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Liu JM, Gao M, Zhang R, Wong NML, Wu J, Chan CCH, Lee TMC. A machine-learning approach to model risk and protective factors of vulnerability to depression. J Psychiatr Res 2024; 175:374-380. [PMID: 38772128 DOI: 10.1016/j.jpsychires.2024.04.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 04/17/2024] [Accepted: 04/25/2024] [Indexed: 05/23/2024]
Abstract
There are multiple risk and protective factors for depression. The association between these factors with vulnerability to depression is unclear. Such knowledge is an important insight into assessing risk for developing depression for precision interventions. Based on the behavioral data of 496 participants (all unmarried and not cohabiting, with a college education level or above), we applied machine-learning approaches to model risk and protective factors in estimating depression and its symptoms. Then, we employed Random Forest to identify important factors which were then used to differentiate participants who had high risk of depression from those who had low risk. Results revealed that risk and protective factors could significantly estimate depression and depressive symptoms. Feature selection revealed four key factors including three risk factors (brooding, perceived loneliness, and perceived stress) and one protective factor (resilience). The classification model built by the four factors achieved an ROC-AUC score of 75.50% to classify the high- and low-risk groups, which was comparable to the classification performance based on all risk and protective factors (ROC-AUC = 77.83%). Based on the selected four factors, we generated a mood vulnerability index useful for identifying people's risk for depression. Our findings provide potential clinical insights for developing quick screening tools for mood disorders and potential targets for intervention programs designed to improve depressive symptoms.
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Affiliation(s)
- June M Liu
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China; Laboratory of Neuropsychology and Human Neuroscience, The University of Hong Kong, Hong Kong, China
| | - Mengxia Gao
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China; Laboratory of Neuropsychology and Human Neuroscience, The University of Hong Kong, Hong Kong, China
| | - Ruibin Zhang
- Cognitive Control and Brain Healthy Laboratory, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Nichol M L Wong
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China; Laboratory of Neuropsychology and Human Neuroscience, The University of Hong Kong, Hong Kong, China; Department of Psychology, The Education University of Hong Kong, Hong Kong, China
| | - Jingsong Wu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Chetwyn C H Chan
- Department of Psychology, The Education University of Hong Kong, Hong Kong, China.
| | - Tatia M C Lee
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China; Laboratory of Neuropsychology and Human Neuroscience, The University of Hong Kong, Hong Kong, China.
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2
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Wang Q, Huang X, Liu M, Wang C, Sun Z, Huang C, Tang S. Prevalence and risk factors of depression among elderly people in nursing homes from 2012 to 2022: a systematic review and meta-analysis. Aging Ment Health 2024:1-12. [PMID: 38952191 DOI: 10.1080/13607863.2024.2367044] [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: 04/24/2023] [Accepted: 02/20/2024] [Indexed: 07/03/2024]
Abstract
OBJECTIVES To determine a pooled prevalence of depression and its influencing factors among nursing home residents. METHOD PsycINFO, PubMed, Embase, and Web of Science were searched for studies investigating the prevalence and risk factors of late-life depression among nursing home residents between January 2012 and November 2022. Two reviewers independently completed the literature screening, data extraction and quality assessment. A random-effects model was utilized to pool the prevalence of depression and summarize the influencing factors. RESULTS This meta-analysis included 48 studies involving 28,501 participants. The pooled prevalence of depressive mood and major depressive disorder was 53% and 27%, respectively. The rate of depressive mood is higher in lower-middle-income countries (60.0%), compared with high- (53.0%) and upper-middle-income countries (44.0%). The rate of depressive mood (35.0%) is higher among females than male (19.0%). Depression was influenced by factors, including male (OR = 0.28), insufficient income (OR = 3.53), comorbidities (OR = 2.66), pain (OR = 2.67; r = 0.31), functional disability (r = 0.33), loneliness (r = 0.43), number of chronic health problems (r = 0.18), social support (r = -0.28), activities of daily living (r = -0.43), subjective health (r = -0.28), autonomy (r = -0.41), environment (r = -0.50) and physical (r = -0.57) and psychological health (r = -0.65). CONCLUSION The prevalence of depressive mood is high among nursing home residents, especially in lower-middle-income countries. It is influenced by factors including gender, income, social support, daily activities, environment, physical and psychological health and autonomy. Understanding those factors can provide evidence-based recommendations for improved awareness, prevention and better management of late-life depression.
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Affiliation(s)
- Qing Wang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Xiaoting Huang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Minhui Liu
- School of Nursing, Ningxia Medical University, Yinchuan, China
| | - Chunyu Wang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Zaiqing Sun
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Chongmei Huang
- School of Nursing, Ningxia Medical University, Yinchuan, China
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, Changsha, China
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Zhou X, Yang F, Gao Y. A meta-analysis of the association between loneliness and all-cause mortality in older adults. Psychiatry Res 2023; 328:115430. [PMID: 37647699 DOI: 10.1016/j.psychres.2023.115430] [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: 11/18/2022] [Revised: 08/19/2023] [Accepted: 08/20/2023] [Indexed: 09/01/2023]
Abstract
Despite the well-established association between loneliness and all-cause mortality in older adults, it remains unknown whether this association holds for older adults of different sex and whether it is influenced by different samples and study characteristics. Thus, this meta-analysis aims to examine moderators of the association between loneliness and all-cause mortality in older adults. To this end, relevant literature was retrieved from the PubMed, Embase, PsycINFO, Web of Science, Chinese National Knowledge Infrastructure, Weipu, and Wanfang databases (inception to May 2023) and was processed in the Comprehensive Meta-Analysis 3.3 software. Moreover, subgroup analysis was performed to explore the sources of heterogeneity and further explore potential moderators. Funnel plots, Begg's test, and Egger's linear regression test were used to examine the publication bias, and sensitivity analysis was used to test the robustness of the results. Thirty-six studies involving 128,927 older adults were included in this meta-analysis. In general, loneliness was related to an increase in all-cause mortality in older adults (HR = 1.09, 95% CI = 1.06-1.12, I2 = 63.31%, p < 0.001). The overall effect size for older men was 1.18 (95% CI = 1.04-1.33, p = 0.010). The association between loneliness and all-cause mortality was found to be significantly influenced by the source country of the data, follow-up length, and covariates for chronic disease as moderators. In conclusion, loneliness among older adults deserves more attention, and services are needed to improve their mental health.
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Affiliation(s)
- Xiang Zhou
- Department of Social Work, School of Sociology and Political Science, Shanghai University, Nanchen Road, Baoshan District, Shanghai, 200444, China
| | - Fang Yang
- Department of Social Work, School of Sociology and Political Science, Shanghai University, Nanchen Road, Baoshan District, Shanghai, 200444, China.
| | - Yourong Gao
- Department of Social Work, School of Sociology and Political Science, Shanghai University, Nanchen Road, Baoshan District, Shanghai, 200444, China
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Zagaria A, Ballesio A, Vacca M, Lombardo C. Repetitive Negative Thinking as a Central Node Between Psychopathological Domains: a Network Analysis. Int J Cogn Ther 2023. [DOI: 10.1007/s41811-023-00162-4] [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: 04/03/2023]
Abstract
AbstractRepetitive negative thinking (RNT) may be defined as a reiterative, passive and uncontrollable thinking process. RNT has been recognized as a transdiagnostic phenomenon associated with the onset and maintenance of several clinical conditions including depression, generalised anxiety, psychosis and insomnia. We aimed to estimate a network model of mutual associations between RNT and the aforementioned indicators whilst controlling for other well-established transdiagnostic factors (i.e. perceived stress, loneliness). A total of 324 participants (Mage = 25.26 years, SD = 6.89; 69.3% females) completed a cross-sectional survey of self-report questionnaires. A Gaussian graphical model was estimated using the graphical LASSO in combination with the extended Bayesian information criterion. We found a dense network in which RNT exhibited substantial connections with the majority of the psychopathological domains. The centrality indices confirmed that RNT was one of the most important nodes in the network. Moreover, the estimated network showed satisfactory accuracy and stability. Findings emphasized RNT as a potentially good therapeutic target for psychopathology prevention and treatment protocols.
