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Abdallah K, Udaipuria S, Murden R, McKinnon II, Erving CL, Fields N, Moore R, Booker B, Burey T, Dunlop-Thomas C, Drenkard C, Johnson DA, Vaccarino V, Lim SS, Lewis TT. Financial Hardship and Sleep Quality Among Black American Women With and Without Systemic Lupus Erythematosus. Psychosom Med 2024; 86:315-323. [PMID: 38724039 PMCID: PMC11090455 DOI: 10.1097/psy.0000000000001296] [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] [Indexed: 05/15/2024]
Abstract
OBJECTIVE To compare dimensions of financial hardship and self-reported sleep quality among Black women with versus without systemic lupus erythematosus (SLE). METHODS Participants were 402 Black women (50% with validated diagnosis of SLE) living in Georgia between 2017 and 2020. Black women with SLE were recruited from a population-based cohort established in Atlanta, and Black women without SLE were recruited to be of comparable age and from the same geographic areas as SLE women. Financial hardship was measured using three different scales: financial adjustments, financial setbacks, and financial strain. Sleep was assessed continuously using the Pittsburgh Sleep Quality Index (PSQI) scale. Each dimension of financial hardship was analyzed separately in SLE-stratified multivariable linear regression models and adjusted by sociodemographic and health status factors. RESULTS Dimensions of financial hardship were similarly distributed across the two groups. Sleep quality was worse in Black women with, versus without, SLE (p < .001). Among Black women with SLE, financial adjustment was positively associated with a 0.40-unit increase in poor sleep quality (95% CI = 0.12-0.67, p = .005). When accounting for cognitive depressive symptoms, financial setbacks and strain were somewhat attenuated for Black women with SLE. Overall, no associations between financial hardships and sleep quality were observed for the women without SLE. CONCLUSIONS Black women with SLE who experience financial hardships may be more at risk for poor sleep quality than Black women without SLE. Economic interventions targeting this population may help improve their overall health and quality of life.
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Affiliation(s)
- Khadijah Abdallah
- From the Department of Epidemiology (Abdallah, Udaipuria, Murden, McKinnon, Fields, Booker, Burey, Dunlop-Thomas, Drenkard, Johnson, Vaccarino, Lim, Lewis), Rollins School of Public Health, Emory University, Atlanta, Georgia; Department of Sociology (Erving), Population Research Center, University of Texas, Austin, Texas; Dornsife School of Public Health (Moore), Drexel University, Philadelphia, Pennsylvania; Division of Rheumatology (Drenkard), Emory University; and Division of Rheumatology (Lim), Grady Health System, Atlanta, Georgia
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2
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Oude Voshaar RC. The 'discontinuity hypothesis' of depression in later life-clinical and research implications. Age Ageing 2023; 52:afad239. [PMID: 38156879 PMCID: PMC10756079 DOI: 10.1093/ageing/afad239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 01/08/2023] [Indexed: 01/03/2024] Open
Abstract
The term depression is overused as an umbrella term for a variety of conditions, including depressed mood and various psychiatric disorders. According to psychiatric diagnostic criteria, depressive disorders impact nearly all aspects of human life and are a leading cause of disability worldwide. The widespread assumption that different types of depression lie on a continuum of severity has stimulated important research on subthreshold depression in later life. This view assumes that depressed mood is a precursor of a depressive disorder. The present narrative review argues why in later life depressed mood might either (i) lie on a continuum with depressive disorders among people vulnerable for a depressive disorder or (ii) be an ageing-related epiphenomenon of underlying physical illnesses in people who are resilient to depressive disorders ('discontinuity hypothesis'). Three arguments are discussed. First, the course of depressed mood and depressive disorders differs across the life span. Second, screening instruments for depression have low predictive value for depressive disorders in later life. Third, a dose-response relationship has not been consistently found across different types of depression and detrimental health outcomes. Using the umbrella term depression may partly explain why pharmacological treatment is less effective with increasing age, and negative health-related outcomes might be overestimated. The discontinuity hypothesis may prevent pharmacological overtreatment of milder subtypes of depression and may stimulate comprehensive multidisciplinary assessment as well as the development of separate treatment algorithms for depressed mood and depressive disorders.
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Affiliation(s)
- Richard C Oude Voshaar
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherland
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3
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Ben-Tzur D, Sabovich S, Hutzler Y, Rimon J, Zach S, Epstein M, Vadasz B, Diniz CV, Nabutovsky I, Klempfner R, Eilat-Adar S, Gabizon I, Menachemi DM, Grosman-Rimon L. Advances in Technology Promote Patient-Centered Care in Cardiac Rehabilitation. Cardiol Rev 2023:00045415-990000000-00144. [PMID: 37607080 DOI: 10.1097/crd.0000000000000599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Patient-centered health care (PCC) is a framework of clinical care focused on the patient's individual health care needs. In particular, it emphasizes the development of a partnership between the patient, physician, and healthcare workers to actively involve and empower the patient in their health care decisions. Additionally, PCC goals include ensuring access to care, emotional support, engaging patient support systems, physical comfort, and continuity of care. Technology also provides a platform to engage patients and their families in their care and can be a useful tool to gauge their level of interest, knowledge, and motivations to adequately educate them on the many factors that contribute to their disease, including diet, exercise, medication adherence, psychological support, and early symptom detection. In this article, we summarize the importance of technology in promoting PCC in cardiac rehabilitation and the impact technology may have on the different aspects of patient and physician relationships. Modern technological devices including smartphones, tablets, wearables, and other internet-enabled devices have been shown to help patient-staff communication, cater to patients' individual needs, increase access to health care, and implement aspects of PCC domains.
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Affiliation(s)
- Dana Ben-Tzur
- From the The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Solomon Sabovich
- University of Toronto, Faculty of Medicine, Toronto, Ontario, Canada
| | - Yeshayahu Hutzler
- School of Graduate Studies, Levinsky-Wingate Academic College, Wingate Institute, Netanya, Israel
| | - Jordan Rimon
- Faculty of Health, York University, Toronto, Ontario, Canada
| | - Sima Zach
- School of Graduate Studies, Levinsky-Wingate Academic College, Wingate Institute, Netanya, Israel
| | - Maor Epstein
- Department of Cardiology, Soroka Medical Center, Ben-Gurion University, Negev, Beer Sheva, Israel
| | - Brian Vadasz
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago
| | - Camilla V Diniz
- University of Toronto, Faculty of Medicine, Toronto, Ontario, Canada
| | - Irene Nabutovsky
- Cardiac Prevention and Rehabilitation Institute, Leviev Heart Center, Sheba Medical Center, Tel HaShomer, Israel, Faculty of Medicine, Tel Aviv University, Israel
| | - Robert Klempfner
- Cardiac Prevention and Rehabilitation Institute, Leviev Heart Center, Sheba Medical Center, Tel HaShomer, Israel, Faculty of Medicine, Tel Aviv University, Israel
| | - Sigal Eilat-Adar
- School of Graduate Studies, Levinsky-Wingate Academic College, Wingate Institute, Netanya, Israel
| | - Itzhak Gabizon
- Department of Cardiology, Soroka Medical Center, Ben-Gurion University, Negev, Beer Sheva, Israel
| | - Doron M Menachemi
- Internal Medicine and Heart Failure Services, Wolfson UMC Holon, Tel-Aviv University, Israel
| | - Liza Grosman-Rimon
- School of Graduate Studies, Levinsky-Wingate Academic College, Wingate Institute, Netanya, Israel
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4
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Monteiro AJ, de Labra C, Losa-Iglesias ME, Dias A, Becerro-de-Bengoa-Vallejo R, Silva-Migueis H, Cardoso P, López-López D, Gómez-Salgado J. Depressive symptoms and their severity in a sample with lymphedema: a case-control investigation. Front Psychiatry 2023; 14:1202940. [PMID: 37476539 PMCID: PMC10354281 DOI: 10.3389/fpsyt.2023.1202940] [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: 04/09/2023] [Accepted: 06/13/2023] [Indexed: 07/22/2023] Open
Abstract
Objectives Depression is a condition that can be associated with other illnesses, especially chronic illnesses. Lower limb lymphedema is a chronic, disabling condition that can affect the quality of life and be related to psychological and psychosocial factors that interfere with people's lives. This study aims to characterize and analyze the depressive symptoms and their severity reported by people with lower limb lymphedema and compare them with a matched group without lymphedema. Methods A case-control study was carried out (n = 80) with participants divided into a case group (40 people with lower limb lymphedema) and a control group (40 people without lower limb lymphedema). Both groups were anthropometrically, sociodemographically, and clinically characterized. In the case group, a characterization of lymphedema was performed. Participants completed the Beck Depression Inventory-II. Results Individuals with lower limb lymphedema have higher BDI-II scores than the matched group without lymphedema. Somatic depressive symptoms were, in general, the most reported and the ones with the highest scores. The depressive symptoms most reported by the case group were tiredness or fatigue, loss of energy, and changes in sleeping. Tiredness or fatigue, loss of energy, and loss of interest in sex were the most severe depressive symptoms reported by individuals with lower limb lymphedema. Conclusion Considering the apparent tendency to depression, greater attention should be given to the mental health of people with lower limb lymphedema.
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Affiliation(s)
- Ana Júlia Monteiro
- Research, Health, and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Industrial Campus of Ferrol, Universidade da Coruña, Ferrol, Spain
- Physiotherapy Department, Escola Superior de Saúde da Cruz Vermelha Portuguesa - Lisboa, Lisbon, Portugal
| | - Carmen de Labra
- NEUROcom, Centro Interdisciplinar de Química e Bioloxía (CICA), Instituto de Investigación Biomédica de A Coruña (INIBIC), School of Nursery and Podiatry, University of A Coruña, A Coruña, Spain
| | | | - Adriano Dias
- Epidemiology – Department of Public Health and Grade Program of Public/Collective Health, Botucatu Medical School/UNESP, Botucatu, Brazil
| | | | - Helena Silva-Migueis
- Research, Health, and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Industrial Campus of Ferrol, Universidade da Coruña, Ferrol, Spain
- Physiotherapy Department, Escola Superior de Saúde da Cruz Vermelha Portuguesa - Lisboa, Lisbon, Portugal
| | - Paula Cardoso
- Physiotherapy Department, Escola Superior de Saúde da Cruz Vermelha Portuguesa - Lisboa, Lisbon, Portugal
- Instituto Português de Oncologia de Lisboa Francisco Gentil – E.P.E. – Lisboa, Lisboa, Portugal
| | - Daniel López-López
- Research, Health, and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Industrial Campus of Ferrol, Universidade da Coruña, Ferrol, Spain
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
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5
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Prins EM, Geerlings AD, Ben-Shlomo Y, Meinders MJ, Bloem BR, Darweesh SKL. Determinants of coping styles of people with Parkinson's Disease. NPJ Parkinsons Dis 2023; 9:99. [PMID: 37369650 DOI: 10.1038/s41531-023-00548-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Little is known about how people with Parkinson's disease (PD) cope with stressful life events. We examined the determinants of specific coping strategies and whether specific choices have any impact on quality of life (QoL). We recruited patients with PD who had been seen at a neurology outpatient clinic at least once during the past year as part of the PRIME-NL cohort study. Coping was measured using the Ways of Coping Questionnaire (WCQ) and QoL was measured using the Parkinson's Disease Questionnaire (PDQ-39). 977 out of 988 participants completed the questionnaires and 935 participants were diagnosed with PD. Factor analysis was undertaken to test if ways of coping were similar or different to previous findings in a PD population. We used linear regression analyses to examine predictors of coping styles. We then used multivariable linear regression to test how coping style was associated with the domains of QoL conditional on potential confounders. The five coping styles identified by the factor analysis were: "taking action and emphasizing the positive", "distancing and fantasizing", "goal oriented and planful problem solving", "seeking social support" and "avoidance and acceptance". Age, gender, education and anxiety were associated with the type of coping strategy. For example, higher education was associated with more active coping strategies (e.g. β = 4.39, p < 0.001 for goal oriented). Conditional on other confounders, most coping strategies had little effect on QoL domains. These findings demonstrate that coping behavior of people with PD is influenced by psychological status and personal traits. However, there was only a modest effect of coping behavior on QoL. Future research needs to test whether the enhancement or discouragement of certain coping strategies is feasible and can enhance QoL.
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Affiliation(s)
- Eva M Prins
- Radboud University Medical Center; Donders Institute for Brain, Cognition and Behaviour; Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Nijmegen, The Netherlands
| | - Angelika D Geerlings
- Radboud University Medical Center; Donders Institute for Brain, Cognition and Behaviour; Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Nijmegen, The Netherlands
| | - Yoav Ben-Shlomo
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU, UK
| | - Marjan J Meinders
- Radboud University Medical Center; Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare, Nijmegen, The Netherlands
| | - Bastiaan R Bloem
- Radboud University Medical Center; Donders Institute for Brain, Cognition and Behaviour; Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Nijmegen, The Netherlands
| | - Sirwan K L Darweesh
- Radboud University Medical Center; Donders Institute for Brain, Cognition and Behaviour; Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Nijmegen, The Netherlands.
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Importance of Depressive Symptoms in Patients With Coronary Heart Disease - Review Article. Curr Probl Cardiol 2023; 48:101646. [PMID: 36773947 DOI: 10.1016/j.cpcardiol.2023.101646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 02/04/2023] [Indexed: 02/12/2023]
Abstract
Patients with myocardial infarction (MI) have both major depression as well as depressive symptoms. Therefore, due to the high prevalence of depression in post-MI patients, an assessment of its prognostic importance was put on the agenda. Patients after ACS frequently report fatigue, sleep problems, and sadness. Evaluation of these symptoms is very important because it should be clarified whether these symptoms are related only to the main disease or they indicate the presence of concomitant depression. Given a high predictive value of somatic-affective symptoms, it is recommended to assess them in post-MI patients. Further treatment of somatic and cognitive-affective symptoms of depression will improve the quality of life of patients with acute coronary events.
