors, and depression. The prevalence of depression and social impairment in older people was 7.8% and 20.6%. The correlates significantly associated with depression in Model 2 were education, income earned, resilience, and self-esteem (F (6, 358) = 19.5, p < .001; R2 = 23%) after adjusting for all influencing factors. Self-perceived health was associated with depression in Model 3 [F (11,340) = 12.5, p < .001; R2 = 28%]. In the final model, resilience, quality of life (QOL), and leisure were significantly associated with depression (p < .001), followed by anxiety, somatic symptoms, and social impairment (p < .05) [F (20,214) = 9.2, p < .001; R2 = 46%]. Findings provide preliminary information on the determinants of depression for further review by the research community. Stakeholders should also take cognizance of these correlates during their practice to curb depression in older people.
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15
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Wei Z, Liang J, Cao K, Wang L, Baudouin C, Labbé A, Liang Q. A multi-center study evaluating the correlation between meibomian gland dysfunction and depressive symptoms. Sci Rep 2022; 12:443. [PMID: 35013413 PMCID: PMC8748897 DOI: 10.1038/s41598-021-04167-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 12/16/2021] [Indexed: 11/09/2022] Open
Abstract
Increased prevalence of depression has been found in patients with meibomian gland dysfunction (MGD); however, specific conditions of patients suffered from MGD and depression remains unclear. Our aim was to investigate the prevalence of depression in patients with MGD and analyze the risk factors of depression in MGD patients. In this multi-center cross-sectional study, we enrolled 830 MGD patients and 114 normal controls. Demographic information was collected by designed questionnaires about lifestyle habits, systemic and ocular medical history. Ophthalmic examinations were performed in a formal order. Depression symptoms were evaluated with a questionnaire survey using a modified self-rating depression scale (M-SDS). The correlations between the M-SDS score and demographic and clinical information were analyzed. The prevalence of hyperlipidemia and obstructive sleep apnea-hypopnea syndrome (OSAHS) was higher in the MGD group. There were 78 cases (9.4%) with depressive symptoms in the MGD group whereas there were 4 cases (3.5%) in controls. Similarly, M-SDS was higher in the MGD group. The characteristics of depression in the MGD group included: crying spells, sleep disturbance and depressed appetite. Some systemic diseases (OSAHS, allergy, skin disease) and the use of contact lenses was correlated with an increased risk of depressive symptoms in MGD patients.
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Affiliation(s)
- Zhenyu Wei
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, 100005, China
| | - Junqi Liang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, 100005, China.,School of Medicine, University of Central Lancashire, Preston, UK
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, 100005, China
| | - Leying Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, 100005, China
| | - Christophe Baudouin
- Quinze-Vingts National Ophthalmology Hospital, IHU FOReSIGHT, Paris and Versailles Saint-Quentin-en-Yvelines University, Versailles, France.,Institut de la Vision, IHU FOReSIGHT, Sorbonne Université, INSERM, CNRS, 17 rue Moreau, 75012, Paris, France
| | - Antoine Labbé
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, 100005, China.,School of Medicine, University of Central Lancashire, Preston, UK.,Quinze-Vingts National Ophthalmology Hospital, IHU FOReSIGHT, Paris and Versailles Saint-Quentin-en-Yvelines University, Versailles, France
| | - Qingfeng Liang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, 100005, China.
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Abstract
PURPOSE OF REVIEW The present review aims to examine, summarize and update information on the sociodemographic and cultural determinants of mood disorders. RECENT FINDINGS Known sociodemographic and cultural determinants continue to be good predictors of the risk of developing a mood disorder over the lifetime. Polygenic risk scores do not appear to offer any advantages over these determinants at present. There is also new and emerging understanding of the role of lifestyle and environmental factors in mediating vulnerability to mood disorder. The influence of ethnicity and migration, on the other hand, is far more complex than initially envisaged. SUMMARY Recent evidence on sociodemographic determinants of mood disorders confirms associations derived from existing literature. There is also new and emerging evidence on how quality of sleep, diet and the environment influence risk of mood disorders. Culture and ethnicity, depending on context, may contribute to both vulnerability and resilience. Socioeconomic deprivation may be the final common pathway through which several sociodemographic and cultural determinants of mood disorders act.