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Svensson M, Rosso A, Elmståhl S, Ekström H. Loneliness, social isolation, and health complaints among older people: A population-based study from the “Good Aging in Skåne (GÅS)” project. SSM Popul Health 2022; 20:101287. [DOI: 10.1016/j.ssmph.2022.101287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/05/2022] [Accepted: 11/06/2022] [Indexed: 11/09/2022] Open
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Zeng M, Chen S, Zhou X, Zhang J, Chen X, Sun J. The relationship between physical exercise and mobile phone addiction among Chinese college students: Testing mediation and moderation effects. Front Psychol 2022; 13:1000109. [PMID: 36262440 PMCID: PMC9574398 DOI: 10.3389/fpsyg.2022.1000109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/01/2022] [Indexed: 11/21/2022] Open
Abstract
Background During the COVID-19 pandemic, suspensions of activities and long periods of self-isolation led to a sharp increase in excessive use of mobile phones, which sparked public concern about mobile phone addiction (MPA). In recent years, more and more attention has been paid to physical exercise as a protective effect of MPA. However, more studies are needed to reveal this relationship and the exact mechanisms, based on which this study tested the mediating and moderating roles of self-control, rumination, psychological distress, and loneliness between physical exercise and MPA. Methods In this cross-sectional study, primary data was collected by questionnaire from 1,843 college students (19.75 ± 1.3) from five universities in Sichuan Province in Mainland China. Mobile Phone Addiction Tendency Scale (MPATS), Physical Activity Rating Scale-3 (PARS-3), Self-Control Scale (SCS), Ruminative Response Scale (RRS), Depression Anxiety Stress Scale-21 (DASS-21), and UCLA Loneliness Scale (UCLA-20) were investigated. The mediating models were examined using SPSS PROCESS macro 3.3 software, in which the mediation variables were self-control, rumination, and psychological distress, and the moderation was loneliness. Gender, major, and grade were included as control variables. Result Self-control, rumination, and psychological distress played a simple mediating role between physical exercise and MPA. Moreover, not only self-control and rumination but also self-control and psychological distress played the chain mediating roles between physical exercise and MPA. The chain pathways were moderated by loneliness. Specifically, the effect was more substantial among college students with higher loneliness. Conclusion The conclusions corroborate and clarify that self-control, rumination, and psychological distress mediated the association between physical exercise and MPA, and the mediation effects were moderated via loneliness. This present study advanced our understanding of how and when college students’ physical exercise was related to MPA. It also illustrates that educators and parents should pay more attention to college students’ physical exercise.
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Affiliation(s)
- Miaolin Zeng
- Institute of Sports Science, Sichuan University, Chengdu, China
| | - Siyu Chen
- Institute of Sports Science, Sichuan University, Chengdu, China
| | - Xiangyi Zhou
- Institute of Sports Science, Sichuan University, Chengdu, China
| | - Jincheng Zhang
- Institute of Sports Science, Sichuan University, Chengdu, China
| | - Xin Chen
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Jingquan Sun
- Institute of Sports Science, Sichuan University, Chengdu, China
- School of Physical Education, Sichuan University, Chengdu, China
- *Correspondence: Jingquan Sun,
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Zhang Z, Li G, Song Z, Han Y, Tang X. Relationship among number of close friends, subclinical geriatric depression, and subjective cognitive decline based on regional homogeneity of functional magnetic resonance imaging data. Front Aging Neurosci 2022; 14:978611. [PMID: 36212042 PMCID: PMC9541299 DOI: 10.3389/fnagi.2022.978611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 08/26/2022] [Indexed: 01/10/2023] Open
Abstract
The relationship between geriatric depression and dementia has been widely debated, and the neurological mechanisms underlying subjective cognitive decline (SCD) associated with social relationships remain elusive. Subclinical geriatric depression (SGD) is common in patients with SCD, and close friends (CFs) have a great influence on a person's social life. Studies have proven that communication or leisure activities with CFs can improve the cognitive performance of elderly. However, it remains unclear whether the engagement of specific brain regions mediates having CFs, SGD, and SCD. In this study, we aimed to assess the association between social relationships (that is, CFs), SGD, and SCD from the perspective of brain function. We examined the data of 66 patients with SCD and 63 normal controls (NC). Compared with NC, SGD was significantly inversely correlated with the number of CFs in the SCD group. We calculated regional homogeneity (ReHo) of functional magnetic resonance imaging (MRI) data of each subject. At a corrected threshold, the right occipital gyrus (SOG.R) and right fusiform gyrus (FFG.R) exhibited positive correlation with SGD in patients with SCD. Mediation analyses to query the inter-relationships between the neural markers and clinical variables exhibited a best fit of the model with CFs → FFG.R → SGD → SOG.R → SCD. These findings suggested a pathway whereby social relationships alter the function of specific brain regions, and SGD may be an early symptom of SCD. We observed that the FFG.R mediate social relationships and SGD, and the abnormality of the SOG.R may be a key factor in the SCD caused by depression. Moreover, a greater number of CFs may reduce the risk of developing SGD.
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Affiliation(s)
- Zhao Zhang
- Department of Biomedical Engineering, School of Life Sciences, Beijing Institute of Technology, Beijing, China
| | - Guangfei Li
- Department of Biomedical Engineering, School of Life Sciences, Beijing Institute of Technology, Beijing, China,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Zeyu Song
- Department of Biomedical Engineering, School of Life Sciences, Beijing Institute of Technology, Beijing, China
| | - Ying Han
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Xiaoying Tang
- Department of Biomedical Engineering, School of Life Sciences, Beijing Institute of Technology, Beijing, China,*Correspondence: Xiaoying Tang,
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8
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Yun RC, Fardghassemi S, Joffe H. Thinking too much: How young people experience rumination in the context of loneliness. JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY 2022. [DOI: 10.1002/casp.2635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Rumi Chloe Yun
- Division of Psychology and Language Sciences University College London London UK
| | - Sam Fardghassemi
- Division of Psychology and Language Sciences University College London London UK
| | - Hélène Joffe
- Division of Psychology and Language Sciences University College London London UK
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9
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Zhang J, Wang Y, Li R, Li C. Depressive rumination and life satisfaction among institution-dwelling Chinese older adults: the roles of perceived burdensomeness and social support from individuals within the institution. Aging Ment Health 2022; 26:1170-1177. [PMID: 34125640 DOI: 10.1080/13607863.2021.1937054] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Objectives: We examined how institution-dwelling older adults' depressive rumination was associated with their life satisfaction by taking perceived burdensomeness as a mediator and social support from individuals within the institution (SSII) as a moderator.Method: A total of 194 older adults from 24 institutions in four provinces of China completed a questionnaire survey.Results: Depressive rumination was negatively associated with life satisfaction, and perceived burdensomeness mediated this association. Moreover, SSII moderated the indirect association between depressive rumination and life satisfaction through perceived burdensomeness. Specifically, depressive rumination had a negative effect on life satisfaction through perceived burdensomeness only for older adults with less SSII.Conclusion: Our study indicated that depressive rumination could damage older adults' life satisfaction by increasing their perceived burdensomeness. Fortunately, older adults' perception of social support from individuals within the institution could attenuate this negative effect. This study has implications for designing intervention programs to improve the institution-dwelling older adults' life satisfaction.
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Affiliation(s)
- Jinfeng Zhang
- School of Public Policy and Administration, Chongqing University, Chongqing, China
| | - Yan Wang
- School of Public Policy and Administration, Chongqing University, Chongqing, China
| | - Rui Li
- School of Public Policy and Administration, Chongqing University, Chongqing, China
| | - Chenxi Li
- School of Nursing, Yueyang Vocational Technical College, Yueyang, China
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10
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Health effects of loneliness and social isolation in older adults living in congregate long term care settings: A systematic review of quantitative and qualitative evidence. Arch Gerontol Geriatr 2022; 102:104728. [DOI: 10.1016/j.archger.2022.104728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/03/2022] [Accepted: 05/09/2022] [Indexed: 11/18/2022]
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11
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Zhang D, Wang R, Tian Y, Qi C, Zhao F, Su Y. Exploring life and help-seeking experiences regarding suicidal ideations among nursing home residents. Geriatr Nurs 2022; 45:69-76. [PMID: 35339953 DOI: 10.1016/j.gerinurse.2022.03.004] [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: 01/16/2022] [Revised: 03/10/2022] [Accepted: 03/10/2022] [Indexed: 11/25/2022]
Abstract
Globally, older adults, especially nursing home residents, are at a higher risk of suicide. This study examined the life of nursing home residents with suicidal ideations and their help-seeking experiences. A qualitative analysis of 19 semi-structured interviews was conducted. Results indicate that suicidal ideations among nursing home residents correlates with their negative life experiences, both personally and institutionally. In terms of their life experiences, themes included the desire for death, emotional loneliness, a state of discomfort arising from incapacity, feeling like a burden on children, and dealing with the low-quality service. Older adults' negative attitudes toward seeking assistance as well as limited resort resources and ineffective help-seeking hinder them from finding more support or treatment. This study adds to a growing body of research on late-life suicide in institutional settings, and relevant findings can serve as references in improving nursing home residents' life quality and developing suicide-prevention strategies.