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7
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Lombardo G, Nettis MA, Hastings C, Zajkowska Z, Mariani N, Nikkheslat N, Worrell C, Enache D, McLaughlin A, Kose M, Bogdanova A, Sforzini L, Cleare AJ, Young AH, Dazzan P, Mondelli V, Pariante CM. Sex differences in a double-blind randomized clinical trial with minocycline in treatment-resistant depressed patients: CRP and IL-6 as sex-specific predictors of treatment response. Brain Behav Immun Health 2022; 26:100561. [PMID: 36467125 PMCID: PMC9712814 DOI: 10.1016/j.bbih.2022.100561] [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: 11/09/2022] [Accepted: 11/13/2022] [Indexed: 11/18/2022] Open
Abstract
Background Inflammation is a well-known risk factor for depression. Specifically, patients who do not respond to antidepressant treatment show higher levels of inflammatory biomarkers compared with responders. Thus, several studies have investigated the efficacy of anti-inflammatory add-on treatment in this population. However, major depressive disorder is more prevalent in females than in males, with sex differences present in antidepressant treatment response and in immune system regulation. To explore sex differences in inflammatory profiles and treatment responses, we investigated a cohort of patients with treatment resistant depression (TRD), for which they received an adjunctive, anti-inflammatory treatment with minocycline - the Minocycline in Depression (MINDEP) study. Methods The MINDEP study is a 4-week double-blind, randomised, placebo-controlled clinical trial (stratified by sex) with 39 TRD participants, which demonstrated the efficacy of minocycline, an antibiotic with anti-inflammatory properties, in TRD patients with major depressive disorder (MDD) and evidence of low-grade inflammation measured with C-reactive protein (CRP) ≥ 3 mg/L. In these secondary analyses, we investigated the differential effects of minocycline in females (N = 22, 10 randomised to minocycline and 12 randomised to placebo) and in males (N = 17, 8 randomised to minocycline and 9 randomised to placebo) on changes in depressive symptoms (Δ- Hamilton Rating Scale for Depression (HAMD)-17), taking also into consideration CRP levels (CRP ≥3 mg/L vs. CRP <3 mg/L). Additionally, we investigated the role of serum IL-6 in predicting treatment response to minocycline, using sex-specific medians of IL-6, in novel exploratory analyses. Results Sex differences in Δ-HAMD-17 indicate that only females (F = 10.49, p = 0.005), but not males (F = 1.64, p = 0.22), presented an effect of CRP levels on the response to minocycline. Also, we detected sex differences in the relationship between serum CRP and IL-6 levels: CRP was strongly correlated with IL-6 in females (Spearman's ρ = 0.658, P < 0.001) but not in males (ρ = 0.007, p = 0.979). Exploratory analyses found that IL-6 was indeed a better predictor of response than minocycline than CRP, as we found an interaction between study arms and IL-6 groups (above and below the IL-6 sex-specific median) in females (F = 4.435 p = 0.050) and, at trend statistical level, in males (F = 4.258 p = 0.060). Moreover, Δ-HAMD-17 was numerically comparable in the two high-IL-6 group taking minocycline (females, mean 9.20 ± SD 7.80; males, mean 8.80 ± SD 5.97), confirming that high IL-6, differently from high CRP, identified responders to minocycline both in males and females. Conclusion Our findings highlight the need of sex-specific inflammatory biomarkers in predicting antidepressant response to anti-inflammatories in TRD patients, with the possibility of CRP being a relevant predictor of treatment response only for females, and IL-6 being relevant for both sexes.
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Affiliation(s)
- Giulia Lombardo
- King's College London, Institute of Psychiatry Psychology and Neuroscience, Department of Psychological Medicine, London, UK
| | - Maria Antonietta Nettis
- King's College London, Institute of Psychiatry Psychology and Neuroscience, Department of Psychological Medicine, London, UK.,National Institute for Health Research Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Caitlin Hastings
- King's College London, Institute of Psychiatry Psychology and Neuroscience, Department of Psychological Medicine, London, UK
| | - Zuzanna Zajkowska
- King's College London, Institute of Psychiatry Psychology and Neuroscience, Department of Psychological Medicine, London, UK
| | - Nicole Mariani
- King's College London, Institute of Psychiatry Psychology and Neuroscience, Department of Psychological Medicine, London, UK
| | - Naghmeh Nikkheslat
- King's College London, Institute of Psychiatry Psychology and Neuroscience, Department of Psychological Medicine, London, UK
| | - Courtney Worrell
- King's College London, Institute of Psychiatry Psychology and Neuroscience, Department of Psychological Medicine, London, UK
| | - Daniela Enache
- King's College London, Institute of Psychiatry Psychology and Neuroscience, Department of Psychological Medicine, London, UK.,Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Anna McLaughlin
- King's College London, Institute of Psychiatry Psychology and Neuroscience, Department of Psychological Medicine, London, UK
| | - Melisa Kose
- King's College London, Institute of Psychiatry Psychology and Neuroscience, Department of Psychological Medicine, London, UK
| | - Anna Bogdanova
- King's College London, Institute of Psychiatry Psychology and Neuroscience, Department of Psychological Medicine, London, UK
| | - Luca Sforzini
- King's College London, Institute of Psychiatry Psychology and Neuroscience, Department of Psychological Medicine, London, UK
| | - Anthony J Cleare
- King's College London, Institute of Psychiatry Psychology and Neuroscience, Department of Psychological Medicine, London, UK.,National Institute for Health Research Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Allan H Young
- King's College London, Institute of Psychiatry Psychology and Neuroscience, Department of Psychological Medicine, London, UK.,National Institute for Health Research Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Paola Dazzan
- King's College London, Institute of Psychiatry Psychology and Neuroscience, Department of Psychological Medicine, London, UK.,National Institute for Health Research Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Valeria Mondelli
- King's College London, Institute of Psychiatry Psychology and Neuroscience, Department of Psychological Medicine, London, UK.,National Institute for Health Research Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Carmine M Pariante
- King's College London, Institute of Psychiatry Psychology and Neuroscience, Department of Psychological Medicine, London, UK.,National Institute for Health Research Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King's College London, London, UK
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Impact of fasting on stress systems and depressive symptoms in patients with major depressive disorder: a cross-sectional study. Sci Rep 2022; 12:7642. [PMID: 35538177 PMCID: PMC9091273 DOI: 10.1038/s41598-022-11639-1] [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: 12/15/2021] [Accepted: 04/22/2022] [Indexed: 11/08/2022] Open
Abstract
Major depressive disorder (MDD) is frequently associated with poor response to treatment. Common antidepressants target neurotransmission and neuronal plasticity, which require adequate energy supply. As imaging studies indicate disturbances in central energy metabolism, and caloric restriction improves neuroplasticity and impacts mood and cognition, correction of energy status might increase the effectiveness of antidepressant treatments and reduce the psychopathological symptoms of depression. Metabolic parameters, stress hormones, and brain-derived neurotrophic factor (BDNF) levels were assessed in serum of depressed inpatients (MDD, N = 21) and healthy volunteers (Ctrl, N = 28) before and after a 72 h fasting period during which only water was consumed. Depression severity was assessed by Beck's Depression Inventory (BDI)-2 sum-score and cognitive-affective and somatic sub-scores. Fasting similarly impacted metabolic parameters and stress systems in both groups. Fasting elevated BDI-2 sum-scores and somatic sub-scores in Ctrl. In MDD, fasting increased somatic-, but decreased cognitive-affective symptoms. Sub-group analyses based on BDI-2 sum-scores pre-fasting showed that cognitive-affective symptoms decreased in patients with moderate/severe but not in those with mild symptoms. This was associated with differential changes in BDNF levels. In conclusion, fasting improved cognitive-affective sub-scores in MDD patients with moderate/severe symptoms that had not responded to prior therapy. Interventions that modulate energy metabolism might directly improve cognitive-affective symptoms and/or augment therapeutic efficacy in moderate-to-severely depressed patients.
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Borges MK, Aprahamian I, Romanini CV, Oliveira FM, Mingardi SVB, Lima NA, Cecato JF, Petrella M, Oude Voshaar RC. Depression as a determinant of frailty in late life. Aging Ment Health 2021; 25:2279-2285. [PMID: 33307781 DOI: 10.1080/13607863.2020.1857689] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Accumulating evidence shows depression as a risk factor for frailty, but studies are mainly population-based and widely differ in their assessment of either depression or frailty. We investigated the association between depression and frailty among geriatric outpatients using different assessment instruments for both conditions. METHOD Among 315 geriatric outpatients (mean age 72.1 years, 68.3% female sex) participating the MiMiCS-FRAIL cohort study, major and subthreshold depression were measured with psychiatric diagnostic interview according to DSM-5 criteria (SCID-5) as well as with instruments to screen and measure severity of depressive symptoms (GDS-15 and PHQ-9). Frailty was assessed according to a screening instrument (FRAIL-BR) and a multidimensional Frailty Index (FI-36 items). Multiple logistic and linear regression were performed to assess the association between depression (independent variable) and frailty (dependent variable) adjusted for confounders. RESULTS Frailty prevalence in patients with no, subthreshold or major depressive disorder increases from either 14.5%, 46.5% to 65.1% when using the FRAIL-BR questionnaire, and from 10.2%, 20.9%, to 30.2% when using the FI-36 index. These association remain nearly the same when adjusted for covariates. Both the FRAIL-BR and the FI-36 were strongly associated with major depressive disorder, subthreshold depression, and depressive symptoms by PHQ-9 and GDS-15. CONCLUSION Late life depression and frailty are associated in a dose-dependent manner, irrespective of the used definitions. Nonetheless, to avoid residual confounding, future research on underlying biological mechanisms should preferably be based on formal psychiatric diagnoses and objectively assessment frailty status.
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Affiliation(s)
- Marcus K Borges
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Ivan Aprahamian
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.,Geriatrics Division, Internal Medicine Department, Jundiaí Medical School, Group of Investigation on Multimorbidity and Mental Health in Aging (GIMMA), Jundiaí, Brazil.,Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Carla V Romanini
- Geriatrics Division, Internal Medicine Department, Jundiaí Medical School, Group of Investigation on Multimorbidity and Mental Health in Aging (GIMMA), Jundiaí, Brazil
| | - Fabiana M Oliveira
- Geriatrics Division, Internal Medicine Department, Jundiaí Medical School, Group of Investigation on Multimorbidity and Mental Health in Aging (GIMMA), Jundiaí, Brazil
| | - Silvana V B Mingardi
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.,Geriatrics Division, Internal Medicine Department, Jundiaí Medical School, Group of Investigation on Multimorbidity and Mental Health in Aging (GIMMA), Jundiaí, Brazil
| | - Natália A Lima
- Geriatrics Division, Internal Medicine Department, Jundiaí Medical School, Group of Investigation on Multimorbidity and Mental Health in Aging (GIMMA), Jundiaí, Brazil
| | - Juliana F Cecato
- Geriatrics Division, Internal Medicine Department, Jundiaí Medical School, Group of Investigation on Multimorbidity and Mental Health in Aging (GIMMA), Jundiaí, Brazil
| | - Marina Petrella
- Geriatrics Division, Internal Medicine Department, Jundiaí Medical School, Group of Investigation on Multimorbidity and Mental Health in Aging (GIMMA), Jundiaí, Brazil
| | - Richard C Oude Voshaar
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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10
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The Effect of Depression on Health-Related Quality of Life Is Mediated by Fatigue in Persons with Multiple Sclerosis. Brain Sci 2021; 11:brainsci11060751. [PMID: 34198920 PMCID: PMC8227168 DOI: 10.3390/brainsci11060751] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 06/01/2021] [Indexed: 11/17/2022] Open
Abstract
The interrelations between fatigue, depression and health-related quality of life (HRQoL) in persons with multiple sclerosis (PwMS) are complex, and the directionality of the effects is unclear. To address this gap, the current study used a longitudinal design to assess direct and indirect effects of fatigue and depression on HRQoL in a one-year follow-up survey. A sample of 210 PwMS from the nationwide Swiss MS Registry was used. HRQoL was assessed using the European Quality of Life 5-Dimension 5-Level questionnaire. Path analysis on HRQoL, with fatigue and depression as predictors, was applied. Fatigue was measured by the Modified Fatigue Impact Scale (MFIS), including physical, cognitive and psychosocial subscales, and non-somatic depressive symptomatology was examined with the Beck Depression Inventory-Fast Screen (BDI-FS). Fatigue acted as a fully mediating variable (B = -0.718, SE = 0.253) between non-somatic depressive symptomatology and HRQoL. This indirect effect became apparent in the physical (B = -0.624, SE = 0.250), psychosocial (B = -0.538, SE = 0.256) and cognitive subscales (B = -0.485, SE = 0.192) of fatigue. In contrast, non-somatic depressive symptomatology did not act as a mediator. Our findings provide novel and clinically relevant longitudinal evidence showing that the debilitating effect of non-somatic aspects of depression on HRQoL was fully mediated and therefore explainable via fatigue.
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Boecking B, Rose M, Brueggemann P, Mazurek B. Two birds with one stone.-Addressing depressive symptoms, emotional tension and worry improves tinnitus-related distress and affective pain perceptions in patients with chronic tinnitus. PLoS One 2021; 16:e0246747. [PMID: 33705407 PMCID: PMC7951911 DOI: 10.1371/journal.pone.0246747] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 01/26/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Psychological factors link the co-occurrence of tinnitus-related distress and pain perceptions in patients with chronic tinnitus. OBJECTIVE This study examines, if treatment-related changes in these factors ameliorate both tinnitus-related distress and pain perceptions in a sample of patients with chronic tinnitus. METHODS N = 1238 patients with chronic tinnitus provided pre- and post-treatment ratings of tinnitus-related distress and affective or sensory pain perceptions alongside measures of depressive symptoms and perceived stress. Treatment comprised an intensive tinnitus-specific multimodal treatment program. Using serial indirect-effects analyses, we examined association patterns between baseline values and change rates of those variables that were found to respond to treatment. RESULTS Small effect sizes emerged for changes in tinnitus-related distress, affective (but not sensory) pain perceptions, depressive symptoms, emotional tension and worry. At pre- or post-treatment respectively, baseline values and change rates intercorrelated. Across timepoints, (1) baseline tinnitus-related distress and affective pain perceptions were positively associated with improvements in tinnitus-related distress, affective pain perceptions and depressive symptoms. (2) Baseline depressive symptoms or emotional tension mediated positive associations between baseline tinnitus-related distress and improvement in affective pain perceptions. (3) Change in depressive symptoms mediated the effect of baseline tinnitus-related distress on change in affective pain perceptions-partly through associated change in emotional tension or worry. Mood-independent aspects of emotional tension were negatively associated with improvement in affective pain perceptions. CONCLUSIONS Depressive symptoms, emotional tension and worry emerge as key predictors of treatment response and transdiagnostic treatment targets for alleviating tinnitus-related distress and functionally associated affective pain perceptions.
