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Liu J, Wu J, Wang J, Chen S, Yin X, Gong Y. Prevalence and associated factors for depressive symptoms among the general population from 31 provinces in China: The utility of social determinants of health theory. J Affect Disord 2024; 347:269-277. [PMID: 37940057 DOI: 10.1016/j.jad.2023.10.134] [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: 05/17/2023] [Revised: 09/30/2023] [Accepted: 10/21/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Depression is one of the most common types of mental disorders. Guided by the theory of social determinants of health (SDH), the study aimed to assess the prevalence of depressive symptoms and to identify factors related to depressive symptoms in the general population of China. METHODS A cross-sectional, online survey was conducted among 101,392 residents from 31 provinces of mainland China from January to March 2019, and 97,126 survey responses were included in the final analysis. Multilevel linear regression models were used to identify SDH associated with depressive symptoms. RESULTS The prevalence of depressive symptoms (PHQ-9 scores ≥10) in Chinese residents was 15.81 %. The results of the multilevel analysis demonstrated that depressive symptoms were affected by various factors on five levels, including individual characteristics, behavioral lifestyle, community support network, social structural factors, and macro social factors. LIMITATIONS The cross-sectional design of the study makes it difficult to establish causality between variables. CONCLUSIONS The prevalence of depressive symptoms is high among general population in China. According to the theory of SDH, the study shows that the depressive symptoms are complex and involves all areas of social life. Therefore, adopting a multi-level, cross-sectoral intervention approach will be instrumental to improving the mental health of residents in China.
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Affiliation(s)
- Jiaming Liu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Department of Public Health, Shihezi University School of Medicine, Shihezi 832000, Xinjiang, China
| | - Jianxiong Wu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jing Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Silin Chen
- Department of Public Health, Shihezi University School of Medicine, Shihezi 832000, Xinjiang, China
| | - Xiaoxv Yin
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yanhong Gong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Li J, Wang L, Wang Z, Zhao F, Sun Y, Lu Y, Yang L. Association between suicide attempts and anemia in late-life depression inpatients. BMC Geriatr 2024; 24:43. [PMID: 38200429 PMCID: PMC10782764 DOI: 10.1186/s12877-023-04649-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Anemia is strongly associated with late-life depression (LLD), however, few studies have investigated the relationship between anemia and suicide attempts in LLD patients. It is still challenging to predict suicide risk in patients with depression. Therefore, there is growing interest in potential biomarkers of depressive disorders and suicidal behavior, which may play a significant role in the early diagnosis and treatment of depression. This study aimed to compare serum ferritin, folate, vitamin B12, and erythrocyte parameter levels in patients with LLD with those in healthy older adults, and the relationship between serum ferritin, folate, vitamin B12, and suicide attempts in patients. METHODS Serum ferritin, folate, vitamin B12, and erythrocyte parameter levels were measured in 66 hospitalized LLD patients (30 without suicide attempt, 36 with suicide attempt) and 47 healthy individuals. All participants were surveyed for basic conditions and suicide attempts, and depression was assessed in LLD patients. RESULTS Serum ferritin, folate, vitamin B12, red blood cell count, hemoglobin, hematocrit, mean platelet volume and plateletcrit levels were significantly lower in LLD patients compared with healthy older adults (P < 0.05). Further analysis of the relationship between serum ferritin, folate, and vitamin B12 levels and LLD patients' suicide attempts and showed a significant negative association between serum folate and vitamin B12 and suicide attempts (P < 0.05). CONCLUSIONS Serum ferritin, folate, vitamin B12, red blood cell count, hemoglobin, hematocrit, mean platelet volume and plateletcrit levels were significantly lower in LLD patients than in healthy older adults. In addition, reduced serum folate and vitamin B12 levels in patients may have some effect on suicide attempts. More mechanistic studies are needed to further explain this association.