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Affiliation(s)
- Dan Zhang
- Department of Medical Psychology and Ethics, School of Basic Medical Sciences, Shandong University, Jinan, 250012, Shandong, China
| | - Rui Wang
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Yinong Tian
- School of Foreign Languages and Literature, Shandong University, Jinan, Shandong, China
| | - Chun Qi
- School of Foreign Languages and Literature, Shandong University, Jinan, Shandong, China
| | - Fuchang Zhao
- Department of Medical Psychology and Ethics, School of Basic Medical Sciences, Shandong University, Jinan, 250012, Shandong, China.
| | - Yonggang Su
- Department of Medical Psychology and Ethics, School of Basic Medical Sciences, Shandong University, Jinan, 250012, Shandong, China; School of Foreign Languages and Literature, Shandong University, Jinan, Shandong, China; Shandong Provincial Key Laboratory of Mental Disorders, School of Basic Medical Sciences, Shandong University, Jinan, Shandong, China.
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12
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Herrman H, Patel V, Kieling C, Berk M, Buchweitz C, Cuijpers P, Furukawa TA, Kessler RC, Kohrt BA, Maj M, McGorry P, Reynolds CF, Weissman MM, Chibanda D, Dowrick C, Howard LM, Hoven CW, Knapp M, Mayberg HS, Penninx BWJH, Xiao S, Trivedi M, Uher R, Vijayakumar L, Wolpert M. Time for united action on depression: a Lancet-World Psychiatric Association Commission. Lancet 2022; 399:957-1022. [PMID: 35180424 DOI: 10.1016/s0140-6736(21)02141-3] [Citation(s) in RCA: 301] [Impact Index Per Article: 150.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 09/15/2021] [Accepted: 09/21/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Helen Herrman
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Sangath, Goa, India; Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Christian Kieling
- Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Child & Adolescent Psychiatry Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Michael Berk
- Deakin University, IMPACT Institute, Geelong, VIC, Australia
| | - Claudia Buchweitz
- Graduate Program in Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Toshiaki A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Brandon A Kohrt
- Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC, USA
| | - Mario Maj
- Department of Psychiatry, University of Campania L Vanvitelli, Naples, Italy
| | - Patrick McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Charles F Reynolds
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Myrna M Weissman
- Columbia University Mailman School of Public Health, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Dixon Chibanda
- Department of Psychiatry, University of Zimbabwe, Harare, Zimbabwe; Centre for Global Mental Health, The London School of Hygiene and Tropical Medicine, London, UK
| | - Christopher Dowrick
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Louise M Howard
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Christina W Hoven
- Columbia University Mailman School of Public Health, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Martin Knapp
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Helen S Mayberg
- Departments of Neurology, Neurosurgery, Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Shuiyuan Xiao
- Central South University Xiangya School of Public Health, Changsha, China
| | - Madhukar Trivedi
- Peter O'Donnell Jr Brain Institute and the Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Lakshmi Vijayakumar
- Sneha, Suicide Prevention Centre and Voluntary Health Services, Chennai, India
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Alsubheen SA, Oliveira A, Habash R, Goldstein R, Brooks D. Systematic review of psychometric properties and cross-cultural adaptation of the University of California and Los Angeles loneliness scale in adults. CURRENT PSYCHOLOGY 2021; 42:1-15. [PMID: 34785877 PMCID: PMC8586628 DOI: 10.1007/s12144-021-02494-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2021] [Indexed: 12/30/2022]
Abstract
This systematic review assessed the psychometric properties and the cross-cultural adaptation of the University of California and Los Angeles Loneliness scale (UCLA-LS) in adults. A systematic search of four electronic databases (PubMed, EMBASE, Scopus, and PsycINFO) was conducted from inception until March 2021. We followed the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines for data extraction and evidence synthesis. Eighty-one studies assessed the validity and reliability of the UCLA-LS, translated into many languages, and applied across several countries/societies. Three versions of the 20-item and nine short versions of the UCLA-LS with 3 to 20 questions were identified. High-quality evidence supported the internal structure of the UCLAs: 4, 6, 7 and 10, while low-to moderate-quality evidence supported the construct validity of the UCLAs: 3, 4, 6, 8, 16 and 20. Moderate-quality evidence supported the test-retest reliability of version 3 UCLA-20 with excellent interclass coefficients values of 0.76-0.93. The UCLAs: 4, 6, 7 and 10 had the most robust internal structure and may therefore be the most useful for informing clinicians and social psychologists engaged in assisting those with loneliness. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s12144-021-02494-w.
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Affiliation(s)
- Sanaa A. Alsubheen
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, IAHS Building Room 430, Hamilton, ON L8S 1C7 Canada
| | - Ana Oliveira
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, IAHS Building Room 430, Hamilton, ON L8S 1C7 Canada
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON Canada
- Lab3R – Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
- Institute for Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
| | - Razanne Habash
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON Canada
| | - Roger Goldstein
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON Canada
- Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Dina Brooks
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, IAHS Building Room 430, Hamilton, ON L8S 1C7 Canada
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON Canada
- Department of Physical Therapy and Rehabilitation Science, University of Toronto, Toronto, ON Canada
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14
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Zhang D, Wang R, Zhao X, Zhang J, Jia J, Su Y, Wang K. Role of resilience and social support in the relationship between loneliness and suicidal ideation among Chinese nursing home residents. Aging Ment Health 2021; 25:1262-1272. [PMID: 32602736 DOI: 10.1080/13607863.2020.1786798] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Loneliness is a risk factor of suicidal ideation, while resilience and social support are protective factors; however, the complex mechanisms behind these factors have not been examined among nursing home residents. This study evaluated the mediating effect of resilience on the association between loneliness and suicidal ideation and whether this mediating effect was moderated by social support. METHODS Residents (N = 538; Aged ≥60years; 321 female, 217 male) from 37 nursing homes in China completed this cross-sectional study. Their loneliness, resilience, social support, and suicidal ideation were measured. Regression analyses using bootstrapping methods were conducted to explore the mediating and moderating effects. RESULTS Some residents (14.9%, 80/538) reported current suicidal ideation. The correlation between loneliness and suicidal ideation was partially mediated by resilience (indirect effect = 0.067, 95% CI = 0.011-0.122). Overall social support moderated the resilience on suicidal ideation, indirectly impacting loneliness on suicidal ideation (moderating effect = 0.086 [95% CI = 0.005-0.167]). Support from family and nursing home staff moderated the direct (path c') and indirect path (path b) of the mediation model, respectively. CONCLUSIONS Our findings underscore the vital role of resilience and social support to buffer against suicidal ideation, which is common among nursing home residents in China.HighlightsWe evaluated suicidal ideation in mainland Chinese nursing home residentsLoneliness and suicidal ideation were partially mediated by resilienceSocial support moderated the effect of loneliness and resilience on suicidal ideationThe results were self-reported and are not generalizable to all of ChinaResilience and social support can buffer against suicidal ideation among residents.
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Affiliation(s)
- Dan Zhang
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Rui Wang
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Xia Zhao
- Department of Health Management, Heze Medical College, Heze, Shandong, China
| | - Jie Zhang
- China Department of Sociology, State University of New York Buffalo State, Buffalo, NY, USA.,School of Public Health, Shandong University, Jinan, Shandong, China
| | - Jihui Jia
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Yonggang Su
- School of Nursing, Shandong University, Jinan, Shandong, China.,School of Foreign Languages and Literature, Shandong University, Jinan, Shandong, China
| | - Kefang Wang
- School of Nursing, Shandong University, Jinan, Shandong, China
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15
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Abstract
AIMS Alienation towards parents often occurs when parents divorce; however, it can also occur when one or both parents leave for work for more than 6 months. Our previous investigation has confirmed a high level of feelings of alienation towards parents among Chinese left-behind children. However, the longitudinal prediction of alienation on children's mental health outcomes remains largely unknown. This study aims to observe the prediction of alienation towards parents on children's depression 12 months later and potential mediators and moderators. METHODS A total of 1090 Chinese left-behind children took part in this 12-month follow-up investigation, using the Chinese version of the Inventory of Alienation towards Parents (IAP), the Children's Depression Inventory (CDI), the Adolescent Self-Rating Life-events Checklist (ASLEC), and the Adolescent Resilience Scale. RESULTS Alienation towards parents was high (16.42 ± 7.27 for mother, 15.63 ± 7.17 for father) in left-behind children, and 21.01% of children reported depression. Alienation towards parents predicted current depression of children directly and later depression indirectly; children's alienation toward their mothers was a stronger predictor of depression than alienation towards fathers. In models, stressful life-events acted as a risk mediator. Previous depression was the strongest risk predictor, resilience was the strongest protective factor, and duration of fathers' absence and parents' marital status moderated the predictive effects. CONCLUSIONS This study is among the first to longitudinally confirm that alienation towards parents is a predictor of children's later depression. The results provide important suggestions for families and schools; i.e. to prevent depression in left-behind children, parent-child bonds especially alienation towards mothers, should be carefully considered, and individuals with more negative life-events and weaker resilience need further attention.