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Affiliation(s)
- Benjamin Boecking
- Charité–Universitaetsmedizin Berlin—Tinnitus Center, Berlin, Germany
| | - Matthias Rose
- Division of Psychosomatic Medicine, Medical Department, Charité–Universitaetsmedizin Berlin, Berlin, Germany
| | - Petra Brueggemann
- Charité–Universitaetsmedizin Berlin—Tinnitus Center, Berlin, Germany
| | - Birgit Mazurek
- Charité–Universitaetsmedizin Berlin—Tinnitus Center, Berlin, Germany
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12
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Tully PJ, Higgins R. Depression Screening, Assessment, and Treatment for Patients with Coronary Heart Disease: A Review for Psychologists. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12075] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Phillip J Tully
- Freemasons Foundation Centre for Men's Health, Discipline of Medicine, School of Medicine, The University of Adelaide,
- Department of Medicine, Flinders Medical Centre and Flinders University of South Australia,
| | - Rosemary Higgins
- Heart Research Centre,
- Department of Physiotherapy, The University of Melbourne,
- Cabrini Health,
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Winzer E, Ludvik B, Grabovac I, Kruschitz R, Schindler K, Prager G, Klammer C, Hoppichler F, Marculescu R, Wakolbinger M. Course of depressive symptomatology and its association with serum uric acid in one-anastomosis gastric bypass patients. Sci Rep 2020; 10:18405. [PMID: 33110226 PMCID: PMC7591541 DOI: 10.1038/s41598-020-75407-9] [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: 01/20/2020] [Accepted: 10/13/2020] [Indexed: 11/09/2022] Open
Abstract
The changes in depressive symptomatology during the first year following one-anastomosis gastric bypass (OAGB) were evaluated and its association with uric acid (sUA). Fifty patients were included in this analysis. Beck Depression Inventory (BDI) for measuring depressive symptomatology, blood samples, and anthropometric measurements were assessed before (T0), at 6 (T6), and 12 months (T12) after surgery. There was a significant reduction in BDI total score at T6 (− 5.6 (95% CI − 2.1, − 9.1) points; p = 0.001) and at T12 (− 4.3 (95% CI − 0.9, − 7.9) points; p = 0.011). BMI loss was unrelated to depressive symptomatology. Patients with moderate to severe depressive symptomatology presented lower sUA levels than patients with none or minimal to mild (p = 0.028). ROC analysis revealed that sUA levels below 5.0 at T6 and 4.5 mg/dl at T12 had a prognostic accuracy for depression severity. Furthermore, delta sUA was significantly associated with delta BMI (β = 0.473; p = 0.012) and delta waist circumference (β = 0.531; p = 0.003). These findings support an improvement in depressive symptomatology in the first year postoperatively, however, without relation to BMI loss. Patients with moderate to severe depressive symptomatology presented with lower sUA levels over time. Therefore, sUA could be useful to predict moderate to severe depressive symptomatology in patients undergoing OAGB in clinical practice.
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Affiliation(s)
- Eva Winzer
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria.,Special Institute for Preventive Cardiology and Nutrition-SIPCAN, Salzburg, Austria
| | - Bernhard Ludvik
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.,Department of Medicine 1 and Karl Landsteiner Institute for Obesity and Metabolic Diseases, Rudolfstiftung Hospital, Vienna, Austria
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria.
| | - Renate Kruschitz
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.,Division of Internal Medicine, General Public Hospital of the Order of Saint Elisabeth, Klagenfurt, Austria
| | - Karin Schindler
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Gerhard Prager
- Division of General Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - Carmen Klammer
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.,Department of Internal Medicine, Convent of the Brothers of Saint John of God Linz, Linz, Austria
| | - Friedrich Hoppichler
- Special Institute for Preventive Cardiology and Nutrition-SIPCAN, Salzburg, Austria.,Division of Internal Medicine, General Public Hospital of the Brothers of St. John of God Salzburg, Salzburg, Austria
| | - Rodrig Marculescu
- Clinical Institute for Medical and Chemical Laboratory Diagnostics, Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Maria Wakolbinger
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria.,Special Institute for Preventive Cardiology and Nutrition-SIPCAN, Salzburg, Austria.,Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
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Willem C, Gandolphe MC, Doba K, Roussel M, Verkindt H, Pattou F, Nandrino JL. Eating in case of emotion dys-regulation, depression and anxiety: Different pathways to emotional eating in moderate and severe obesity. Clin Obes 2020; 10:e12388. [PMID: 32633060 DOI: 10.1111/cob.12388] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/09/2020] [Accepted: 06/10/2020] [Indexed: 12/20/2022]
Abstract
Emotion dys-regulation is thought to be involved in the development and maintenance of emotional eating (EE), notably through its links with anxious and depressive symptoms. AIM: The aims of the study were to: (a) examine the mediating effect of depressive and anxious symptoms on the relationship between emotion dys-regulation and EE in obesity and (b) compare those links with various degrees of obesity severity. One hundred and twenty patients with obesity, including 60 with "n" (MO) (30 ≤ BMI < 40) and 60 with "severe obesity" (SO) (BMI > 40), completed self-report measures of emotion dys-regulation, depression, anxiety and EE. Partial least square structural equation modelling and multi-group analyses were performed. Emotion dys-regulation was found to be significantly associated with EE only when the severity of obesity was taken into account. In addition, although the MO and SO groups reported similar levels of emotional and eating disorders, significant differences were found between the groups in pathways leading to EE. In MO, emotion dys-regulation was only associated with more EE through more anxiety. In SO, emotion dys-regulation was both directly and indirectly associated with more EE, but only through more depression in the latter. Emotion dys-regulation, anxiety and depression do not have the same impact on EE depending on the severity of obesity. Psychotherapeutic interventions should aim at reducing emotion dys-regulation in obesity from MO onwards, but the focus should be on the management of anxiety-related affects in MO and depression-related affects in SO.
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Affiliation(s)
- Clémence Willem
- SCALab - Cognitive and Affective Sciences (UMR 9193), Department of psychology, University of Lille, Lille, France
| | - Marie-Charlotte Gandolphe
- SCALab - Cognitive and Affective Sciences (UMR 9193), Department of psychology, University of Lille, Lille, France
| | - Karyn Doba
- SCALab - Cognitive and Affective Sciences (UMR 9193), Department of psychology, University of Lille, Lille, France
| | - Méline Roussel
- Diabetology Center - CETRADIMN, Roubaix Hospital, Roubaix, France
| | - Hélène Verkindt
- General and Endocrine Surgery, Faculty of Medicine, University of Lille, CHU Lille, Inserm, Lille, France
| | - François Pattou
- General and Endocrine Surgery, Faculty of Medicine, University of Lille, CHU Lille, Inserm, Lille, France
| | - Jean-Louis Nandrino
- SCALab - Cognitive and Affective Sciences (UMR 9193), Department of psychology, University of Lille, Lille, France
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15
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Gruszka W, Wyskida K, Owczarek AJ, Jędrusik E, Alraquayee N, Glinianowicz M, Bąk-Sosnowska M, Chudek J, Olszanecka-Glinianowicz M. The occurrence of depressive symptoms in obese subjects starting treatment and not seeking treatment for obesity. Eat Weight Disord 2020; 25:283-289. [PMID: 30264389 PMCID: PMC7083818 DOI: 10.1007/s40519-018-0578-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 09/11/2018] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION The psychological profile of obese people deciding to start obesity treatment may be different from those not choosing to seek the therapy. Previous studies have shown a higher incidence of depression in obese than in normal weight people. However, data are lacking concerning the occurrence of depressive symptoms and their severity in obese subjects who do or do not decide to start treatment for obesity. Therefore, the aim of this study was to evaluate the prevalence and severity of depressive symptoms among obese people starting treatment and not seeking treatment for obesity. MATERIALS AND METHODS Enrolled subjects were 331 adults (241 women, 90 men), including 193 obese subjects starting treatment for obesity (46.8 ± 13.2 years, BMI 37.6 ± 5.5 kg/m2) and 138 obese volunteers never seeking treatment for obesity (44.3 ± 12.5 years, BMI 34.7 ± 4.3 kg/m2). Depression levels were determined using the Beck Depression Inventory (BDI). RESULTS The level of depression was significantly higher among those starting treatment for obesity than those never seeking treatment for obesity (13.2 ± 9.2 vs. 9.5 ± 7.9 points; p < 0.001). This difference was statistically significant in women (14.4 ± 9.2 and 11.0 ± 8.2 points, respectively; p < 0.01), but not in men (7.2 ± 6.4 and 7.3 ± 7.1 points, respectively; p = 0.95). There were more women with moderate/severe depressive symptoms in the group starting treatment than in the group not seeking treatment for obesity (44.7 and 24.4%, respectively). No such difference was observed in men. CONCLUSIONS Obese subjects, especially women, with depressive symptoms are more likely to start treatment for obesity. LEVEL OF EVIDENCE Level III, case-control analytic study.
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Affiliation(s)
- Wojciech Gruszka
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, Katowice, Poland.
- Pathophysiology Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, Medyków Street 18 20, 40-752, Katowice, Poland.
| | - Katarzyna Wyskida
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, Katowice, Poland
| | - Aleksander J Owczarek
- Department of Statistics, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Katowice, Poland
| | - Ewa Jędrusik
- Department of Statistics, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Katowice, Poland
| | - Nasser Alraquayee
- Pathophysiology Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, Medyków Street 18 20, 40-752, Katowice, Poland
| | - Mateusz Glinianowicz
- Department of Psychology, Chair of Social Sciences and Humanities, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
| | - Monika Bąk-Sosnowska
- Department of Psychology, Chair of Social Sciences and Humanities, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
| | - Jerzy Chudek
- Pathophysiology Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, Medyków Street 18 20, 40-752, Katowice, Poland
- Department of Internal Medicine and Oncological Chemotherapy, Medical Faculty in Katowice, Medical University of Silesia, Katowice, Poland
| | - Magdalena Olszanecka-Glinianowicz
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, Katowice, Poland
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Allary A, Proulx-Tremblay V, Bélanger C, Hudon C, Marchand A, O'Connor K, Pérodeau G, Roberge P, Tannenbaum C, Vasiliadis HM, Desrosiers C, Cruz-Santiago D, Grenier S. Psychological predictors of benzodiazepine discontinuation among older adults: Results from the PASSE 60. Addict Behav 2020; 102:106195. [PMID: 31838367 DOI: 10.1016/j.addbeh.2019.106195] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 10/22/2019] [Accepted: 10/24/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND Long-term benzodiazepine (BZD) use among seniors is mostly inappropriate and associated with adverse health outcomes. To prevent these consequences, withdrawal is crucial, yet knowledge is limited about what predicts BZD discontinuation. Until now, most studies have focused on sociodemographic and BZD intake factors as predictors while neglecting psychological factors. This research addresses this issue by studying how the intensity of depressive symptoms, social support satisfaction, self-perceived competence in the ability to withdraw, and overall quality of sleep predict discontinuation in long-term older consumers. METHOD Seventy-three participants aged 60 years and older were enrolled in this study. There were four time measures: before discontinuation (T1), after (T2), 3 months after (T3), and 12 months after (T4). Data were collected in the "Programme d'Aide du Succès au SEvrage" (PASSE-60+) study. RESULTS Social support satisfaction predicted discontinuation at T2 and T4. Self-perceived competence in the ability to withdraw and depressive symptoms predicted discontinuation at T4. This later prediction was counterintuitive; higher depressive symptoms at T1 were linked with higher discontinuation success. BZD intake factors (length of use and dose) were good predictors for short term discontinuation. Psychological factors were moderate predictors for short term and good predictors for long term discontinuation. CONCLUSION Psychological factors are good predictors of discontinuation and are better predictors than BZD intake factors of long-term discontinuation. Discontinuation programs should focus on social support and self-perceived competence to improve their efficacy. Further studies are needed to acquire a more complete picture of the psychological predictors of discontinuation success. ClinicalTrials.gov Identifier: NCT02281175.
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Affiliation(s)
- Arnaud Allary
- Département de psychologie, Université du Québec à Montréal (UQAM), Québec, Canada; Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Québec, Canada
| | - Virginie Proulx-Tremblay
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Québec, Canada; Département de psychologie, Université de Montréal, Québec, Canada
| | - Claude Bélanger
- Département de psychologie, Université du Québec à Montréal (UQAM), Québec, Canada
| | - Carol Hudon
- École de psychologie de l'Université Laval, Québec, Canada; Centre de recherche CERVO, Québec, Canada
| | - André Marchand
- Département de psychologie, Université du Québec à Montréal (UQAM), Québec, Canada
| | - Kieron O'Connor
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Québec, Canada
| | - Guilhème Pérodeau
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais (UQO), Québec, Canada
| | - Pasquale Roberge
- Département de médecine de famille et de médecine d'urgence à l'Université de Sherbrooke, Québec, Canada
| | - Cara Tannenbaum
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Québec, Canada; Faculté de médicine, Université de Montréal, Québec, Canada; Faculté de pharmacie, Université de Montréal, Québec, Canada
| | | | - Caroline Desrosiers
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Québec, Canada
| | - Diana Cruz-Santiago
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Québec, Canada; Département de médecine familiale et de médecine d'urgence, Université de Montréal, Québec, Canada
| | - Sébastien Grenier
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Québec, Canada; Département de psychologie, Université de Montréal, Québec, Canada.
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Li H, Marsland AL, Conley YP, Sereika SM, Bender CM. Genes Involved in the HPA Axis and the Symptom Cluster of Fatigue, Depressive Symptoms, and Anxiety in Women With Breast Cancer During 18 Months of Adjuvant Therapy. Biol Res Nurs 2020; 22:277-286. [PMID: 31908177 DOI: 10.1177/1099800419899727] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
This study aimed to (1) identify subgroups of women with breast cancer with the psychological symptom cluster (fatigue, depressive symptoms, and anxiety) during the first 18 months of adjuvant therapy and (2) explore associations between demographic and clinical characteristics and variations in genetic polymorphisms related to hypothalamic-pituitary-adrenal (HPA) axis function and predicted symptom trajectory subgroup membership. We obtained symptom data at 4 time points from baseline to 18 months of adjuvant therapy among 292 postmenopausal women with breast cancer. Genetic data were collected in a subgroup at baseline (N = 184). Group-based multitrajectory modeling was used to classify women into subgroups with similar psychological symptom cluster trajectories. Binary logistic regression was used to explore the associations between each genotypic and phenotypic predictor and predicted subgroup membership. Two distinct symptom subgroups (low and high) were identified based on the trajectories of the symptom cluster of fatigue, depressive symptoms, and anxiety over the first 18 months of adjuvant therapy. Women who were younger, less educated, and who received chemotherapy had greater likelihood of being in the high-symptom subgroup. Variation in genes regulating the HPA axis (FKBP5 rs9394309 [odds ratio (OR) = 3.98, p = .015], NR3C2 rs5525 [OR = 2.54, p = .036], and CRHR1 rs12944712 [OR = 3.99, p = .021]) was associated with membership in the high-symptom subgroup. These results may help to identify women with breast cancer who are at increased risk for psychological symptoms, facilitating the development of individualized and preemptive interventions to better manage these symptoms during adjuvant therapy.