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Affiliation(s)
- Jie Li
- The Second Affiliated Hospital, School of Nursing, Xinxiang Medical University, 453000, Xinxiang, Henan, China
| | - Lan Wang
- The Second Affiliated Hospital, School of Nursing, Xinxiang Medical University, 453000, Xinxiang, Henan, China
| | - Ziyi Wang
- The Second Affiliated Hospital, School of Nursing, Xinxiang Medical University, 453000, Xinxiang, Henan, China
| | - Fengxue Zhao
- The Second Affiliated Hospital, School of Nursing, Xinxiang Medical University, 453000, Xinxiang, Henan, China
| | - Yadi Sun
- The Second Affiliated Hospital, School of Nursing, Xinxiang Medical University, 453000, Xinxiang, Henan, China
| | - Ying Lu
- Nursing Department of Henan Provincial People's Hospital, 450003, Zhengzhou, Henan, China
| | - Lei Yang
- The Second Affiliated Hospital, School of Nursing, Xinxiang Medical University, 453000, Xinxiang, Henan, China.
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Leung CY, Kyung M. Associations of iron deficiency and depressive symptoms among young adult males and Females: NHANES 2017 to 2020. Prev Med Rep 2024; 37:102549. [PMID: 38226328 PMCID: PMC10788288 DOI: 10.1016/j.pmedr.2023.102549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 01/17/2024] Open
Abstract
Depression is one of the most prevalent mental health conditions throughout the lifespan. Notable differences in the prevalence of depression among females and males arise during adolescence and may peak during young adulthood. Since iron deficiency is a treatable condition that may contribute to depression, this topic among youth (18 to 25 years of age) needs to be further explored. Thus, our study examines the associations between three measures of iron (ferritin, serum iron, and transferrin saturation levels) with Patient Health Questionnaire-9 (PHQ-9) depressive symptoms and depression among young adult males and females using the National Health and Nutrition Examination Survey (NHANES) 2017-2020. Using multivariable Poisson and logistic regression models, adjusting for several demographic and clinical variables, we report 1) the prevalence of depression and 2) the associations between iron deficiency and depressive symptoms and depression among males and females. 917 participants were included in our study. More females (12.5 %) than males (6.8 %) had PHQ-9 depression. Males with ferritin (adjusted odds ratio [AOR] = 14.13, 95 % confidence interval [CI]: 1.51, 132.21), serum iron (AOR = 4.84, 95 % CI: 1.02, 22.92), and transferrin (AOR = 13.79, 95 % CI: 3.59, 53.06) deficiencies were at higher risk for depression, while females with ferritin deficiency (AOR = 0.34, 95 % CI: 0.11, 0.97) had a lower risk for depression. Our study highlights the need to focus on depression screening among young adults as well as risk factors for depression among this age group. Identifying risk factors and screening for iron deficiency, especially among females, should be considered as well.
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Affiliation(s)
- Cherry Y. Leung
- Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA, USA
| | - Minjung Kyung
- Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA, USA
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Ciulei MA, Ahluwalia N, McCormick BJJ, Teti DM, Murray-Kolb LE. Iron Deficiency is Related to Depressive Symptoms in United States Nonpregnant Women of Reproductive Age: A Cross-Sectional Analysis of NHANES 2005-2010. J Nutr 2023; 153:3521-3528. [PMID: 37783449 DOI: 10.1016/j.tjnut.2023.09.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 09/18/2023] [Accepted: 09/28/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Findings of the association between iron status and depressive symptoms in nonpregnant women of reproductive age (WRA) are equivocal, limited by a small sample size, or did not consistently control for confounders. OBJECTIVE We tested the association between iron status and depressive symptoms in WRA with the NHANES data (2005-2010). METHODS Nonpregnant WRA (20-44 y) with complete data on iron (ferritin and transferrin receptor (TfR)) and anemia (hemoglobin) biomarkers, depressive symptoms (Patient Health Questionnaire-9), and sociodemographic variables were included. Logistic and negative binomial regressions were used to estimate presence (odds ratios) and magnitude (prevalence ratios), respectively, for depressive symptoms by iron deficiency (ID)/anemia/ID anemia in the total sample and stratified by poverty:income ratio (≤ 1.85 or >1.85). RESULTS Among 2516 females, the prevalence of ID was 8 to 16% (depending on the iron biomarker used), of anemia 8%, of which 52 to 65% were also ID. The prevalence of depressive symptoms was 10%. Crude logistic models showed that females with ID (TfR ≥ 8.3 mg/L or body iron <0 mg/kg) from the total sample had 1.82 (95% confidence interval [CI]: 1.24, 2.68) and 1.62 (95% CI: 1.05, 2.48), respectively, higher odds of depressive symptoms than females with iron sufficiency; these associations were attenuated after adjustments for confounders. Adjusted negative binomial models showed that females with ID (TfR ≥ 8.3 mg/L) from the total and low-income samples showed 1.19 (95% CI: 1:00, 1.40) and 1.27 (95% CI: 1.03, 1.58), respectively, higher prevalence ratios of depressive symptoms scores than females with iron sufficiency. CONCLUSIONS These nationally representative data indicate that nonpregnant WRA with ID (based on high TfR) in the United States have higher prevalence of somatic depressive symptoms scores than those with iron sufficiency, especially if they are of low income.