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16
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Lee SL, Pearce E, Ajnakina O, Johnson S, Lewis G, Mann F, Pitman A, Solmi F, Sommerlad A, Steptoe A, Tymoszuk U, Lewis G. The association between loneliness and depressive symptoms among adults aged 50 years and older: a 12-year population-based cohort study. Lancet Psychiatry 2021; 8:48-57. [PMID: 33181096 PMCID: PMC8009277 DOI: 10.1016/s2215-0366(20)30383-7] [Citation(s) in RCA: 165] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/05/2020] [Accepted: 08/07/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Loneliness is experienced by a third of older adults in the UK and is a modifiable potential risk factor for depressive symptoms. It is unclear how the association between loneliness and depressive symptoms persists over time, and whether it is independent of related social constructs and genetic confounders. We aimed to investigate the association between loneliness and depressive symptoms, assessed on multiple occasions during 12 years of follow-up, in a large, nationally representative cohort of adults aged 50 years and older in England. METHODS We did a longitudinal study using seven waves of data that were collected once every 2 years between 2004 and 2017, from adults aged 50 years and older in the English Longitudinal Study of Ageing (ELSA). The exposure was loneliness at baseline (wave two), measured with the short 1980 revision of the University of California, Los Angeles Loneliness Scale (R-UCLA). The primary outcome was a score indicating severity of depression measured at six subsequent timepoints (waves three to eight), using the eight-item version of the Centre for Epidemiologic Studies Depression Scale (CES-D). Analyses were linear multilevel regressions, before and after adjusting for social isolation, social support, polygenic risk scores, and other sociodemographic and health-related confounders. The secondary outcome was depression diagnosis, measured using a binary version of the CES-D. FINDINGS 4211 (46%) of 9171 eligible participants had complete data on exposure, outcome, and confounders, and were included in our complete case sample. After all adjustments, a 1-point increase in loneliness score was associated with a 0·16 (95% CI 0·13-0·19) increase in depressive symptom severity score (averaged across all follow-ups). We estimated a population attributable fraction for depression associated with loneliness of 18% (95% CI 12-24) at 1 year of follow-up and 11% (3-19) at the final follow-up (wave eight), suggesting that 11-18% of cases of depression could potentially be prevented if loneliness were eliminated. Associations between loneliness and depressive symptoms remained after 12 years of follow-up, although effect sizes were smaller with longer follow-up. INTERPRETATION Irrespective of other social experiences, higher loneliness scores at baseline were associated with higher depression symptom severity scores during 12 years of follow-up among adults aged 50 years and older. Interventions that reduce loneliness could prevent or reduce depression in older adults, which presents a growing public health problem worldwide. FUNDING National Institute on Aging and a consortium of UK Government departments coordinated by the National Institute for Health Research.
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Affiliation(s)
- Siu Long Lee
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Eiluned Pearce
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Olesya Ajnakina
- Department of Behavioural Science and Health, University College London, London, UK; Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Sonia Johnson
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK; Camden and Islington National Health Service Foundation Trust, London, UK
| | - Glyn Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK; Camden and Islington National Health Service Foundation Trust, London, UK
| | - Farhana Mann
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK; Camden and Islington National Health Service Foundation Trust, London, UK
| | - Alexandra Pitman
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK; Camden and Islington National Health Service Foundation Trust, London, UK
| | - Francesca Solmi
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Andrew Sommerlad
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK; Camden and Islington National Health Service Foundation Trust, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| | - Urszula Tymoszuk
- Centre for Performance Science, Royal College of Music, Imperial College London, London, UK
| | - Gemma Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK.
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17
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McComb SE, Goldberg JO, Flett GL, Rose AL. The Double Jeopardy of Feeling Lonely and Unimportant: State and Trait Loneliness and Feelings and Fears of Not Mattering. Front Psychol 2020; 11:563420. [PMID: 33391078 PMCID: PMC7773912 DOI: 10.3389/fpsyg.2020.563420] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 11/23/2020] [Indexed: 11/13/2022] Open
Abstract
There have been recent concerns about an "epidemic of loneliness" during the pandemic, given the pervasiveness of loneliness in the population and its harmful effects on health and well-being. Therefore, it is important to establish the correlates of loneliness. The purpose of the current study was to explore how loneliness relates to a construct termed mattering, which is the feeling of being important to other people. Mattering was assessed with multiple measures in the current study (e.g., mattering in general, fears of not mattering, and mattering to peers). A sample of 172 female psychology undergraduate students aged 18-25 years completed self-report measures of general mattering, mattering to peers, anti-mattering, fear of not mattering, and state and trait loneliness. As predicted, lower levels of both general mattering and mattering to peers were associated with higher state loneliness. Higher feelings of anti-mattering (feelings of being invisible and insignificant to others) and fears of not mattering were associated with greater trait loneliness, as well as a reduced sense of mattering to friends. The findings illustrate that feeling as though one does not matter to others (i.e., feeling insignificant and unimportant) is associated with increased state and trait loneliness among young women. Implications are discussed for loneliness theory and how these results can enhance both clinical understanding and practice.
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18
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Frinking E, Jans-Beken L, Janssens M, Peeters S, Lataster J, Jacobs N, Reijnders J. Gratitude and loneliness in adults over 40 years: examining the role of psychological flexibility and engaged living. Aging Ment Health 2020; 24:2117-2124. [PMID: 31591900 DOI: 10.1080/13607863.2019.1673309] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES The aim of the present study was to investigate the association between trait gratitude and loneliness in a Dutch population sample of adults over 40 years. In addition, the mediating role of psychological flexibility and engaged living between trait gratitude and loneliness was assessed. METHOD A total sample of 163 adults of which 65 men (40%) and 98 women (60%) between 41 and 92 years (Mage = 66, SDage = 12) participated in this study. Data from the Loneliness Questionnaire, Flexibility Index Test, Engaged Living Scale and the Short Gratitude, Resentment, and Appreciation Test were used. Mediation analysis was performed. RESULTS Analysis showed a negative association between trait gratitude and loneliness. In addition, after adjusting for the demographic variables age, gender and educational level, the association between trait gratitude and loneliness was fully mediated by psychological flexibility, and partially mediated by engaged living. CONCLUSION This study endorses the importance of trait gratitude and psychological flexibility in relation to experiencing loneliness. Further research is needed to replicate these findings in a more diverse sample and to investigate the causal relationships between these constructs. It would also be interesting to further investigate the role of different age groups and goal (dis)engagement strategies in this relation.