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Affiliation(s)
- Hongjin Li
- Department of Health and Community Systems, School of Nursing, University of Pittsburgh, PA, USA
| | | | - Yvette P Conley
- Department of Health Promotion and Development, School of Nursing, University of Pittsburgh, PA, USA
| | - Susan M Sereika
- Center for Research and Evaluation, University of Pittsburgh, PA, USA.,Department of Health and Community Systems, University of Pittsburgh, PA, USA
| | - Catherine M Bender
- Department of Health and Community Systems, School of Nursing, University of Pittsburgh, PA, USA
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The Association Between Depressive Symptoms and N-Terminal Pro-B-Type Natriuretic Peptide With Functional Status in Patients With Heart Failure. J Cardiovasc Nurs 2019; 33:378-383. [PMID: 29438191 DOI: 10.1097/jcn.0000000000000470] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND N-terminal pro-B-type natriuretic peptide (NT-proBNP) and depressive symptoms are each associated with functional status in patients with heart failure (HF), but their association together with functional status has not been examined. OBJECTIVE The aim of this study was to determine whether functional status scores differ as a function of depressive symptoms and NT-proBNP levels considered together. METHODS We studied 284 patients with HF who were divided into 4 groups based on the median split of NT-proBNP levels and cut point for depressive symptoms (Beck Depression Inventory ≥ 14): (1) low NT-proBNP of 562.5 pg/mL or less without depressive symptoms, (2) low NT-proBNP of 562.5 pg/mL or less with depressive symptoms, (3) high NT-proBNP of greater than 562.5 pg/mL without depressive symptoms, and (4) high NT-proBNP of greater than 562.5 pg/mL with depressive symptoms. The Duke Activity Status Index was used to assess functional status. RESULTS Nonlinear regression demonstrated that patients without depressive symptoms were more than twice as likely to have higher (better) functional status scores than patients with depressive symptoms regardless of NT-proBNP levels after controlling for age, gender, prescribed antidepressants, and body mass index. Functional status levels of patients with low NT-proBNP did not differ from those with high NT-proBNP in the presence of depressive symptoms. CONCLUSION When examined together, depressive symptoms rather than NT-proBNP levels predicted functional status. CLINICAL IMPLICATIONS Adequate treatment of depressive symptoms may lead to better functional status regardless of HF severity.
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Goyal NG, Maddocks KJ, Johnson AJ, Byrd JC, Westbrook TD, Andersen BL. Cancer-Specific Stress and Trajectories of Psychological and Physical Functioning in Patients With Relapsed/Refractory Chronic Lymphocytic Leukemia. Ann Behav Med 2019; 52:287-298. [PMID: 30084895 DOI: 10.1093/abm/kax004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background Chronic lymphocytic leukemia is the most prevalent adult leukemia. The disease is incurable with a cycling of treatment and relapse common. Little is known about the psychological and physical functioning of patients with relapsed/refractory chronic lymphocytic leukemia. Cancer-specific stress is an important individual difference variable that predicts psychological and physical outcomes. Purpose To examine cancer-specific stress at treatment initiation as a predictor of psychological and physical functioning trajectories in patients with relapsed/refractory chronic lymphocytic leukemia during the first 5 months of treatment. Methods Patients with relapsed/refractory chronic lymphocytic leukemia (N = 152) enrolled in a phase II clinical trial completed self-report measures at treatment initiation (baseline), 1, 2, and 5 months of treatment. Cancer-specific stress at baseline was examined as a predictor of psychological (cognitive-affective depressive symptoms, negative mood, mental health quality of life) and physical functioning (fatigue interference, sleep problems, physical health quality of life), controlling for demographic and treatment variables. Results Using multilevel modeling, higher baseline cancer-specific stress was related to worse psychological (cognitive-affective depressive symptoms, negative mood, mental health quality of life) and physical functioning (fatigue interference, sleep problems) at baseline and more rapid improvements during the next 5 months. Despite these improvements, higher baseline cancer-specific stress remained associated with poorer 5-month psychological, though not physical, functioning. Conclusions Findings suggest cancer-specific stress at treatment initiation may be a risk factor for poorer psychological functioning during treatment for patients with relapsed/refractory chronic lymphocytic leukemia.
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Affiliation(s)
- Neha G Goyal
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC
| | - Kami J Maddocks
- Division of Hematology, Department of Internal Medicine, The Ohio State University Medical Center, Columbus, OH
| | - Amy J Johnson
- Division of Hematology, Department of Internal Medicine, The Ohio State University Medical Center, Columbus, OH
| | - John C Byrd
- Division of Hematology, Department of Internal Medicine, The Ohio State University Medical Center, Columbus, OH
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Kokkeler KJE, van den Berg KS, Comijs HC, Oude Voshaar RC, Marijnissen RM. Sarcopenic obesity predicts nonremission of late-life depression. Int J Geriatr Psychiatry 2019; 34:1226-1234. [PMID: 30990918 DOI: 10.1002/gps.5121] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 04/08/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND/OBJECTIVES Aging-related physiological changes like metabolic dysregulation and physical frailty are associated with depression and worsen its prognosis. Since central obesity is a key component of the metabolic syndrome and sarcopenia of physical frailty, we examined the association of sarcopenic obesity with depression cross-sectional and over time. METHODS Cohort study of depressed patients and a nondepressed comparison group. SETTING Primary and secondary mental health care. PARTICIPANTS Three hundred seventy-eight older (≥60 y) depressed patients of which 285 were followed up at 2 years and 132 nondepressed persons participating in the Netherlands Study of Depression in Older (NESDO) persons. MEASUREMENTS Sarcopenic obesity was based on predefined cutoffs for both maximum handgrip strength (assessed with a dynamometer) and waist circumference (dichotomous) as well as the product term of handgrip strength by waist circumference (dimensional). Depressive disorder according to DSM-IV-TR criteria was assessed with fully structured psychiatric interview at baseline and 2-year follow-up. RESULTS Sarcopenic obesity was more prevalent among depressed patients compared with nondepressed participants (18.9% versus 10.7%, P = 0.030). Neither the dichotomous nor dimensional operationalization of sarcopenic obesity was associated with baseline depressive disorder when adjusted for covariates. Nonetheless, among depressed patients, logistic regression showed that the interaction of handgrip strength by waist circumference was associated with remitted depression at 2-year follow-up (P = 0.044). Only among patients with a low handgrip strength, a higher waist circumference predicted nonremission. CONCLUSION Among depressed patients, sarcopenic obesity predicts nonremission of depression. Therefore, combined exercise and nutritional interventions might be effective for depressed patients with sarcopenic obesity.
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Affiliation(s)
- Kitty J E Kokkeler
- Department of Old Age Psychiatry, ProPersona, Wolfheze/ Ede, The Netherlands.,University Center of Psychiatry & Interdisciplinary Center for Psychopathology of Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Karen S van den Berg
- University Center of Psychiatry & Interdisciplinary Center for Psychopathology of Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Psychiatry, St Antonius Hospital, Utrecht, The Netherlands
| | - Hannie C Comijs
- GGZinGeest/Department Psychiatry/Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Richard C Oude Voshaar
- University Center of Psychiatry & Interdisciplinary Center for Psychopathology of Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Radboud M Marijnissen
- Department of Old Age Psychiatry, ProPersona, Wolfheze/ Ede, The Netherlands.,University Center of Psychiatry & Interdisciplinary Center for Psychopathology of Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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21
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Jokela M, García-Velázquez R, Airaksinen J, Gluschkoff K, Kivimäki M, Rosenström T. Chronic diseases and social risk factors in relation to specific symptoms of depression: Evidence from the U.S. national health and nutrition examination surveys. J Affect Disord 2019; 251:242-247. [PMID: 30928864 DOI: 10.1016/j.jad.2019.03.074] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 03/19/2019] [Accepted: 03/21/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Depression is a heterogeneous mental disorder with multiple symptoms, but only few studies have examined whether associations of risk factors with depression are symptom-specific. We examined whether chronic diseases and social risk factors (poverty, divorce, and perceived lack of emotional support) are differently associated with somatic and cognitive/affective symptoms of depression. METHODS Cross-sectional analyses were based on individual-level data from the 31,191 participants of six cross-sectional U.S. National Health and Nutrition Examination Surveys (NHANES) carried out between 2005 and 2016. Depressive symptoms were assessed using the 9-item Patient Health Questionnaire. Information on chronic diseases and social risk factors was self-reported by participants. RESULTS After adjustment for sex, age, race/ethnicity, and all the of other symptoms besides the outcome symptom, higher number of chronic diseases was independently related to fatigue, psychomotor retardation/agitation, and sleep problems in a dose-response pattern (range of odds ratios: 1.21 to 2.59). Except for concentration problems, social risk factors were associated with almost all of the cognitive/affective symptoms (range of odds ratios: 1.02 to 2.09) but only sporadically with somatic symptoms. LIMITATIONS All measures were self-reported by the participants, which may have introduced bias to the associations. Cross-sectional data did not allow us to study temporal dynamics. CONCLUSIONS Specific symptoms of depression may be useful in characterizing the heterogeneous etiology of depression with respect to somatic versus social risk factors.
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Affiliation(s)
- Markus Jokela
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Regina García-Velázquez
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Jaakko Airaksinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Kia Gluschkoff
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, UK; Clinicum, Faculty of Medicine, University of Helsinki, Finland
| | - Tom Rosenström
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland; Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
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22
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Richards SH, Campbell JL, Dickens C, Anderson R, Gandhi M, Gibson A, Kessler D, Knight L, Kuyken W, Richards DA, Taylor RS, Turner K, Ukoumunne OC, Davey A, Warren FC, Winder RE, Wright CA. Enhanced psychological care in cardiac rehabilitation services for patients with new-onset depression: the CADENCE feasibility study and pilot RCT. Health Technol Assess 2019; 22:1-220. [PMID: 29856312 DOI: 10.3310/hta22300] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Around 19% of people screened by UK cardiac rehabilitation programmes report having moderate or severe symptoms of depression. These individuals are at an increased risk of cardiac mortality and morbidity, reduced quality of life and increased use of health resources compared with their non-depressed counterparts. Maximising psychological health is a goal of cardiac rehabilitation, but psychological care is patchy. OBJECTIVE(S) To examine the feasibility and acceptability of embedding enhanced psychological care (EPC) within cardiac rehabilitation, we tested the feasibility of developing/implementing EPC and documented the key uncertainties associated with undertaking a definitive evaluation. DESIGN A two-stage multimethods study; a feasibility study and a qualitative evaluation, followed by an external pilot cluster randomised controlled trial (RCT) with a nested qualitative study. SETTING UK comprehensive cardiac rehabilitation teams. PARTICIPANTS Adults eligible for cardiac rehabilitation following an acute coronary syndrome with new-onset depressive symptoms on initial nurse assessment. Patients who had received treatment for depression in the preceding 6 months were excluded. INTERVENTIONS The EPC intervention comprised nurse-led mental health-care co-ordination and behavioural activation within cardiac rehabilitation. The comparator was usual cardiac rehabilitation care. MAIN OUTCOME MEASURES Measures at baseline, and at the 5- (feasibility and pilot) and 8-month follow-ups (pilot only). Process measures related to cardiac team and patient recruitment, and participant retention. Outcomes included depressive symptoms, cardiac mortality and morbidity, anxiety, health-related quality of life and service resource use. Interviews explored participant and nurses' views and experiences. RESULTS Between September 2014 and May 2015, five nurses from four teams recruited participants into the feasibility study. Of the 203 patients screened, 30 were eligible and nine took part (the target was 20 participants). At interview, participants and nurses gave valuable insights into the EPC intervention design and delivery. Although acceptable, the EPC delivery was challenging for nurses (e.g. the ability to allocate sufficient time within existing workloads) and the intervention was modified accordingly. Between December 2014 and February 2015, 8 out of 20 teams approached agreed to participate in the pilot RCT [five were randomised to the EPC arm and three were randomised to the usual-care (UC) arm]. Of the 614 patients screened, 55 were eligible and 29 took part (the target was 43 participants). At baseline, the trial arms were well matched for sex and ethnicity, although the EPC arm participants were younger, from more deprived areas and had higher depression scores than the UC participants. A total of 27 out of 29 participants were followed up at 5 months. Interviews with 18 participants (12 in the EPC arm and six in the UC arm) and seven nurses who delivered EPC identified that both groups acknowledged the importance of receiving psychological support embedded within routine cardiac rehabilitation. For those experiencing/delivering EPC, the intervention was broadly acceptable, albeit challenging to deliver within existing care. LIMITATIONS Both the feasibility and the pilot studies encountered significant challenges in recruiting patients, which limited the power of the pilot study analyses. CONCLUSIONS Cardiac rehabilitation nurses can be trained to deliver EPC. Although valued by both patients and nurses, organisational and workload constraints were significant barriers to implementation in participating teams, suggesting that future research may require a modified approach to intervention delivery within current service arrangements. We obtained important data informing definitive research regarding participant recruitment and retention, and optimal methods of data collection. FUTURE RESEARCH Consideration should be given to the delivery of EPC by dedicated mental health practitioners, working closely with cardiac rehabilitation services. TRIAL REGISTRATION Current Controlled Trials ISRCTN34701576. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 22, No. 30. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Suzanne H Richards
- Primary Care Research Group, University of Exeter Medical School, Exeter, UK
| | - John L Campbell
- Primary Care Research Group, University of Exeter Medical School, Exeter, UK
| | - Christopher Dickens
- Institute of Health Service Research, University of Exeter Medical School, Exeter, UK
| | - Rob Anderson
- Institute of Health Service Research, University of Exeter Medical School, Exeter, UK
| | - Manish Gandhi
- Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Andy Gibson
- Department of Health and Social Sciences, University of the West of England, Bristol, UK
| | - David Kessler
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Luke Knight
- Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Willem Kuyken
- University Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - David A Richards
- Institute of Health Service Research, University of Exeter Medical School, Exeter, UK
| | - Rod S Taylor
- Primary Care Research Group, University of Exeter Medical School, Exeter, UK.,Institute of Health Service Research, University of Exeter Medical School, Exeter, UK
| | - Katrina Turner
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Obioha C Ukoumunne
- NIHR Collaborations for Leadership in Applied Health Research and Care South West Peninsula (PenCLAHRC), University of Exeter Medical School, Exeter, UK
| | - Antoinette Davey
- Primary Care Research Group, University of Exeter Medical School, Exeter, UK
| | - Fiona C Warren
- Primary Care Research Group, University of Exeter Medical School, Exeter, UK
| | - Rachel E Winder
- Primary Care Research Group, University of Exeter Medical School, Exeter, UK
| | - Christine A Wright
- Primary Care Research Group, University of Exeter Medical School, Exeter, UK
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Abstract
OBJECTIVE Patients undergoing chronic dialysis often display sustained elevations of inflammation markers and also have a high prevalence of depressive symptoms. Although multiple studies demonstrated cross-sectional associations between inflammation markers and depressive symptoms in this patient group, longitudinal associations have not been examined. We therefore investigated whether longitudinal associations exist between inflammation markers and depressive symptoms in chronic dialysis patients. METHODS Data of three consecutive measurements of an observational, prospective cohort study among chronic dialysis patients were used. At baseline, 6-month, and 12-month follow-up, patients completed the Beck Depression Inventory, and inflammation markers (high-sensitivity C-reactive protein [HsCRP], interleukin (IL)-1β, IL-6, IL-10, and tumor necrosis factor α) were measured. We examined cross-sectional associations between inflammation markers and depressive symptoms using linear regression models. The longitudinal association between inflammation and depressive symptoms was assessed using a linear mixed model analyses. RESULTS A total of 513 patients were included. Cross-sectional associations were found between HsCRP and depressive symptoms at baseline (β = 0.9, confidence interval [CI] = 0.4-1.4) and 6-month follow-up (β = 1.1, CI = 0.3-2.0), and between IL-1β and depressive symptoms at 6-month follow-up (β = 1.3, CI = 0.8-1.8) and 12-month follow-up (β = 1.2, CI = 0.4-1.9). Inflammation makers (HsCRP, IL-6, IL-1β, IL-10, and tumor necrosis factor α) at baseline were not associated with depressive symptoms at follow-up and vice versa. CONCLUSIONS We confirmed the presence of cross-sectional associations between inflammation markers and depressive symptoms in chronic dialysis patients, but with our longitudinal data, we found no longitudinal associations. This supports an associative instead of a causal relationship between inflammation and depressive symptoms.