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Affiliation(s)
- Mihaela A Ciulei
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, United States
| | - Namanjeet Ahluwalia
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, United States
| | | | - Douglas M Teti
- Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
| | - Laura E Murray-Kolb
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, United States; Department of Nutrition Science, Purdue University, West Lafayette, IN, United States.
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Beydoun MA, Obhi HK, Weiss J, Canas JA, Beydoun HA, Evans MK, Zonderman AB. Systemic inflammation is associated with depressive symptoms differentially by sex and race: a longitudinal study of urban adults. Mol Psychiatry 2020; 25:1286-1300. [PMID: 31019266 PMCID: PMC6813878 DOI: 10.1038/s41380-019-0408-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 02/18/2019] [Accepted: 03/05/2019] [Indexed: 12/22/2022]
Abstract
Systemic inflammation may influence trajectories of depressive symptoms over time, perhaps differentially by sex and race. Inflammatory markers and the Center for Epidemiologic Studies-Depression scale [total score: CES-Dtotal and four distinctive domains: somatic complaints, depressed affect, positive affect and interpersonal problems] were examined among African-American (AA) and White urban adults participating in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study [2004-2013, Agebase:30-64 y, mean ± SD follow-up time: 4.64 ± 0.93 y, N = 150 (with cytokine data) to N = 1,767 (with other inflammatory markers)]. Findings suggest that serum concentrations of high-sensitivity C-reactive protein (hsCRP), z-inflammation composite score [ICS, combining elevated hsCRP and ESR with low serum albumin and iron], and serum interleukin (IL) 1β were positively associated with ΔCES-Dtotal (Δ: annual rate of increase) among Whites only. IL-12 was directly related to ΔCES-Dtotal among men and AA. The race-specific associations of hsCRP, ICS, IL-1β and the sex-specific association of IL-12 with ΔCES-Dtotal were replicated for the "depressed affect" domain. Similarly, among men, lower serum albumin and higher ICS were linked with higher baseline "somatic complaints". IL-10 among AA and IL-12 among men were inversely related to Δ"positive affect", while "interpersonal problems" were cross-sectionally associated with IL-6 among AA and IL-10 among Whites. Finally, baseline ICS was positively associated with incident "elevated depressive symptoms" (EDS: CES-Dtotal ≥ 16) among AA (HR = 1.28, 95% CI: 1.04-1.56, P = 0.017). Overall, systemic inflammation was directly linked to increased depressive symptoms over time and at baseline, differentially across sex and race groups. More longitudinal research is needed to replicate our findings.