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Affiliation(s)
- Migita M D'cruz
- DM Geriatric Psychiatry, Consultant, Geriatric Psychiatry, Kollam, Kerala, India
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17
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Zhang W, Cao G, Sun Y, Wu F, Wang Q, Xu T, Hu H, Xu K. Depressive symptoms in individuals diagnosed with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) in middle-aged and older Chinese individuals: Results from the China Health and Retirement Longitudinal Study. J Affect Disord 2022; 296:660-666. [PMID: 34565588 DOI: 10.1016/j.jad.2021.09.045] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 09/11/2021] [Accepted: 09/14/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Male lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) is common and may increase the risk of depressive symptoms. This study aimed to investigate the associated factors of LUTS/BPH and its association with depressive symptoms in middle-aged and older Chinese men. METHODS This study used data from the 2015 China Health and Retirement Longitudinal Study (CHARLS). A total number of 8,586 men aged ≥45 years were included in this study. Participants answered positively to whether they have ever been diagnosed with a prostate illness (excluding prostatic cancer) were defined as LUTS/BPH individuals. Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression Scale (CESD-10). Multivariate logistic analyses were applied to explore the associated factors of LUTS/BPH, association between LUTS/BPH and depressive symptoms, and risk factors of depressive symptoms according to LUTS/BPH status. RESULTS The weighted overall prevalence of LUTS/BPH was 13.1% in Chinese men aged ≥45 years. The prevalence of depressive symptoms was 29.1% in LUTS/BPH individuals and 22.9% in non-LUTS/BPH individuals. Depressive symptoms and LUTS/BPH shared some same risk factors, which were education, living regions, annual household consumption, sleep duration and multimorbidity. The results from logistic models showed that education, sleep duration and multimorbidity were significantly and independently associated with depression of LUTS/BPH individuals (P<0.001). CONCLUSIONS Prevalence of depressive symptoms in LUTS/BPH population was higher than in non-LUTS/BPH population. Education, sleep duration and multimorbidity were associated with the onset of depressive symptoms in LUTS/BPH individuals (P<0.001).
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Affiliation(s)
- Weiyu Zhang
- Department of Urology, Peking University People's Hospital, 100044 Beijing, China
| | - Guiying Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 100191 Beijing, China; Medical Informatics Center, Peking University, 100191 Beijing, China
| | - Yiran Sun
- Department of Urology, Peking University People's Hospital, 100044 Beijing, China
| | - Feng Wu
- Institute for Disease Control and Prevention, Chinese PLA, 100071 Beijing, China
| | - Qi Wang
- Department of Urology, Peking University People's Hospital, 100044 Beijing, China
| | - Tao Xu
- Department of Urology, Peking University People's Hospital, 100044 Beijing, China
| | - Hao Hu
- Department of Urology, Peking University People's Hospital, 100044 Beijing, China.
| | - Kexin Xu
- Department of Urology, Peking University People's Hospital, 100044 Beijing, China.
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18
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Li A, Wang D, Lin S, Chu M, Huang S, Lee CY, Chiang YC. Depression and Life Satisfaction Among Middle-Aged and Older Adults: Mediation Effect of Functional Disability. Front Psychol 2021; 12:755220. [PMID: 34899497 PMCID: PMC8656258 DOI: 10.3389/fpsyg.2021.755220] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 10/25/2021] [Indexed: 12/29/2022] Open
Abstract
With increasing age, middle-aged and older persons face a series of physical and mental health problems. This study aimed to explore the latent relationships among age, functional disability, depression, and life satisfaction. The data were obtained from the Wave 2 (in 2013–2014) and Wave 3 (in 2015–2016) surveys of the China Health and Retirement Longitudinal Study. The analytic sample in the present study included 15,950 individuals aged 45 years and over. The participants answered the same questions concerning depression and life satisfaction in both study waves, and functional disability was measured based on the activities of daily living and instrumental activities of daily living. Age was directly associated with functional disability, life satisfaction, and depression. Functional disability was positively correlated with depression and negatively correlated with life satisfaction. Functional disability strongly mediated the relationships among age, depression, and life satisfaction. Depression and life satisfaction were found to have enduring effects and effects on each other. Additionally, the model revealed a gender difference. Depression in middle-aged people should receive closer attention. Avoiding or improving functional disability may be an effective way to improve life satisfaction and reduce the level of depression in middle-aged and older persons. If prevention work successfully decreases depression, the life dissatisfaction of middle-aged and older people could be improved. Additionally, for the prevention of functional disability and depression and improvement in life satisfaction, gender differences need to be considered.