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Affiliation(s)
- Esther Frinking
- Faculty of Psychology and Educational Sciences, Open University, Heerlen, The Netherlands
| | - Lilian Jans-Beken
- Faculty of Psychology and Educational Sciences, Open University, Heerlen, The Netherlands.,Institute for Globally Distributed Open Research and Education (IGDORE), Oudorp, The Netherlands
| | - Mayke Janssens
- Faculty of Psychology and Educational Sciences, Open University, Heerlen, The Netherlands.,Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Sanne Peeters
- Faculty of Psychology and Educational Sciences, Open University, Heerlen, The Netherlands.,Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Johan Lataster
- Faculty of Psychology and Educational Sciences, Open University, Heerlen, The Netherlands.,Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Nele Jacobs
- Faculty of Psychology and Educational Sciences, Open University, Heerlen, The Netherlands.,Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jennifer Reijnders
- Faculty of Psychology and Educational Sciences, Open University, Heerlen, The Netherlands
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19
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Bethell J, Aelick K, Babineau J, Bretzlaff M, Edwards C, Gibson JL, Hewitt Colborne D, Iaboni A, Lender D, Schon D, McGilton KS. Social Connection in Long-Term Care Homes: A Scoping Review of Published Research on the Mental Health Impacts and Potential Strategies During COVID-19. J Am Med Dir Assoc 2020; 22:228-237.e25. [PMID: 33347846 PMCID: PMC9186333 DOI: 10.1016/j.jamda.2020.11.025] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/16/2020] [Accepted: 11/20/2020] [Indexed: 01/23/2023]
Abstract
Objectives Good social connection is associated with better health and wellbeing. However, social connection has distinct considerations for people living in long-term care (LTC) homes. The objective of this scoping review was to summarize research literature linking social connection to mental health outcomes, specifically among LTC residents, as well as research to identify strategies to help build and maintain social connection in this population during COVID-19. Design Scoping review. Settings and Participants Residents of LTC homes, care homes, and nursing homes. Methods We searched MEDLINE(R) ALL (Ovid), CINAHL (EBSCO), PsycINFO (Ovid), Scopus, Sociological Abstracts (ProQuest), Embase and Embase Classic (Ovid), Emcare Nursing (Ovid), and AgeLine (EBSCO) for research that quantified an aspect of social connection among LTC residents; we limited searches to English-language articles published from database inception to search date (July 2019). For the current analysis, we included studies that reported (1) the association between social connection and a mental health outcome, (2) the association between a modifiable risk factor and social connection, or (3) intervention studies with social connection as an outcome. From studies in (2) and (3), we identified strategies that could be implemented and adapted by LTC residents, families and staff during COVID-19 and included the articles that informed these strategies. Results We included 133 studies in our review. We found 61 studies that tested the association between social connection and a mental health outcome. We highlighted 12 strategies, informed by 72 observational and intervention studies, that might help LTC residents, families, and staff build and maintain social connection for LTC residents. Conclusions and Implications Published research conducted among LTC residents has linked good social connection to better mental health outcomes. Observational and intervention studies provide some evidence on approaches to address social connection in this population. Although further research is needed, it does not obviate the need to act given the sudden and severe impact of COVID-19 on social connection in LTC residents.
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Affiliation(s)
- Jennifer Bethell
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
| | - Katelynn Aelick
- Behavioural Supports Ontario Provincial Coordinating Office, North Bay Regional Health Centre, North Bay, Canada
| | - Jessica Babineau
- Library and Information Services, University Health Network, Toronto, Canada; The Institute for Education Research, University Health Network, Toronto, Canada
| | - Monica Bretzlaff
- Behavioural Supports Ontario Provincial Coordinating Office, North Bay Regional Health Centre, North Bay, Canada
| | | | | | - Debbie Hewitt Colborne
- Behavioural Supports Ontario Provincial Coordinating Office, North Bay Regional Health Centre, North Bay, Canada
| | - Andrea Iaboni
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Dee Lender
- Ontario Association of Residents' Councils, Newmarket, Canada
| | - Denise Schon
- Lakeside Long-Term Care Centre Family Council, Toronto, Canada
| | - Katherine S McGilton
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
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20
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Arslan G, Yıldırım M, Aytaç M. Subjective vitality and loneliness explain how coronavirus anxiety increases rumination among college students. DEATH STUDIES 2020; 46:1042-1051. [PMID: 32998663 DOI: 10.1080/07481187.2020.1824204] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
We investigated the relationship between coronavirus anxiety and rumination with subjective vitality and loneliness as mediators. The online sample included 356 Turkish young people (M = 22.06, SD = 4.43 years). The analysis indicated that the coronavirus anxiety was directly associated with subjective vitality, loneliness, and rumination. Subjective vitality and loneliness also had direct effects on rumination. Furthermore, the indirect effect of coronavirus anxiety on rumination was mediated by subjective vitality and loneliness. These findings highlight the importance of having effective systems that account for subjective vitality and loneliness to minimize the impact of the coronavirus anxiety on rumination.
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Affiliation(s)
- Gökmen Arslan
- Department of Psychological Counseling and Guidance, Burdur Mehmet Akif Ersoy University, Burdur, Turkey
| | - Murat Yıldırım
- Department of Psychology, Ağrı İbrahim Çeçen University, Ağrı, Turkey
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, United Kingdom
| | - Mert Aytaç
- Department of Psychology, Bingöl University, Bingöl, Turkey
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21
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Li Y, Jia J, Zhao X, Zhang D. Preparation for future care moderates the relationship between loneliness and depression among Chinese rural older adults: A cross-sectional study. Geriatr Nurs 2020; 41:641-647. [PMID: 32387000 DOI: 10.1016/j.gerinurse.2020.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 04/01/2020] [Accepted: 04/06/2020] [Indexed: 12/01/2022]
Abstract
Loneliness has been identified as a risk factor for depression, while preparation for future care (PFC) can be a protective factor. Little is known about their complex relationships in older adults in China. This study aimed to explore whether PFC moderated the association between loneliness and depression. A total of 481 older adults aged 60 years and above were recruited in rural Shandong, China. After excluding those whose data missing rates were over 15%, data were analyzed for a total of 436 participants. Loneliness, PFC, and depression were measured. Statistical analyses included descriptive analysis, and moderating effects analyses. Our findings showed that PFC and its related dimensions can moderate the relationship between loneliness and depression. When the level of PFC and its dimensions were higher, the effect of loneliness on depression was weaker. PFC should be taken into consideration when interventions are being developed to reduce depression in older adults.
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Affiliation(s)
- Yuqin Li
- School of Philosophy and social development, Shandong University, Jinan, Shandong, China; College of Humanities, Shandong Management University, Jinan, Shandong, China
| | - Jihui Jia
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Xia Zhao
- School of Nursing, Shandong University, Jinan, Shandong, China.
| | - Dan Zhang
- School of Nursing, Shandong University, Jinan, Shandong, China.
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22
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Yan Z, Lu R, Li Y, Zheng Z. Exploring the Risk Factors for Depressive Symptoms Among Chinese Rural Older Adults. J Psychosoc Nurs Ment Health Serv 2020; 58:41-47. [PMID: 31710367 DOI: 10.3928/02793695-20191030-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 09/03/2019] [Indexed: 11/20/2022]
Abstract
The purpose of the current study was to examine risk factors for depressive symptoms among older adults in rural China. Data were derived from the National Health Services Survey in China. A total of 2,586 rural adults age ≥60 were included in the study. Sociodemographic factors, health risk factors, and behavioral factors were measured, along with self-rated depressive symptoms. Older age (>70 years), lower education level, and living without a partner were associated with depressive symptoms. After adjusting for socioeconomic status and social support, individuals who had at least one chronic disease, experienced pain, and were unable to take care of themselves or perform household chores were more likely to report depressive symptoms (all p < 0.001). Community health care and nursing services should focus on pain control, improvement of daily physical function, and social support for older adults in rural China. [Journal of Psychosocial Nursing and Mental Health Services, 58(2), 41-47.].
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23
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Whisman MA, du Pont A, Butterworth P. Longitudinal associations between rumination and depressive symptoms in a probability sample of adults. J Affect Disord 2020; 260:680-686. [PMID: 31550614 DOI: 10.1016/j.jad.2019.09.035] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 08/15/2019] [Accepted: 09/08/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND According to the Response Styles Theory, rumination maintains and exacerbates depression. This study was conducted to examine the bidirectional longitudinal associations between rumination and depressive symptoms in a probability sample of Australian adults, evaluate the degree to which the strength of these longitudinal associations was moderated by gender, and test whether these longitudinal associations remained statistically significant when adjusting for the influence of demographic characteristics and neuroticism. METHODS A probability sample of Australian adults (N = 5891) completed self-report measures of rumination, neuroticism, and depressive symptoms at baseline and rumination and depressive symptoms at a four-year follow-up. RESULTS Results from regression analyses indicated that rumination predicted residual change in depressive symptoms and depressive symptoms predicted residual change in rumination, suggesting that rumination and depressive symptoms influence one another in a bidirectional, recursive fashion. Gender was not a significant moderator of the longitudinal associations between rumination and depressive symptoms. Analyses including the covariates of age, gender, and neuroticism, a personality trait characterized by heightened negative emotionality, indicated that the bidirectional longitudinal associations between rumination and depressive symptoms were not explained by their shared association with demographic characteristics or neuroticism. LIMITATIONS Within-person analyses involving repeated assessments, shorter time intervals, and assessment of brooding rumination would provide a stronger test of the potential causal association between rumination and depressive symptoms. CONCLUSIONS Study findings suggest that rumination may be both a potential risk factor for and a consequence of depressive symptoms in adults.