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24
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Yang Z, Huang X, Liu X, Hou J, Wu W, Song A, Meyers K, Zhang T, Chen H, Wu H. Psychometric Properties and Factor Structure of the Chinese Version of the Hospital Anxiety and Depression Scale in People Living With HIV. Front Psychiatry 2019; 10:346. [PMID: 31156484 PMCID: PMC6531499 DOI: 10.3389/fpsyt.2019.00346] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 05/01/2019] [Indexed: 01/01/2023] Open
Abstract
The population of people living with HIV (PLWH) is growing in number and usually results in mental health problems that impact their quality of life. Therefore, valid instruments and screening methods for psychological disorders are of great significance. The Hospital Anxiety and Depression Scale (HADS) reveals good psychometric properties, but shows ambiguous results in factor structure. This study aims to evaluate psychometric properties in terms of the internal reliability and structure validity of the Chinese version of the HADS (C-HADS) in a large sample of PLWH in China. The C-HADS was administered to 4,102 HIV-infected adults at an HIV clinic in China. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to examine the factor structure. Measurement invariance was assessed across gender and course of infection. Internal reliability was also assessed. A bifactor model with anomalous loadings of items 7, 8, and 10 fits the data best and holds measurement invariance across gender and course of infection. Internal reliability was good with all Cronbach's alphas > 0.70 and Spearman's ρ between 0.30 and 0.70. The C-HADS has good psychometric properties in terms of internal reliability and structure validity of a bifactor model. The C-HADS is recommended to be used as a total scale that measures general psychological distress, instead of anxiety and depression separately, when applied to PLWH. Further studies are needed to evaluate criterion validity, the cutoff score, and the effect of wording and scoring of the HADS.
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Affiliation(s)
- Zhiyuan Yang
- Peking University People's Hospital, Peking University Health Science Center, Beijing, China.,Center for Infectious Diseases, Beijing You'an Hospital, Capital Medical University, Beijing, China
| | - Xiaojie Huang
- Center for Infectious Diseases, Beijing You'an Hospital, Capital Medical University, Beijing, China
| | - Xinchao Liu
- Department of Infectious Diseases, Peking Union Medical College Hospital, Beijing, China
| | - Jianhua Hou
- Center for Infectious Diseases, Beijing You'an Hospital, Capital Medical University, Beijing, China
| | - Wenfang Wu
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Aixin Song
- Center for Infectious Diseases, Beijing You'an Hospital, Capital Medical University, Beijing, China
| | - Kathrine Meyers
- The Aaron Diamond AIDS Research Center, New York, NY, United States
| | - Tong Zhang
- Center for Infectious Diseases, Beijing You'an Hospital, Capital Medical University, Beijing, China
| | - Hui Chen
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Hao Wu
- Center for Infectious Diseases, Beijing You'an Hospital, Capital Medical University, Beijing, China
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25
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de Sá Junior AR, Liebel G, de Andrade AG, Andrade LH, Gorenstein C, Wang YP. Can Gender and Age Impact on Response Pattern of Depressive Symptoms Among College Students? A Differential Item Functioning Analysis. Front Psychiatry 2019; 10:50. [PMID: 30809161 PMCID: PMC6379252 DOI: 10.3389/fpsyt.2019.00050] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 01/24/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Self-reported depressive complaints among college students might indicate different degrees of severity of depressive states. Through the framework of item response theory, we aim to describe the pattern of responses to items of the Beck Depression Inventory-II (BDI-II), in terms of endorsement probability and discrimination along the continuum of depression. Potential differential item functioning of the scale items of the BDI-II is investigated, by gender and age, to compare across sub-groups of students. Methods: The 21-item BDI-II was cross-sectionally administered to a representative sample of 12,677 Brazilian college students. Reliability was evaluated based on Cronbach's alpha coefficient. Severity (b i ) and discrimination (a) parameters of each BDI-II items were calculated through the graded response model. The influence of gender and age were tested for differential item functioning (DIF) within the item response theory-based approach. Results: The BDI-II presented good reliability (α = 0.91). Women and younger students significantly presented a higher likelihood of depression (cut-off > 13) than men and older counterparts. In general, participants endorsed more easily cognitive-somatic items than affective items of the scale. "Guilty feelings," "suicidal thoughts," and "loss of interest in sex" were the items that most likely indicated depression severity (b ≥ 3.60). However, all BDI-II items showed moderate-to-high discrimination (a ≥ 1.32) for depressive state. While two items were flagged for DIF, "crying" and "loss of interest in sex," respectively for gender and age, the global weight of these items on the total score was negligible. Conclusions: Although respondents' gender and age might present influence on response pattern of depressive symptoms, the measures of self-reported symptoms have not inflated severity scores. These findings provide further support to the validity of using BDI-II for assessing depression in academic contexts and highlight the value of considering gender- and age-related common symptoms of depression.
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Affiliation(s)
- Antonio Reis de Sá Junior
- Department of Health Sciences, Federal University of Santa Catarina, Araranguá, Brazil.,Institute and Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, Brazil
| | - Graziela Liebel
- Department of Collective Health, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Arthur Guerra de Andrade
- Institute and Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, Brazil.,Department of Neuroscience, Medical School, ABC Foundation, Santo André, Brazil
| | - Laura Helena Andrade
- Institute and Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, Brazil
| | - Clarice Gorenstein
- Institute and Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, Brazil.,Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Yuan-Pang Wang
- Institute and Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, Brazil
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26
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Biella MM, Borges MK, Strauss J, Mauer S, Martinelli JE, Aprahamian I. Subthreshold Depression Needs A Prime Time In Old Age Psychiatry? A Narrative Review Of Current Evidence. Neuropsychiatr Dis Treat 2019; 15:2763-2772. [PMID: 31576131 PMCID: PMC6765057 DOI: 10.2147/ndt.s223640] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 09/06/2019] [Indexed: 11/23/2022] Open
Abstract
This study aims to carry out a narrative review, aiming to update the literature on subsyndromic depression (SD), which is the most prevalent depressive disorder in older adults, and no formal guidelines or consensus are dedicated to this topic. We carried out an electronic search for articles on SD. Relevant articles were retrieved from Pubmed, EMBASE and Web of Science using the search terms "subthreshold depression," "prevalence," "treatment" and "older adults" in several combinations. Original articles in English were included from inception to 1st March 2019. No clear consensus exists in the literature on its nosologic classification, diagnostic tools, causes, course, outcomes or management. SD diagnosis should base in depressive symptoms scales and DSM criteria. Treatment relies mainly on collaborative care and psychotherapy. SD is relevant in clinical practice and research in geriatric psychiatry. Given the negative outcomes and potential benefits of treatment, we recommend brief psychotherapy as first-line treatment and use of psychotropic agents in cases with greater severity and/or functional impairment in association with psychotherapy. SD can precede major depressive disorder, but it also may consist of a primary depressive disorder in older adults. Furthermore, adequate treatment of SD can prevent or reduce negative outcomes associated with depressive symptoms such as worsening of clinical comorbidities, loss of functionality, increased demand for health services, and increased mortality.
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Affiliation(s)
- Marina Maria Biella
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Marcus Kiiti Borges
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Jason Strauss
- Geriatric Psychiatry, Cambridge Health Alliance, Harvard Medical School, Boston, MA, USA
| | - Sivan Mauer
- Department of Psychiatry, Tufts Medical Center, Tufts University Scholl of Medicine, Boston, MA, USA
| | - José Eduardo Martinelli
- Geriatrics & Psychiatry Division, Department of Internal Medicine, Faculty of Medicine of Jundiaí, Jundiaí, Brazil
| | - Ivan Aprahamian
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.,Geriatrics & Psychiatry Division, Department of Internal Medicine, Faculty of Medicine of Jundiaí, Jundiaí, Brazil
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27
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Skonieczna-Żydecka K, Grochans E, Maciejewska D, Szkup M, Schneider-Matyka D, Jurczak A, Łoniewski I, Kaczmarczyk M, Marlicz W, Czerwińska-Rogowska M, Pełka-Wysiecka J, Dec K, Stachowska E. Faecal Short Chain Fatty Acids Profile is Changed in Polish Depressive Women. Nutrients 2018; 10:E1939. [PMID: 30544489 PMCID: PMC6316414 DOI: 10.3390/nu10121939] [Citation(s) in RCA: 145] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 11/28/2018] [Accepted: 12/05/2018] [Indexed: 12/27/2022] Open
Abstract
Short chain fatty acids (SCFAs) being produced during fermentation of non-digestible polysaccharides are regulatory compounds with the potential to influence inflammatory, as well as emotional state and cognition through the gut⁻brain axis. We analyzed the association between stool concentration of SCFAs (acetic acid (C 2:0), propionic acid (C 3:0), isobutyric acid (C 4:0 i), butyric acid (C 4:0 n), isovaleric acid (C 5:0 i) valeric acid (C 5:0 n), isocaproic acid (C 6:0 i), caproic acid, and (C 6:0 n) heptanoic acid (C 7:0)) and depressive symptoms among women and looked for the potential confounders of microbiota byproduct synthesis. We enrolled 116 women aged 52.0 ± 4.7 years and recognized depression in 47 (40.52%). To analyze the emotional state, Beck's Depression Inventory (BDI) was used. We assessed SCFAs content by means of gas chromatography. Fiber intake was estimated using parts of food frequency questionnaire. The content of acetic acid was significantly lowered compared to non-depressed women (median {IQR}: 29.49 {20.81} vs. 34.99 {19.55}, p = 0.04). A tendency toward decreased level of propionic acid was noticed (median {IQR}: 16.88 {9.73} vs. 21.64 {12.17}, p = 0.07), while the concentration of isocaproic acid was significantly increased in (median {IQR}: 0.89 {1.15} vs. 0.56 {0.95}, p < 0.01) comparison to matched healthy subjects. We found negative correlations between acetate, propionate, and Beck's score (r = -0.2, p = 0.03; r = -0.21, p = 0.02, respectively). Statistically significant correlations between acetate and propionate and BDI somatic score (r = -0.21, p = 0.01; r = -0.17, p = 0.03), as well as correlations regarding isocaproic and both cognitive/affective (r = 0.37, p = 0.0001) and somatic (r = 9.37, p < 0.001) scores were found. Women who declared current usage of lipid-lowering and thyroid drugs in the past, had higher content of C6:0-i (Users; median {IQR}: 1.91 {3.62} vs. non-users; 0.55 {0.67}; p = 0.0048).and lower of C2:0 (Users; median {IQR}: 23.07 {12.80} vs. non users 33.73 {21.44}; p = 0.041), respectively. No correlations regarding SCFAs concentration and fiber intake were found. We concluded that SCFAs may potentially contribute to depression phenotype, however, due to the small size of groups suffering from moderately heavy (n = 5) and severe (n = 7) depression, the conclusion should be treated with caution. Pharmacotherapy of hyperlipidemia and thyroid disease might affect SCFAs synthesis. Studies with more participants are required.
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Affiliation(s)
| | - Elżbieta Grochans
- Department of Nursing, Pomeranian Medical University, 71-210 Szczecin, Poland.
| | - Dominika Maciejewska
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University, 71-460 Szczecin, Poland.
| | - Małgorzata Szkup
- Department of Nursing, Pomeranian Medical University, 71-210 Szczecin, Poland.
| | | | - Anna Jurczak
- Department of Clinical Nursing, Pomeranian Medical University, 71-210 Szczecin, Poland.
| | - Igor Łoniewski
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University, 71-460 Szczecin, Poland.
| | - Mariusz Kaczmarczyk
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University, 70-111 Szczecin, Poland.
| | - Wojciech Marlicz
- Department of Gastroenterology, Pomeranian Medical University, 71-252 Szczecin, Poland.
| | - Maja Czerwińska-Rogowska
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University, 71-460 Szczecin, Poland.
| | | | - Karolina Dec
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University, 71-460 Szczecin, Poland.
| | - Ewa Stachowska
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University, 71-460 Szczecin, Poland.
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28
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Roberts AKP. The Effects of the EMDR Group Traumatic Episode Protocol With Cancer Survivors. JOURNAL OF EMDR PRACTICE AND RESEARCH 2018. [DOI: 10.1891/1933-3196.12.3.105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of this pre-experimental case study was to explore the efficacy and safety of the Eye Movement Desensitization and Reprocessing (EMDR) Group Traumatic Episode Protocol (G-TEP) in the psychological treatment of cancer survivors and its potential effects on posttraumatic stress, anxiety, and depressive symptoms. Participants (N = 35) were patients with various types of cancer, in different stages, initial or recurring, with diagnosis or oncology treatment received within the past year. Following an individual psychoeducational intake session, participants received two 90-minute EMDR G-TEP sessions, administered on consecutive days. They were randomly assigned to a treatment group or a delayed treatment group. Assessments were administered at pre, post, and follow-up using the Short PostTraumatic Stress Disorder Interview (SPRINT), State-Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI-II). Repeated measures comparisons of PTSD symptoms, anxiety, and depression revealed significant differences between pretest and posttest, with most results maintained at follow-up. Pre-follow-up effect sizes showed medium effects. These promising results suggest the value in providing a lengthier course of treatment. They support the need for research with large sample, randomized clinical trials to examine the viability of providing EMDR G-TEP in the psychological treatment of cancer survivors. No serious adverse effects were reported and we conclude that the EMDR G-TEP may be effective and safe in the psychological treatment of an oncology population.