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Affiliation(s)
- An Li
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Dewen Wang
- School of Public Affairs, Xiamen University, Xiamen, China
| | - Shengnan Lin
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Meijie Chu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Shiling Huang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Chun-Yang Lee
- School of International Business, Xiamen University Tan Kah Kee College, Zhangzhou, China
| | - Yi-Chen Chiang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
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Zhou S, Gao L, Liu F, Tian W, Jin Y, Zheng ZJ. Socioeconomic status and depressive symptoms in older people with the mediation role of social support: A population-based longitudinal study. Int J Methods Psychiatr Res 2021; 30:e1894. [PMID: 34591341 PMCID: PMC8633935 DOI: 10.1002/mpr.1894] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 08/12/2021] [Accepted: 09/14/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Depressive symptoms has become an increasingly important public health issue, contributing to disability and disease burden around the world. Higher socioeconomic status (SES) has been found to be associated with lower prevalence of depression, but there are few studies about the older Chinese adults with long-term follow up and rigorous prospective design. Meanwhile, there is little conclusive evidence about the mechanisms through which SES influences the onset of depressive symptoms. OBJECTIVE To prospectively examine the association of baseline socioeconomic factors with the risks of developing depressive symptoms during 7-year follow up in older Chinese population, and to study the mechanism by which SES impacts the prevalence of depressive symptoms. METHODS A total of 5677 individuals over 45 years who participated in an ongoing nationally representative prospective cohort study, China Health and Retirement Longitudinal Study, were free from depressive symptoms at baseline, and completed 7-year follow-up were included. Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression Scale score. Cox proportional hazards regression models were used to examine the association of SES and the incidence of depressive symptoms in 2011 to 2018. Generalized structural equation model was used to analyze the mediation effects of social support on the relation between SES and depressive symptoms. RESULTS During the 7-year follow-up, 2398 (42.2%) cases were identified as depressive symptoms. Compared with the lowest level of household income, participants with the highest level of household income had a 20% reduction in risk (95% CI, 0.70-0.92, P < 0.001). Participants who had junior high school or above education had a 41% lower risk of depressive disorders compared with illiterate participants (95% CI, 0.52-0.69, P < 0.001). The relationship between SES and depressive symptoms was partially mediated by the social support, where higher social support was negatively associated with depressive symptoms. The proportion of mediation effect was even larger for women compared with men. CONCLUSION Socioeconomic factors were independently associated with the development of depressive symptoms, and the relationship was partially mediated by social support. Social support could be an effective intervention to alleviate the negative effects of lower SES on mental health. Multiple-level policies should precisely target low-SES groups, and timely intervention to promote social support for this group should be used to reduce the influence of depression on individuals, family as well as the whole society.
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Affiliation(s)
- Shuduo Zhou
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Liqun Gao
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Fangjing Liu
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Wenya Tian
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Yinzi Jin
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Zhi-Jie Zheng
- Department of Global Health, Peking University School of Public Health, Beijing, China.,Institute for Global Health and Development, Peking University, Beijing, China
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20
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Hossain B, Yadav PK, Nagargoje VP, Vinod Joseph KJ. Association between physical limitations and depressive symptoms among Indian elderly: marital status as a moderator. BMC Psychiatry 2021; 21:573. [PMID: 34781925 PMCID: PMC8594119 DOI: 10.1186/s12888-021-03587-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 11/08/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Depression among the elderly is well-documented and associated with socio-economic factors, physical and mental health conditions. Few studies have focused on older adults' physical limitations and depressive symptoms. However, very little is known about marital status' role in such associations, especially in India. The present study examines the association between physical limitations and self-reported depressive symptoms and moderating role of marital status in such association separately for men and women. METHODS The present study used data from the Longitudinal Ageing Study in India (LASI) wave 1, 2017-2018, a nationally and state representative longitudinal large-scale survey of ageing and health. For the present research, a total sample of 20,806 older adults aged 60+ years was selected after excluding missing values. Along with descriptive statistics, binary logistic regression analysis and interaction effect of marital status were applied to examine the association between physical limitations (functional limitations and mobility difficulty) with the depressive symptoms separately for men and women. RESULTS About 58, 50, and 45% elderly reported having depressive symptoms and had difficulty in 2+ ADLs, 2+ IADLs, and 2+ mobility difficulties, respectively. By the marital status, the prevalence of depressive symptoms was higher among currently unmarried than currently married, irrespective of type and number of physical limitations. The unadjusted, marital and multivariate-adjusted association suggested that elderly with more than two ADLs, IADLs, and mobility difficulty had higher odds of depressive symptoms. The gender stratified interaction effect of marital status and physical limitations on depressive symptoms indicated that currently unmarried elderly, particularly unmarried older women with 2+ ADLs (OR = 2.85; CI 95% = 1.88-3.09), 2+ IADLs (OR = 2.01; CI 95% = 1.74-2.31) and 2+ mobility difficulty (OR = 2.20; CI 95% = 1.86-2.60) had higher odds of depressive symptoms. However, such association was only valid for unmarried men having mobility difficulty. CONCLUSION The study highlights that the elderly with physical limitations such as ADLs, IADLs, and mobility difficulty require attention and care. Although married elderly are less likely to have depressive symptoms even with all the mentioned physical limitations, unmarried women are more vulnerable to have depressive symptoms with physical limitations.