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Affiliation(s)
- Mark A Whisman
- Department of Psychology and Neuroscience, University of Colorado Boulder, United States.
| | - Alta du Pont
- Department of Psychology and Neuroscience, University of Colorado Boulder, United States; Institute for Behavioral Genetics, University of Colorado Boulder, United States
| | - Peter Butterworth
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University, Australia
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24
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Zhang R, Jia J, Zhang D, Zhao X. Association between fatigue and depressive symptoms among kidney transplantation recipients: The mediating role of rumination. J Adv Nurs 2019; 75:3602-3608. [PMID: 31531988 DOI: 10.1111/jan.14200] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 08/06/2019] [Accepted: 09/04/2019] [Indexed: 01/19/2023]
Abstract
AIMS Depressive symptoms are common among kidney transplantation recipients. Previous studies have reported that fatigue and rumination are risk factors for depressive symptoms. To date, the underlying mechanisms of fatigue, rumination, and depressive symptoms among kidney transplantation recipients remain unclear. This study aimed to assess the prevalence of depressive symptoms and investigate whether rumination mediates the association between fatigue and depressive symptoms among kidney transplantation recipients. DESIGN Cross-sectional study. METHODS The study of 207 kidney transplantation recipients with an average age of 44.5 years was conducted from January 2017-July 2017. Sociodemographic and clinical characteristics, fatigue, rumination, and depressive symptoms data were collected. For the descriptive analysis, Pearson correlations and mediation analysis based on the PROCESS macro were used. RESULTS The prevalence of depressive symptoms among kidney transplantation recipients was 21.7%. Rumination mediated the association between fatigue and depressive symptoms and the indirect effect was 0.19 (95% confidence interval: 0.10-0.28). CONCLUSION Depressive symptoms were highly prevalent among kidney transplantation recipients. Rumination exerts a mediating role between fatigue and depressive symptoms. IMPACT This study alerts physicians and nurses for the importance of considering the mental health of these patients and contributes to the development of effective depression management interventions.
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Affiliation(s)
- Rongmei Zhang
- Department of Transplantation, No. 2 of Affiliated Hospital of Shandong University, Jinan, China
| | - Jihui Jia
- School of Nursing, Shandong University, Jinan, China
| | - Dan Zhang
- School of Nursing, Shandong University, Jinan, China
| | - Xia Zhao
- School of Nursing, Shandong University, Jinan, China
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25
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Hsueh YC, Chen CY, Hsiao YC, Lin CC. A longitudinal, cross-lagged panel analysis of loneliness and depression among community-based older adults. J Elder Abuse Negl 2019; 31:281-293. [DOI: 10.1080/08946566.2019.1660936] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Yu-Chun Hsueh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chun-Yuan Chen
- Department of Medical Research, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Biostatistics Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yi-Chen Hsiao
- Institute of Health and Welfare Policy, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Cheng-Ching Lin
- Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
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26
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Risk factors for depression in elderly diabetic patients and the effect of metformin on the condition. BMC Public Health 2019; 19:1063. [PMID: 31391021 PMCID: PMC6686369 DOI: 10.1186/s12889-019-7392-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 07/29/2019] [Indexed: 11/10/2022] Open
Abstract
Background At present, only a few studies have focused on the risk factors for depression in elderly diabetic patients, and there is little evidence for the effect of metformin in depressed elderly patients with diabetes than on its effect on blood glucose. The aim of the current work was to study the risk factors for depression in elderly diabetic patients and to ascertain the effects of metformin on the depressive state. Methods We initiated a 1:4 matched case–control study. The case group comprised 110 elderly diabetic patients with depression from nine communities in Shenyang in 2017. The control group comprised 440 non-depressed elderly diabetic patients from the same communities, which were matched by gender and age (± 2 years of age) with the case group. Depression was measured using the Geriatric Depression Scale-15, and we performed matched univariate and multivariate logistic regression analyses. Results In the multivariate analysis, overweight status, poor physical capabilities and low activity level, and the presence of more than two additional illnesses were risk factors for depression in elderly patients with diabetes. For these risk factors, the adjusted ORs (all P < 0.05) were as follows: an adjusted OR of 2.031 and 95% CI of 1.180–3.495; an adjusted OR of 2.342 and 95% CI of 1.465–3.743; and an adjusted OR of 5.350 and 95% CI of 2.222–12.883, respectively. Patients taking metformin had a lower risk of depression than those taking no medication, with an adjusted OR of 0.567 and 95% CI of 0.323–0.997 (P < 0.05). Conclusions Overweight status, poor physical capabilities and low activity level, and the presence of more than two additional illnesses were risk factors for depression in elderly diabetic patients, and metformin was a protective factor against depression in elderly diabetic patients.
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Winter L, Gottschalk J, Nielsen J, Wells A, Schweiger U, Kahl KG. A Comparison of Metacognitive Therapy in Current Versus Persistent Depressive Disorder - A Pilot Outpatient Study. Front Psychol 2019; 10:1714. [PMID: 31447722 PMCID: PMC6691034 DOI: 10.3389/fpsyg.2019.01714] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 07/09/2019] [Indexed: 01/20/2023] Open
Abstract
Background: Metacognitive therapy (MCT) is a modern approach with demonstrated efficacy in current major depressive disorder (MDD). The treatment aims to modify thinking styles of rumination and worry and their underlying metacognitions, which have been shown to be involved in the initiation and perpetuation of MDD. We hypothesized that metacognitive therapy may also be effective in treating persistent depressive disorder (PDD). Methods: Thirty depressed patients (15 with MDD; 15 with PDD) were included. Patients in both groups were comparable on depression severity and sociodemographic characteristics, but PDD was associated with more former treatments. Metacognitive therapy was applied by trained psychotherapists for a mean of 16 weeks. Results: We observed a significant improvement of depressive symptoms in both groups, and comparable remission rates at the end of treatment and after 6 months follow-up. Furthermore, we observed significant and similar levels of improvement in rumination, dysfunctional metacognitions, and anxiety symptoms in both groups. Limitations: The study is limited by the small sample size and a missing independent control group. The effect of the therapeutic alliance was not controlled. The quality of depression rating could have been higher. Conclusions: We demonstrated that metacognitive therapy can successfully be applied to patients with PDD. The observed results were comparable to those obtained for patients with current major depressive disorder. Further studies with larger groups and a randomized design are needed to confirm these promising initial findings.
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Affiliation(s)
- Lotta Winter
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Julia Gottschalk
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Janina Nielsen
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Adrian Wells
- Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom.,Greater Manchester Mental Health NHS Trust, Manchester, United Kingdom
| | - Ulrich Schweiger
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Kai G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
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28
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Sum G, Tan YR, Hong SI, Koh GCH. Psychosocial and physical factors associated with depression in older adults living in studio apartments: A cross-sectional study of a multi-ethnic Asian population. PROCEEDINGS OF SINGAPORE HEALTHCARE 2019. [DOI: 10.1177/2010105819860853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background: There is a rapidly ageing population globally, leading to a rise in subsidised public housing in many countries for older adults. According to the World Health Organisation, depression is the most prevalent mental disorder in older adults. There is a gap in literature on the factors associated with depression in those residing in studio apartments for older adults, characterised by small living spaces and isolated community settings. Objective: The aim of this study was to examine the associations between socio-demographic variables, social support, self-perceived health and mental status, life satisfaction, exercise, physical functioning, chronic conditions, and the use of eldercare services, with depressive symptoms. Methods: We utilised a cross-sectional study of older adults aged ⩾55 years residing in Singapore’s studio apartments. Multivariable logistic regression was applied. Results: Widowhood was associated with depressive symptoms, compared to being married or having a domestic partner (adjusted odds ratio (AOR) = 1.70, 95% confidence interval (CI) = 1.01 to 2.86). Odds of depressive symptoms were associated with difficulty bathing and showering (AOR = 3.74, 95% CI = 1.06 to 13.21). Depressive symptoms were associated with cataract (AOR = 1.67, 95% CI = 1.01 to 2.77) and urinary tract disorder (AOR = 4.70, 95% CI = 1.21 to 18.26). There were dose-response relationships between higher odds of depressive symptoms and poorer social support, self-perceived mental health, life satisfaction, and exercise behaviour ( p for trend < 0.001). Conclusion: Factors including widowhood, physical functioning difficulty, chronic conditions, low social support, low self-perceived mental health, poor life satisfaction, and lack of exercise behaviour, were associated with depressive symptoms in older adults residing in studio apartments. More attention is needed to care for the psychosocial and physical needs of older adults in studio apartments.