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29
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Weiss JJ, Prieto S, Bräu N, Dieterich DT, Marcus SM, Stivala A, Gorman JM. Multimethod assessment of baseline depression and relationship to hepatitis C treatment discontinuation. Int J Psychiatry Med 2018; 53:256-272. [PMID: 29298535 PMCID: PMC5975203 DOI: 10.1177/0091217417749796] [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: 11/15/2022]
Abstract
Objective The primary study objective is to determine which measures of depression are associated with early discontinuation of hepatitis C virus infection treatment and to determine which measure best characterizes the depression that develops during treatment. Methods Seventy-eight treatment-naïve subjects who initiated pegylated interferon/ribavirin treatment for hepatitis C virus infection were included. Baseline depression was assessed with the Structured Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), the Hamilton Depression Rating Scale, and the Beck Depression Inventory-II. The latter two measures were repeated at treatment weeks 12 and 24. Results Depression scores, as measured by the three instruments, lacked adequate consistency. Baseline depression as measured by the Beck Depression Inventory-II, but not by the other scales, was associated with early treatment discontinuation at weeks 12 and 24. Changes in depression during treatment were restricted to somatic symptoms. Of those who completed treatment, those who were not depressed at baseline tended to demonstrate significant depression increases during treatment. Conclusion The Beck Depression Inventory-II is recommended to assess depression prior to hepatitis C virus infection treatment. Somatic symptoms of depression should be monitored during treatment. Baseline depression as measured by the Beck Depression Inventory-II was associated with early treatment discontinuation. The Beck Depression Inventory-II, Structured Interview for DSM-IV, and Hamilton Depression Rating Scale yielded results that were not consistent with each other in this sample. Future research should focus on standardizing depression assessment in medically ill populations to identify measures that predict treatment discontinuation.
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Affiliation(s)
- Jeffrey J Weiss
- Department of Medicine, Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Sarah Prieto
- Department of Medicine, Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Norbert Bräu
- James J. Peters Veterans Affairs Medical Center, Infectious Diseases Section, Bronx, USA,Department of Medicine, Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Douglas T Dieterich
- Department of Medicine, Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Sue M Marcus
- Independent Statistical Consultant, Philadelphia, USA
| | - Alicia Stivala
- Department of Medicine, Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Jack M Gorman
- Franklin Behavioral Health Consultants and Critica LLC, Bronx, USA
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30
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Wassink-Vossen S, Collard RM, Penninx BW, Hiles SA, Oude Voshaar RC, Naarding P. The reciprocal relationship between physical activity and depression: Does age matter? Eur Psychiatry 2018; 51:9-15. [PMID: 29510298 DOI: 10.1016/j.eurpsy.2017.12.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 12/21/2017] [Accepted: 12/30/2017] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The level of physical activity (PA) and the prevalence of depression both change across the lifespan. We examined whether the association between PA and depression is moderated by age. As sense of mastery and functional limitations have been previously associated with low PA and depression in older adults, we also examined whether these are determinants of the differential effect of age on PA and depression. METHODS 1079 patients with major depressive disorder (aged 18-88 years) were followed-up after two-years; depression diagnosis and severity as well as PA were re-assessed. Linear and logistic regression analyses were used to test reciprocal prospective associations between PA and depression outcomes. In all models the interaction with age was tested. RESULTS PA at baseline predicted remission of depressive disorder at follow-up (OR = 1.43 [95% CI: 1.07-1.93], p = .018). This effect was not moderated by age. PA predicted improvement of depression symptom severity in younger (B = -2.03; SE = .88; p = .022), but not in older adults (B = 2.24; SE = 1.48; p = .128) (p = .015 for the interaction PA by age in the whole sample). The level of PA was relatively stable over time. Depression, sense of mastery and functional limitation were for all ages not associated with PA at follow-up. CONCLUSIONS Age did not moderate the impact of PA on depressive disorder remission. Only in younger adults, sufficient PA independently predicts improvement of depressive symptom severity after two-year follow-up. Level of PA rarely changed over time, and none of the determinants tested predicted change in PA, independent of age.
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Affiliation(s)
- S Wassink-Vossen
- Department of Old-Age Psychiatry, GGNet Apeldoorn, Zutphen, The Netherlands.
| | - R M Collard
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - B W Penninx
- Department of Psychiatry and EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - S A Hiles
- School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, Australia
| | - R C Oude Voshaar
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Groningen, Netherlands
| | - P Naarding
- Department of Old-Age Psychiatry, GGNet Apeldoorn, Zutphen, The Netherlands
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Trevizan FB, Miyazaki MCDOS, Silva YLW, Roque CMW. Quality of Life, Depression, Anxiety and Coping Strategies after Heart Transplantation. Braz J Cardiovasc Surg 2017; 32:162-170. [PMID: 28832793 PMCID: PMC5570391 DOI: 10.21470/1678-9741-2017-0029] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 04/06/2017] [Indexed: 12/20/2022] Open
Abstract
Introduction Heart transplantation is the therapeutic procedure indicated to increase the
survival of patients with refractory heart failure. Improvement in overall
functioning and quality of life are expected factors in the postoperative
period. Objective To identify and evaluate mental disorders and symptoms, such as depression
and anxiety, quality of life and coping strategies in the post-surgical
situation of heart transplantation. Methods A cross-sectional, quantitative study with patients who have undergone heart
transplantation. Participants answered to the Sociodemographic
Questionnaire, Beck Depression Inventory (BDI-II), Beck Anxiety Inventory
(BAI), MINI International Neuropsychiatric Interview, Escala Modos de
Enfrentamento de Problemas (Ways of Coping Scale) (EMEP) and World Health
Organization Quality of Life-BREF (WHOQOL-BREF). For data analysis, the
significance level was considered P≤0.05. Results A total of 33 patients participated in the study. The BDI-II results
indicated that 91% (n=30) of the patients presented a minimal level. In BAI,
94% (n=31) of the patients demonstrated minimal level of anxiety symptoms.
WHOQOL-BREF showed a perception of quality of life considered good in all
domains. The EMEP data have registered a problem-focused coping strategy.
According to MINI, a single case of major depressive episode, current and
recurrent was recorded. Conclusion Although most participants in the sample had symptoms of depression and
anxiety, only one patient was identified with moderate symptoms in both
domains. The most used strategy was coping focused on the problem. Patients
have classified the perceptions of quality of life as 'good', pointing out
satisfaction with their health.
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Affiliation(s)
| | | | | | - Christiane Maia Waetman Roque
- Fundação Faculdade Regional de Medicina de São José do Rio Preto (FUN-FARME), São José do Rio Preto, SP, Brazil.,Hospital de Base (HB), São José do Rio Preto, SP, Brazil
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Turner KM, Winder R, Campbell JL, Richards DA, Gandhi M, Dickens CM, Richards S. Patients' and nurses' views on providing psychological support within cardiac rehabilitation programmes: a qualitative study. BMJ Open 2017; 7:e017510. [PMID: 28864707 PMCID: PMC5589022 DOI: 10.1136/bmjopen-2017-017510] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 07/11/2017] [Accepted: 07/12/2017] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To explore patients' and nurses' views on the feasibility and acceptability of providing psychological care within cardiac rehabilitation services. DESIGN In-depth interviews analysed thematically. PARTICIPANTS 18 patients and 7 cardiac nurses taking part in a pilot trial (CADENCE) of an enhanced psychological care intervention delivered within cardiac rehabilitation programmes by nurses to patients with symptoms of depression. SETTING Cardiac services based in the South West of England and the East Midlands, UK. RESULTS Patients and nurses viewed psychological support as central to good cardiac rehabilitation. Patients' accounts highlighted the significant and immediate adverse effect a cardiac event can have on an individual's mental well-being. They also showed that patients valued nurses attending to both their mental and physical health, and felt this was essential to their overall recovery. Nurses were committed to providing psychological support, believed it benefited patients, and advocated for this support to be delivered within cardiac rehabilitation programmes rather than within a parallel healthcare service. However, nurses were time-constrained and found it challenging to provide psychological care within their existing workloads. CONCLUSIONS Both patients and nurses highly value psychological support being delivered within cardiac rehabilitation programmes but resource constraints raise barriers to implementation. Consideration, therefore, should be given to alternative forms of delivery which do not rely solely on nurses to enable patients to receive psychological support during cardiac rehabilitation. TRIAL REGISTRATION NUMBER ISCTRN34701576.
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Affiliation(s)
- Katrina M Turner
- Population Health Sciences, University of Bristol, Bristol, UK
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West), Bristol, UK
| | - Rachel Winder
- University of Exeter Medical School, Exeter, Devon, UK
| | | | | | - Manish Gandhi
- Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | | | - Suzanne Richards
- University of Exeter Medical School, Exeter, Devon, UK
- Leeds Institute of Health Research, Leeds, UK
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Marijnissen RM, Vogelzangs N, Mulder ME, van den Brink RHS, Comijs HC, Oude Voshaar RC. Metabolic dysregulation and late-life depression: a prospective study. Psychol Med 2017; 47:1041-1052. [PMID: 27938429 DOI: 10.1017/s0033291716003196] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Depression is associated with the metabolic syndrome (MS). We examined whether metabolic dysregulation predicted the 2-year course of clinical depression. METHOD A total of 285 older persons (⩾60 years) suffering from depressive disorder according to DSM-IV-TR criteria was followed up for 2 years. Severity of depression was assessed with the Inventory of Depressive Symptomatology (IDS) at 6-month intervals. Metabolic syndrome was defined according the National Cholesterol Education Programme (NCEP-ATP III). We applied logistic regression and linear mixed models adjusted for age, sex, years of education, smoking, alcohol use, physical activity, somatic co-morbidity, cognitive functioning and drug use (antidepressants, anti-inflammatory drugs) and severity of depression at baseline. RESULTS MS predicted non-remission at 2 years (odds ratioper component = 1.26, 95% confidence interval 1.00-1.58), p = 0.047), which was driven by the waist circumference and HDL cholesterol. MS was not associated with IDS sum score. Subsequent analyses on its subscales, however, identified an association with the somatic symptom subscale score over time (interaction time × somatic subscale, p = 0.005), driven by higher waist circumference and elevated fasting glucose level. CONCLUSIONS Metabolic dysregulation predicts a poor course of late-life depression. This finding supports the concept of 'metabolic depression', recently proposed on population-based findings of a protracted course of depressive symptoms in the presence of metabolic dysregulation. Our findings seem to be driven by abdominal obesity (as indicated by the waist circumference) and HDL cholesterol dysregulation.
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Affiliation(s)
- R M Marijnissen
- Department of Old Age Psychiatry,ProPersona,Arnhem/Wolfheze,The Netherlands
| | - N Vogelzangs
- Department of Epidemiology,Cardiovascular Research Institute Maastricht (CARIM) & Maastricht Centre for Systems Biology (MaCSBio),Maastricht University,Maastricht,The Netherlands
| | - M E Mulder
- Department of Old Age Psychiatry,ProPersona,Arnhem/Wolfheze,The Netherlands
| | - R H S van den Brink
- University Center of Psychiatry & Interdisciplinary Center for Psychopathology of Emotion Regulation,University Medical Center Groningen,University of Groningen,Groningen,The Netherlands
| | - H C Comijs
- Department Psychiatry,EMGO Institute for Health and Care Research VU University Medical Center/GGZinGeest,Amsterdam,The Netherlands
| | - R C Oude Voshaar
- University Center of Psychiatry & Interdisciplinary Center for Psychopathology of Emotion Regulation,University Medical Center Groningen,University of Groningen,Groningen,The Netherlands
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34
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Benraad CEM, Kamerman-Celie F, van Munster BC, Oude Voshaar RC, Spijker J, Olde Rikkert MGM. Geriatric characteristics in randomised controlled trials on antidepressant drugs for older adults: a systematic review. Int J Geriatr Psychiatry 2016; 31:990-1003. [PMID: 26924120 DOI: 10.1002/gps.4443] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 01/10/2016] [Accepted: 01/20/2016] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Meta-analyses of antidepressant drug treatment trials have found that increasing age is associated with a less favourable outcome. Because the prevalence of geriatric characteristics, like disability, medical co-morbidity, malnutrition, cognitive (dys)function and frailty increase with age and are associated with depression, these characteristics are likely to modify the treatment outcome of antidepressant drugs in late-life depression. This review examines how these five characteristics are taken into account in randomised controlled trials (RCTs) with antidepressant drugs for major depressive disorder in patients aged 60 years or above. DESIGN A systematic search in PubMED, PsychInfo and EMBASE, from the year 2000 onwards, yielded 27 RCTs, with a total of 6356 subjects with a median age of 71 years. Two reviewers independently assessed whether each characteristic was considered as inclusion or exclusion criterion, descriptive variable, stratification variable, co-variable, outcome measure, or in adverse effect monitoring. RESULTS Malnutrition and frailty were not taken into account in any study. Disability was used as an outcome measure in five studies. Two studies explicitly included a population with possibly serious medical co-morbidity. Cognitive status was the only condition taken into account as co-variable (n = 3) or stratifying variable (n = 1) and was used as outcome measure in seven studies. CONCLUSIONS We conclude that geriatric characteristics are rarely taken into account in RCTs on antidepressant drugs in late-life depression, and studies including the oldest adults are underrepresented. This warrants recruitment of the oldest adults and adjustment of treatment strategies in future studies. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Carolien E M Benraad
- Department of Geriatrics/Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Old Age Psychiatry and Geriatrics, Pro Persona Mental Health Care, Nijmegen, The Netherlands
| | - Floor Kamerman-Celie
- Department of Old Age Psychiatry and Geriatrics, Pro Persona Mental Health Care, Nijmegen, The Netherlands
| | - Barbara C van Munster
- Department of Old Age Psychiatry and Geriatrics, Pro Persona Mental Health Care, Nijmegen, The Netherlands.,Department of Internal Medicine, Section of Geriatrics, Academic Medical Center, Amsterdam, The Netherlands
| | | | - Jan Spijker
- Program for Mood Disorders, Pro Persona Mental Health Care, Nijmegen, The Netherlands.,Behavioral Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Marcel G M Olde Rikkert
- Department of Geriatrics/Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands
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35
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Pederson JL, Warkentin LM, Majumdar SR, McAlister FA. Depressive symptoms are associated with higher rates of readmission or mortality after medical hospitalization: A systematic review and meta-analysis. J Hosp Med 2016; 11:373-80. [PMID: 26824220 PMCID: PMC5066695 DOI: 10.1002/jhm.2547] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 12/01/2015] [Accepted: 12/21/2015] [Indexed: 12/02/2022]
Abstract
Depressive symptoms during a medical hospitalization may be an overlooked prognostic factor for adverse events postdischarge. Our aim was to evaluate whether depressive symptoms predict 30-day readmission or death after medical hospitalization. We conducted a systematic review of studies that compared postdischarge outcomes by in-hospital depressive status. We assessed study quality and pooled published and unpublished data using random effects models. Overall, one-third of 6104 patients discharged from medical wards were depressed (interquartile range, 27%-40%). Compared to inpatients without depression, those discharged with depressive symptoms were more likely to be readmitted (20.4% vs 13.7%, risk ratio [RR]: 1.73, 95% confidence interval [CI]: 1.16-2.58) or die (2.8% vs 1.5%, RR: 2.13, 95% CI: 1.31-3.44) within 30 days. Depressive symptoms were common in medical inpatients and are associated with an increased risk of adverse events postdischarge. Journal of Hospital Medicine 2016;11:373-380. © 2016 The Authors Journal of Hospital Medicine published by Wiley Periodicals, Inc. on behalf of Society of Hospital Medicine.