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Affiliation(s)
- Babul Hossain
- International Institute for Population Sciences, Mumbai, 400088, India.
| | - Pawan Kumar Yadav
- grid.419349.20000 0001 0613 2600Department of Bio-statistics and Epidemiology, International Institute for Population Sciences, Mumbai, 400088 India
| | - Varsha P. Nagargoje
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, 400088 India
| | - K. J. Vinod Joseph
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, 400088 India
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21
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Tang X, Qi S, Zhang H, Wang Z. Prevalence of depressive symptoms and its related factors among China's older adults in 2016. J Affect Disord 2021; 292:95-101. [PMID: 34107426 DOI: 10.1016/j.jad.2021.04.041] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND Depression seriously threatens Chinese elderly. This study analysis the prevalence of depressive symptoms (DS) and its related factors among China's aging population. METHODS All participants were from the PINDEC project. Multi-stage clustered sampling was conducted. A total of 20,019 participants aged 60 or above completed the DS screening in 2016, and among them, 19,420 were taken into analysis. Univariate and multivariate logistic regression analysis were performed to explore the related factors of DS. RESULTS Of the 19,420 adults, 9,444 were male (48.63%) and 9,976 were female (51.37%). The prevalence of DS was 15.94%. The risk factors of DS were: female gender (OR=1.198, 1.097-1.308), daily alcohol consumption (OR=1.480, 1.284-1.705), disturbed sleep (OR=1.864, 1.716-2.024), chronic diseases (OR=1.214, 1.181-1.249), greater age (OR=1.012, 1.077-1.018), impaired cognition (OR=2.567,2.202-2.993), poor ADL performance (OR=1.545, 1.380-1.729), and insufficient social communication (OR=1.241, 1.134-1.358). Protective factors of DS included: higher education level, greater BMI (OR=0.986, 0.975-0.997), living in urban areas (OR=0.677, 0.611-0.749), and leisure activities such as playing cards or mahjong (OR=0.816, 0.730-0.912). For the DS risk factors, multiplicative interaction was found between cognition and ADL performance, in addition to cognition and social communication. LIMITATIONS Causality cannot be drawn from this cross-sectional survey. And the elderly who were looked after by nannies or living in nursing homes were not taken into analysis. CONCLUSIONS DS is prevalent among older adults in China. It is recommended that periodic screening for DS should be conducted for elderly individuals. Furthermore, it is suggested that the elderly adopt healthy lifestyles to prevent DS.
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Affiliation(s)
- Xue Tang
- Center for Behavioral Health & School of Social Development and Public Policy, Beijing Normal University, No.19 Xinjiekouwai St., Beijing 100875, China..
| | - Shige Qi
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Rd, Xicheng District, 100050 Beijing, China
| | - Han Zhang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Rd, Xicheng District, 100050 Beijing, China
| | - Zhihui Wang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Rd, Xicheng District, 100050 Beijing, China.