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Affiliation(s)
- May A. Beydoun
- 0000 0000 9372 4913grid.419475.aLaboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD USA
| | - Hardeep K. Obhi
- 0000 0000 9372 4913grid.419475.aLaboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD USA
| | - Jordan Weiss
- 0000 0000 9372 4913grid.419475.aLaboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD USA ,0000 0004 1936 8972grid.25879.31Population Studies Center and the Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA USA
| | - Jose A. Canas
- 0000 0004 0467 2330grid.413611.0Johns Hopkins All Children’s Hospital, St. Petersburg, FL USA
| | - Hind A. Beydoun
- 0000 0004 0595 1323grid.413661.7Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA USA
| | - Michele K. Evans
- 0000 0000 9372 4913grid.419475.aLaboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD USA
| | - Alan B. Zonderman
- 0000 0000 9372 4913grid.419475.aLaboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD USA
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Lee HS, Park E. Association of serum ferritin level and depression with respect to the body mass index in Korean male adults. Nutr Res Pract 2019; 13:263-267. [PMID: 31214295 PMCID: PMC6548707 DOI: 10.4162/nrp.2019.13.3.263] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 09/29/2018] [Accepted: 02/12/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND/OBJECTIVES Obesity is globally a major public health issue. Evidence suggests that elevated ferritin levels are associated with obesity, dyslipidemia, insulin resistance, and metabolic syndrome. This study was undertaken to examine the relationship between the serum ferritin level and depression in Korean male adults with respect to classification of the prevailing obesity. SUBJECTS/METHODS This was a case-control study; subjects were classified into obese group (≥ 25.0 kg/m2, 28 subjects) and normal group (18.5–22.9 kg/m2, 27 subjects). A survey was conducted to assess the depression levels as per the guidelines suggested by the Center program for Epidemiological Studies-Depression (CES-D). Blood was collected from each group for assessing biomarkers, and isolated plasma was evaluated for fasting glucose, insulin, quantitative insulin sensitivity check index, and ferritin levels. Data were analyzed, and groups were compared with respect to Body Mass Index (BMI), depression scale and biomarkers. RESULTS The average depression score of the obesity group was 16.86, which was higher than the normal group (12.56). Subjects scoring more than 16 points comprised 53.6% of the population in the obese group, which was more than double that in the normal group, as assessed by the CES-D program. Furthermore, the serum ferritin level of the obesity group was 207.12 ng/mL, which was higher than that of the normal group (132.66 ng/mL). Lastly, the BMI appeared to be significantly correlated with both depression (r = 0.320, P = 0.017) and elevated ferritin levels (r = 0.352, P = 0.008). CONCLUSION This study provides evidence of existing correlation between ferritin and depression with obesity.
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Affiliation(s)
- Hea Shoon Lee
- Department of Nursing, Hannam University, Daejeon 34054, Korea
| | - Eunmi Park
- Department of Food and Nutrition, School of Life Science and Nano-Technology, Hannam University, Daejeon 34054, Korea
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Zhao W, Jin H, Xu M, Wang D, Liu Y, Tang Y, Zhang Q, Hua J, Wang B. Sleep Quality of Functional Gastrointestinal Disorder Patients in Class-Three Hospitals: A Cross-Sectional Study in Tianjin, China. BIOMED RESEARCH INTERNATIONAL 2018; 2018:3619748. [PMID: 29977909 PMCID: PMC6011102 DOI: 10.1155/2018/3619748] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 05/08/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Functional gastrointestinal disorder (FGID) patients are influenced by anxiety, depression, and low sleep quality, which reduce the quality of their life. However, epidemiological data on the quality of sleep in FGID patients were lacking. This study aims to explore the sleep quality and influencing factors of the sleep quality in FGID patients. METHODS 1200 subjects, diagnosed as FGID in one of the six class-three hospitals in Tianjin, China, from January to December 2014, were recruited. The information about demographic information, the severity of clinical symptoms, psychological status (Zung self-rating depression scale), and sleep quality (evaluated with Pittsburgh sleep quality index) was gathered. RESULTS The questionnaires from 1117 participants were collected including 920 of functional dyspepsia (FD) patients, 77 of irritable bowel disease (IBS) patients, 26 of functional constipation (FC) patients, and 94 other FGID patients. The results showed that morbidity rate for FD patients who had sleep disorders was higher than those who suffered from IBS or FC (P < 0.001). The proportion of elderly patients suffering from low sleep quality was higher than that of middle-aged and young patients (P < 0.001). The binary logistic regression analysis showed that age, education, and the severity of FGID symptom were influencing factors for poor sleep quality in FGID patients. CONCLUSION The issue of poor sleep quality in FGID patients in Tianjin area is prominent, and elderly patients suffer lower sleep quality than other FGID patients. Age, education, and the severity of FGID symptoms are critical influencing factors which result in a drop-in sleep quality.