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Affiliation(s)
- Jenelle L. Pederson
- Division of General Internal Medicine, Faculty of Medicine and DentistryUniversity of AlbertaEdmontonCanada
| | - Lindsey M. Warkentin
- Division of Surgery, Faculty of Medicine and DentistryUniversity of AlbertaEdmontonCanada
| | - Sumit R. Majumdar
- Division of General Internal Medicine, Faculty of Medicine and DentistryUniversity of AlbertaEdmontonCanada
- Alberta Diabetes InstituteEdmontonCanada
| | - Finlay A. McAlister
- Division of General Internal Medicine, Faculty of Medicine and DentistryUniversity of AlbertaEdmontonCanada
- The Patient Health Outcomes Research and Clinical Effectiveness Unit, Faculty of Medicine and DentistryUniversity of AlbertaEdmontonCanada
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36
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van den Berg KS, Marijnissen RM, van den Brink RHS, Naarding P, Comijs HC, Oude Voshaar RC. Vitamin D deficiency, depression course and mortality: Longitudinal results from the Netherlands Study on Depression in Older persons (NESDO). J Psychosom Res 2016; 83:50-6. [PMID: 27020077 DOI: 10.1016/j.jpsychores.2016.03.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 03/02/2016] [Accepted: 03/07/2016] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To study the effect of vitamin D levels on depression course and remission status after two years, as well as attrition and mortality, in an older cohort. METHODS This study was part of the Netherlands Study on Depression in Older persons (NESDO), a prospective cohort study. 367 depressed older persons (≥ 60 years) were included. Baseline vitamin D status, reasons for loss to follow up, clinical depression diagnosis at two-year follow up, and six-monthly symptom scores were obtained. Data were analyzed by logistic regression and random coefficient models and adjusted for confounders of vitamin D status. RESULTS Vitamin D had no effect on the course of depression or remission, except for a trend towards lower remission rates in the severely deficient subgroup (25-(OH) vitamin D<25 nmol/l). Patients who died during follow up had significantly lower 25-(OH) vitamin D and 1,25-(OH)2 vitamin D levels than patients with continued participation. CONCLUSIONS For the total sample we found no effect of vitamin D levels on the course of depression or remission rates. However, we did find an effect of lower vitamin D levels on mortality. This strengthens the interpretation of vitamin D deficiency being a marker for poor somatic health status. The trend towards lower remission rates in the severely deficient subgroup raises the question whether this group could benefit from supplementation. Randomized controlled trials are necessary to study this.
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Affiliation(s)
- Karen S van den Berg
- University Medical Center Groningen, University Center of Psychiatry, University of Groningen, Groningen, The Netherlands; Department of Old Age Psychiatry, Pro Persona, Wolfheze, The Netherlands.
| | - Radboud M Marijnissen
- University Medical Center Groningen, University Center of Psychiatry, University of Groningen, Groningen, The Netherlands; Department of Old Age Psychiatry, Pro Persona, Wolfheze, The Netherlands
| | - Rob H S van den Brink
- University Medical Center Groningen, University Center of Psychiatry, University of Groningen, Groningen, The Netherlands
| | - Paul Naarding
- GGNet, Center for Old Age Psychiatry, Apeldoorn, The Netherlands
| | - Hannie C Comijs
- Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center/GGZinGeest, Amsterdam, The Netherlands
| | - Richard C Oude Voshaar
- University Medical Center Groningen, University Center of Psychiatry, University of Groningen, Groningen, The Netherlands
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37
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Richards SH, Dickens C, Anderson R, Richards DA, Taylor RS, Ukoumunne OC, Kessler D, Turner K, Kuyken W, Gandhi M, Knight L, Gibson A, Davey A, Warren F, Winder R, Wright C, Campbell J. Assessing the effectiveness of enhanced psychological care for patients with depressive symptoms attending cardiac rehabilitation compared with treatment as usual (CADENCE): study protocol for a pilot cluster randomised controlled trial. Trials 2016; 17:59. [PMID: 26830029 PMCID: PMC4736496 DOI: 10.1186/s13063-016-1184-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 01/16/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Around 17% of people eligible for UK cardiac rehabilitation programmes following an acute coronary syndrome report moderate or severe depressive symptoms. While maximising psychological health is a core goal of cardiac rehabilitation, psychological care can be fragmented and patchy. This study tests the feasibility and acceptability of embedding enhanced psychological care, composed of two management strategies of proven effectiveness in other settings (nurse-led mental health care coordination and behavioural activation), within the cardiac rehabilitation care pathway. METHODS/DESIGN This study tests the uncertainties associated with a large-scale evaluation by conducting an external pilot trial with a nested qualitative study. We aim to recruit and randomise eight comprehensive cardiac rehabilitation teams (clusters) to intervention (embedding enhanced psychological care into routine cardiac rehabilitation programmes) or control (routine cardiac rehabilitation programmes alone) arms. Up to 64 patients (eight per team) identified with depressive symptoms upon initial assessment by the cardiac rehabilitation team will be recruited, and study measures will be administered at baseline (before starting rehabilitation) and at 5 months and 8 months post baseline. Outcomes include depressive symptoms, cardiac mortality and morbidity, anxiety, health-related quality of life and service resource use. Trial data on cardiac team and patient recruitment, and the retention and flow of patients through treatment will be used to assess intervention feasibility and acceptability. Qualitative interviews will be undertaken to explore trial participants' and cardiac rehabilitation nurses' views and experiences of the trial methods and intervention, and to identify reasons why patients declined to take part in the trial. Outcome data will inform a sample size calculation for a definitive trial. DISCUSSION The pilot trial and qualitative study will inform the design of a fully powered cluster randomised controlled trial to evaluate the effectiveness and cost-effectiveness of the provision of enhanced psychological care within cardiac rehabilitation programmes. TRIAL REGISTRATION ISRCTN34701576 (Registered 29 May 2014).
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Affiliation(s)
- Suzanne H Richards
- University of Exeter Medical School, St Luke's Campus, Exeter, EX1 2LU, UK.
| | - Chris Dickens
- University of Exeter Medical School, St Luke's Campus, Exeter, EX1 2LU, UK.
| | - Rob Anderson
- University of Exeter Medical School, St Luke's Campus, Exeter, EX1 2LU, UK.
| | - David A Richards
- University of Exeter Medical School, St Luke's Campus, Exeter, EX1 2LU, UK.
| | - Rod S Taylor
- University of Exeter Medical School, St Luke's Campus, Exeter, EX1 2LU, UK.
| | - Obioha C Ukoumunne
- NIHR Collaboration for Leadership in Applied Health Research and Care for the South West Peninsula, University of Exeter Medical School, St Luke's Campus, Exeter, EX1 2LU, UK.
| | - David Kessler
- School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Clifton, Bristol, BS8 2BN, UK.
| | - Katrina Turner
- School of Social and Community Medicine, University of Bristol, Canynge Hall, Whatley Road, Bristol, BS8 2PS, UK.
| | - Willem Kuyken
- University Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, 0X3 7JX, UK.
| | - Manish Gandhi
- Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK.
| | - Luke Knight
- Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK.
| | - Andrew Gibson
- Health and Social Sciences, University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol, BS16 1QY, UK.
| | - Antoinette Davey
- University of Exeter Medical School, St Luke's Campus, Exeter, EX1 2LU, UK.
| | - Fiona Warren
- University of Exeter Medical School, St Luke's Campus, Exeter, EX1 2LU, UK.
| | - Rachel Winder
- University of Exeter Medical School, St Luke's Campus, Exeter, EX1 2LU, UK.
| | - Christine Wright
- University of Exeter Medical School, St Luke's Campus, Exeter, EX1 2LU, UK.
| | - John Campbell
- University of Exeter Medical School, St Luke's Campus, Exeter, EX1 2LU, UK.
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Acute coronary syndrome-associated depression: the salience of a sickness response analogy? Brain Behav Immun 2015; 49:18-24. [PMID: 25746589 DOI: 10.1016/j.bbi.2015.02.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 02/09/2015] [Accepted: 02/23/2015] [Indexed: 12/12/2022] Open
Abstract
Depression emerging in conjunction with acute coronary syndrome (ACS) is thought to constitute a distinct high-risk phenotype with inflammatory determinants. This review critically examines the notion put forward in the literature that ACS-associated depression constitutes a meaningful subtype that is qualitatively different from depressive syndromes observed in psychiatric patients; and evaluates the salience of an analogy to the acute sickness response to infection or injury as an explanatory model. Specific features differentiating ACS-associated depression from other phenotypes are discussed, including differences in depression symptom profiles, timing of the depressive episode in relation to ACS, severity of the cardiac event, and associated immune activation. While an acute sickness response analogy offers a plausible conceptual framework, concrete evidence is lacking for inflammatory activity as the triggering mechanism. It is likely that ACS-associated depression encompasses several causative scenarios.
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39
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Food Insecurity is Longitudinally Associated with Depressive Symptoms Among Homeless and Marginally-Housed Individuals Living with HIV. AIDS Behav 2015; 19:1527-34. [PMID: 25351185 DOI: 10.1007/s10461-014-0922-9] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Depression and food insecurity are prevalent among people with HIV (PLHIV) and contribute to poor HIV outcomes. Longitudinal data can help clarify the effect of food insecurity on depression among PLHIV in the United States. We assessed the longitudinal association of food insecurity with symptoms of depression using validated measures among participants living with HIV from the Research on Access to Care in the Homeless cohort in San Francisco. We followed 346 participants for a median of 28 months. Over half of participants (55.0 %) were food insecure and 35.8 % had symptoms of depression. In adjusted models, severe food insecurity in the previous period was associated with increased depressive symptom severity (b = 1.22; p < 0.001). The association remained statistically significant in models including participant fixed effects. Severe food insecurity was also longitudinally associated with a binary variable indicating probable depression. Efforts to increase access to and participation in food security safety net programs for PLHIV could improve depression.
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40
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Dicianno BE, Kinback N, Bellin MH, Chaikind L, Buhari AM, Holmbeck GN, Zabel TA, Donlan RM, Collins DM. Depressive symptoms in adults with spina bifida. Rehabil Psychol 2015; 60:246-53. [PMID: 26147238 DOI: 10.1037/rep0000044] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To examine the prevalence of depressive symptoms in adults with spina bifida and identify contributing factors for depressive symptomatology. METHOD Retrospective Cohort Study. Data collection was conducted at a regional adult spina bifida clinic. A total of 190 charts from adult patients with spina bifida were included. The main outcome measures were the Beck Depression Inventory-II (BDI-II) and the mobility domain of the Craig Handicap Assessment Reporting Technique-Short Form (CHART-SF). RESULTS Of the 190 participants, 49 (25.8%) had BDI-II scores (14+) indicative of depressive symptomatology. Sixty-nine (36.3%) were on antidepressants to treat depressive symptoms, and 31 (63.3%) of those with clinical symptoms of depression were on antidepressants. Participants with a history of depressive symptoms may be as high as 45.7% if both participants with BDI-II scores 14+ and those with antidepressant use specifically for the purposes of depression treatment are combined. In this population, lower CHART-SF mobility score, expressing "emotional concerns" as a reason for the visit on an intake sheet, and use of antidepressant medications were significantly associated with depressive symptoms. CONCLUSIONS Depressive symptomatology appears to be common and undertreated in this cohort of adults with spina bifida, which may warrant screening for emotional concerns in routine clinic appointments. Significant depressive symptoms are associated with fewer hours out of bed and fewer days leaving the house. Additional research is needed to assess the impact of interventions directed toward mobility on depression and in the treatment of depression in this patient population.
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Affiliation(s)
| | | | | | | | | | | | - T Andrew Zabel
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine
| | | | - Diane M Collins
- Department of Occupational Therapy, University of Texas Medical Branch
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Wardenaar KJ, Wanders RBK, Roest AM, Meijer RR, De Jonge P. What does the beck depression inventory measure in myocardial infarction patients? a psychometric approach using item response theory and person-fit. Int J Methods Psychiatr Res 2015; 24:130-42. [PMID: 25994207 PMCID: PMC6878327 DOI: 10.1002/mpr.1467] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 02/04/2015] [Accepted: 03/17/2015] [Indexed: 11/05/2022] Open
Abstract
Observed associations between depression following myocardial infarction (MI) and adverse cardiac outcomes could be overestimated due to patients' tendency to over report somatic depressive symptoms. This study was aimed to investigate this issue with modern psychometrics, using item response theory (IRT) and person-fit statistics to investigate if the Beck Depression Inventory (BDI) measures depression or something else among MI-patients. An IRT-model was fit to BDI-data of 1135 MI patients. Patients' adherence to this IRT-model was investigated with person-fit statistics. Subgroups of "atypical" (low person-fit) and "prototypical" (high person-fit) responders were identified and compared in terms of item-response patterns, psychiatric diagnoses, socio-demographics and somatic factors. In the IRT model, somatic items had lower thresholds compared to depressive mood/cognition items. Empirically identified "atypical" responders (n = 113) had more depressive mood/cognitions, scored lower on somatic items and more often had a Comprehensive International Diagnostic Interview (CIDI) depressive diagnosis than "prototypical" responders (n = 147). Additionally, "atypical" responders were younger and more likely to smoke. In conclusion, the BDI measures somatic symptoms in most MI patients, but measures depression in a subgroup of patients with atypical response patterns. The presented approach to account for interpersonal differences in item responding could help improve the validity of depression assessments in somatic patients.