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22
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Scott G, Beauchamp-Lebrón AM, Rosa-Jiménez AA, Hernández-Justiniano JG, Ramos-Lucca A, Asencio-Toro G, Jiménez-Chávez J. Commonly diagnosed mental disorders in a general hospital system. Int J Ment Health Syst 2021; 15:61. [PMID: 34147115 PMCID: PMC8214275 DOI: 10.1186/s13033-021-00484-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 06/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Considering many patients receive care from general hospitals, these healthcare institutions are uniquely situated to address mental and physical health needs. Little is documented, however, on the common current mental disorders diagnosed in patients receiving care in general hospital settings, especially in Puerto Rico. The objective of this study was to characterize the five most common current DSM-5 mental disorder diagnoses made in patients receiving non-psychiatric medical and surgical care from a general hospital system in southern Puerto Rico between January 2015 and December 2019. METHODS Our clinical health psychology team provides integrated psychology consultation-liaison services to select clinical units in general hospitals across the southwestern region of Puerto Rico. The clinical team conducted routine standardized psychological evaluations at patients' bedside, arrived at a current DSM-5 diagnosis if warranted, and documented the diagnosis and other select variables. A retrospective study of cross-sectional data generated from the clinical team's standardized evaluations of 5494 medical patients was implemented. Multinomial logistic regression analyses were used to assess the odds of being diagnosed with a current DSM-5 mental disorder during hospitalization. RESULTS Overall, 53% of the entire sample was diagnosed with a mental disorder during hospitalization. Major depressive, neurocognitive, anxiety, substance-related and schizophrenia-spectrum disorders were the most frequently diagnosed. Interestingly, females were 23% less likely to have been diagnosed with major depressive disorder than males (aOR: 0.769, CI [0.650, 0.909], p = 0.002). This is to say males evidenced 1.30 higher odds of being diagnosed with depression compared to their female counterpart. Age, biological sex, civil status, employment status, monthly household income, previous mental disorder and history substance use/abuse history was differentially associated with receiving a current DSM-5 disorder. CONCLUSION The integration of clinical health psychology services within a general hospital facilitated our team's work of identifying and treating co-occurring mental disorders among hospitalized patients receiving medical and surgical care. Future studies examining the opportunities and barriers of integrating clinical health psychology services within a general hospital's administrative and clinical infrastructure for rapid identification and treatment of co-occurring mental disorders among medical patients is encouraged.
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Affiliation(s)
- George Scott
- Health Psychology Training and Research Core, School of Behavior and Brain Sciences, Ponce Health Sciences University, 388 Zona Industrial Reparada 2, Ponce, PR 00717 USA
| | - Alessandra M. Beauchamp-Lebrón
- Health Psychology Training and Research Core, School of Behavior and Brain Sciences, Ponce Health Sciences University, 388 Zona Industrial Reparada 2, Ponce, PR 00717 USA
| | - Ashley A. Rosa-Jiménez
- Health Psychology Training and Research Core, School of Behavior and Brain Sciences, Ponce Health Sciences University, 388 Zona Industrial Reparada 2, Ponce, PR 00717 USA
| | - Javier G. Hernández-Justiniano
- Health Psychology Training and Research Core, School of Behavior and Brain Sciences, Ponce Health Sciences University, 388 Zona Industrial Reparada 2, Ponce, PR 00717 USA
- Department of Behavioral Medicine, Damas Hospital, 2213 Ponce Bypass, Ponce, PR 00717 USA
| | - Axel Ramos-Lucca
- Health Psychology Training and Research Core, School of Behavior and Brain Sciences, Ponce Health Sciences University, 388 Zona Industrial Reparada 2, Ponce, PR 00717 USA
- Department of Behavioral Medicine, Damas Hospital, 2213 Ponce Bypass, Ponce, PR 00717 USA
| | - Gloria Asencio-Toro
- Health Psychology Training and Research Core, School of Behavior and Brain Sciences, Ponce Health Sciences University, 388 Zona Industrial Reparada 2, Ponce, PR 00717 USA
| | - Julio Jiménez-Chávez
- Health Psychology Training and Research Core, School of Behavior and Brain Sciences, Ponce Health Sciences University, 388 Zona Industrial Reparada 2, Ponce, PR 00717 USA
- Department of Behavioral Medicine, Damas Hospital, 2213 Ponce Bypass, Ponce, PR 00717 USA
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23
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Tsaras K, Tsiantoula M, Papathanasiou IV, Papagiannis D, Chatzi M, Fradelos EC. Predictors of Depression and Insomnia in Community-Dwelling Elderly People: A Cross-Sectional Evidence of Their Bidirectional Relationship. Cureus 2021; 13:e13965. [PMID: 33880299 PMCID: PMC8052590 DOI: 10.7759/cureus.13965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective The aim of this study was to examine associated factors of depression and insomnia in community-dwelling elderly people in order to identify independent predictors. Materials and methods A cross-sectional study was conducted among 250 older people aged 60 years and over living in an urban area. A stratified random sampling method was used for recruiting samples from five Open Care Centers for Elderly People of the Municipality of Larissa, Greece. Data were obtained through a questionnaire that included demographic, socioeconomic, and health-related characteristics, 15-item Geriatric Depression Scale (GDS-15), and Athens Insomnia Scale (AIS). Simple and multiple logistic regression analysis was performed. Results The prevalence of depression and insomnia was 28.4% (95% CI: 22.9-33.9) and 39.2% (95% CI: 33.0-45.4), respectively. Our findings showed that the overall GDS-15 score was positively related to the overall AIS score (r = 0.405; p < 0.001). The best-fit regression analysis demonstrated four significant predictors (marital status, monthly income, body weight status, and insomnia) explaining 31.6% of the variance in depression risk. Moreover, community-dwelling elderly Greek people with insomnia symptoms were females, had a lower monthly income, and more likely to suffer from chronic diseases and depression. Conclusion These findings point to the importance of recognizing risk factors for both depression and insomnia in attempting to apply preventive interventions in the elderly and optimize their quality of life.