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Affiliation(s)
- Grace Sum
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Yun Ru Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Song-Iee Hong
- Department of Social Welfare, Dongguk University, South Korea
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Kroemeke A. Coping Flexibility and Health-Related Quality of Life Among Older Adults: The Compensatory Effect of Co-rumination. Front Psychol 2019; 10:59. [PMID: 30728797 PMCID: PMC6351461 DOI: 10.3389/fpsyg.2019.00059] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 01/09/2019] [Indexed: 11/24/2022] Open
Abstract
Background: Coping flexibility, defined as a wide range of coping strategies, may be a promising construct in determining coping effectiveness, especially in conjunction with a person-centered approach. However, no studies have focused on these issues. The study aimed to identify the distinct, multidimensional patterns of strategies for coping with chronic health conditions and their association with changes in physical and psychological health-related quality of life (HRQoL) among older adults over a one month period. Methods: Coping strategies (brooding, reflection, co-rumination, and positive reappraisal) and HRQoL psychological and physical domains were assessed twice (at the baseline and one month later) among 210 older adults (age 76.12 ± 9.09 years, 66% women). Findings: The parallel process analysis demonstrated the sample heterogeneity regarding coping. In multidimensional latent class growth analysis (MLCGA), four coping classes of overall strategies were identified: consistently low (46%), medium and decreasing (18%), medium and increasing (20%), and consistently high (16%). The last two can be considered the coping flexibility. Participants in the medium and increasing subgroup reported enhancement in HRQoL psychological domain, whereas members of the consistently high subgroup indicated its decrease. The favorable effects were related to an increase in co-rumination. Discussion: The findings shed light on the longitudinal patterns of coping in older adults, showing that coping flexibility is more adaptive when it relies on modifying coping efforts rather than coping complexity. Co-rumination played a key role, compensated by the effect of maladaptive strategies.
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Affiliation(s)
- Aleksandra Kroemeke
- Department of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
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30
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Zhao X, Zhang D, Wu M, Yang Y, Xie H, Li Y, Jia J, Su Y. Loneliness and depression symptoms among the elderly in nursing homes: A moderated mediation model of resilience and social support. Psychiatry Res 2018; 268:143-151. [PMID: 30025285 DOI: 10.1016/j.psychres.2018.07.011] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 07/03/2018] [Accepted: 07/06/2018] [Indexed: 12/16/2022]
Abstract
Loneliness has been identified as a risk factor for depressive symptoms. Resilience and social support have been regarded as underlying protective factors. Little is known about the complex relations among these factors in the nursing home elderly. This study aimed to assess the prevalence of depressive symptoms, explore whether resilience mediated the association between loneliness and depressive symptoms, and investigate whether social support moderated the indirect or direct effect of mediation model. A total of 323 nursing home elderly were recruited in Jinan City, China. Loneliness, resilience, social support and depressive symptoms were measured. Results shown the association between loneliness and depressive symptoms was partially mediated by resilience. Besides, the indirect effect of the mediation model was moderated by social support. When the level of social support was higher, the indirect effect of loneliness on depressive symptoms through resilience was weaker. The incidence of depressive symptoms among the nursing home elderly could not be neglected. The findings suggest that interventions, such as improving resilience and social support, may help break the link between loneliness and depressive symptoms among the elderly in nursing homes.
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Affiliation(s)
- Xia Zhao
- School of Nursing, Shandong University, Jinan 250012, China
| | - Dan Zhang
- School of Nursing, Shandong University, Jinan 250012, China
| | - Menglian Wu
- School of Nursing, Shandong University, Jinan 250012, China
| | - Yang Yang
- School of Nursing, Shandong University, Jinan 250012, China
| | - Hui Xie
- School of Nursing, Shandong University, Jinan 250012, China
| | - Yuqin Li
- School of Philosophy and Social Development, Shandong University, Jinan 250100, China
| | - Jihui Jia
- School of Nursing, Shandong University, Jinan 250012, China
| | - Yonggang Su
- School of Nursing, Shandong University, Jinan 250012, China; School of Foreign Languages and Literature, Shandong University, Jinan 250012, China.
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31
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Lebedeva A, Sundström A, Lindgren L, Stomby A, Aarsland D, Westman E, Winblad B, Olsson T, Nyberg L. Longitudinal relationships among depressive symptoms, cortisol, and brain atrophy in the neocortex and the hippocampus. Acta Psychiatr Scand 2018; 137:491-502. [PMID: 29457245 DOI: 10.1111/acps.12860] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/23/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Depression is associated with accelerated aging and age-related diseases. However, mechanisms underlying this relationship remain unclear. The aim of this study was to longitudinally assess the link between depressive symptoms, brain atrophy, and cortisol levels. METHOD Participants from the Betula prospective cohort study (mean age = 59 years, SD = 13.4 years) underwent clinical, neuropsychological and brain 3T MRI assessments at baseline and a 4-year follow-up. Cortisol levels were measured at baseline in four saliva samples. Cortical and hippocampal atrophy rates were estimated and compared between participants with and without depressive symptoms (n = 81) and correlated with cortisol levels (n = 49). RESULTS Atrophy in the left superior frontal gyrus and right lingual gyrus developed in parallel with depressive symptoms, and in the left temporal pole, superior temporal cortex, and supramarginal cortex after the onset of depressive symptom. Depression-related atrophy was significantly associated with elevated cortisol levels. Elevated cortisol levels were also associated with widespread prefrontal, parietal, lateral, and medial temporal atrophy. CONCLUSION Depressive symptoms and elevated cortisol levels are associated with atrophy of the prefrontal and limbic areas of the brain.
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Affiliation(s)
- A Lebedeva
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institute, Huddinge, Sweden
| | - A Sundström
- Department of Psychology, Umeå University, Umeå, Sweden.,Center for Demographic and Ageing Research, Umeå University, Umeå, Sweden
| | - L Lindgren
- Department of Nursing, Umeå University, Umeå, Sweden.,Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden
| | - A Stomby
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.,Jönköping County Hospital, Region Jönköping County, Jönköping, Sweden
| | - D Aarsland
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institute, Huddinge, Sweden.,Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK.,Center for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - E Westman
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institute, Huddinge, Sweden
| | - B Winblad
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institute, Huddinge, Sweden.,Geriatric Clinics, Karolinska University Hospital, Huddinge, Sweden
| | - T Olsson
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - L Nyberg
- Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden.,Department of Integrative Medical Biology, Physiology, Umeå University, Umeå, Sweden.,Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå, Sweden
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Association between social support and health-related quality of life among Chinese rural elders in nursing homes: the mediating role of resilience. Qual Life Res 2017; 27:783-792. [PMID: 29124499 DOI: 10.1007/s11136-017-1730-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2017] [Indexed: 12/24/2022]
Abstract
PURPOSE This study aims to confirm the relationship between social support and health-related quality of life (HRQOL) among rural Chinese elders in nursing homes, and to examine the mediating role of resilience in the impact of social support on HRQOL. METHODS A cross-sectional survey of 205 elders aged 60 and above was conducted in five rural public nursing homes. Sociodemographic characteristics, the SF-36 questionnaire, and information about social support and resilience were collected. The researchers administered the questionnaires to the participants in a face-to-face setting. Descriptive analysis and a correlation matrix were used to indicate characteristics of the participants and bivariate correlations, respectively. The mediation analyses, composed of regression analysis and PROCESS analysis, were preformed to test both direct and indirect effects of social support on HRQOL, namely the mediating role of resilience. RESULTS Social support was positively related to HRQOL (β = 0.303, p < 0.001) among Chinese rural elders in nursing homes. The mediating role of resilience in the relationship between social support and HRQOL was confirmed (a*b bootstrapped 95% confidence interval = [0.098, 0.257]), which revealed that social support had an indirect effect on HRQOL through resilience. CONCLUSIONS Resilience partially mediates the relationship between social support and HRQOL. The mediation model provides a better understanding of how social support and resilience work together to affect HRQOL, and it could guide the interventions in health care for promoting HRQOL among Chinese rural elders in nursing homes.