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Affiliation(s)
- Wei Zhao
- Department of Digestive Diseases, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - Hong Jin
- Department of Digestive Diseases, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - Mengque Xu
- Department of Gastroenterology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, Zhejiang 310016, China
| | - Dongxu Wang
- Department of Gastroenterology, The 254 Hospital of the People's Liberation Army, Tianjin 300142, China
| | - Yandi Liu
- Department of Gastroenterology, Tianjin Union Medical Center, Tianjin 300121, China
| | - Yanping Tang
- Department of Gastroenterology, Nankai Hospital of Tianjin, Tianjin 300100, China
| | - Qiuzan Zhang
- Department of Gastroenterology, Tianjin 4th Center Hospital, Tianjin 300140, China
| | - Jianping Hua
- Department of Gastroenterology, Tianjin First Center Hospital, Tianjin 300192, China
| | - Bangmao Wang
- Department of Digestive Diseases, General Hospital of Tianjin Medical University, Tianjin 300052, China
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Yao S, Zhong Y, Xu Y, Qin J, Zhang N, Zhu X, Li Y. Quantitative Susceptibility Mapping Reveals an Association between Brain Iron Load and Depression Severity. Front Hum Neurosci 2017; 11:442. [PMID: 28900391 PMCID: PMC5581806 DOI: 10.3389/fnhum.2017.00442] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 08/17/2017] [Indexed: 01/13/2023] Open
Abstract
Previous studies have detected abnormal serum ferritin levels in patients with depression; however, the results have been inconsistent. This study used quantitative susceptibility mapping (QSM) for the first time to examine brain iron concentration in depressed patients and evaluated whether it is related to severity. We included three groups of age- and gender-matched participants: 30 patients with mild-moderate depression (MD), 14 patients with major depression disorder (MDD) and 20 control subjects. All participants underwent MR scans with a 3D gradient-echo sequence reconstructing for QSM and performed the 17-item Hamilton Depression Rating Scale (HDRS) test. In MDD, the susceptibility value in the bilateral putamen was significantly increased compared with MD or control subjects. In addition, a significant difference was also observed in the left thalamus in MDD patients compared with controls. However, the susceptibility values did not differ between MD patients and controls. The susceptibility values positively correlated with the severity of depression as indicated by the HDRS scores. Our results provide evidence that brain iron deposition may be associated with depression and may even be a biomarker for investigating the pathophysiological mechanism of depression.
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Affiliation(s)
- Shun Yao
- Department of Radiology, The Affiliated Hospital of Jiangsu UniversityZhenjiang, China
| | - Yi Zhong
- Department of Research and Development, Magnetic Resonance Innovations Inc.Detroit, MI, United States
| | - Yuhao Xu
- Department of Neurology, The Affiliated Hospital of Jiangsu UniversityZhenjiang, China
| | - Jiasheng Qin
- Department of Radiology, The Affiliated Hospital of Jiangsu UniversityZhenjiang, China
| | - Ningning Zhang
- Department of Radiology, The Affiliated Hospital of Jiangsu UniversityZhenjiang, China
| | - Xiaolan Zhu
- Department of Gynaecology and Obstetrics, The Fourth Affiliated Hospital of Jiangsu UniversityZhenjiang, China
| | - Yuefeng Li
- Department of Radiology, The Affiliated Hospital of Jiangsu UniversityZhenjiang, China
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