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Affiliation(s)
| | | | | | | | - Maria Chatzi
- Department of Infection, University Hospital of Larissa, Larissa, GRC
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24
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Collazos-Perdomo D, Ramirez-Ramos CF, Torres de Galvis MY, Correas-Orozco L, Ramirez-Mendez D, Castilla Agudelo GA, Martinez Cano CA, Gallego C, Saldarriaga C. [Association between major depression and arterial hypertension in a Colombian population]. HIPERTENSION Y RIESGO VASCULAR 2020; 37:162-168. [PMID: 32675035 DOI: 10.1016/j.hipert.2020.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 05/18/2020] [Accepted: 06/14/2020] [Indexed: 12/24/2022]
Abstract
INTRODUCTION A third of hypertensive patients have major depression, a relationship that is associated with a worse prognosis. The objective of the study was to estimate the association between depression and high blood pressure, as well as to establish the possible bidirectionality of the conditions. MATERIALS AND METHODS Retrospective cohort study. People between 18 and 65 years old with high blood pressure, depression or use of medications for their management were included. To analyze the antecedent, a comorbidity model was performed. A bivariate analysis was performed and then a multivariate logistic regression. The association was estimated using the Chi-square test and the odds ratios that were crude and adjusted to the other variables included in the analysis. The Hosmer-Lemeshow test was used to assess the goodness of fit. SPSS® v.21 was used as the statistical package. RESULTS A total of 1,721 people were included in the study. The prevalence of depression in patients with and without hypertension was 17.4 and 12.6%, respectively, with a 43% risk of hypertension in people with depression. In patients with depression, it preceded the diagnosis of hypertension in 64.8% of cases and in hypertensive patients, 22.2% were later diagnosed with depression. The association between high blood pressure and major depression remained significant after adjusting for the other risk factors. CONCLUSIONS Depression was found as a risk factor for high blood pressure, with a 2-way risk relationship between depression and high blood pressure.
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Affiliation(s)
| | - C F Ramirez-Ramos
- Departamento de Cardiología Clínica, Universidad Pontificia Bolivariana y clínica CardioVID, Medellín, Colombia.
| | - M Y Torres de Galvis
- Departamento de Epidemiología y Salud Pública, Grupo de Investigación en Salud Mental, Universidad CES, Medellín, Colombia
| | | | - D Ramirez-Mendez
- Clínica Antioquia y Universidad Surcolombiana, Medellín, Colombia
| | - G A Castilla Agudelo
- Departamento de Medicina Interna, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - C A Martinez Cano
- Departamento de Cardiología Clínica, Universidad Pontificia Bolivariana y clínica CardioVID, Medellín, Colombia
| | - C Gallego
- Departamento de Cardiología Clínica y Cuidado Intensivo Cardiovascular, Universidad Pontificia Bolivariana y clínica CardioVID, Medellín, Colombia
| | - C Saldarriaga
- Departamento de Cardiología y Clínica de Insuficiencia Cardiaca, Universidad Pontificia Bolivariana, Universidad de Antioquia y clínica CardioVID, Medellín, Colombia
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