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Affiliation(s)
- Klaas J Wardenaar
- University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, Groningen, The Netherlands
| | - Rob B K Wanders
- University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, Groningen, The Netherlands
| | - Annelieke M Roest
- University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, Groningen, The Netherlands
| | - Rob R Meijer
- Department of Psychometrics and Statistics, University of Groningen, Groningen, The Netherlands
| | - Peter De Jonge
- University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, Groningen, The Netherlands
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42
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Herbison P, Tie CL, Tang E, Bermingham B, Wong CK. Components of depression and 6-year mortality after an acute coronary syndrome. Am J Med 2015; 128:540.e1-6. [PMID: 25534421 DOI: 10.1016/j.amjmed.2014.11.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Revised: 11/11/2014] [Accepted: 11/12/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Post-myocardial infarct depression includes both somatic depressive symptoms and nonsomatic cognitive symptoms. Their respective relationships to long-term survival are unclear. METHODS Depression was diagnosed by measuring the Beck Depression Inventory-II (BDI-II) on consecutive patients who presented with acute coronary syndrome in 2005. Six-year mortality data were extracted from the National Health Index. This study investigated whether mortality was related to the somatic or cognitive elements of the BDI-II score, controlling for baseline characteristics including the Global Registry of Acute Coronary Events score. The BDI-II, somatic, and cognitive scores were treated as continuous variables. RESULTS Of the 277 patients, 52 died over 6 years. Higher BDI-II score did not predict mortality at 6 years (odds ratio [OR], 1.02; 95% confidence interval [CI], 0.98-1.06). In the Cognitive/Affective-Somatic model, somatic depressive symptoms (OR, 1.10; 95% CI, 1.01-1.20) predicted all-cause mortality, but cognitive/affective depressive symptoms (OR, 1.01; 95% CI, 0.96-1.08) did not. This association attenuated after controlling for age and sex (OR, 1.10; 95% CI, 0.99-1.22), and age, sex, and Global Registry of Acute Coronary Events score (OR, 1.09; 95% CI, 0.99-1.21). Results from the Somatic/Affective-Cognitive model did not reach statistical significance. Differences were small and unlikely to be of clinical importance. CONCLUSIONS In patients with acute coronary syndrome, those who died had a higher baseline BDI-II score, particularly somatic score, although this did not reach statistical significance.
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Affiliation(s)
- Peter Herbison
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
| | - Charles LokHui Tie
- Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - EngWei Tang
- Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Cheuk-Kit Wong
- Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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Fuss S, Trottier K, Carter J. An investigation of the factor structure of the beck depression inventory-II in anorexia nervosa. EUROPEAN EATING DISORDERS REVIEW 2014; 23:43-50. [PMID: 25504530 DOI: 10.1002/erv.2338] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 10/24/2014] [Accepted: 11/18/2014] [Indexed: 11/09/2022]
Abstract
Symptoms of depression frequently co-occur with eating disorders and have been associated with negative outcomes. Self-report measures such as the Beck Depression Inventory-II (BDI-II) are commonly used to assess for the presence of depressive symptoms in eating disorders, but the instrument's factor structure in this population has not been examined. The purposes of this study were to explore the factor structure of the BDI-II in a sample of individuals (N = 437) with anorexia nervosa undergoing inpatient treatment and to examine changes in depressive symptoms on each of the identified factors following a course of treatment for anorexia nervosa in order to provide evidence supporting the construct validity of the measure. Exploratory factor analysis revealed that a three-factor model reflected the best fit for the data. Confirmatory factor analysis was used to validate this model against competing models and the three-factor model exhibited strong model fit characteristics. BDI-II scores were significantly reduced on all three factors following inpatient treatment, which supported the construct validity of the scale. The BDI-II appears to be reliable in this population, and the factor structure identified through this analysis may offer predictive utility for identifying individuals who may have more difficulty achieving weight restoration in the context of inpatient treatment. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Samantha Fuss
- Eating Disorder Program, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
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44
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de Miranda Azevedo R, Roest AM, Hoen PW, de Jonge P. Cognitive/affective and somatic/affective symptoms of depression in patients with heart disease and their association with cardiovascular prognosis: a meta-analysis. Psychol Med 2014; 44:2689-2703. [PMID: 24467963 DOI: 10.1017/s0033291714000063] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Several prospective longitudinal studies have suggested that somatic/affective depressive symptoms, but not cognitive/affective depressive symptoms, are related to prognosis in patients with heart disease, but findings have been inconsistent. The aim of this study was to investigate the association of cognitive/affective and somatic/affective symptoms of depression with cardiovascular prognosis in patients with heart disease using a meta-analytic perspective. METHOD A systematic search was performed in PubMed, EMBASE and PsycInfo. Thirteen prospective studies on symptom dimensions of depression and cardiovascular prognosis fulfilled the inclusion criteria, providing data on a total of 11,128 subjects. The risk estimates for each dimension of depressive symptoms, demographic and methodological variables were extracted from the included articles. RESULTS In least-adjusted analyses, both the somatic/affective [hazard ratio (HR) 1.30, 95% confidence interval (CI) 1.19-1.41, p < 0.001] and cognitive/affective (HR 1.07, 95% CI 1.00-1.15, p = 0.05) dimensions of depressive symptoms were associated with cardiovascular prognosis. In fully adjusted analyses, somatic/affective symptoms were significantly associated with adverse prognosis (HR 1.19, 95% CI 1.10-1.29, p < 0.001) but cognitive/affective symptoms were not (HR 1.04, 95% CI 0.97-1.12, p = 0.25). An increase of one standard deviation (±1 s.d.) in the scores of the somatic/affective dimension was associated with a 32% increased risk of adverse outcomes (HR 1.32, 95% CI 1.17-1.48, p < 0.001). CONCLUSIONS Somatic/affective depressive symptoms were more strongly and consistently associated with mortality and cardiovascular events in patients with heart disease compared with cognitive/affective symptoms. Future research should focus on the mechanisms by which somatic/affective depressive symptoms may affect cardiovascular prognosis.
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Affiliation(s)
- R de Miranda Azevedo
- Department of Psychiatry,University Medical Center Groningen, University of Groningen,The Netherlands
| | - A M Roest
- Department of Psychiatry,University Medical Center Groningen, University of Groningen,The Netherlands
| | - P W Hoen
- Department of Psychiatry,University Medical Center Groningen, University of Groningen,The Netherlands
| | - P de Jonge
- Department of Psychiatry,University Medical Center Groningen, University of Groningen,The Netherlands
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45
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Wong JYH, Fong DYT. Anxiety mediates the impact of stress on psychosomatic symptoms in Chinese. PSYCHOL HEALTH MED 2014; 20:457-68. [DOI: 10.1080/13548506.2014.951372] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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46
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Marijnissen RM, Smits JEMP, Schoevers RA, van den Brink RHS, Holewijn S, Franke B, de Graaf J, Oude Voshaar RC. Association between metabolic syndrome and depressive symptom profiles--sex-specific? J Affect Disord 2013; 151:1138-42. [PMID: 24011730 DOI: 10.1016/j.jad.2013.07.029] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2013] [Revised: 07/27/2013] [Accepted: 07/30/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND The association between depression and metabolic syndrome is becoming more obvious. Waist circumference (WC) might be the most important metabolic syndrome (MetS) feature in relation to late-life depression, with a possible mediating role for adiponectin. METHODS Cross-sectional population based survey of 1277 participants (50-70 years). We measured all components of MetS, plasma adiponectin levels and depressive symptoms using Beck Depression Inventory (BDI). Principal components analysis on the BDI items revealed two factors, representing a cognitive-affective and a somatic-affective symptom-cluster. Multiple linear regression models with the BDI sum score and both depression symptom-clusters as dependent variables, respectively, were used to examine the association with each component of metabolic syndrome adjusted for confounders. We explored sex-differences as well as a hypothesised mediating effect of adiponectin. RESULTS The presence of MetS as well as number of metabolic risk factors were significantly associated with BDI sum score. In men WC, triglycerides and HDL cholesterol explained variance in depressive symptoms, whereas in women this effect was confined to WC. Moreover, irrespective of sex, all associations were primarily driven by the somatic-affective symptom-cluster. Adiponectin neither mediated nor moderated any of the associations found. LIMITATIONS Cross-sectional design limits causal interpretation. Being a population-based survey, some selection bias might have occurred toward healthier part of population. CONCLUSIONS Although pathophysiological mechanisms underlying the association between metabolic disturbances and depression remains to be elucidated, our study points to sex-differences as well as a specific phenotype of depression that is associated with metabolic disturbances.
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Affiliation(s)
- Radboud M Marijnissen
- Pro Persona, Department of Old Age Psychiatry, Wolfheze/Arnhem, The Netherlands; Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
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Tedeschini E, Pingani L, Simoni E, Ferrari D, Giubbarelli C, Giuggioli D, Lumetti F, Rigatelli M, Ferri C, Ferrari S. Correlation of articular involvement, skin disfigurement and unemployment with depressive symptoms in patients with systemic sclerosis: a hospital sample. Int J Rheum Dis 2013; 17:186-94. [DOI: 10.1111/1756-185x.12100] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
| | - Luca Pingani
- Department of Human Resources; Azienda USL Reggio Emilia; Reggio Emilia Italy
- International PhD School in Clinical and Experimental Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - Elena Simoni
- Psychiatry Unit; Department of Clinical-Diagnostic Medicine and Public Health; University of Modena and Reggio Emilia; Modena Italy
| | - Daniela Ferrari
- Rheumatology Unit; Department of Internal Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - Cinzia Giubbarelli
- Psychiatry Unit; Department of Clinical-Diagnostic Medicine and Public Health; University of Modena and Reggio Emilia; Modena Italy
| | - Dilia Giuggioli
- Rheumatology Unit; Department of Internal Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - Federica Lumetti
- Rheumatology Unit; Department of Internal Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - Marco Rigatelli
- Psychiatry Unit; Department of Clinical-Diagnostic Medicine and Public Health; University of Modena and Reggio Emilia; Modena Italy
| | - Clodoveo Ferri
- Rheumatology Unit; Department of Internal Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - Silvia Ferrari
- Psychiatry Unit; Department of Clinical-Diagnostic Medicine and Public Health; University of Modena and Reggio Emilia; Modena Italy
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Seo Y, Yates B, Dizona P, LaFramboise L, Norman J. Predictors of Cognitive/Affective and Somatic Depression in Heart Failure Patients. Clin Nurs Res 2013; 23:259-80. [DOI: 10.1177/1054773812473476] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The effects of depression on patients with heart failure (HF) are substantial, yet the predictors remain unclear. The predictors of cognitive/affective and somatic depression in stable HF patients were studied. Using a cross-sectional design, 150 HF outpatients were recruited at two mid-Western HF clinics. Predictors included dyspnea with activities of daily living, family and friend social support, and loneliness; age and gender were control variables. All constructs were measured using standardized instruments. Structural equation modeling (SEM) showed that cognitive/affective depression was predicted by greater dyspnea and loneliness, whereas somatic depression was predicted by more dyspnea and friend support. Also, greater dyspnea was related to more loneliness and less friend support; less friend support was related to loneliness. Women reported more dyspnea and loneliness. Since cognitive/affective and somatic depression have different predictors, further study is warranted to identify HF patients at risk for depression and to establish interventions targeted at improving depression.
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Affiliation(s)
- Yaewon Seo
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - Bernice Yates
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - Paul Dizona
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - Louise LaFramboise
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - Joseph Norman
- Physical Therapy Education, School of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, USA
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Comparing cognitive and somatic symptoms of depression in myocardial infarction patients and depressed patients in primary and mental health care. PLoS One 2013; 8:e53859. [PMID: 23342019 PMCID: PMC3544747 DOI: 10.1371/journal.pone.0053859] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 12/04/2012] [Indexed: 11/19/2022] Open
Abstract
Depression in myocardial infarction patients is often a first episode with a late age of onset. Two studies that compared depressed myocardial infarction patients to psychiatric patients found similar levels of somatic symptoms, and one study reported lower levels of cognitive/affective symptoms in myocardial infarction patients. We hypothesized that myocardial infarction patients with first depression onset at a late age would experience fewer cognitive/affective symptoms than depressed patients without cardiovascular disease. Combined data from two large multicenter depression studies resulted in a sample of 734 depressed individuals (194 myocardial infarction, 214 primary care, and 326 mental health care patients). A structured clinical interview provided information about depression diagnosis. Summed cognitive/affective and somatic symptom levels were compared between groups using analysis of covariance, with and without adjusting for the effects of recurrence and age of onset. Depressed myocardial infarction and primary care patients reported significantly lower cognitive/affective symptom levels than mental health care patients (F (2,682) = 6.043, p = 0.003). Additional analyses showed that the difference between myocardial infarction and mental health care patients disappeared after adjusting for age of onset but not recurrence of depression. These group differences were also supported by data-driven latent class analyses. There were no significant group differences in somatic symptom levels. Depression after myocardial infarction appears to have a different phenomenology than depression observed in mental health care. Future studies should investigate the etiological factors predictive of symptom dimensions in myocardial infarction and late-onset depression patients.
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Groenewold NA, Doornbos B, Zuidersma M, Vogelzangs N, Penninx BWJH, Aleman A, de Jonge P. Comparing cognitive and somatic symptoms of depression in myocardial infarction patients and depressed patients in primary and mental health care. PLoS One 2013. [PMID: 23342019 DOI: 10.1371/journal.pone.00589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Depression in myocardial infarction patients is often a first episode with a late age of onset. Two studies that compared depressed myocardial infarction patients to psychiatric patients found similar levels of somatic symptoms, and one study reported lower levels of cognitive/affective symptoms in myocardial infarction patients. We hypothesized that myocardial infarction patients with first depression onset at a late age would experience fewer cognitive/affective symptoms than depressed patients without cardiovascular disease. Combined data from two large multicenter depression studies resulted in a sample of 734 depressed individuals (194 myocardial infarction, 214 primary care, and 326 mental health care patients). A structured clinical interview provided information about depression diagnosis. Summed cognitive/affective and somatic symptom levels were compared between groups using analysis of covariance, with and without adjusting for the effects of recurrence and age of onset. Depressed myocardial infarction and primary care patients reported significantly lower cognitive/affective symptom levels than mental health care patients (F (2,682) = 6.043, p = 0.003). Additional analyses showed that the difference between myocardial infarction and mental health care patients disappeared after adjusting for age of onset but not recurrence of depression. These group differences were also supported by data-driven latent class analyses. There were no significant group differences in somatic symptom levels. Depression after myocardial infarction appears to have a different phenomenology than depression observed in mental health care. Future studies should investigate the etiological factors predictive of symptom dimensions in myocardial infarction and late-onset depression patients.
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Affiliation(s)
- Nynke A Groenewold
- Interdisciplinary Center for Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands.
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