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33
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Timm C, Ubl B, Zamoscik V, Ebner-Priemer U, Reinhard I, Huffziger S, Kirsch P, Kuehner C. Cognitive and affective trait and state factors influencing the long-term symptom course in remitted depressed patients. PLoS One 2017; 12:e0178759. [PMID: 28575049 PMCID: PMC5456349 DOI: 10.1371/journal.pone.0178759] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 05/18/2017] [Indexed: 12/16/2022] Open
Abstract
Background Major depressive disorder (MDD) is characterized by a high risk for relapses and chronic developments. Clinical characteristics such as residual symptoms have been shown to negatively affect the long-term course of MDD. However, it is unclear so far how trait repetitive negative thinking (RNT) as well as cognitive and affective momentary states, the latter experienced during daily-life, affect the long-term course of MDD. Method We followed up 57 remitted depressed (rMDD) individuals six (T2) and 36 (T3) months after baseline. Clinical outcomes were time to relapse, time spent with significant symptoms as a marker of chronicity, and levels of depressive symptoms at T2 and T3. Predictors assessed at baseline included residual symptoms and trait RNT. Furthermore, momentary daily life affect and momentary rumination, and their variation over the day were assessed at baseline using ambulatory assessment (AA). Results In multiple models, residual symptoms and instability of daily-life affect at baseline independently predicted a faster time to relapse, while chronicity was significantly predicted by trait RNT. Multilevel models revealed that depressive symptom levels during follow-up were predicted by baseline residual symptom levels and by instability of daily-life rumination. Both instability features were linked to a higher number of anamnestic MDD episodes. Conclusions Our findings indicate that trait RNT, but also affective and cognitive processes during daily life impact the longer-term course of MDD. Future longitudinal research on the role of respective AA-phenotypes as potential transdiagnostic course-modifiers is warranted.
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Affiliation(s)
- Christina Timm
- Research Group Longitudinal and Intervention Research, Department of Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Bettina Ubl
- Research Group Longitudinal and Intervention Research, Department of Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Vera Zamoscik
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Ulrich Ebner-Priemer
- Karlsruhe Institute of Technology, Institut für Sport und Sportwissenschaften, University of Karlsruhe, Karlsruhe, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Iris Reinhard
- Department of Biostatistics, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Silke Huffziger
- Research Group Longitudinal and Intervention Research, Department of Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Peter Kirsch
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christine Kuehner
- Research Group Longitudinal and Intervention Research, Department of Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Wu M, Yang Y, Zhang D, Sun Y, Xie H, Zhang J, Jia J, Su Y. Prevalence and related factors of successful aging among Chinese rural elders living in nursing homes. Eur J Ageing 2017; 14:419-428. [PMID: 29180947 DOI: 10.1007/s10433-017-0423-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Few studies focus on the prevalence and related factors of successful aging (SA) among Chinese rural elders living in nursing homes. This study aims to make an operational definition of successful aging, estimate the prevalence of SA, and identify factors related to SA among Chinese rural elders living in nursing homes. Data for this cross-sectional study were collected by face-to-face interviews in five rural public nursing homes. A total of 205 elders aged 60 years and above were asked to answer a series of questions. Descriptive analysis, independent sample t tests, χ2 tests, and multivariate logistic regression were used to show the prevalence and related factors of SA. The prevalence of SA in this population is 17.6% based on a multidimensional construct composed of: few chronic diseases, good cognitive and physical functioning, good mental health, and active social engagement. The logistic regression results indicate that successful agers are more likely to be younger, married, resilient, and better off economically, whereas gender, education, and social support are not related to SA independently. This model accounts for 45.8% of the variance in SA. These results suggest some tentative recommendations for elders, relevant decision-makers or employees in nursing homes, and administrative bodies. More rigorous longitudinal design is necessary to investigate the causality of the related factors and SA.
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Affiliation(s)
- Menglian Wu
- School of Nursing, Shandong University, Jinan, 250012 Shandong China
| | - Yang Yang
- School of Nursing, Shandong University, Jinan, 250012 Shandong China
| | - Dan Zhang
- School of Nursing, Shandong University, Jinan, 250012 Shandong China
| | - Yaoyao Sun
- School of Nursing, Shandong University, Jinan, 250012 Shandong China
| | - Hui Xie
- School of Nursing, Shandong University, Jinan, 250012 Shandong China
| | - Jie Zhang
- School of Public Health, Shandong University, Jinan, 250012 Shandong China
- Department of Sociology, State University of New York Buffalo State, Buffalo, NY USA
| | - Jihui Jia
- School of Nursing, Shandong University, Jinan, 250012 Shandong China
| | - Yonggang Su
- School of Nursing, Shandong University, Jinan, 250012 Shandong China
- School of Foreign Languages and Literature, Shandong University, Jinan, 250100 Shandong China
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35
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Zhang D, Yang Y, Sun Y, Wu M, Xie H, Wang K, Zhang J, Jia J, Su Y. Characteristics of the Chinese rural elderly living in nursing homes who have suicidal ideation: A multiple regression model. Geriatr Nurs 2017; 38:423-430. [PMID: 28347559 DOI: 10.1016/j.gerinurse.2017.02.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 02/09/2017] [Accepted: 02/13/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Chinese rural elderly are at higher risk of committing suicide. However, little is known about the suicidal ideation (SI) of institutional elderly residents in rural China. METHODS 250 participants aged 60 or above living in Chinese rural nursing homes were recruited. Data were collected on subjects' SI, social-demographic characters, physical illness and psychological factors. Univariate comparisons and path analysis were conducted then. RESULTS 19.5% (40/205) of the participants reported a current SI. Hopelessness and depression had significant direct impacts on SI, and self-esteem and loneliness can impact SI through the mediating of depression and hopelessness. Visiting frequency of children, number of physical illnesses and social activities can also affect SI through the mediating of loneliness or self-esteem. CONCLUSION As the first study on path analysis of SI of rural institutional elderly, the findings are significant. All these factors in our model should be considered when interventions are being conducted.
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Affiliation(s)
- Dan Zhang
- School of Nursing, Shandong University, Jinan, 250012, Shandong, China
| | - Yang Yang
- School of Nursing, Shandong University, Jinan, 250012, Shandong, China
| | - Yaoyao Sun
- School of Nursing, Shandong University, Jinan, 250012, Shandong, China
| | - Menglian Wu
- School of Nursing, Shandong University, Jinan, 250012, Shandong, China
| | - Hui Xie
- School of Nursing, Shandong University, Jinan, 250012, Shandong, China
| | - Kefang Wang
- School of Nursing, Shandong University, Jinan, 250012, Shandong, China
| | - Jie Zhang
- School of Public Health, Shandong University, Jinan, 250012, Shandong, China; Department of Sociology, State University of New York Buffalo State, Buffalo, NY, 14222, USA
| | - Jihui Jia
- School of Nursing, Shandong University, Jinan, 250012, Shandong, China
| | - Yonggang Su
- School of Foreign Languages and Literature, Shandong University, Jinan, 250100, Shandong, China; School of Nursing, Shandong University, Jinan, 250012, Shandong, China.
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36
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Peng X, Xing P, Li X, Qian Y, Song F, Bai Z, Han G, Lei H. Towards Personalized Intervention for Alzheimer's Disease. GENOMICS PROTEOMICS & BIOINFORMATICS 2016; 14:289-297. [PMID: 27693548 PMCID: PMC5093853 DOI: 10.1016/j.gpb.2016.01.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 01/14/2016] [Accepted: 01/31/2016] [Indexed: 01/17/2023]
Abstract
Alzheimer's disease (AD) remains to be a grand challenge for the international community despite over a century of exploration. A key factor likely accounting for such a situation is the vast heterogeneity in the disease etiology, which involves very complex and divergent pathways. Therefore, intervention strategies shall be tailored for subgroups of AD patients. Both demographic and in-depth information is needed for patient stratification. The demographic information includes primarily APOE genotype, age, gender, education, environmental exposure, life style, and medical history, whereas in-depth information stems from genome sequencing, brain imaging, peripheral biomarkers, and even functional assays on neurons derived from patient-specific induced pluripotent cells (iPSCs). Comprehensive information collection, better understanding of the disease mechanisms, and diversified strategies of drug development would help with more effective intervention in the foreseeable future.
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Affiliation(s)
- Xing Peng
- CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China; Cunji Medical School, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Peiqi Xing
- CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China; Cunji Medical School, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Xiuhui Li
- CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China; Cunji Medical School, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Ying Qian
- CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China; Cunji Medical School, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Fuhai Song
- CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China; Cunji Medical School, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zhouxian Bai
- CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China; Cunji Medical School, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Guangchun Han
- CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China
| | - Hongxing Lei
- CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China; Cunji Medical School, University of Chinese Academy of Sciences, Beijing 100049, China; Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing 100053, China.
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